OB EXAM #2: PART E: POSITIONS + MASTITIS

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1.

OB EXAM #2

POSITIONS

2.

POSITOINS

1. STANDING
2. WALKING
3. STANDING AND LEARNING FWD ON
PARTNER, BED, BALL
4. SLOW DANCING
5. LUNGE
6. SITTING UPRIGHT
7. SEMI-SITTING (HEAD OF BED AT 45 DEG
ANGLE W PILLOWS USED FOR SUPPORT)
8. SITTING ON TOILET OR COMMODE
9. ROCKING IN CHAIR
10. SITTING, LEARNING FWD W SUPPORT
11. ON ALL FOURS, HANDS AND KNEES
12. KNEELING, LEARNING FWD W
SUPPORT ON A CHAIR
13. SIDE LYING

3.

1. STANDING

-Adv of gravity during and bw cont

-Makes contr less painful and more pxive
-HElps fetus line up w angle of maternal
pelvis
-Helps to inc urge to piush in 2nd stage

4.

2. WALKING

-Has same adv as standing

-Causes changes in pelvis joints, helping
fetus move thorugh canal

5.

3. STANDING
AND LEANING
FWD

-Same as standing
-Is a good pos for backrub
-May feel more restful that standing
-Can be used w electronic fetal monitor

6.

4. SLOW
DANCING

-Has same as walking

-Back pressure helps relieve back pain
-Rhrthm and music help woman relax and
provide comfort

7.

5. LUNGE

-Wides one side of pelvis (side toward

lunge)
-Encourages rotation of baby
-Can also be done in kneeling positoin

8.

6. SITTING
UPRIGHT

-Helps promote rest

-Has more gravity advantage than lying
down
-Can be used w elecontronic fetal
movement

9.

7. SEMI-SITTING

-Has same adv as siting upright

-Is easy if on bed

10.

8. SITTING ON
TOILET

-Has same as sitting upright

-May help relax perineum for effective
bearing down

11.

9. ROCKING IN
CHAIR

-Same as sitting upright

-May help speed labor

12.

10. SITTING,
LEANING FWD

-Same as sitting upright

-Is goood for backrub

13.

11. ON ALL
FOURS

-Helps relieve backache

-Assists rotation of baby in post pos
-Allows for pelvic rocking and body
movement
-Relieves pressure on hemorrhoids
-Allows for vag exams
-Is sometimes presferes as pushing pos
by women w back labor

14.

12. KNEELING,
LEANING FWD W
SUPPORT ON
CHAIR

-Has same as all fours

-Put less strain on wrists and hands

15.

13. SIDE LYING

-Very good for rest and conventn for

many kind of med interventions
-Helps lower elevated BP
-May promote progress of labor when
alternated w walking
-Useful to slow very rapid scond stage
-Avoids vena cava syndrome
-May offer inc contorl of pushing efforts
-Takes pressure off hemorrhoids
-Facilitates relaxatoin bw contr

16.

MASTITIS PG 178

MASTITIS PG 178

17.

MASTITIS

=Inf or inflam of CT in the breast that

occurs primarily in lactating or engorged
women
-Lactational or non-lactational
-Staph auerus, hemophil influenzae, and
haemophilus and strepcoccus most
common
-One or more of ducts drains poorly of
gets blocked resutling in back growth in
retained milk
RISK FACTORS: Dev of milk stasis,
damages or cracked nipples, irregular or
missed feedings, failing to allow infant to
empty breast before moving to next, poor
latch and transfer of milk, illness of mom
or baby oversupply, tight bra, blocked
nipple pore or duct, and maternal stress
and fatuigue

18.

NONLACTACTING
MASTISTI

-Caused by duckt ectasia, which occurs

when milk ducts get congestion w
secretions and debris
-Central and periphreal lesions
-PEriaerola absesses common and assoc w
diabetes, RA, steroid tx, granulomatous
lobular masitis, and trauma
-Greenish dipple discharge, ni retraction
and noncylical pain

19.

MGMT

-Remove milk to preevnt it

-ORal anitbiotics=peniccilin or cephalosporin
-Tylonol

20.

RN
ASSESSMENT

-Assess for risk factors: poor handwashing, ductal abnormalities, nip cracks and fissures, lowered maternal defenses
due to fatigue, tight clothes, poor support of penulous breasts, faulure to empty, missing feedings
-S/S=Flu like, malaise, leukoyctosis, fever, chills
-Inc warm redness tender and swelling, nip crackes or abraded and breast distengin w milkd

21.

RN MGMT

-Tell her its ok safe to breast feed stil

-Keep pumping of BFing to get rid of it
-Risk of cancer poss 20%
-6, 12, and 24 mo imaging mammogram needed
-Massage before and during feedings
-Feed on bad breat first
-Wear bra 24 hr day
-INc fluids
-Warm compress before feeding
-Freq pos changes
-Adequate rest and nutrition to support or improive immune system