Textbook of Midwifery and Obstetrical Nursing [First Edition] 934838533X, 9789348385338

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          (As per the Syllabus of Indian Nursing Council for BSc)

Sandeep Kaur MSc, PhD(N) [Obstetrics and Gynecological Nursing]

Associate Professor Khalsa College of Nursing Amritsar, Punjab

Reviewed by

Sunita Lawrence MSc, PhD(N) [Obstetrics and Gynecological Nursing] RN, RM, MA (Sociology)

Principal cum Professor Pragyan College of Nursing Bhopal, Madhya Pradesh

CBS Publishers & Distributors Pvt Ltd • New Delhi • Bengaluru • Chennai • Kochi • Kolkata • Mumbai • Hyderabad • Nagpur • Patna • Pune • Vijayawada

Disclaimer Science and technology are constantly changing fields. New research and experience broaden the scope of information and knowledge. The authors have tried their best in giving information available to them while preparing the material for this book. Although, all efforts have been made to ensure optimum accuracy of the material, yet it is quite possible some errors might have been left uncorrected. The publisher, the printer and the authors will not be held responsible for any inadvertent errors, omissions or inaccuracies. eISBN: 978-93-483-8533-8 Copyright © Authors and Publisher First e Book Edition: 2021

All rights reserved. No part of this eBook may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system without permission, in writing, from the authors and the publisher. Published by Satish Kumar Jain and produced by Varun Jain for CBS Publishers & Distributors Pvt. Ltd. Corporate O ice: 204 FIE, Industrial Area, Patparganj, New Delhi-110092 Ph: +91-11-49344934; Fax: +91-11-49344935; Website: www.cbspd.com; www.eduport-global.com; E-mail: [email protected] Head O ice: CBS PLAZA, 4819/XI Prahlad Street, 24 Ansari Road, Daryaganj, New Delhi-110002, India. Ph: +91-11-23289259, 23266861, 23266867; Fax: 011-23243014; Website: www.cbspd.com; E-mail: [email protected]; [email protected].

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Representatives Hyderabad Pune Nagpur Manipal Vijayawada Patna

Dedicated to My parents, husband and teachers who blessed my life with their tireless support and encouragements

Reviewers' List Anilkumar H Mandalia MSc (MSN)

Principal Government College of Nursing Bhavnagar, Gujarat

Anjali Sancha MSc (MSN)

Nursing Tutor College of Nursing, AIIMS Patna, Bihar

Asha Yadav MSc (OBG Nursing)

Principal IIMT College of Medical Sciences Meerut, Uttar Pradesh

Bilqees Ara MSc (OBG Nursing)

Vice Principal Bibi Halima College of Nursing and Medical Technology Srinagar, Jammu & Kashmir

Enu Boro PhD, MSc (OBG Nursing)

Lecturer Regional College of Nursing Guwahati, Assam

Gaurav Tyagi PhD(N) Scholar MBA in Hospital Administration

Vice Principal KMC College of Nursing Meerut, Uttar Pradesh

Geetanjali Sharma MSc (OBG Nursing) PhD(N) (Pursuing)

Head of Department (OBG Nursing) Pacific College of Nursing Udaipur, Rajasthan

Janet Anbumani MSc (OBG Nursing)

Associate Professor BEE ENN College of Nursing Jammu & Kashmir

Kiran Taneja MSc (OBG Nursing)

Vice Principal Metro College of Nursing Greater Noida, Uttar Pradesh

Livin Varghese MSc (Nursing)

Professor cum Principal Pink City College of Nursing Jaipur, Rajasthan

Mahalakshmi B MSc (OBG Nursing)

Vice Principal MVJ College of Nursing Bengaluru, Karnataka

Mallika Faruk Vhora PhD Scholar, MSc (MSN)

Principal Krishna Nursing College Vadodara, Gujarat

P Beulah MSc (OBG Nursing)

Associate Professor Eashwari Bai Memorial College of Nursing Secunderabad, Telangana

Prabha Kumari MSc (OBG Nursing)

Lecturer College of Nursing Dr Ram Manohar Lohia Hospital New Delhi

The name of the reviewers are arranged in alphabetical order

vi

Rachna Khanna

Sheuli Sen

MSc (Obstetrical Nursing)

MSc (Nursing) PhD (Public Health)—Pursuing

Assistant Professor NIMT Institute of Medical & Paramedical Sciences Greater Noida, Uttar Pradesh

Rekha Kumari MSc (OBG Nursing)

HOD, Assistant Professor School of Nursing Sciences & Research (SNSR), Sharda University Greater Noida, Uttar Pradesh

Rohi Jan

Textbook of Midwifery and Obstetrical Nursing for BSc Nursing Students

MSc (OBG Nursing)

Principal Sumandeep Vidyapeeth Nursing College Vadodara, Gujarat

Shwetha Rani CM MSc (OBG Nursing)

Associate Professor One Beat College of Medical Sciences Lakhimpur Kheri, Uttar Pradesh

Sunil Joshi

Nursing Tutor Syed Mantaqi Memorial College of Nursing and Medical Technology, IUST Awantipora, Jammu & Kashmir

MSc (Nursing)

Rupali Verma

Syed Shahid Siraj (Mr)

Principal Tirupati College of Nursing Udaipur, Rajasthan

MSc (Nursing)

MSc (Nursing)

Assistant Professor Government Nursing College Haldwani, Uttarakhand

Nursing Tutor Alamdar Memorial College of Nursing and Medical Technology Charar-i-Sharief, Jammu & Kashmir

Sameer Ahmad Dar

Vipin Kumar Pillai

MSc (MSN)

MSc (MSN)

Nursing Tutor Government College of Nursing Srinagar, Jammu & Kashmir

Principal Udaipur College of Nursing Udaipur, Rajasthan

Shazia

Virendra Singh Choudhary

MSc (OBG Nursing)

Assistant Professor Bibi Halima College of Nursing & Medical Technology Srinagar, Jammu & Kashmir

Sheema Bashir MSc (OBG Nursing)

Tutor/Clinical Instructor Government College of Nursing, GMC Srinagar, Jammu & Kashmir

MSc (MSN), PhD(N) MBA, BAMS (AM)

Principal/Dean School of Nursing Jaipur National University Jaipur, Rajasthan

Yugal Swarnkar MSc (Nursing)

Principal Sanjeevani College of Nursing Udaipur, Rajasthan

The name of the reviewers are arranged in alphabetical order

Preface T

he midwives and nurses are recognized as responsible and accountable professionals, who work in close association with women to provide them with necessary support, care and advice during pregnancy, labor, while conducting births, and also during postpartum period. The midwives are also responsible for providing proper care to the newborn and infants. Besides, they take preventive measures, facilitate normal birth, detect complications in mother and child, provide access to medical care or other appropriate assistance and further carry out the emergency measures. Keeping in mind the request and constant persuasion of my beloved students of nursing, I have tried my level best to write a compact, comprehensive and practical-oriented textbook on midwifery and obstetrical nursing. It is an honest effort to provide the students with extensive as well as uncomplicated techniques of midwifery and obstetrics with an aim to emphasize the text in simplified manner rather than the intricated one. “Textbook of Midwifery and Obstetrical Nursing” offers a unique opportunity of imbibing the evergrowing body of scientific knowledge and developing the technical and analytical skills necessary to apply the same into practice. This book has been organized into 12 Units, which are strictly based on BSc Nursing Syllabus by INC. Precise and updated text matter has been presented in a concise and lucid language, which makes this textbook reader-friendly. The book has flavor of its own, both in scope and contents and has apparently an edge over the existing textbooks. The main aim of this book is to encourage the students to learn midwifery and obstetrics in a comparatively easy way. Each unit starts with ‘‘Learning Objectives’’, and ends with frequently asked questions in exams in the form of ‘‘Assess Yourself’’. Each Unit carries ‘‘Multiple Choice Questions’’ that may be helpful for the students when appearing for viva and attempting multiple choice questions. Special care has been taken to develop the content by avoiding the unnecessary details and keeping the text as per the requirement and structure of the recent trends of the examinations. The common procedures and their targeted management have been emphasized with the help of images and flowcharts in order to improve the knowledge of students and facilitate the teachers to explain the concepts in comfortable way. I am pretty sure that this book will be extremely helpful for the student nurses, teachers, professional nurses, as well as general readers. No work is entirely free from errors, therefore critical evaluation and feedback regarding the content are welcomed for the improvement of this book.

Sandeep Kaur

Acknowledgments F

irst and foremost, I would like to thank the Almighty for all His Blessings showered upon me. Thank you God for the strength you have given me and for keeping me protected in your hands. No endeavors are complete when tried all alone and likewise this book is also a product of efforts and blessings of many noble people around me. I am very fortunate to have the valuable guidance, help and support of all those who have been my constant advisors, my friends, well-wishers and family members. I convey my heartfelt thanks to all those who have been associated with this book and have contributed to it in one way or the other.

I would like to thank Mr Satish Kumar Jain (Chairman) and Mr Varun Jain (Managing Director), M/s CBS Publishers and Distributors Pvt Ltd for providing me the platform for bringing out the book. I have no words to describe the role, efforts, inputs and initiatives undertaken by Mr Bhupesh Arora, (Vice President – Publishing & Marketing, PGMEE and Nursing Division) for helping and motivating me. I sincerely thank the entire CBS team for bringing out the book with utmost care and attractive presentation. I thank Ms Nitasha Arora (Production Head & Content Strategist), Dr Anju Dhir (Project Manager & Senior Scientific Coordinator), Mr Shivendu Bhushan Pandey (Senior Editor), Mr Ashutosh Pathak (Senior Proof Reader) and all the production team members, Mr Prakash Gaur, Mr Phool Kumar, Mr Bunty Kashyap, Mr Chaman Lal, Mr Chander Mani, Ms Manorama Gupta, Ms Babita Verma, Mr Manoj Chaudhary, Mr Vikram Chaudhary, Mr Manoj Malakar and Mr Arun Kumar for devoting laborious hours in designing and typesetting of the book. Mr Anubhav Puri (Sr Territory Sales Manager), without whom it was impossible to complete this task.

Special Features of the Book

Self-explanatory images included to enhance understanding of topic

Fig. 18:  Stages of development-early embryo

Useful tables from Practical Point of View are inculcated in the book

TABLE 2:  Sedatives and analgesics used during labor Drug

Usual dose

Route

Frequency

Pethidine

50–100 mg

IM

4 hrs

Neonatal half life 13-20 hrs

Fentanyl

50–100 ug

IV

1 hr

5 hrs

Morphine

10 mg

IM

4 hrs

7 hrs

Meperidine

5–25 mg

IV/IM

4 hrs

-

Extra and important topic-related points are highlighted

Know it Indication for positive pressure ventilation (PPV)

• Apnea or gasping • HR