obgyn clerkship lifestyle?
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"hey guys -" might not be the most realistic opener when posting on the OB/GYN list server 
best of luck
best of luckDrBuzzLightYear said:"hey guys -" might not be the most realistic opener when posting on the OB/GYN list server
I regret that, we are a solid 30%! and falling.........
EKMO
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why is that? any thoughts on the matter?
ask the chief resident what the expectations are. Doing postpartum rounds in am before intern will get you bonus points. Also write sig prenatal labs, i.e. if abn pap write this or if HBV+ then make sure Peds know they give the baby immunoglobin. Also always wite pertinent labs like antibiotics and when Tmax was. And if baby was preterm ask the nurse how baby is doing and write in note
for svd spont vag deliveries age g'sp's vitals (esp Tmax)
write-Rh status, rubella status, HIV?HBV?RPR, wt baby apgars, any tears on vag delivery. Fundus lochia, extr clonus meds birth control
i.e
S:Ambulating, tol PO and solids, flatus
O:VSS AF (vital signs stable afebrile)-if on Magnesium for preeclampsia do BP range
Breast engorgement no redness
FF below umb lochia mild rubor (fundus firm =FF) nontender non distended
no C/C/E+1 no cyanosis club edema1+
Labs: H&H 12.5/35
A-/ RI/ HIV,RPR,HBV negative
Pap LGSIL
Infant: Male 2155g Apgars 3/6/8
A/P: 32yo G2P0100 at 32-2wks/18 wk ultrasound PPROM (premature rupture of membranes s/p steroids and magnesium theraphy SVD midline epis 2nd degreePPD #1 (post partum day)
1. Ambulate
2. Birth control-depo etc
3. A+/ RI/ HIV,RPR,HBV negative
4. Breast feeding- letdown and bonding well with baby
5. Pap colpo clinic if +HPV or repap at post partum visit in 6 weeks
6.Baby in NICU- on room air mother has seen baby
7. No si/sx of chorio
8. Anticipate d/c to bonding
For C-sec:
S:Ambulating, tol PO , no flatus
O: VSSAF (Tmax 1/2/5 101'5 afebrile since)
Chest
Lungs
Abd- ff below umb nondistend approap inc tenderness
INC C/D/I (note induraion or redness if none state) staplestype incison vertical/Pfan.(transverse low)
Ext-negative hohmans no C/C/+1E Clonus- DTR 2+
Meds: PCA, Tordol , Amp/Gent
Labs:A+/ RI/ HIV,RPR,HBV negative CBC=19 WBC (can be norm stress from labor Hgb=11 Hct 41 Plt 112
Baby: Male 3500g apgars 9/9 doing well in newborn nursery
A/P: 22 yo G1P0 LTCS 2ndary to non reassuring FHT (NRFHT) Chorioamnitis (fever during labor of mom and fetal tachycardia with abd tenderness)
POD#1
1. Chorio- cont Rx Amp/Gent until 24 hrs afebrile then suggest PO , pt afebrile no uterine tenderness inc C/D/I no erthyema/redness
2. POD#1- d/c foley and PCA- ambulate, IS (incentive spirometry), pain meds switch PO vicodin 1-2 prn q4 hrs
3. Birth control-Depo
4. Bottle feeding
5. A+/ RI/ HIV,RPR,HBV negative
6. Gestational Thrombocytopenia (plt are under 150-prior plt 256 on 1/1/5
7. Anemia-s/p sx prior H&H 13.5/38- suggest iron supplementation
8. Plan d/s POD#3 with f/u in 7-10 days for staple removal and 6 wk PPV (post partum visit)
9. Circumcision-desired consent signed by mom
just some examples on the OB stuff.
Good luck
🙂 Diane
for svd spont vag deliveries age g'sp's vitals (esp Tmax)
write-Rh status, rubella status, HIV?HBV?RPR, wt baby apgars, any tears on vag delivery. Fundus lochia, extr clonus meds birth control
i.e
S:Ambulating, tol PO and solids, flatus
O:VSS AF (vital signs stable afebrile)-if on Magnesium for preeclampsia do BP range
Breast engorgement no redness
FF below umb lochia mild rubor (fundus firm =FF) nontender non distended
no C/C/E+1 no cyanosis club edema1+
Labs: H&H 12.5/35
A-/ RI/ HIV,RPR,HBV negative
Pap LGSIL
Infant: Male 2155g Apgars 3/6/8
A/P: 32yo G2P0100 at 32-2wks/18 wk ultrasound PPROM (premature rupture of membranes s/p steroids and magnesium theraphy SVD midline epis 2nd degreePPD #1 (post partum day)
1. Ambulate
2. Birth control-depo etc
3. A+/ RI/ HIV,RPR,HBV negative
4. Breast feeding- letdown and bonding well with baby
5. Pap colpo clinic if +HPV or repap at post partum visit in 6 weeks
6.Baby in NICU- on room air mother has seen baby
7. No si/sx of chorio
8. Anticipate d/c to bonding
For C-sec:
S:Ambulating, tol PO , no flatus
O: VSSAF (Tmax 1/2/5 101'5 afebrile since)
Chest
Lungs
Abd- ff below umb nondistend approap inc tenderness
INC C/D/I (note induraion or redness if none state) staplestype incison vertical/Pfan.(transverse low)
Ext-negative hohmans no C/C/+1E Clonus- DTR 2+
Meds: PCA, Tordol , Amp/Gent
Labs:A+/ RI/ HIV,RPR,HBV negative CBC=19 WBC (can be norm stress from labor Hgb=11 Hct 41 Plt 112
Baby: Male 3500g apgars 9/9 doing well in newborn nursery
A/P: 22 yo G1P0 LTCS 2ndary to non reassuring FHT (NRFHT) Chorioamnitis (fever during labor of mom and fetal tachycardia with abd tenderness)
POD#1
1. Chorio- cont Rx Amp/Gent until 24 hrs afebrile then suggest PO , pt afebrile no uterine tenderness inc C/D/I no erthyema/redness
2. POD#1- d/c foley and PCA- ambulate, IS (incentive spirometry), pain meds switch PO vicodin 1-2 prn q4 hrs
3. Birth control-Depo
4. Bottle feeding
5. A+/ RI/ HIV,RPR,HBV negative
6. Gestational Thrombocytopenia (plt are under 150-prior plt 256 on 1/1/5
7. Anemia-s/p sx prior H&H 13.5/38- suggest iron supplementation
8. Plan d/s POD#3 with f/u in 7-10 days for staple removal and 6 wk PPV (post partum visit)
9. Circumcision-desired consent signed by mom
just some examples on the OB stuff.
Good luck
🙂 Diane
Thanks so much for the examples, Diane. Helps to see them. 👍
