OB nurse pet peeve — The Bump
2nd Trimester

OB nurse pet peeve

I thought I would share with you my biggest pet peeve when it comes to pregnant patients...dehydration!  Almost every patient that comes in with "abdominal pain" and is not "in labor" is dehydrated.  I had a patient tell me that she just "can't drink water, it makes her nauseated," well that makes your nurse even more nauseated! Not to mention the patient that has only had 2 liters of Mountain Dew to drink that day, uggh!  If you aren't drinking enough WATER you can cause yourself preterm contractions which can sometimes cause preterm labor. It is the simplest thing in the world to do to prevent yourself pain, so why not just do it.  The test for me if I am drinking enough is, I look at my pee when it comes out, if it is almost clear or clear then I am hydrated enough. If you get up from the toilet and it is neon yellow or orange, GO DRINK SOME WATER!!!!

Thanks for listening! 

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Re: OB nurse pet peeve

  • Thanks for this...any suggestions for those of us who get heartburn with water that Zantac won't touch?  I am worried about my own fluid intake and need some advice.
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  • Too much plain water makes me gag but I've been making pitchers of spa water...I add cucumbers to a pitcher of water or sliced limes, oranges and mint and just let it sit in the fridge for a little while to meld. 

    If I'm feeling lazy, I just mix a 1/4 cup of OJ or apple cider with a big glasss of water too.

    The flavored water is so good that I feel like all I ever do is pee now b/c all I ever do is drink water. 


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  • Damn ... glad I won't be running into you as an OB nurse. Any advice for those of us who know we aren't drinking enough, who want to drink more, but who really feel sick when drinking? Glad you never had that problem.
  • Um...I drink a TON of water and my pee is really yellow.  The dr said it was from  my vitamins.
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  • image bbhalphen:
    Um...I drink a TON of water and my pee is really yellow.  The dr said it was from  my vitamins.

    Your pee is yellow all day long?  I find that my first pee after I take my vitamin is pretty yellow, but it's a weird neon-ish yellow and so I know that's from the vitamin.  The rest of the time it's pretty light.  How much water is a ton?

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  • Geez. Glad you don't work at my OBs office. You sound like a real peach.
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  • Thanks for the tip! Good to know :)
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  • Oh, I have an OB nurse pet peeve too!  It involves my OB's nurse being a real biitch when I have a legitimate concern as a pregnant woman...

    Gabriel Ross - August 24, 2009 * Vivienne Rose - May 1, 2012

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  • image gothgrrl:
    Thanks for this...any suggestions for those of us who get heartburn with water that Zantac won't touch?  I am worried about my own fluid intake and need some advice.

    Try Prevacid or Priolsec. Zantac is an antacid while Priolosec and Prevacid work to stop the acid from being produced in the first place. Also, you can try taking your Zantac at least 1/2 hr before eating/drinking anything (except the water need to take the pill). 

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  • I'm a dialysis nurse and I know where you're coming from. Its a matter of-- why am I here taking care of you if you wont even do whats required to take care of yourself (and in this case, your baby!!). Not only are you making MY life/job harder, but your risking you and your babies health. I'm 100% with you here. I get awful heartburn with too much water, but I know that Kyle needs it. So I keep my crappy tums nearby and drink anyway. Its only 9 months.
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  • I think it is funny that people are saying you sound like a peach. My mom is a nurse and this just made me giggle, because it sounds like something she would say to me! LOL. Maybe I have just toughened up over the years with a nurse for a mom! She can't stand paitents that don't use common sense.

    Thank you truely for the reminder! I don't drink enough water, and I know it. I try but most of the time I am lacking big time. Any other reminders or info for the ladies on here, I am sure would be totally appreciated!!

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  • People are stupid, and it's your job to be a good nurse and educate them.  Crying
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  • image Girlyontheway:

    I think it is funny that people are saying you sound like a peach. My mom is a nurse and this just made me giggle, because it sounds like something she would say to me! LOL. Maybe I have just toughened up over the years with a nurse for a mom! She can't stand paitents that don't use common sense.

    Thank you truely for the reminder! I don't drink enough water, and I know it. I try but most of the time I am lacking big time. Any other reminders or info for the ladies on here, I am sure would be totally appreciated!!

    The difference is in the way she posted. It came across as very condescending and biitchy. Do I think it's smart to not drink water while pregnant because you don't like it? No. Do I know that it takes a huge amount of water to keep hydrated while pregnant? Yes. Do I try my best to stay hydrated? Sure do but it doesn't always work out that way. Sure the woman drinking only Mt Dew is a fool for numerous reasons but as an OB nurse, it's your job to educate her not treat her like an idiot.
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  • image danlexi04:
    image Girlyontheway:

    I think it is funny that people are saying you sound like a peach. My mom is a nurse and this just made me giggle, because it sounds like something she would say to me! LOL. Maybe I have just toughened up over the years with a nurse for a mom! She can't stand paitents that don't use common sense.

    Thank you truely for the reminder! I don't drink enough water, and I know it. I try but most of the time I am lacking big time. Any other reminders or info for the ladies on here, I am sure would be totally appreciated!!

    The difference is in the way she posted. It came across as very condescending and biitchy. Do I think it's smart to not drink water while pregnant because you don't like it? No. Do I know that it takes a huge amount of water to keep hydrated while pregnant? Yes. Do I try my best to stay hydrated? Sure do but it doesn't always work out that way. Sure the woman drinking only Mt Dew is a fool for numerous reasons but as an OB nurse, it's your job to educate her not treat her like an idiot.

    Pretty much that.  I take great pains to drink way more plain water than normal, and it is pretty amazing how much less crampy or sore I feel.  But I cannot stand it when nurses treat patients badly for legitimate concerns.  


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  • Thanks.  I don't know how many bumpies really fall into this as we tend to be a little more educated/interested in healthy pregnancies. 

    However, where I live, I guarantee you there are plenty of moms that don't drink enough water.  At my last dr, I would be there for HOURS and rarely did I see another woman with a water bottle.  There is no way you should go hours without putting fluids in your body (especially when you need to give a urine sample).

     FWIW, I don't think you were being a "peach".  I think you probably get really tired of seeing the darkside of pregnancy that can be avoided.  

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  • image danlexi04:

     Sure the woman drinking only Mt Dew is a fool for numerous reasons but as an OB nurse, it's your job to educate her not treat her like an idiot.

    I disagree that it's the job of the OB nurse to educate the patients in basic things like, "Mt. Dew is not good for you. Water is. You need to drink it."

    How much time do you spend with your OB nurse at your appointments? I see mine for maybe 5 minutes, and during that time, she is taking my blood pressure and pulse, weighing me, and getting a urine sample. If she took the time to say, "Oh, also, a lot of chocolate does not count as a meal, and drinking only soda is bad for you, and you need vegetables, and corn chips don't count as vegetables, and don't eat only fatty foods, and you need to drink water, and you probably shouldn't have 13 triple espressos, and..." then I'd be at my OB's office for hours. 

    Most OB's offices give newly pregnant patients information regarding having a healthy pregnancy at their initial visit. This includes dietary information, info on exercising, vitamins, etc. It is YOUR job as a patient to read that information and educate yourself. It is not the nurse's job to hold your hand and read it to you. I feel like a lot of adults today refuse to take responsibility for themselves and instead expect that any piece of information they ever need to know should be fed to them by someone else. ANYTHING you read about good health during pregnancy will tell you that you need to drink a lot of water. Your OB nurse is not your kindergarten teacher - it's reasonable for her to assume that since you're an adult who will be having a child, you should be able to read and have some common sense.

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  • Just a follow up to the post about prilosec, prevacid and zantac. Zantac does prevent acid formation, because it is a histamine 2 receptor antagonist. Meaning it blocks histamine, which is a precursor to stomach acid. Yes, do take it 30 minutes before you want it to work because it takes longer to "kick-in." Prilose and prevacid are proton pump inhibitors and take up to 14 days to reach their maximum effectiveness. I do not know if these are recommended during pregnancy, because they weren't on my "safe meds" list but that doesn't mean it isn't completely okay to take during pregnancy. Proton pump inhibitors have a long-term impact on your acid production by acting directly on the pumps release hydrogen ions into your stomach, which become stomach acid (HCl or hydrochloric acid). Sorry, just wanted to clarify because zantac is a wonder drug for me - not just because of heartburn but because I have crazy skin/environmental allergies that they help me out with.
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  • image melisdf:

    Thanks.  I don't know how many bumpies really fall into this as we tend to be a little more educated/interested in healthy pregnancies. 

    However, where I live, I guarantee you there are plenty of moms that don't drink enough water.  At my last dr, I would be there for HOURS and rarely did I see another woman with a water bottle.  There is no way you should go hours without putting fluids in your body (especially when you need to give a urine sample).

     FWIW, I don't think you were being a "peach".  I think you probably get really tired of seeing the darkside of pregnancy that can be avoided.  

    Wow, its amazing how early the judging of other mommies starts.  Even during pregnancy. Indifferent  

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  • Isn't your brain like 85% water? Whenever I don't want to drink water, I just think about how crunchy and dried up my brain gets if I am dehydrated, and that fixes me right up :-)

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  • Quick question (because nowhere in your post did you mention this) how much is enough? I was told 80oz minimum a day of water but I have heard from other people they were told more/less.
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  • image Vuja_de:
    Quick question (because nowhere in your post did you mention this) how much is enough? I was told 80oz minimum a day of water but I have heard from other people they were told more/less.

    The amount is going to be different for every person, because not every person is the same size. She did mention in her post that if your urine is clear, you're drinking enough water. If it's dark or very yellow, you're not.  

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  • this is for everyone getting mad at OP for sounding mad and b!tchy...

    The reason the poster sounds so frustrated is because she tells people day after day to drink more water....and she does it in a respectful way.  If she didn't do it in a respectful way then her frustration wouldn't be pent up...it would have already been released on her patients.  So thank you to OP for continuing to educate your patients as you do...and as a fellow OB nurse I thank you for putting the PSA out there.  People have no idea how much money it costs to even be seen in triage for dehydration and possible iv hydration...hundreds of dollars.  Now do you think you can drink another glass or two of WATER?

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  • Maybe it is because we are ALL pregnant and a little sensitive to what others say - especially when we feel like we are being judged in any way as to how we are doing in our pregnancy or that we are being personally attacked - but I really do not think that this post was meant to be B!tc#y at all... I think she posted out of frustration (as this IS a forum meant to be a sounding board and a place to vent as needed) and out of a place of "FYI".

    If you know that you are drinking all of the water that you can stand to inhale, whether it be plain or infused with a little "flavor", then why take it so personal? And if you know that you could probably do better about drinking more water, then take it as a "reminder" that checking your urine as a guideline is important. We should support each other!

    I for one try to balance my day out with water, 100% juice, and soda! LOL My guilty pleasure is the carbonated drink of my choice with lunch and then drink water for the rest of my day as well as a glass of either OJ or cranberry @ night to help with regularity (I am on an iron supplement). So I know I can improve my water intake by omitting my afternoon sugar rush but I try to use my urine color as my guide. I said all of this so that no one thinks I am pointing the finger - we all have faults - but wow, some of these posts were kinda harsh, don't ya think?

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  • Probably not the healthiest or best suggestion, but when I know I need to drink some water, I get some chocolate. :-) Eating the chocolate makes me thirsty, so I can down a whole water bottle (16 oz) of water in one sitting with a big chunk of chocolate. :-) This may or may not be why I've gained a crap ton of weight. LOL

    And FWIW- ditto the previous posters. I would go CRAZY telling pregnant women the same thing all the time and seeing it over and over again especially with stupid excuses. Just drink the [email protected] water.

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  • image speckledfrog:

    image bbhalphen:
    Um...I drink a TON of water and my pee is really yellow.  The dr said it was from  my vitamins.

    Your pee is yellow all day long?  I find that my first pee after I take my vitamin is pretty yellow, but it's a weird neon-ish yellow and so I know that's from the vitamin.  The rest of the time it's pretty light.  How much water is a ton?



    I drink nothing but water all day long.  It averages out to at least 80oz per day.  My pee is pretty yellow up until around 6pm, and yes, it is that neon color.  I take my regular PNV, plus extra folic acid and also a B complex, so maybe it's because I'm taking more vitamins?  I did talk to the dr about it already because I was worried I was dehydrated simply because of my pee color, and he told me it was most likely from the vitamins.  I haven't had any symptoms of dehydration.
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  • image KRISTA555:
    image melisdf:

    Thanks.  I don't know how many bumpies really fall into this as we tend to be a little more educated/interested in healthy pregnancies. 

    However, where I live, I guarantee you there are plenty of moms that don't drink enough water.  At my last dr, I would be there for HOURS and rarely did I see another woman with a water bottle.  There is no way you should go hours without putting fluids in your body (especially when you need to give a urine sample).

     FWIW, I don't think you were being a "peach".  I think you probably get really tired of seeing the darkside of pregnancy that can be avoided.  

    Wow, its amazing how early the judging of other mommies starts.  Even during pregnancy. Indifferent  

    Yes Agreed. I never bring water to my appointments. I drink water throughout the day at work from a red plastic cup (yes, the kind you use for beer at college). I think I can handle not having liquids for the time it takes to go to the doctor. And I provide my urine sample in the cup they give me prior to going to the appointment. I have no symptoms of dehydration, and my pee color is just fine, thank you very much. Man, I would hate to think that other pregnant women in the waiting room are judging me for not having a water bottle with me at all times.

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  • As someone who experienced preterm labor because of dehydration, I have to say the OP is a WONDERFUL nurse.  

    When I was pregnant with my son, I wasn't a big fan of drinking water.  I was trying to drink what was recommended, but it wasn't enough for me because my body doesn't retain water like some other people.  When I was admitted to L&D for preterm labor, every nurse there (they were all super nice and sweet!) told me, "YOU HAVE TO DRINK MORE WATER!!!!"  I was clearly very dehydrated.  

    Now I drink a gallon of water every day.  I actually drink warm water because drinking cold water just makes me feel cold and my muscles tense.  I NEVER want to repeat what I went through with my son.  You know how scary it is to go into preterm labor with a breech baby?  

     

     

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  • image sarahlyn:
    Just a follow up to the post about prilosec, prevacid and zantac. Zantac does prevent acid formation, because it is a histamine 2 receptor antagonist. Meaning it blocks histamine, which is a precursor to stomach acid. Yes, do take it 30 minutes before you want it to work because it takes longer to "kick-in." Prilose and prevacid are proton pump inhibitors and take up to 14 days to reach their maximum effectiveness. I do not know if these are recommended during pregnancy, because they weren't on my "safe meds" list but that doesn't mean it isn't completely okay to take during pregnancy. Proton pump inhibitors have a long-term impact on your acid production by acting directly on the pumps release hydrogen ions into your stomach, which become stomach acid (HCl or hydrochloric acid). Sorry, just wanted to clarify because zantac is a wonder drug for me - not just because of heartburn but because I have crazy skin/environmental allergies that they help me out with.

    I am on Prilosec and it was ok'd by my high-risk ob. I started taking it at 16 weeks due to the fact Tums and zantec do not work for me. I was the full amount of Tums a day. I have no issues now with reflux (I was a tum popper before my pregnancy due to GERD). 

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  • Sure, she could have been a bit more tactful, but she is also venting her work frustrations. And I think you have bigger problems if you are taking her tone personally Hmm
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  • image PregsterDD:

    I thought I would share with you my biggest pet peeve when it comes to pregnant patients...dehydration!  Almost every patient that comes in with "abdominal pain" and is not "in labor" is dehydrated.  I had a patient tell me that she just "can't drink water, it makes her nauseated," well that makes your nurse even more nauseated! Not to mention the patient that has only had 2 liters of Mountain Dew to drink that day, uggh!  If you aren't drinking enough WATER you can cause yourself preterm contractions which can sometimes cause preterm labor. It is the simplest thing in the world to do to prevent yourself pain, so why not just do it.  The test for me if I am drinking enough is, I look at my pee when it comes out, if it is almost clear or clear then I am hydrated enough. If you get up from the toilet and it is neon yellow or orange, GO DRINK SOME WATER!!!!

    Thanks for listening! 

    Uh, water actually did make my morning sickness worse & my CNM told me to just drink whatever was appealing (obviously not alcohol). I don't get why you don't understand that it can happen to some women.   Have some compassion.  Geez.

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  • image sarahlyn:
    Just a follow up to the post about prilosec, prevacid and zantac. Zantac does prevent acid formation, because it is a histamine 2 receptor antagonist. Meaning it blocks histamine, which is a precursor to stomach acid. Yes, do take it 30 minutes before you want it to work because it takes longer to "kick-in." Prilose and prevacid are proton pump inhibitors and take up to 14 days to reach their maximum effectiveness. I do not know if these are recommended during pregnancy, because they weren't on my "safe meds" list but that doesn't mean it isn't completely okay to take during pregnancy. Proton pump inhibitors have a long-term impact on your acid production by acting directly on the pumps release hydrogen ions into your stomach, which become stomach acid (HCl or hydrochloric acid). Sorry, just wanted to clarify because zantac is a wonder drug for me - not just because of heartburn but because I have crazy skin/environmental allergies that they help me out with.

    Yes, I looked it up and you are correct about Zantac. Prilosec and Prevacid are ok'ed during pregnancy, at least by my OB. 

    Zantac was a waste for me and for my Lo. She was on Prevacid, and I have been on Prilosec for years. 

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  • I totally agree with you, and it's also the number one reason why women 'can't' breastfeed. 
    But the nauseated thing is true for me. I don't drink soda, haven't in a few years. I don't drink much else than water. And the first few weeks of my pregnancy I drank a lot more water than usual, but the past week or two I actually haven't been able to drink water unless I was eating which then meant I was hungry because I got full too fast.

    I have a little bit of sympathy for some women, but I'm sure most are probably exactly like you're saying lol 

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  • image speckledfrog:

    image bbhalphen:
    Um...I drink a TON of water and my pee is really yellow.  The dr said it was from  my vitamins.

    Your pee is yellow all day long?  I find that my first pee after I take my vitamin is pretty yellow, but it's a weird neon-ish yellow and so I know that's from the vitamin.  The rest of the time it's pretty light.  How much water is a ton?

    My pee is super yellow all day long... I drink like 40 oz a day (I probably should drink more, but I have to force myself do down that). And my dr said its my prenatal vitamins too. The vitamins said that they discolor your urine... so I guess its normal

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  • Try telling a patient who has Hyperemesis to drink water.

    Water actually makes me projectile vomit all over the place.

    It's not so cut and dry, FFS. 

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  • I think some of you guys are taking this a little too personally.

    If you know you're doing the best you can, then don't worry about what anyone else says.

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  • LMFAO I love this entire thread!! It's amazing what some people on here will flame for. I vented about my banking job last night and fully expected to get flamed, but didn't. Dodged a bullet there!!

    I think the OP was ranting about her job, which we all need to do occasionally. I didn't think there was anything wrong with it, but maybe I'm just less sesitive than others.

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  • image redheadscu:
    image KRISTA555:
    image melisdf:

    Thanks.  I don't know how many bumpies really fall into this as we tend to be a little more educated/interested in healthy pregnancies. 

    However, where I live, I guarantee you there are plenty of moms that don't drink enough water.  At my last dr, I would be there for HOURS and rarely did I see another woman with a water bottle.  There is no way you should go hours without putting fluids in your body (especially when you need to give a urine sample).

     FWIW, I don't think you were being a "peach".  I think you probably get really tired of seeing the darkside of pregnancy that can be avoided.  

    Wow, its amazing how early the judging of other mommies starts.  Even during pregnancy. Indifferent  

    Yes Agreed. I never bring water to my appointments. I drink water throughout the day at work from a red plastic cup (yes, the kind you use for beer at college). I think I can handle not having liquids for the time it takes to go to the doctor. And I provide my urine sample in the cup they give me prior to going to the appointment. I have no symptoms of dehydration, and my pee color is just fine, thank you very much. Man, I would hate to think that other pregnant women in the waiting room are judging me for not having a water bottle with me at all times.

    You know what, you're right, you don't have to bring water to an average appt.  But, if water or some other liquid is not readily available for over 3-4 hours during the day, I think most of us would bring something.  This clinic does not have a water fountain or vending machine in the waiting room (there might be one for staff, but definitely not patients), so liquids are not readily available.  My avg wait was over 2 hours before my weight and blood pressure were even taken, then 30-45 minutes for urine or blood samples, and then at least another 30 minutes to an hour before you saw the dr. One appt, I waited over 6 hours for the dr, because he had an emergency call (not complaining, just stating a fact). My shortest appt was right at 3 hours, not including drive time.

    So, if in these kinds of wait times you can go without any liquids, great for you. I personally cannot, so I brought my water bottle, a book and a snack to help make the best of what I knew each appt was going to be like. So, maybe I am judging the other moms, because after 2-3 appts that lasted over half a work day, I would hope more people would do the same.  The extremely long waits are only part of the reason I switched practices this time around.

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  • image kris_kelsey:

    this is for everyone getting mad at OP for sounding mad and b!tchy...

    The reason the poster sounds so frustrated is because she tells people day after day to drink more water....and she does it in a respectful way.  If she didn't do it in a respectful way then her frustration wouldn't be pent up...it would have already been released on her patients.  So thank you to OP for continuing to educate your patients as you do...and as a fellow OB nurse I thank you for putting the PSA out there.  People have no idea how much money it costs to even be seen in triage for dehydration and possible iv hydration...hundreds of dollars.  Now do you think you can drink another glass or two of WATER?

    This, from another OB nurse. I'm with ya sisters.
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  • image KRISTA555:

    I think some of you guys are taking this a little too personally.

    No kidding!

    The OP's just venting. It's not as if she approaches these patients and tells them they're idiots.

    Relax.

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