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Midterm Study Guide
Terms in this set (39)
Actions 1-4 during a PP hemorrhage:
1. Massage fundus/call for help
2. Check bladder
3. IV bolus Pitocin
4. Administer meds: Methergine (don't give to somebody with hypertension), Cytotec and Hemabate (gives diarrhea and fever). Don't give Hemabate to somebody with asthma.
Priority intervention for prolapse cord?
• Call for help and put them in all fours
sterile hand into vagina and holding presenting part of the cord
• If cervix is fully dilated, can do a forceps or vacuum-assisted birth
• C-section is likely
The fetal monitoring strip shows: no bradycardia & no variability - What is the fetus experiencing?
What would you do to treat hypoxia?
could do an SVE to see if the baby is ready to deliver or do a scalp stimulation
Fetal decelerations that could indicate fetal distress
Variable and Late
What would you do for variable decels
What would you do for late decels
· IV bolus
· O2 100% non rebreather
· May need to discontinue Pitocin, but keep fetus in belly longer if do that
· Doc in
· Vag exam - maybe baby needs to be delivered
· Monitor on
· Sometimes C-section
Treatment for breast infections?
Mastitis is treated with wide spectrum antibiotics, support the breasts using heat and cold. Encouraging feeding also helps.
When is Rhogam administered?
Give at 28 weeks prophylactically
after any trauma or
72 hours after giving birth
Name the antepartum blood or amniotic fluid test that evaluates for neural tube defects (increased) and decreased in down's syndrome.
High levels of AFP (alpha-fetoprotein)
Complications of PPROM
Chorioamnionitis (bacterial infection of the chorion and amnion)
Umbilical cord compression associated with oligohydramnios
Pulmonary hypoplasia (incomplete development of the lungs)
What is a normal attitude?
Head to chest, thighs to abdomen, legs are flexed back to the knees and arms are crossed over the thorax.
what is the best way for a woman to push during labor?
Open glottis pushing
When is a SVE used intrapartum?
Upon admission, decels, delivery.
Contraindications to Epidural Anesthesia
• Low platelet count
• Maternal hypotension
• Coagulopathy (if a woman is receiving anticoagulant therapy or bleeding disorder.)
• some types of maternal cardiac conditions
• allergy to anesthetic drug
• increased intracranial pressure caused by mass lesion
• infection at the needle site
• Active or anticipated serious maternal hemorrhage
A side effect of epidural anesthesia immediately after placement?
Marked hypotension, impaired placental perfusion, and ineffective breathing pattern
Name 3 treatments for a placental previa / abruption.
Call for help
IV to replace fluids
Place 2 18 gauge IV's in and do NS
Type and cross
3 effects or Side effects of magnesium sulfate therapy.
Reflexes - to see if she is going to sieze +3 or 4 would be indicative (potential)
OD of magnesium could be +2
Check for headache
When noticing the possible negative effects of mag sulfate therapay, what is your first action? Second?
Turn mag off keep her breathing!
Call for help
and apply oxygen
When is rubella given to a mother who is NonImmune? Why?
You can give them the live virus vaccine is right after they deliver because rubella is a teratogen.
Which type of C/S incision allows the mother to be a TOLAC?
Trial of labor after cesarean - low-transverse cesarean births.
How do you know a pregnant woman is in labor?
Contractions that occur regularly, becoming stronger, lasting longer and occurring close together. They become more intense with walking are usually felt in the low back and radiate to the lower portion of the abdomen; they continue despite comfort measures. Cervix shows progressive change (softening, effacement, and dilation)
What are DFMC?
Kick Counts ( 10x in 1 hour or no movement in 12 hours) daily fetal movement count
What should a GDM's Blood Sugars be at fasting and 2 hours Postmeal?
Fasting blood glucose levels should range from 65-95 mg/dL
2 hour postmeal levels should be >120mg/dL
A normal platelet count in a healthy individual is
between 150,000 and 450,000 per μl (microlitre) of blood (150-450 × 109/L).
Name some reasons why would a MD do an amniocentesis?
Indications include prenatal diagnosis of genetic disorders or congenital anomalies (NTD's in particular) assessment of pulmonary maturity, and rarely diagnosis of fetal hemolytic disease.
B\P of 142/95, +2 protein in the urine, sudden weight gain and facial edema indicate what?
Mild preeclampsia is defined as
BP reading of > or = 140/90 x 2 readings at least 4-6 hours apart ALONG with > or = to 1+ proteinuria on 2 random urine samples collected at least 4-6 hours apart.
Severe Preeclampsia is defined as
BP reading > or = 160/110 x2 readings at least 6 hours apart ALONG with > or = to 3+ proteinuria on 2 random samples collected at least 4 hours apart.
slight spotting, mild uterine cramping. NI= transvaginal ultrasound, assessment of hcg and progesterone levels
moderate bleeding, mild to severe uterine cramping along with cervical dilation NI= uterus is emptied promptly usually by dilation and curettage.
Heavy or profuse bleeding, severe uterine cramping, passage of tissue, dilation of the cervix NI= suction curettage may be performed
slight bleeding, mild uterine cramping, passage of tissue, no dilation of cervix because it closed after tissue was passed NI= no further intervention may be needed if uterine contractions are adequate to prevent hemorrhage and no infection is present. If remained tissue is suspected then a suction curettage may be performed.
no bleeding, uterine cramping, passage of tissue, or dilation. If spontaneous evacuation does not occur within 1 month the uterus is emptied by a method appropriate for the GA (dilation or curettage of misoprostol (Cytotec) )
What treatments are ordered for Hyperemesis gravidarum? -
• IV therapy
• Medications such as pyridoxine (vitamin B6) along with doxylamine (Unisom) are used as initial treatment because they are considered safe and effective
• antiemetics : Phenergen, Thorazine, Compazine, Reglan, Zofran.
• Enteral or parenteral nutrition may be used for women who are nonresponsive to other medical therapies.
• feedings are started in small amounts at frequent intervals.
What is Vasa Previa?
A type of elementus insertion of the cord.
when does vasa previa bleed easily?
when it's not covered with wartons jelly, if it's just in the membrane, when the water breaking will cause it to bleed.
Name some nursing considerations when giving IVP narcs during labor?
• pain relief is incomplete temporary, and more effective in the early part of active labor
• most serious side effect is respiratory depression
Adverse side effects of IVP narcotics during labor:
Sedation, N/V, dizziness, altered mental status, euphoria, decreased gastric motility, urinary retention. Need to use caution in women with respiratory and cardiovascular disorders because BP & RR can be adversely affected.
THIS SET IS OFTEN IN FOLDERS WITH...
Complications of Pregnancy
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