Am I Pregnant?
Name 3 probably signs of pregnancy
-Goodell's Sign
-Chadwick's Sign
-Hegar's Sign
-Positive Pregnancy Test
-Gestational sac present on ultrasound
What is placenta previa?
Placenta previa occurs when the placenta implants low in the uterus and partially or completely covers the cervical opening (os).
*Bright red, painless bleeding
**No digital vaginal exams > causes hemorrhage
***Monitor mother and baby
What hormone stimulates milk production?
Prolactin
What quantity of blood is considered a postpartum hemorrhage?
Vaginal delivery - > 500cc
C-Section - > 1000 cc
Any delivery > 1000cc in 24 hours
What is vernix?
A white, creamy, cheese-like protective coating found on a newborn's skin at birth that protects the skin.
This medication is a uterotonic agent used to induce or augment labor and treat postpartum hemorrhage.
Pitocin
What is Chadwick's sign?
When the vaginal color changes from pink to a bluish/violet hue
What interventions could you perform for a shoulder dystocia during delivery?
- Change positions > McRobert's Maneuver (ankles to ears), Hands and Knees
-Suprapubic pressure
**All interventions performed at the direction of the delivering physician
You go to check the uterus of a mother who delivered 24 hours ago. She is asleep in bed. Her uterus is boggy and displaced (Not midline). What is her first intervention?
Ask her to pee - a full bladder can cause uterus bogginss and displacement
What is the first nursing intervention to do for excessive bleeding after delivery?
Fundal Massage
-Skin to Skin
-Place hat
-Double wrap baby
-Place in warmer
-Check blood sugar
What medication is used to stimulate the production of surfactant and mature fetal lungs?
Betamethasone
Name 2 positive signs of pregnancy
-Fetal outline on ultrasound
-Fetal heart tones heard
-Palpation of fetal movement
When does pre-eclampsia turn into eclampsia and what is treatment?
When the patient seizes
-Monitor airway
-Turn to left side
-Administer magnesium sulfate
A 2-week postpartum mother presents to your outpatient office. She complains of flu-like symptoms and a fever, and reports "My breast hurts and feels like no milk is coming out." What are you concerned for?
Mastitis
What is Disseminated Intravascular Coagulation (DIC)?
A condition in which the body's clotting system becomes excessively activated throughout the bloodstream. This causes widespread tiny clots, which consume platelets and clotting factors and can ultimately lead to severe bleeding.
Signs of hypoglycemia in newborns
-Jitteriness
-Irritability
-Poor feeding
-Low body temp
-Lethargy
-Poor tone
-Breathing Problems
What is the treatment for Group B Strep-positive patients? What is the alternative treatment if they are allergic to the first?
-Penicillin
-Cefazolin (Ancef)
What is Goodell's Sign?
When the cervical tissue softens
What is placental abruption?
Placental abruption is the premature separation of the placenta from the uterine wall after 20 weeks of pregnancy and before delivery.
- Extreme pain with or without vaginal bleeding
-Fetal distress
What does BUBBLE-HE stand for?
B - Breast
U - Uterus
B - Bowel
B - Bladder
L - Lochia
E - Episiotomy/Perineum
H - Homan's sign
E - Emotional Status
What are the 4 T's of PPH?
Tone
Tissue
Trauma
Thrombin
What are the components of the APGAR and how often is it performed?
A - Appearance
P - Pulse
G - Grimace
A - Activity
R - Respiration
At 1 and 5 Minutes
This medication is used to treat PPH. Contraindicated in asthma patients
Hemabate
Name 3 presumptive signs of pregnacy
-Amenorrhea
-Nausea and Vomiting
-Quickening
-Fatigue
-Breast Changes
You're monitoring the fetal heart tracing and notice a decrease in the heart rate after every contraction. What is this called, and what should you be concerned about?
Late decelerations
Fetal distress
How do postpartum depression differ from postpartum blues?
Postpartum blues last less than 2 weeks, while depression lasts over 2 weeks.
Symptoms worsen with depression, persist, and can lead to suicidal ideation
Name 3 causes of uterine atony?
-Large uterus: big baby, multiple baby's, increased amniotic fluid
-Prolonged labor
-Multiple previous pregnancies
-Magnesium Sulfate infusion
-Infection of uterus (Chorioamnionitis)
THINK: "Too much, too tired, too stretched"
-Grunting
-Nasal flaring
-Retractions
-Cyanosis
-Tachypnea
This medication is used for PPH to treat uterine atony. Contraindicated in hypertensive patients.
Methergine