Labor Complications
Why is a patient given glucocorticoids when threatening preterm labor?
increases fetal lung maturity
What type of lochia is expected on day 1-3 postpartum?
Lochia rubra
What is the most common cause of early postpartum hemorrhage?
Uterine atony
Why is the relaxation phase between contractions important?
Relaxation phase gives mom time to relax and the placenta to refill with oxygenated blood for the fetus
Where should the fundus be located immediately after delivery?
Midline at or just below the umbilicus
What are contraindications for labor induction?
High station of fetus, placenta previa, prolapsed cord
What color is lochia serosa?
Pinkish-brown
What signs suggest postpartum infection?
fever >100.4 F, foul lochia, uterine tenderness
What are contractions doing in the first stage of labor?
Dilation and effacement of the cervix
Why is Rho(D) immune globulin (RhoGAM) given?
To Rh-negative mothers with Rh-positive babies to prevent sensitization
What is an adverse effect when administering terbutaline (Brethine) to prevent preterm labor?
Maternal tachycardia
What interventions would be anticipated for a patient experiencing hypovolemic shock?
IV fluids, urinary catheter, assessing oxygen saturations, assessment of vital signs, possible blood transfusion
What is a sign of deep vein thrombosis (DVT)?
Unilateral leg pain/swelling, possible warmth and redness
What is the APGAR assessment?
Appearance, Pulse, Grimace, Activity, Respirations
What medication might be used for postpartum pain management?
Acetaminophen, ibuprofen, or narcotics as needed
What nursing actions will help with hypotonic labor dysfunction?
Frequent position changes
On assessment, one hour postdelivery, you find the mom has saturated three perineal pads. What is the priority nursing action?
Check the fundus for position and firmness; Notify the provider; may indicate hemorrhage
What distinguishes baby blues from postpartum depression?
Baby blues resolve within 2 weeks; PPD persists and worsens
What initials actions should be done for variable decelerations with uterine contractions?
Reposition the mom on her side
What is failure of the uterus to return to the pre-pregnant state?
Subinvolution
On assessment you find a pulsating structure during a vaginal examination. What is the priority action?
Position supine with head down
On assessment you find a firm uterine fundus and a trickle of bright red blood. What would the nurse suspect?
Possible cervical laceration
What intervention is prioritized if a postpartum patient becomes dizzy, pale and hypotensive?
Lay flat, elevate legs, monitor vitals, call for help - possible hemorrhage
What is the priority in the initial care of the newborn?
Thermoregulation
What does it mean on assessment when you find the fundus displaced to the right?
The bladder is likely full