Pregnancy Complications/Fetal Strips
This is an Acceleration
What is short increases in the FHR above the baseline
This is Leopold's maneuver
a series of palpation done to determine fetal position and presentation
These are some tocolytic drugs used for preterm labor OR to stop contractions
Magnesium Sulfate
Bretherine/Terbutaline
Nifedipine/Procardia XL
What are the different types of lochia?
Lochia rubra: first discharge, dark red blood
Lochia serosa: 3rd-4th day, brownish red, lighter color
Lochia alba: Over 1-2 wks, lighter and yellowish color
An inflammation of breast tissue that sometimes involves an infection. The inflammation results in breast pain, swelling, warmth and redness. You might also have fever and chills. Mastitis most commonly affects women who are breast-feeding
This is a Deceleration
What is a decrease in FHR from the baseline
True Labor versus False Labor
Regular timed contractions that increase in intensity and frequency and have cervical changes is TRUE labor.
Irregular contractions that are not regular, do not change in intensity or frequency and do not have any cervical changes are FALSE labor.
Your patient is in labor at 8cm. She starts to have late decelerations. What is your interventions?
Vaginal Exam
Turn Patient to the side (preferred left side)
Bolus Regular Fluids AND Stop medication/s if applicable
Apply Oxygen
What are the critical things needing to be assessed after delivery? How do we assess them?
Vital signs- Every 15 minutes minimum
Fundal height/location/tone- U/-1/-2/-3, midline, firm
Lochia-scant, light, moderate, and heavy and color
What are risk factors for a Postpartum Hemorrhage
Retained placenta
Failure to progress during second stage of labor
Placenta accreta
Lacerations
Large-for-gestational-age newborn
Instrumental delivery
Hypertension
Induced labor
VEAL CHOP IS...
What is Variable Deceleration=Cord Compression
Early Deceleration= Head Compression
Acceleration= Okay
Late Deceleration= Placental insufficiency
Latent phase: Length is unpredictable especially for a primipara
Active phase: TRUE labor signs
Transition phase: Most intense phase of labor, women is irritable and will start to have the urge to push
The nurse is caring for the laboring patient with cervical dilation of 10cm and 100% effacement. The patient wants pain medication, and the doctor orders Butorphanol Tartrate/Stadol. What is your next step?
Question the order, it can cause respiratory depression to the newborn. It must not be given at least an hour prior to delivery minimum.
How do we calculate Estimated Blood Loss (EBL)?
measure all items that has blood on it.
must zero out original weight.
add all items together in grams. document in mLs.
GRAMS=mLs
What are the 4 T's
Tone: (uterine atony) most common cause
Tissue
Trauma
Thrombosis
PIH includes
gestational HTN, pre-eclampsia, eclampsia, and HELLP syndrome
Your OB completes a AROM, What do you need to document?
Time
Amount of fluid
Color
Odor
This is the Kleihauer-Betke’s test
Blood test used to measure the amount of fetal hemoglobin transferred from a fetus to a mother's bloodstream. Especially used when a RH- mother has a trauma.
What is the normal blood loss in a vaginal and cesarean section
less than 500ml in a vaginal delivery
less than 1000ml in a cesarean section
Your patient is hemorrhaging after a precipitous delivery. What are your expected nursing interventions?
Fundal massage- ENSURE to Support lower segment, measure vitals, assess level of consciousness and amount of vaginal bleeding
Notify physician or midwife
Expected Medications:
Oxytocin (Pitocin), Methylergonovine (methergine), Carboprost (Hemabate)
Your patient is seizing... what is your interventions
Delegate Roles.
Document description of seizure, duration as well as all nursing care provided after seizure is completed.
Administer medications to stop seizure as ordered by provider.
Turn patient on side and apply oxygen during seizure.
Ensure a clear airway during seizure.
Expect to administers Magnesium Sulfate
Establish IV access if not already there
Prepare patient to have a cesarean section if treatment is unsuccessful
What are the 7 P's of labor
Passage, Passenger, Powers, Position, Psyche, Pain Management, and Patience
Your patient has been pushing for 30 minutes. The head comes out, but the shoulders don't. What are the next expected interventions?
McRoberts maneuver, suprapubic pressure, keep calm and calm the patient
what does BUBBLE LE stand for and what are some of the things we assess for each thing?
Breast
Uterus
Bowels
Bladder
Lochia
Episiotomy/Lacerations
Legs
Emotions
What are the top complications of a cesarean section? How do you assess for them?
Wound Infection: REEDA
DVT: Leg assessment (Size, color, temperature, location)
UTI: due to foley, frequency, urgency, burning when urinating, fever, increased WBC