Hemorrhage is defined as
Greater than 500 mL for a vaginal delivery and greater than 1000 mL for a cesarean section.
Used for cerebral protection
What is Magnesium Sulfate
The #1 indicator of fetal well-being is
Variability- variation in the baby's heart rate from it's baseline.
Interventions to avoid mastitis.
What is wash hands, position baby correctly at the breast, make sure baby grasps areola as well as nipple, expose nipples to air during the day, and use vitamin E ointment to soften nipples daily?
Most likely complication for a pregnant patient that abuses cocaine
Placental abruption
2 labs needed upon admission to give you a "bleeding baseline"
Type and screen
Platelet count
HTN presenting after 20weeks, no proteinuria
What is gestational HTN
Definition of a reactive NST
2 accels lasting 15 seconds that are 15 beats above the FHR baseline in a 20 minute window. (>32 weeks)
2 accels lasting 10 seconds that are 10 x 10 in a 20 minute window (<32 weeks)
Postpartum psychosis.
What is delusions, hallucinations of harming the infant or self.
The drug given to stimulate fetal surfactant production in a preterm labor.
What is betamethasone
Painless, bright red bleeding
Placenta previa
Define pre-eclampsia
What is SBP ≥ 140 or DBP ≥ 90 on 2 occasions at least 4 hrs. apart + proteinuria (>=300mg in 24hr UrPr) or abnormal (platelet, serum creatinine, liver function, pulmonary edema, unresolved HA)
Name this deceleration
Early deceleration
Pre-E develops in the post partum period. B/P is 188/96. What medications would be initiated for this patient (Name 2)
Labetalol or Apresoline for the acute high B/P, and Mag for cerebral protection.
Define HELLP syndrome
What is Hemolysis, Elevated Liver Enz, Low platelets
Double Jeopardy!!!
3 types of placenta previa with description, and is a vaginal delivery possible
Marginal-at the margin of the cervix-vag possible
Partial-partially covering the cervix-vag can be attempted, but usually not successful
Total-entire cervical os is covered-vag not possible
Define Pre-eclampsia w/Severe Features
What is If one or more of the following criteria is present: SBP ≥ 160 or DBP ≥ 110 at least 6 hours apart at rest -Proteinuria >=5 g in 24hr UrPr or 3+ or greater on two random urine samples collected at least 4 hours apart -Oliguria of less than 500 mL in 24 hours -Cerebral or visual disturbances -Pulmonary edema or cyanosis -Epigastric or right upper-quadrant pain -Impaired liver function -Thrombocytopenia -Fetal growth restriction
Name this deceleration
Variable deceleration
Double Jeopardy!!!
The #1 cause of post partum hemorrhage is...
and what it a nurses priority intervention when she discovers it?
Uterine atony and fundal massage.
form of birth control that increases the risk of PID, uterine perforation, and ectopic pregnancy
What is an IUD
After an MVA, a 34 weeker presents with severe abdominal pain. Her B/P is 92/48, P-135, R-32. She is not experiencing any visible bleeding at this time, but her abdomen is rigid. FHR-100 with minimal variability and late decels. You suspect:
Placental abruption
Hemorrhage associated with antepartum HTN and embolitic disorder is usually associated with this condition.
What is disseminated intravascular coagulation
Double Jeopardy!!!
The cause of these decelerations, and nursing interventions with most important named first.
Late decelerations are caused by utero-placental insufficiency.
1-Turn pt to L side.
2-Give o2 as 10-12 L via tight face mask or non-rebreather.
3-Give IVF bolus of of 500-1000mL.
4-Stop the pitocin if infusing.
5-Administer tocolytics as needed.
What is usually in left leg, patient has high temperature and chills, tenderness, coolness, pale limb, decreased pedal pulse,and pain with Homan's sign, and an increase in size of limb by 2cm.
What is a DVT
The destruction of RBC's in a fetus that results from an antigen-antibody reaction
What is erythroblastosis fetalis
3 drugs used to treat post partum hemorrhage
-who would you not give these to and why
What is pitocin, methergine, Hemabate (prostaglandins)
Do not give methergine to hypertensive pts- works by vasoconstriction.
Do not give Hemabate to asthmatics- works by increasing muscle contractility.
Assessment that is of ultimate importance in assessment of neurologic status of pre eclamptic
What is DTRs
2 uses for an IUPC
What is measuring the exact amount of pressure within the uterus, and amnioinfusion.
Medicine of choice for post partum thrombosis prophylaxis
What is lovenox
If found, a patient is at high risk to deliver within 2 weeks
What is fetal fibronectin