What medication is your bodys natural pitocin?
Oxytocin
You just gave 200mg cytotec PO for a boggy fundus, what vital sign do we want to check in about 30 minutes?
Temperature
Your pt comes into L&D complaining of decreased fetal movement. What test will we complete to assess fetal status?
NST
Your pt has been on your postpartum floor for one hour. How would you educate her to gause too much bleeding?
A pad per hour
AT LEAST How long is an NST performed?
What medication do we give to prevent seizures in hypertensive pregnancies?
Magnesium Sulfate
You go to check your pts bleeding 30 minutes after delivery and find her pad is completely saturated. what is your first step?
Fundal massage
How many ML of blood loss constitutes a vaginal postpartum hemorrhage
500ml or more
what is placenta previa?
placenta is placed over the cervical opening
accel
Name 3 medications we give for postpartum hemorrhage?
Hemabate, cytotec, methergine, TXA, pitocin
You go check on your postpartum patient on the postpartum floor, she delivered 4 hours ago and is complaining of heavy bleeding. In conversation you learn she hasnt gotten up to urinate. Where do you expect her uterus to be? What is your next step?
deviated right or left (usually right)
get them up to urinate
According to VEAL CHOP what would indicate some type of cord compression?
According to VEAL CHOP what would indicate some type of cord compression?
Marie
a placental issue
What medication can we not give to a pph patient with asthma?
Hemabate
Your pt is 18 weeks and was direct admitted from the obgyn office for 28lb weight loss in 1 month and frequent n/v. Her potassium is 3.1, Mg is 1.2 and she has not kept any food down in the 2 days since being admitted. What 4 orders do we expect?
TPN/Lipids/parentral nutrition
K replacement
MG replacement
antiemetics
Your pt comes in at 2100 c/o contractions, she is 32 weeks pregnant and worked a 12 hour shift as a waitress. What do you think our first question to her would be?
How much water have you drank today?
1/2 gallon a day is recommended not including tea, soda, juice.
what positioning of the fetus in the uterus would make them a greater risk for prolapsed cord? High or low? and why
High because there is more room for the cord to fall out around the head with breaking of water
Your pt is 38 weeks and her fetus has a baseline HR of 125. Its first accel hit 135bmp and the next, 10 minutes later, hit 140. is it reactive? and why
No.. must be 15x15
what do we need to check before we give a pt MD ordered methergine?
blood pressure
Your patient received cytotec prophylactically after delivery. She was previously ruptured for 48 hours and has a temp of 101.5 now. What medication(s) do you anticipate?
Antibiotic/tylenol
Your pt is sent by their doctor to be evaluated in L&D for elevated BPs in the office. The secretary admits her into a room and tells you she has left upper quadrant pain, her liver enzymes are ALT 486 and AST 646, platelets are 40. what diagnosis do we expect? and what symptom should we clarify?
HELLP
left upper quad pain.. usually right
Your pt is in the middle of a PPH
vs: 97.8, 89, 158/91, 17, 100%
Youve already given pitocin and cytotec with no change in bleeding, your md orders TXA IVP and 0.2mg of methergine IM. What do you do?
Clarify the methergine order, notify of latest trend of BPs.
Your pt has a baseline of 135 on NST.
For the first accel, babys HR went up to 155 at 1230. The second accel occurred with a HR of 160 at 1251. Is it reactive and why?
NO. The accels were 20 minutes apart.