Postpartum Care
When would a nurse initiate skin to skin contact with mother and newborn?
Immediately after delivery
What is the best position to put a healthy woman in for an uncomplicated birth
Whatever position she wants
Painless bright red vaginal bleeding should cue the nurse to think...
Placenta previa
FHR 135bpm increasing to 170bpm over a duration of 17 minutes is what?
Tachycardia/baseline change
Name 2 signs of newborn respiratory distress
Nasal flaring, grunting, retractions, tachypnea
Your patient is started on magnesium sulfate for pre-eclampsia. The nurse knows to have what medication readily available?
Calcium gluconate
When PPROM occurs, what is a probable complication
Chorioamniotis or Cord prolapse
Name 2 of the 4 characteristics of uterine contractions that you would assess and document
Frequency, intensity, duration or resting tone
The most serious condition to occur from bladder distention is
excessive uterine bleeding
What is the first instruction to give your patient when a shoulder dystocia has been called
Stop pushing
A nurse knows that pre-eclampsia can occur anytime after which week of pregnancy
after 20 weeks
What are 3 causes of FHR changes that are not directly related to fetal oxygenation
Maternal fever, infection, medication, sleep cycle, anemia, arrhythmia, anomalies
Your patients estimated blood loss on a vaginal delivery is reported to be 800ml. Methergine has been given and you have received an order to start TXA. Name 3 interventions/task that need to be started immediately.
1. A 2nd IV access
2. Weigh and document ALL chux/peri pads
3. Have Henry or Henretta outside or inside the room
If this uterotonic medication is administered too rapidly it may decrease systemic vascular resistance and result in subsequent hypotension
Oxytocin
Your patient is on magnesium sulfate with magnesium assessments Q2hrs. A lab order for magnesium level has been ordered. What is the therapeutic range for magnesium related to pre-eclampsia?
5-8mg/dl
You are performing an assessment on a patient that has CHTN and a headache. Her reflexes are 4+ and clonus is present upon assessment. What is your patient at high risk for?
Seizure - implement seizure precautions and notify physician
What are the 4 main causes of postpartum hemorrhage that account for the majority of cases?
Tone, Tissue, Trauma, Thrombin
To decrease the transfer of medication to the baby, IVP pain medication should be given when?
During a contraction
This medical diagnosis shares a common pathologic mechanism with obesity, diabetes, and dyslipidemia, which are responsible for insulin resistance and cardiovascular disease
Hypertension
A newborn assessment finds head swelling that stops at the sutures, parietal and occipital bones and can be bilaterial
Cephalohematoma