Fetal Monitoring
True or False: Fetal Monitoring is 100 percent reliable
False: you should always palpate the mother's abdomen regularly with your hand.
What are the top two nursing priorities post birth for mom.
Risk for Bleeding
Risk for infection- intrauterine
When did Lobotomies and electro-convulsive therapy get used as treatment for the mentally ill?
19th-20th century when asylums became overcrowded
What medications would you see for a patient with Anxiety?
Benzodiazepines: Short term, very addictive
Lorazepam (Ativan)
Alprazolam (Xanax)
Diazepam (Valium)
Where should you position yourself in a mentally unstable patients' room?
What is the most important indicator of reassuring fetal status?
Variability
How fast should the fundus decrease in size after birth?
Fundus should decrease in size 1-2 cm every 24hours following birth
When did Thorazine and Lithium become available as psychiatric drugs?
1950's
What is first line treatment for depression?
SSRI-
EX. Fluoxetine (Prozac)
What are the side effects of Haloperidol? (1st generation antipsychotic)
SE: pesudoparkinsons- hand tremors
Normal fetal heart rate?
110-160 bpm
What is the location of the fundus if the bladder is full?
Uterus is displaced and deviated to the right if bladder is full.
When did the release of patients confined to mental institutions into the communities happen and when did it become a failure?
1965: released
1990's deinstitutionalized was considered a failure
What is a Atypical Antidepressant that can also be used for smoking cessation?
Bupropion (Wellbutrin)
What intervention is 1st line when dealing with a mental unstable patient that is becoming aggressive?
Least restrictive first- de-escalation: verbally intervene, active listening, offer PRN medication before putting on restraints
What does each of the three-tier FHR interpretation system categories stand for?
Category 1: Normal
Category 2: Intermediate prevent deterioration
Category 3: Abnormal, immediate intervention
ND: Risk for unstable blood glucose, what should a newborns blood glucose levels be less then 48 hours and over 48 hours old?
less then 48 hours 45-60
Older then 48 hours: over 60
What are the three types of ACE's?
Abuse
Neglect
Household dysfunction
What medication would we give to a Bipolar patient experiencing episodes of mania and depression? and what would we want their levels to be?
Mood Stabilizer: Lithium (therapeutic range is 0.8-1.4)
what are the rules for restraints? Do you need an order? how long do you check restraints? Documentation time?
RN can place restraints on without order but PCP must visit patient within an hour of restraints being placed and every 4 hours provider rechecks need for restraints.
No more then 24 hours in restraints, D/C at earliest possible time
Documentation every 15 minutes
What does each letter of "VEAL CHOP" stand for?
V: Variable Deceleration C: Cord Compression
E: Early Deceleration H: Head Compression
A: Acceleration O: Okay
L: Late Deceleration P: Placental Insufficiency
What is the key message you should teach all postpartum women before discharge? *think 3 R's
Recognize: S/Sx AFTER discharge of childbirth complications
Respond: call 911 or PCP depending on situation
Remember: to tell recent DATE of CHILDBIRTH
1. What does Sullivans theory focus on?
2. What must be met for Maslow's theory?
Sullivans theory focuses on interpersonal relationships and the need for people to interact and the development of therapeutic milieu
Basic needs must be met in order to in order to grow and get better.
What medication has many side effects and interactions and also has diet restriction? List foods and classification of medication that can't be mixed
Monoamine oxidase inhibitors MAOI's
Can not be mixed with SSRI
Foods: Aged cheese, processed meats, overripe bananas, beer, dried fruits
What are the three types of Crisis and what are examples of each of them?
Developmental: expected EX. marriage or retirement
Situational: Unexpected EX. Loss of job, death of loved one, divorce
Adventitious: Crisis of disaster EX. Terrorist attack, earthquake, school shootings, global pandemics