Chapter 53 : Labor, Delivery, Post Partum

Question 1

Nonpharmacolgic
Pain control measures

Ambulation
Effleurage and counter pressure
Touch and massage
Changing positions and rocking
Engaging support persons
Breathing and relaxation techniques
Transcutaneous electrical nerve stimulation

Application of heat and cold
Aromatherapy
Hydrotherapy
Alternative and complementary drugs

Question 2

What are two anesthetics for delivery?

Answer 2

Spinal for c section
Epidural for vaginal

Question 3

What is the biggest thing to watch out for when regarding spinal and epidural anesthetics?(2)

Answer 3

Hypotension!!
Respiratory depression

Question 4

Before you give an epidural, what must you do?

Answer 4

500-1000ml Bolus of fluid

Question 5

Spinal headache is something that can occur with spinal anesthesia, how do we treat it?

Answer 5

Bed rest
Pain meds
Increased fluids

Blood patch ( injection some blood to try to patch the hole )

Question 6

What are the drug that help induce labor or enhance uterine muscle contractility?

Answer 6

Oxytocin

Question 7

What is the biggest risk of oxytocin? (2)

Answer 7

Sustained contractions
Uterine rupture

Space between contractions

Question 8

How do you administer oxytocin?

Answer 8

Iv pump

Question 9

What is Ergot alkaloids used for when regarding pregnancy and labor?

Answer 9

To help aid with postpartum hemorrhage

Question 10

Why don’t we use Ergot alkaloids during labor?

Answer 10

Tetanic contractions resulting in fetal hypoxia and possible ruptured uterus

Which is really bad contractions that can cause uterine Rupture and make the baby not have oxygen

Question 11

What are the 2 contraindications of Ergot alkaloids?

Answer 11

Gestational hypertension
Peripheral vascular diseases

Question 12

What is the ergot toxicity side effects? (8)

Answer 12

Pain in the arms, legs, lower back
Numbness
Cold hands & feet
Muscular weakness
Diarrhea
Hallucinations
Seizures
Blood hypercoagulability - blood clot

Question 13

What is an expected ergot alkaloid side effect?

Answer 13

Uterine cramping

Help prevent hemorrhage, so we cramp

Question 14

Constipation is a huge thing with pregnancy

So you want to do an abnormal assessment

Assess bowel sounds

What is the main education
- sodium, colace, psyllium

Stool softeners

Question 15

Immunizations
What if mom has rh- blood
What if baby has rh+ blood?

What do we give?

Answer 15

Rhogam

Question 16

Can we give rhogman
With mom RH+
And baby RH- ?

Answer 16

No

Question 17

When should we give rhogam typically? (2) events

Answer 17

72 hours to females with maternal fetal blood mixing

Mainly post partum

Given to first time moms typically, if their is any exposure to the blood of the baby

Question 18

What are side effects of rhogam?

Dont over think it

Answer 18

Hypotension
Headaches
Dizziness
Fevers
Chills
Abdominal pain
Diarrhea
Pruritus
Rash
Injection site reacting

Question 19

What vaccines do we not give during pregnancy?

Answer 19

MMR, varicella, shingles

Any live vaccines

Question 20

What syndrome can a child develop after MMR ?

Answer 20

Congenital rubella syndrome

Question 21

If mom is not immune, you give the dose before !!

She delivers the baby, and is not immune, you give it immediately after birth

Question 22

Postpartum depression
- intensive feelings of sadness, anxiety, despair

Prevents patient from performance of daily tasks

Usually occurs 1-3 weeks after childbirth, but may occur up to you a year

Treatment
- antidepressants
- brexanolone