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nur 112 > L &D > Flashcards

L &D Flashcards

1
Q

__________ STIMULATION -RELEASED BY PITUITARY AT TERM

A

OXYTOCIN STIMULATION -RELEASED BY PITUITARY AT TERM

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2
Q

__________ DECREASED and _____________ INCREASE- INCREASES
ABILITY OF UTERUS TO CONTRACT (______________ MAINTAINS
PREGNANCY, SO LOWER LEVELS STIMULATE LABOR.)

A

PROGESTERONE and ESTROGEN

ROGESTERONE

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3
Q

PROSTAGLANDIN RELEASE - PRODUCED BY ____________, ____________
, AND __________STIMULATES LABOR

A

PROSTAGLANDIN RELEASE - PRODUCED BY DECIDUAS, UMBILICAL
CORD, AND AMNION STIMULATES LABOR

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4
Q
  • AGING PLACENTA-LIMITS ITSELF -MADE TO FUNCTION OPTIMALLY
    FOR _______
A
  • AGING PLACENTA-LIMITS ITSELF -MADE TO FUNCTION OPTIMALLY
    FOR 41 WEEKS
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5
Q

MATERNAL FACTORS for triggering labor

A
  • UTERINE MUSCLES STRETCHED TO
    THRESHOLD POINT =>RELEASE OF
    PROSTAGLANDINS AND OXYTOCIN THAT
    STIMULATE CONTRACTIONS
  • INCREASED PRESSURE ON THE CERVIX
    STIMULATES NERVE PLEXUS => RELEASE OF
    OXYTOCIN BY THE MATERNAL PITUITARY
    GLAND
  • INCREASE IN ESTROGEN WHICH ENHANCES
    MYOMETRIUM TO PRODUCE CONTRACTIONS
  • PROGESTERONE (“PRO-PREGNANCY
    HORMONE”) IS FUNCTIONALLY WITHDRAWN
    ALLOWS ESTROGEN TO CONTRACT THE
    UTERUS
  • OXYTOCIN & PROSTAGLANDINS SOFTEN
    CERVIX AND STIMULATE MYOMETRIAL
    CONTRACTIONS
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6
Q

FETAL FACTORS triggering labor

A
  • PROSTAGLANDIN SYNTHESIS BY THE
    FETAL MEMBRANES AND THE
    DECIDUA STIMULATE
    CONTRACTIONS
  • FETAL CORTISOL INCREASES- ACTS
    ON PLACENTA, INCREASE
    PROSTAGLANDINS, REDUCES
    PROGESTERONE ALL STIMULATE
    UTERUS TO CONTACT.
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7
Q

COMPONENTS OF LABOR
5 “P”S

A
  • PASSENGER- FETUS
  • PASSAGEWAY MOTHER’S PHYSICAL CAPACITY TO DELIVER
    INFANT
  • POWERS-2 TYPES INVOLUNTARY AND VOLUNTARY
  • POSITION OF MOTHER-MAKES A DIFFERENCE PHYSIOLOGICALLY
    IN THE FETUS’S ABILITY TO DESCEND IN THE PELVIS
  • PSYCHOLOGICAL- A WOMAN’S PSYCHE CAN INFLUENCE THE
    PROGRESS OF LABOR
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8
Q

POWERS OF LABOR-

A

voluntary = secondary powers “ bearing down” “ ferguson reflex”
and involuntary = dilation and effacement

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9
Q

_________OF UTERUS RESPONSIBLE FOR DILATION
(OPENING) AND EFFACEMENT (THINNING) OF THE CERVIX

A

Lower 3rd

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10
Q

INTENSITy ( description)

  • MILD –
  • MODERATE –
  • STRONG
A

Mild: UTERINE WALL IS EASILY INDENTED DURING CONTRACTION (NOSE)

  • MODERATE – RESISTANCE TO INDENTATION DURING CONTRACTION (CHIN)
  • STRONG – UTERINE WALL CANNOT BE INDENTED DURING A CONTRACTION
    (FOREHEAD
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11
Q

DILATION AND EFFACEMENT – OCCUR IN________

DILATION –

EFFACEMENT –

A

OCCUR IN THE FIRST STAGE OF LABOR –
UC’S PUSH THE PRESENTING PART OF FETUS TOWARDS CERVIX – OPENS
AND THINS

ENLARGEMENT OR OPENING OF CERVIX (FROM CLOSED TO
10CM)- 10CM CERVIX CAN NO LONGER BE PALPATED

THE SHORTENING AND THINNING OF CERVIX (0% - 100%)

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12
Q

Typically, first time moms will______ and then __________
multipara ______

A

Typically, first time moms will efface and then dilate

do it at the same time

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13
Q

Contractions:

FREQUENCY

  • DURATION
  • RELAXATION
A

FREQUENCY
* FROM BEGINNING OF ONE CONTRACTION TO THE BEGINNING OF
ANOTHER

  • DURATION
  • BEGINNING OF CONTRACTION TO THE END OF
    SAME CONTRACTION
  • RELAXATION
  • PERIOD BETWEEN CONTRACTIONS
  • ALLOWS BLOOD FLOW TO THE UTERUS AND
    PLACENTA THAT WAS REDUCED DURING
    CONTRACTION
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14
Q

(2ND POWERS: VOLUNTARY EFFORTS)

A
  • OCCUR ONCE THE CERVIX IS FULLY DILATED
  • WOMEN FEELS URGE TO PUSH

(2ND POWERS: VOLUNTARY EFFORTS)
BEARING DOWN POWERS

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15
Q

PELVIS

A
  • GYNECOID (NL FEMALE)
  • ANTRHROPOID (APE LIKE)
  • ANDROID (NL MALE)
  • PLATYPELLOID (FLAT)
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16
Q

ISCHIAL SPINES & STATION

A

*REFERS TO THE DESCENT OF THE PRESENTING
PART OF THE FETUS (HEAD, BOTTOM, ETC.) IN
RELATION TO THE ISCHIAL SPINE

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17
Q

-5 CENTIMETERS IS ________ THE ISCHIAL
SPINES

A

above

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18
Q
  • TYPES:
  • COMPLETE FLEXION-VERTEX
  • MODERATE FLEXION-SINCIPUT
  • PARTIAL EXTENSION-BROW
A
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19
Q
  • FETAL POSITION
  • ROA- RIGHT OCCIPUT ANTERIOR
  • ROP- RIGHT OCCIPUT POSTERIOR
  • LOA- LEFT OCCIPUT ANTERIOR
  • LOP-LEFT OCCIPUT POSTERIOR
  • LSA-LEFT SACRUM ANTERIOR
A
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20
Q

LIGHTNING
* URINARY CHANGES
* BACK PAIN
* INCREASED PRESSURE ON HIPS
* HORMONE RELAXIN
* VAGINAL CHANGES
* BLOODY SHOW
* WEIGHT LOSS-PROGESTERONE & ESTROGEN CHANGES CAUSE ELECTROLYTE SHIFT & WATER
LOSS (0.5-5KG)
* ENERGY SURGE-MATERNAL NESTING INSTINCT FROM INCREASED EPINEPHRINE & DECREASED
PROGESTERONE
* RUPTURE OF MEMBRANES MAY OCCUR
* BRAXTON-HICKS CONTRACTIONS BECOME STRONGER & MORE FREQUENT

A
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21
Q

USE OF NITRAZINE PAPER:

A

YELLOW OR GREEN INDICATES MEMBRANES INTACT; BLUE
INDICATES RUPTURE

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22
Q

AMNIOTIC FLUID FERN TEST

A
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23
Q

STRAW COLORED W/NATURAL ODOR:

  • GREENISH- BROWN-
  • YELLOW- FETAL HEMOLYTIC DISEASE-
  • PORT-WINE COLOR-
A

STRAW COLORED W/NATURAL ODOR: NORMAL
* GREENISH- BROWN- MECONIUM- POSSIBLE ANOXIA OR HYPOXIA ASSESS BABY FOR
DEVELOPMENTAL DELAYS HRF CHEMICAL PNEUMONIA
* YELLOW- FETAL HEMOLYTIC DISEASE- CHECK COOMB’S ASSESS BABY FOR JAUNDICE
* PORT-WINE COLOR- BLEEDING (ABRUPTION PLACENTAE) EMERGENCY C-SECTION/EMERGENCY BIRTH

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24
Q

Amniotic fluid

NORMAL

*OLIGOHYDRAMNIOS

*HYDRAMNIOS (POLYHYDRAMNIOS)

A

NORMAL 400-1000 ML (DEPENDS ON
GESTATION)

*OLIGOHYDRAMNIOS- <500 ML 32-36 WKS.-
FAILURE OF KIDNEY DEVELOPMENT

*HYDRAMNIOS (POLYHYDRAMNIOS) 2000 ML 32-
36 GESTATION- FETAL GI OBSTRUCTION/ATRESIA

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25
Q

NORMAL FHR
* TACHYCARDIA HR >
* BRADYCARDIA HR <

A

NORMAL FHR 110-160
* TACHYCARDIA HR > 160 FOR 10 MINUTES OR LONGER
* BRADYCARDIA HR < 110 FOR 10 MINUTES OR LONGER

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26
Q

ABSENCE OF VARIABILITY: ( think about no activity possiblities) doesn’t always have to be bad

A

FETUS SLEEPING, SEDATION (OPIATE,
MAGNESIUM SULFATE) CORD COMPRESSION, FETAL HYPOXIA

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27
Q

LOCATING FHR:

A

LEOPOLD’S MANEUVERS

start at the top to locate what part of the fetus is located in the fundus

The second= location of the fetal back

third : presenting part

fourth= baby cephalic prominence

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28
Q
  • FACTORS THAT HELP MAINTAIN FETAL O2 & + RESPONSE TO UTERINE CONTRACTIONS:
A
  • PLACENTAL PROFUSION
  • HIGH CONCENTRATION OF FETAL RBC’S
  • INCREASED ABILITY OF FETAL HGB TO
    CARRY O2
  • HIGH FETAL CARDIAC OUTPUTSTRESSFUL TIME FOR FETUS
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29
Q
  • EXTERNAL 2 TRANSDUCERS-
A

ULTRASOUND
FOR FHR & TOCOTRANSDUCER UTERINE
ACTIVITY

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30
Q
  • INTERMITTENT OR CONTINUOUS
  • AUSCULTATION W/FETOSCOPE OR DOPPLER
    INTERMITTENT, DETERMINES FHR ONLY
  • ELECTRONIC FETAL MONITOR-DETECTS
    FETAL HYPOXIA &/OR ACIDOSIS DURING
    LABOR-INTERPRETING FHR PATTERNS
    MONITORS FHR & UTERINE ACTIVITY
  • GUIDELINES Q 30 MINS STAGE 1& Q 15
    MINS STAGE 2
A
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31
Q

INTERNAL-

A

DIRECT METHOD
OF MEASURING FHR &
UTERINE ACTION W/ SPIRAL
ELECTRODE ON FETAL
SCALP & INTRAUTERINE
CATHETER MEASURES
INTENSITY OF
CONTRACTIONS

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32
Q

Baseline ___________
bpm. This is the
vertical center of the
strip.
 Horizontal numbers-
increments of _____________
 Small boxes=________

A

Baseline 110-160
bpm. This is the
vertical center of the
strip.
 Horizontal numbers-
increments of 30 BPM
 Small boxes=10 secs

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33
Q

Normal FHR
______BPM above
baseline
 Moderate FHR
over ________ bpm
above baseline

 Loss-

A

Normal FHR 6-
25 BPM above
baseline

 Moderate FHR
over 25 bpm
above baseline

 Loss-flat line-do
not see any
variability in
FHR from
baseline

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34
Q

Reassuring Fetal Heart Rate (FHR) -

A

110-160
bpm, increased heart rate from baseline with
no decreases (Normal), also Indeterminate
FHR- cont. to monitor

35
Q

Non-reassuring FHR-

A

(abnormal evaluate &
Treat)- examples-tachycardia, Bradycardia,
Several decreases from baseline, irregular
rhythm, decreases in FHR within 30 seconds
after contraction

36
Q

Non reassuring:
Tachycardia FHR
 Causes:
 Nursing-

 Bradycardia FHR
 Causes:
 Nursing

A

> 160 for > or = to 10 mins

Fever, infection, chorioamnionitis, dehydration,
anxiety, anemia, certain drugs

Take VS, call MD treat the underlying cause ( antibiotics, antipyretics)

<110 bpm for > or = 10 mins

supine position, problems with placenta or
anything that causes hypoxia (low O2 in tissues) or
hypoxemia (low O2 in blood) to fetus.

37
Q

marked variability

A
38
Q

Accelerations-increase in FHR of at
least _______PM above baseline FHR &
lasting at least _____seconds

 Causes

Medical/nursing interventions

A

Accelerations-increase in FHR of at
least 15 BPM above baseline FHR &
lasting at least 15 seconds- 15 by 15

 Causes-fetal movement during
vaginal exam, nurse touches babies’
head-baby is startled; transient
umbilical vein compression

 Medical/nursing interventions-none
 Good

39
Q

Decelerations-three types:
 Early-
 Cause:

 Variable-
 Causes:

 Nursing interventions:

A

 Early-Decrease in FHR begins and ends with contraction. Bottom of FHR
(Nadir) should match with Acme (peak) of CTX
 Heart rate should go back up during resting phase of CTX; Expected
 Cause: fetal head compressed during second stage of labor(mom
pushes)

 Variable- an abrupt decrease of FHR (<100bmp) during various phases of
CTX< 30 secs.
 Causes: cord compression; nuchal, short, prolapsed, knot, caught
between pelvis and fetus
 Irregular form “V” Unpredictable but quickly returns to baseline
 Nursing interventions:
 Turn mom L side, knee to chest
 Give 02
 give fluids
 call MD prepare for amnioinfusion-relieves pressure on cord

40
Q

Late Decelerations-

Causes:

Nursing interventions-

A

bad!(if uncorrectable & associated
with Tachycardia & Loss of Varitbilty)
 “U” shaped-Starts after Peak of CTX and ends after
contraction during rest period of contraction (returns
to baseline after CTX ends)

Causes: uteroplancental insufficiency such as HTN,
preeclampsia, post-due mom (old placenta), excessive
oxytocin, supine hypotension, uterine tachysystole
(frequent uterine contractions-5 in 10 mins, CTX that
last 2 mins)

 Nursing interventions-turn mom left side, elevate
legs, 10 L 02 via mask, turn off Pitocin, Increase IV
fluids, assess for uterine tachysystole, possible fetal
electrode and intrauterine-pressure catheters (IUPC),
call MD-emergency

41
Q

uterine tachysystole

A
42
Q

Asessing Strips

A

 Assess:
 What is FHR?
 Any
Accelerations?
 Any
Decelerations
?
 Is there
Variability?
 Which
category
(I, II or III)?

43
Q

Strip A

A
44
Q

TRUE VS. FALSE
* TRUE-

  • FALSE-
A
  • TRUE- CTX THAT CHANGES MADE TO THE CERVIX
  • FALSE- CTX ARE IRREGULAR LITTLE TO NO CERVICAL
    CHANGE
45
Q

STAGE ONE-

A

BEGINS WITH THE ONSET OF LABOR ENDS W/ COMPLETE CERVICAL DILATION

46
Q

LATENT PHASE: 😁😁😁😁😁

A

CERVIX BEGINS TO THIN AND OPEN, CTX INCREASE IN
FREQUENCY, INTENSITY, & DURATION

CERVICAL DILATION: 0-5 CM

mother is laughing and chilling…. doing

can eat and drink ( 7-9 hrs for primi)

4-5 for multi

47
Q

ACTIVE PHASE:

A

MODERATE, REGULAR FREQUENCY EVERY 2-3 MINS/CERVICAL DILATION:6-10 CM (COMPLETELY EFFACED)

ACTIVE
* 4-7 CM DILATION
* 80-100% EFFACED
* -1 TO 0 STATION
* MODERATE TO STRONG CTX; UTERUS FIRM
* 3-5 MINUTES APART 40-70 SECONDS

48
Q
A
49
Q

TRANSITION PHASE: URGE TO START PUSHING

A

cervix dilated beyond 7 cm

80-90% top of head may be below ischial spine

CERVICAL DILATION: 10 CM. If sac isnt broken physician may break it

TRANSITION
UTERUS FIRM
* 8-10 CM DILATION
* 100% EFFACED
* +1TO +4 STATION
* CTX 2-3 MINUTES APART 45-90 SECONDS LONG

50
Q

STAGE TWO

A

BEGINS WAS COMPLETE DILATION OF CERVIX, ENDS W/ DELIVERY OF BABY

51
Q

STAGE THREE

A

BEGINS AFTER THE DELIVERY OF THE BABY AND ENDS WITH DELIVERY
OF PLACENTIA

52
Q

Closed glottis technique vs open glottis

A

In childbirth, the closed glottis technique is often referred to as “bearing down” or “valsalva maneuver.”
During the pushing stage of labor, the woman holds her breath and bears down, using abdominal muscles to push the baby through the birth canal.

The individual holds their breath and contracts their abdominal muscles to create intra-abdominal pressure, which can help stabilize the spine and support the body during lifting or exertion.

53
Q

STAGE FOUR

A

BEGINS AFTER DELIVERY OF PLACENTA AND IS COMPLETED AFTER THE
STABILIZATION OF THE BIRTH PARENT AND INFANT; IT IS THE IMMEDIATE POSTPARTUM

54
Q

MECHANISM OF LABOR:

A

ENGAGEMENT
* DESCENT
* FLEXION

  • INTERNAL ROTATION-
  • EXTENSION-
  • RESTITUTION & EXTERNAL ROTATION
  • EXPULSION-
55
Q

ENGAGEMENT-

A

GREATEST DIAMETER OF FETAL HEAD PASSES THROUGH PELVIC INLET;
CAN OCCUR LATE PREGNANCY OR EARLY LABOR

56
Q

DESCENT- ( relation to…)

A

MEASURED BY STATION-DEGREE OF DESCENT OF FETUS IN RELATION TO
ISCHIAL SPINES -5-0-+5

57
Q

FLEXION-

A

HEAD FLEXES SO THAT SMALLEST DIAMETER PASSES THROUGH PELVIC
ARCH

58
Q

INTERNAL ROTATION-

A

HEAD ROTATES TO OCCIPITOANTERIOR POSITION TO PASS
THROUGH ISCHIAL SPINES

59
Q

EXTENSION-

A

HEAD AT PERINEUM DEFLECTED ANTERIORLY

60
Q

RESTITUTION & EXTERNAL ROTATION=PEEK- A- BOO

A

HEAD REVERTS BACK TO LATERAL AND
SHOULDERS DESCEND. Parts of the head is out

61
Q

EXPULSION-

A

ANTERIOR SHOULDER USUALLY COMES FIRST FOLLOWED BY REMAINDER
OF BODY

62
Q

Medications used

A

nalbuhine - not for opiate addicted women

morphine - decrease paina nd pee

sedatives (seconal)

63
Q

HYDROTHERAPY-

A

STIMULATION OF NERVES IN SKIN AND VASODILATION; REDUCES
* CATECHOLAMINE RELEASE

64
Q

ALL ___________________ MEDS AFFECT
FETUS

A

ORAL, IM, & IV

65
Q

THE DECISION TO USE PAIN MEDS IN LABOR SHOULD
BE MADE BY _______________________
* ASSESSMENTS ______________

A

THE DECISION TO USE PAIN MEDS IN LABOR SHOULD
BE MADE BY THE WOMAN IN COLLABORATION WITH
HER PHYSICIAN OR MIDWIFE
* ASSESSMENTS NEEDED BEFORE AND DURING
ADMINISTRATION

66
Q

NALBUPHINE (NUBAIN)-

  • MORPHINE-
  • SEDATIVES-
  • FENTANYL-
A

AGONIST/ANTAGONIST DO NOT USE IN OPIATE
* ADDICTED WOMAN (PRECIPITATE WITHDRAWAL SYNDROME)

ONSET 30 SECS, PEAK 20 MINS, DURATION 2 HOURS INDUCES
* SLEEP

RELIEVE ANXIETY & INDUCE SLEEP. SECONAL, HYDROXYZINE

OPIOID, USED PRIMARILY IN EPIDURAL AS AN ADJUNCT TO
ANESTHETIC AGENTS

67
Q

Medication assessments : maternal

A
  • RESPIRATORY
    DEPRESSION
  • HYPOTENSION
  • URINARY RETENTION
  • DECREASED
    CONTRACTIONS
68
Q

Assessments : Infant

A

FETAL/NEWBORN
* BRADYCARDIA
* RESPIRATORY DEPRESSION
* APNEA
* CYANOSIS
* *****NARCAN (NALOXONE) – OPIOID
ANTAGONIST
* NEONATE – 0.01MG/KG IV, IM, SC
* MATERNAL - 0.4-2MG IV Q2-3 MIN PRN
CNS/RESP DEPRESSION

69
Q

EPIDURAL ANESTHESIA ( disadvantages)* THINK ABOUT WHERE ITS PLACED*

A

DISADVANTAGES:
* MAY NOT BE ABLE TO PUSH
* LONGER LABOR THAN THOSE WITHOUT EPIDURAL
* CONTRAINDICATIONS:

  • HEMORRHAGE, SPINAL INFECTION, ALLERGY, HYPOTENTION, FETAL DISTRESS,
    ITCHING
  • ANTICOAGULATION THERAPY, TUMORS NEAR SITE, HX OF SPINAL INJURY/SURGERY
70
Q

FENTANYL (SUBLIMAZE) - ADVERSE

A
  • RESPIRATORY DEPRESSION (MATERNAL AND FETAL)
  • HYPOTENSION (MATERNAL)
  • CNS DEPRESSION (MATERNAL AND FETAL)
  • FHR CHANGES
71
Q

IF HYPOTENSIVE – ( FENTANYL)

A

IF HYPOTENSIVE – ADMINISTER 02, PLACE WOMAN IN LATERAL POSITION, INCREASE IV FLUIDS

72
Q

REGIONAL ANESTHESIA: SPINAL BLOCK
*

A

LIDOCAINE-SUBARACHNOID SPACE-MIXES W/CSF
* ADVANTAGES: DEEPER LEVEL OF ANESTHESIA; MOTHER HAS
NO FEELING IN LOWER EXTREMITIES
* ADVERSE EFFECTS: HYPOTENSION (MONITOR BLOOD
PRESSURE)SPINAL HA, FETAL BRADYCARDIA.
* NURSING INTERVENTIONS: VS, MOM FLAT, INCREASE FLUIDS,
BLOOD PATCH

73
Q
  • INCREMENT
  • ACME
  • DECREMENT
A

buildup of contraction begins at the fundus and spreads throughout uterus

peak of intensity

the relaxation of the muscle

74
Q

Woman should (pushing)

A

push for 6-8 seconds followe by a slight exhale repeating effort three to four times per contraction

75
Q

convex and concave

A

flexed and extended

76
Q

_____________is an ascending infection, originating in the lower genitourinary tract and migrating to the amniotic cavity

A

Chorioamnionitis

77
Q

LOCAL BLOCK:
PUDENTAL BLOCK

A

GIVEN IN THE 2ND STAGE OF
LABOR JUST BEFORE
DELIVERY BLOCKS
SENSATION AROUND VAGINA

  • EPISIOTOMY REPAIR
  • DOESN’T DEPRESS NEONATE
  • ADVERSE: ALLERGIES,
    PROBLEMS PUSHING
  • INTERVENTIONS: ASSESS
    FOR LOCAL PAIN WHEN
    BLOCK WEARS OFF
78
Q

WHEN TO NOTIFY PHYSICIAN OR ANESTHESIOLOGIST/NURSE
ANESTHETIST

A
  • CONTRACTIONS
  • IF CONTRACTIONS STOP OR DECREASE
  • DECREASED BP
  • NON-REASSURING FHR
  • HYPOTENSION
  • SYSTOLIC BP <100 MMHG
  • 20% DECREASE IN BP FROM PRE-ANESTHESIA
    LEVELS
79
Q

GENERAL ANESTHESIA: IV PENTOTHAL.SUCCINYLCHODHOLINE THEN
NITROUS OXIDE + 02

A
  • MAINLY USED IN EMERGENCY CSECTION
  • RISKS FOR FETAL DEPRESSION, UTERINE RELAXATION, MATERNAL
    VOMITING & ASPIRATION
  • ENSURE WOMAN IS NPO
  • IV WITH LARGE BORE NEEDLE
  • PLACE FOLEY
  • ADMINISTER MEDS TO DECREASE GASTRIC ACIDITY (PANTOPRAZOLE)
  • WEDGE HIP PREVENT VENA CAVA SYNDROME
  • ASSIST WITH SUPPORTIVE CARE OF NEWBORN
80
Q

CERVIX RIPENED –
( bishop)

A

sOFT AND READY TO DILATE* BISHOP SCORE OF 8 OR MORE (BASED ON STATION,
DILATION, EFFACEMENT, POSITION AND CONSISTENCY
* PROSTAGLANDIN GEL
* CERVIDIL INSERT (SE: N/V, FEVER, HYPOTENSION,
UTERINE HYPER STIMULATION

81
Q

METHODS OF INDUCTION

A
  • AMNIOTOMY – ARTIFICIAL RUPTURE OF MEMBRANESASSESS FHR AFTER
  • OXYTOCIN (PITOCIN) IV – HORMONE THAT STIMULATES UC’S
  • NURSING INTERVENTIONS: TITRATE DRUG TO MATERNAL
    AND FETAL RESPONSE, VITAL SIGNS
  • D/C OXYTOCIN IF CONTRACTIONS TOO FREQUENT,
    CONTRACTIONS TOO LONG (>90 SECONDS), FHR NONREASSURING
82
Q

BETAMETHASONE
* CLASS:
* ACTION:
* DOSE:
* SIDE EFFECTS:
* NURSING RESPONSIBILITIES:
* TEACH PT:

A

BETAMETHASONE
* CLASS: SYNTHETIC STEROID HORMONE
* ACTION: STIMULATES FETAL LUNG MATURITY
* DOSE: 0.6 MG PO
* SIDE EFFECTS: HIGH GLUCOSE LEVELS, FATIGUE, FEVER,
HUNGER DIZZINESS, FAINTING, ADRENAL CRISIS, CUSHINGOID
FEATURES, DECREASED WOUND HEALING
* NURSING RESPONSIBILITIES: MONITOR FLUID BALANCE,
INFECTIONS
* TEACH PT: TAPER GRADUALLY, INCREASE ACTIVITY, HIGH
PROTEIN DIET, GOOD ASEPSIS, ABOUT SIDE EFFECTS

83
Q
A

nur 112 (23 decks)

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