lecture 11 labor/delivery continued Flashcards
normal fetal HR is
120-160 (metro/sizzle)
what do if fetal HR is low (under 110 bpm)
P LION
pitocin stop
lie on left side
IV
oxygen
notify HCP
what to do if fetal HR is high (over 160)
document acceleration
take mother temp
is a high fetal HR a bad thing
no baby is WNL
what to do if there is low baseline variability
P LION
pitocin stop
Lie on left side
IV
oxygen
notify HCP
what acronym to call for bad fetal monitor tracing
P LION
what to do if there is high baseline varibility
document finding
is high baseline variability good
yes
are accelerations good or bad
good
what causes variable decelerations (VEAL CHOP)
cord compression/prolapse
what causes early delerations (VEAL CHOP)
head compression
accelerations are? (VEAL CHOP)
okay
what causes late decelerations (VEAL CHOP)
placental insufficiency
if baby has variable decelerations
push baby head of cord and put preg pt in knee chest (finger pt in back shot postion)
what to do if baby has early deceleration
nothing just document
if the fetal HR tracing starts with L it is
bad and u should do lion
if the fetal HR has variable deceleration it is
very bad
variable deceleration equals
very bad
when should the mother stop pushing
when the head is out (the baby has a brain of its own so stop pushing)
should u suction the mouth or nose first
mouth (ABC)
what should u make sure the baby has before it leaves the delivery area
ID band
what should u see in cord
2 arteries and 1 vein
what should assess/do every 15 mins when mother is recovering
-vital signs
-fundus
-peri pads
-roll pt to check for bleeding underneath her
when should u assess post partum pt
every 4-8 hrs
what should u assess for in post partum pt (BUBBLE HEAD)
-breasts
-uterine fundus
-bladder
-bowel
-lochia
-episiotomy
-hemoglobin/hematocrit
-extremities
-affect
-discomforts
where should the fundus be after delivery
umbillicus
how much does the fundus shrink per day after delivery
2 cm
where should the fundus be after delivery
midline
what to do if fundus is boggy and not midline
catheterize pt
what is a moderate amount of lochia
4-6 inches on pad in an hr
what is an excessive amount of lochia
saturated pad in an 15 mins
how to tell if pt has thrombophlebitis
measure calves
is milia on newborn normal
yes
when will milia dissapear
after a few weeks of bathing
are epstein pearls normal
yes
is a mongolian spot (blue discoloration on top of butt) normal
yes
who is more likely to have a mongolian spot
african americans
are erythema toxicum neoratorum normal and when do they appear and disappear
yes, 24-48 hrs and dissapear in a few days
is hemangioma normal
yes
when does physiological jaundice in newborns
24 hrs after birth
when does physiological jaundice disappear in newborns
1 week
when does pathologic jaundice appear
1st 24 hrs
which type of newborn jaundice appears in the 1st day of birth
pathologic
which type of newborn jaundice appears the next day
physiological
is jaundice normal in a new born
yes
is acrocyanosis normal in newborns
yes
what is acrocyanosis
blue discoloration of hands and feet of newborn within 1st few days
is blue discoloration of hands and feet of a newborn normal
yes
why would u give terbutaline
to stop premature labor
what is a side effect of terbutaline
tachycardia
who would u not give terbutaline to
pts with heart problems
why would u give preg pt magnesium sulfate
to stop labor and contractions
magnesium sulfate side effect
hypermagnesemia
what happens to everything in hypermagnesemia
everything goes down
what should u do if pt who got mag sulfate has a low RR
decrease dose
what do if pt has decreased reflexes with mag sulfate
decrease dose
what to do if reflexes are increased w mag sulfate
increase dose
mag sulfase does goes the same as what
reflexes (if reflexes are low then decrease etc)
magnesium sulfate pt has 4+ reflexes what should u do w dose
increase it
magnesium sulfate pt has 2+ reflexes what should u do w dose
nothing its normal
mag sulfate pt has 1+ reflexes what should u do
decrease it
what does pitocin do
stimulates and strengthens labor
pitocin is the same as
oxytocin (love hormone)
methergine is the same as
oxytocin (love hormone)
what is a side effect of methergine
HTN
when can u give betamethasone
before birth
what is a side effect of betamethasone
increased glucose
why would u give betamethasone
for baby’s lungs
when is surfactant given
after birth
what is surfactant for
the baby’s lungs
