Lil bit of everything Flashcards
maternal outcomes of shoulder dystocia
4th degree laceration, postpartum hemorrhage
fetal outcomes of shoulder dystocia
facial bruising, clavicle injury, brachial plexus injury, brain injury d/t hypoxia, death d/t acidosis
nursing interventions of shoulder dystocia
have stool ready
position in McRobert’s to improve diameter of pelvic outlet
apply SUPRAPUBIC pressure from above (stand on stool)
maternal outcome of prolapsed cord
c section
fetal outcome of prolapsed cord
death d/t hypoxia and acidosis
how do you know there is a prolapsed cord
visible cord or pulsating rope like mass
nursing interventions of prolapsed cord
place pressure on presenting part
call for help
pt in Trendelenburg (use gravity)
stat C section
outcomes of amniotic fluid embolism
stroke or anaphylaxis of lungs d/t foreign material
nursing interventions of AFE
warch for LOC changes
respiratory distress
get ready to code pt
transfer to ICU
when PPH bleeding continues
1) oxytocin bolus IV to contract uterus
2) methergine IM to contract uterus
3) hemabate IM to contract uterus
4) cytotec tablets rectal
AND increase O2
what gauge is needed to replace blood that has come out of vasculature during PPH and what do you give
18 gauge and give normal saline or lactated ringers
what is methergine contraindicated in
hypertension
what is hemabate contraindicated in
asthmatics
what is cytotec contraindicated in
3rd and 4th degree perineal laceration
what can PROM cause
Oligohydramnios
deficiency of amniotic fluid
Oligohydramnios
what can increased maternal age cause
chromosomal abnormalities
fetal congenital abnormalities cause
polydramnios
excess of amniotic fluid
polydramnios
what can abnormal placenta development cause
IUGR (fetoplacental)
what can smoking, alcohol, and drugs cause
IUGR (maternal)
temp elevation and infection risk start ______ after delivery and must be present on ______
24 hrs; 2 separate occasions
12 hrs after birth, client temp is 100.4 F, what is the cause?
dehydration d/t expenditure of energy
what does a BPP include and in general check
NST and ultrasound
checks fetal well being
what specifically does a BPP monitor
fetal movement
fetal tone
fetal heart rate
amniotic fluid index
what identifies IUGR
doppler blood flow analysis
what identifies Down Syndrome
triple marker test
what identifies the condition of the fetus
BPP
what is MSAFP
indicates an elevated level of alpha fetoprotein
it is ONLY a screening tool and identifies if diagnostic testing needs to occur
what is the next step if elevated MSAFP
ultrasound
what may be necessary to administer after amniocentesis
Rho(D)
what does amniocentesis determine
fetal lung maturity
when is CVS performed and what is the benefit
10 wks
results come earlier than most
what can DM cause and what does it indicate in pregnant women
polyhydraminos
the need for fetal diagnostic procedure
what identifies chromosomal abnormalities in fetus
multiple marker screening
what doe AFP (alpha fetoprotein) levels indicate
neural tube defects
what does cell free DNA screening identify
fetal Rh status
fetal gender
paternally transmitted gene disorders
trisomy 21
what is a PUBS
cordcentesis
aspiration of fetal blood from umbilical cord for diagnosis
what does a PUBS identify
Rh disease
infection
karyotyping
ultrasound before 20 wks..
needs full bladder
ultrasound after 20 wks..
needs empty bladder
what does a CST do
applies stressful stimulus to fetus
what does a NST monitor
fetal heart activity
describe daily fetal movement counts
need >3 kicks in 1 hr
fetal alarm signal goes off when fetal movements stop entirely for 12 hrs
if preterm labor occurs what test may be needed
amniocentesis for fetal lung maturity
describe ultrasound
ordered/offered for ALL pregnant women
used to determine presence of maternal abnormalities and ebryonic placement
