MATERNAL Flashcards
Schedule of FIRST Pre-natal checkup
AS EARLY IN THE PREGNANCY AS POSSIBLE
Schedule of THIRD Pre-natal checkup
THIRD TRIMESTER
Schedule of SECOND Pre-natal checkup
SECOND TRIMESTER
Schedule of prenatal visits AFTER THE 8TH MONTH of pregnancy UNTIL DELIVERY
EVERY 2 WEEKS
When should VITAMIN A be given to a pregnant woman?
TWICE A WEEK STARTING ON THE 4TH MONTH OF PREGNANCY
When should IRON be given to a pregnant woman?
EVERYDAY STARTING FROM THE 5TH MONTH OF PREGNANCY UNTIL 2 MONTHS POSTPARTUM
When should NEWBORN SCREENING be performed?
WITHIN 48 HOURS UP TO 2 WEEKS AFTER BIRTH
Schedule of the FIRST Postpartum Visit
WITHIN FIRST WEEK POSTPARTUM
Schedule of the SECOND Postpartum Visit
6 WEEKS POSTPARTUM
AVERAGE CYCLE of menstruation
28 DAYS
Normal blood loss during Menstruation
30-80cc (1/4cup)
Hormone responsible for OVULATION
LUTEINIZING HORMONE
Refers to the number of pregnancies REGARDLESS OF THE OUTCOME
GRAVIDA
Refers to the number of VIABLE (after 24wks) pregnancies DELIVERED whether dead or alive
PARITY
Has been pregnant before but has NEVER GIVEN BIRTH to a VIABLE, or a LIVE INFANT
NULLIPAROUS
Has NEVER been pregnant
NULLIGRAVID
Presumptive, Probable or Positive Sign:
Amenorrhea
PRESUMPTIVE
Presumptive, Probable or Positive Sign:
Fetal Heart Tone
POSITIVE
Presumptive, Probable or Positive Sign:
Fetal Movement felt by EXAMINER
POSTIVE
Presumptive, Probable or Positive Sign:
Fetal Movement by WOMAN
PRESUMPTIVE
R: It could be gas or peristalsis
Presumptive, Probable or Positive Sign:
Nausea and Vomiting
PRESUMPTIVE
Presumptive, Probable or Positive Sign:
Positive Pregnancy Test
PROBABLE
Presumptive, Probable or Positive Sign:
Abdominal Enlargement
PROBABLE
Presumptive, Probable or Positive Sign:
Fatigue
PRESUMPTIVE
Presumptive, Probable or Positive Sign:
Breast Changes
PRESUMPTIVE
Presumptive, Probable or Positive Sign:
Chadwick’s Sign
PROBABLE
Presumptive, Probable or Positive Sign:
Braxton Hick’s Contraction
PROBABLE
Presumptive, Probable or Positive Sign:
Ultrasound
POSITIVE
BLUISH PURPLE discoloration of the vagina
CHADWICK’S SIGN
Softening of the CERVIX
GOODELL’S SIGN
Softening of the lower UTERINE segment
HEGAR’S SIGN
When lower uterine segment is tapped during bimanual examination, the fetus can be FELT TO RISE against abdominal wall
BALLOTTMENT
DARKENING of the skin from symphysis pubis to umbilicus
LINEA NEGRA
Spider-like veins and STRETCH MARKS in the abdomen
STRIAE GRAVIDARUM
What should the pt do prior to Leopold’s Maneuver?
VOID TO EMPTY BLADDER PRIOR TO LEOPOLD’S MANEUVER
POSITION of pt for Leopold’s Maneuver
SUPINE WITH KNEES SLIGHTLY FLEXED
R: Flexing knees relaxes abdominal muscles
Maneuver that determines whether FETAL HEAD or BREECH is in the fundus
FUNDAL GRIP
Maneuver that LOCATES the FETAL BACK
UMBILICAL GRIP
Maneuver that determines if the presenting part is ENGAGED OR NOT
PAWLICK’S GRIP
Maneuver that determines FETAL ATTITUDE and DEGREE OF FLEXION into the pelvis
PELVIC GRIP
Where should you be facing when performing the Pelvic Grip?
NURSE SHOULD BE FACING TOWARDS THE HEAD OF THE MOTHER
A medical disorder characterized by an appetite for substances largely NON-NUTRITIVE and sometimes INEDIBLE
PICA
Term for excessive salivation which can occur during pregnancy
PTYALISM
What causes ptyalism in pregnant women?
INCREASED LEVELS OF ESTROGEN
What should the MANAGEMENT be for a pregnant woman with ptyalism?
PROVIDE HARD CANDIES
What frequently used drugs should NOT be taken during pregnancy?
NSAIDS and ASPIRIN
Diagnostic exam wherein amniotic fluid is withdrawn thru the abdominal wall for analysis
AMNIOCENTESIS
When is Amniocentesis best done?
14-16 WEEKS AGE OF GESTATION OR DURING THE SECOND TRIMESTER
What should you instruct the pt to do PRIOR to amniocentesis?
VOID
NORMAL amount of Amniocentesis
800-1,200ml
Amniotic fluid of LESS THAN 500ml
OLIGOHYDRAMNIOS
Amniotic Fluid of more than 2,000ml
POLYHYDRAMNIOS
GREEN Amniotic Fluid indicates
MECONIUM STAINING
STRONG YELLOW colored Amniotic Fluid suggests
BLOOD INCOMPATIBILITY
An inherited disorder wherein the body is UNABLE TO PROCESS certain protein building blocks (amino acids) properly
MAPLE SYRUP URINE DISEASE
SNOWSTORM appearance upon Ultrasound indicates
HYATIDIFORM MOLE/H MOLE
Psychological Tasks of the Mother (First, Second, or Third Trimester):
Mother should accept that she is PREGNANT;
Concern of mother towards herself is GREATER than concern towards the baby
Mother > Baby
FIRST TRIMESTER
Psychological Tasks of the Mother (First, Second, or Third Trimester):
Acceptance of the PARENTHOOD; Concern for self is LESS THAN concern for baby
Baby > Mother
THIRD TRIMESTER
Psychological Tasks of the Mother (First, Second, or Third Trimester):
Acceptance of the BABY; concern towards self is EQUAL to concern for the baby
MOTHER = BABY
SECOND TRIMESTER
Theories of Pregnancy:
The baby feels that it is already capable of living outside utero
THEORIES OF PARTURITION FETAL SIGN
Theories of Pregnancy:
Receptors for oxytocin in the uterus INCREASES as term approaches
OXYTOCIN THEORY OF PARTURITION
Theories of Pregnancy:
Level of progesterone DECREASES causing contraction of uterus while approaching term
PROGESTERONE WITHDRAWAL THEORY
Theories of Pregnancy:
Prostaglandin STIMULATES uterine contraction
PROSTAGLANDIN THEORY
Type of Pelvis:
“Male pelvis”; HEART SHAPED
ANDROID PELVIS
Type of Pelvis:
“Ape-like” pelvis; OVAL SHAPED
ANTHROPOID PELVIS
Type of Pelvis:
“NORMAL female pelvis”
GYNECOID PELVIS
Type of Pelvis:
“FLATTENED pelvis”
PLATYPELLOID PELVIS
Type of pelvis that is the most suitable BIRTH CANAL
GYNECOID
The use of TAMPON is associated with what condition?
TOXIC SHOCK SYNDROME
Family Planning Method:
Sex 3-4 days BEFORE and AFTER ovulation is considered unsafe
RHYTHM METHOD/CALENDAR METHOD
Family Planning Method:
Daily monitoring of TEMPERATURE to determine beginning if ovulation
BASAL BODY TEMP
When should a woman take her temperature when performing the Basal Body Temperature method?
EVERY MORNING BEFORE GETTING OUT OF BED
Family Planning Method:
Checking the SPINNABARKEIT PROPERTY of cervical mucus
CERVICAL MUCUS METHOD
What is the other term for Cervical Mucus Method?
BILLING’S METHOD
THICK, VISCOUS, NON-STRETCHY cervical mucus indicates that the woman is:
NOT FERTILE (safe)
THIN, WATERY, STRETCHY cervical mucus indicates that the woman is:
FERTILE (unsafe)
Family Planning Method:
BBT + Billing’s Method
SYMPTO-THERMAL METHOD
Family Planning Method:
Principle - lactation SUPPRESSES ovulation
LACTATIONAL AMENORRHEA METHOD
3 Parameters of Lactational Amenorrhea Method:
- EXCLUSIVE BREASTFEEDING
- AMENORRHEIC SINCE DELIVERY OF BABY
- FIRST 6 MONTHS ONLY
What is the term for the Withdrawal Method?
COITUS INTERRUPTUS
What is the difference between COC and POP (Oral Contraceptives)?
COC - Combined Oral Contraceptive (Estrogen + Progesterone)
POP - Progesterone Only Pill
Which type of oral contraceptive is suitable for BREASTFEEDING women?
PROGESTERONE ONLY PILL
How many pills are in a set of oral contraceptives?
21 ACTIVE PILLS + 7 PLACEBO
Before administering a “MORNING AFTER PILL” (Ovral), what should you do?
PRE-MEDICATE WITH METROCLOPRAMIDE
R: Morning after pills may cause SEVERE NAUSEA and VOMITING
How many tablets of Ovral should you take?
4 TABLET
2 TABS (within 72hrs from coitus) 2 TABS (12hrs after)
What component of some contraceptives is CONTRAINDICATED for breastfeeding women?
ESTROGEN!
How many years can a subcutaneous/subdermal implant last?
5 YEARS
How often should an injection of LUNELLE (estro + progesterone) be given?
MONTHLY (30 days)
How often should an injection of DEPOPROVERA (progesterone only) be given?
EVERY 3 MONTHS
A t-shaped device that causes INFLAMMATION and is used as a family planning method
INTRAUTERINE DEVICE
What is the position of a pt during an insertion of an IUD?
LITHOTOMY
How often should you check the string of the IUD?
MONTHLY AFTER MENSTRUATION
A type of IUD that is made of PLASTIC
MIRENA
A type of IUD that is made of COPPER
PARAGUARD
How long does MIRENA last?
5 YEARS
How long does PARAGUARD last?
10 YEARS
What diagnostic test is CONTRAINDICATED if a woman is using a paraguard IUD?
MRI
How long should you wait before REMOVING a diaphragm (rubber disk)?
6 HOURS
For how long can you leave a Diaphragm (rubber disk) inside?
24 HOURS
For how long can you leave a Cervical Cap inside?
48 HOURS
Can a Cervical Cap be reused?
YES IT CAN BE REUSED FOR 3 YEARS
When should you RE-FIT a cervical cap?
WHEN YOU GAIN OR LOSE 15lbs
Hormone of PREGNANCY
PROGESTERONE
FINGER-LIKE structures used to attach the blastocysts to the endometrium
CHORIONIC VILLI
SHINY side of the Placenta
SCHULTZ (Fetal Side)
SCH(iny)ULTZ
DIRTY side of the Placenta
DUNCAN (Maternal Side)
D(irty)UNCAN
3 vessels of the umbilical cord (AVA)
2 UMBILICAL ARTERIES
1 UMBILICAL VEIN
How long is the umbilical cord?
APPROXIMATELY 21 INCHES LONG
Hormone that causes UTERINE CONTRACTION and CERVICAL RIPENING
PROSTAGLANDIN
GRAYISH Amniotic Fluid with odor indicates
INFECTION
Fetal Growth and Development (in weeks):
Complete ORGANOGENESIS
8 WEEKS
Fetal Growth and Development (in weeks):
Age of VIABILITY (able to survive extra uterine life)
24 WEEKS
Fetal Growth and Development (in weeks):
Nervous system
3 WEEKS
Fetal Growth and Development (in weeks):
Fetal Heart Tone via DOPPLER
12 WEEKS
Fetal Growth and Development (in weeks):
Sex determination via ULTRASOUND
Quickening (first movement in MULTIPAROUS woman)
16 WEEKS
Fetal Growth and Development (in weeks):
Fetal Heart Tone via STETHOSCOPE;
Quickening (in PRIMI)
20 WEEKS
Fetal Growth and Development (in weeks):
Subctaneous FAT
32 WEEKS
Fetal Growth and Development (in weeks):
Testes DESCEND to scrotum
36 WEEKS
Fetal Growth and Development (in weeks):
Lung Surfactant
28 WEEKS
Term for UNDESCENDED testes
CRYPTORCHIDISM
Normal Blood Loss in NORMAL VAGINAL DELIVERY
300-400ml
Normal Blood Loss in CESAREAN SECTION
800 to 1000ml
EXCESSIVE vomiting during pregnancy
HYPEREMESIS GRAVIDARUM
Urinary frequency during the FIRST TRIMESTER occurs due to
HORMONAL CHANGES
Urinary frequency during the THIRD TRIMESTER occurs due to
PRESSURE FROM THE UTERUS
“MASK” of Pregnancy
MELASMA/CHLOASMA
Dark vertical line on the abdomen
LINEA NEGRA
Itchiness on the palm due to Estrogen
PALMAR ERYTHERMA
Management for BACKACHE d/t Lordosis
- PELVIC ROCKING EXERCISES
2. TAILOR SITTING
Management for LEG CRAMPS for pregnant women
KNEE EXTENSION + DORSIFLEXION
Management for ANKLE EDEMA
ELEVATE THE LEGS
Management for MORNING SICKNESS
- DRY CRACKERS
- LIMIT FLUID INTAKE IN THE MORNING
- SMALL FREQUENT FEEDINGS
Refers to the settling of the presenting part into the ISCHIAL SPINE
ENGAGEMENT
Refers to the FIRST Fetal Movement
QUICKENING
Prior to an ultrasound, what should you instruct to the pt?
BLADDER MUST BE FULL!!
DRINK 1 GLASS OF WATER EVERY 15mins
POSITION of pt while Amniocentesis is performed
SUPINE
Method used to estimate EXPECTED DATE OF DELIVERY
NAGELE’S RULE
How do you compute the Nagele’s Rule?
Month: -3
Day: +7
What is the LANDMARK when measuring the Fundic Height?
FROM SYMPHYSIS PUBIS TO FUNDUS
Refers to the DESCENT of the baby
LIGHTENING
Normal WEIGHT GAIN in a pregnant woman
25-35 POUNDS
Signs of TRUE LABOR
P-B-R
P - ROGRESSIVE CONTRACTIONS
B - LOODY SHOW
R - UPTURE OF MEMBRANE
IMMEDIATE MGT for Cord Prolapse
- TRENDELENBURG/KNEE-CHEST POSITION
2. COVER THE CORD WITH SALINE SOAKED DRESSING OR STERILE GAUZE
When does the ANTERIOR FONTANELLE close?
12-18 MONTHS
When does the POSTERIOR FONTANELLE close?
2-3 MONTHS
Shape of the Anterior Fontanelle
DIAMOND
Shape of Posterior Fontanelle
TRIANGLE
Phases of Labor:
Onset of true labor to COMPLETE dilatation
DILATATION
Phases of Labor:
Complete dilatation up to expulsion of the baby
EXPULSION
Phases of Labor:
From expulsion of baby to delivery of placenta
PLACENTAL DELIVERY
Phases of Labor:
Postpartum Period
RECOVERY
When positioning the mother in Lithotomy for preparation of delivery, what should you do?
RAISE BOTH LEGS SIMULTANEOUSLY
When should a pregnant woman start PUSHING during delivery of baby?
DURING CONTRACTIONS
Maneuver done by applying pressure on the perineum to PREVENT LACERATION
RITGEN’S MANEUVER
Is it recommended to SUCTION once the baby’s head is out?
NO UNLESS IT IS NECESSARY TO SUCTION
R: Suctioning may cause ABRASION of respiratory tract
Maneuver done by ROLLING the cord to assist placental delivery
BRANDT-ANDREW MANEUVER
3 Phases of Dilatation
LATENT - excited cooperative mother; short contractions
ACTIVE - irritable mother; moderate contractions
TRANSITIONAL - uncontrollable mother; longer contractions
What COMPLICATION occurs due to too much Oxytocin?
TETANIC UTERINE CONTRACTIONS
What should you check PRIOR to clamping the cord?
CHECK IF PULSATION HAS STOPPED
Types of Lochia
RSA
R -UBRA (red)
S - EROSA (pinkish)
A - LBA (whitish)
Management for LACERATION caused by delivery
EPISIORRHAPHY
Management for UTERINE ATONY
OXYTOCIN
Management for RETAINED placental fragments
DILATION AND CURETTAGE
Refers to the RETURN of the uterus to a non-pregnant state
INVOLUTION
Refers to when the uterus does NOT go back to its non-pregnant state
SUBINVOLUTION
Where is the uterine fundus on the day of delivery?
LEVEL OF UMBILICUS then decreases in height one finger breadth everyday
When will the fundus be NON-PALPABLE post partum?
10 DAYS AFTER DELIVERY
Stages of Postpartum Adaptation:
SELF-CENTERED mother
TAKING IN
Stages of Postpartum Adaptation:
BABY CENTERED
TAKING HOLD
Stages of Postpartum Adaptation:
Transition to PARENTHOOD
LETTING GO
Expulsion of the conceptus BEFORE viability (24wks)
ABORTION
PLANNED abortion
ELECTIVE ABORTION
SPONTANEOUS abortion
MISCARRIAGE
Types of Abortion:
Spotting, cramping, NO DILATION
THREATENED ABORTION
Types of Abortion:
INEVITABLE; Bright red vaginal bleeding WITH uterine contraction and cervical dilation
IMMINENT ABORTION
Types of Abortion:
Complete expulsion of conceptus
COMPLETE ABORTION
Types of Abortion:
SOME products of conception have passed in the vagina
INCOMPLETE ABORTION
Types of Abortion:
ABSENCE of Fetal Heart Tones
MISSED ABORTION
Types of Abortion:
Occurrence of THREE OR MORE pregnancies that end in miscarriage before fetal viability
HABITUAL ABORTION
Management for THREATENED ABORTION
- BED REST (24-48hrs)
2. NO SEX FOR TWO WEEKS FROM THE TIME BLEEDING STOPS
Drug of choice for THREATENED ABORTION
TOCOLYTIC - causes uterine relaxation
Drug of choice for IMMINENT, INCOMPLETE, or MISSED ABORTION
OXYTOCIN - to expel remaining cells
Implantation occurs OUTSIDE of the uterus
ECTOPIC PREGNANCY
Most common PREDISPOSING FACTOR for Ectopic Pregnancy
PELVIC INFLAMMATORY DISEASE
TRIAD MANIFESTATIONS of Ectopic Pregnancy
- AMENORRHEA
- VAGINAL BLEEDING OR SPOTTING
- UNILATERAL LOWER ABDOMINAL PAIN OR TENDERNESS
Symptom of Ectopic Pregnancy:
Ecchymosis around the UMBILICUS due to hemoperitoneum
CULLEN’S SIGN
Symptom of Ectopic Pregnancy:
Type of pain felt in the lower abdomen
STABBING KNIFE-LIKE PAIN
Drug used to treat Ectopic Pregnancies SHRINKING and ABSORBING products of conception
METHOTREXATE
Surgical Management for UNRUPTURED Ectopic Pregnancy
SALPINGOTOMY
Surgical Management for RUPTURED Ectopic Pregnancy
SALPINGECTOMY
Abnormal proliferation and then degeneration of TROPHOBLASTIC VILLI
HYATIDIFORM MOLE/GESTATIONAL TROPHOBLASTIC DISEASE
What appearance can be seen thru an ultrasound in a pt with H. Mole?
SNOWSTORM APPEARANCE OR GRAPE-LIKE APPEARANCE
High levels of HCG in H Mole causes what specific symptom?
EXCESSIVE VOMITING
Management for H Mole
DILATATION AND CURETTAGE
What do you INSTRUCT to a pt who has recently been treated for H Mole?
NO PREGNANCY FOR 1 YEAR
Refers to a cervix that dilates PREMATURELY and therefore cannot hold a fetus until term; MOST COMMON CAUSE OF HABITUAL ABORTION
PREMATURE CERVICAL DILATION
FIRST SYMPTOM of Premature Cervical Dilation
“SHOW” (pink-stained vaginal discharge) or INCREASED PELVIC PRESSURE
A procedure wherein a suture is applied to the cervical opening to make the cervix TENSE
MCDONALD’S PROCEDURE
What type of suture is done in the Mcdonald’s Procedure?
PURSE STRING SUTURE
When is the MCDONALD’S PROCEDURE performed?
WHEN PRODUCT OF CONCEPTION IS LESS THAN 12 WEEKS OLD
Procedure wherein a STERILE TAPE is threaded in a purse string manner to achieve a closed cervix
SHIRODKAR/BARTER PROCEDURE
POSITION OF CHOICE for a pt with Premature Cervical Dilation
MODIFIED TRENDELENBURG
If contraction occurs in Premature Cervical Dilation, what drug should you administer?
TOCOLYTIC
PAINLESS with BRIGHT RED BLEEDING condition of pregnancy wherein the placenta is implanted ABNORMALLY in the uterus
PLACENTA PREVIA
POSITION OF CHOICE for a Placenta Previa
SIDE LYING
Can a rectal or pelvic exam be performed when there is PAINLESS bleeding late in the pregnancy?
NO!
EARLY SEPARATION of the placenta prior to delivery of the fetus
ABRUPTIO PLACENTA
Difference between ABRUPTIO PLACENTA and PLACENTA PREVIA
Abruptio Placenta - PAINFUL with HEAVY BLEEDING
Placenta Previa - PAINLESS with BRIGHT RED BLEEDING
What position is CONTRAINDICATED in Abruptio Placenta?
SUPINE! POSITION SHOULD BE LATERAL
R: Avoid supine position to PREVENT PRESSURE on the vena cava
Can you perform an INTERNAL EXAMINATION on a pt with Abruptio Placenta?
NO BECAUSE THIS CAN TRIGGER LABOR
Color of vaginal bleeding in HYATIDIFORM MOLE
DARK RED TO BROWN VAGINAL BLEEDING
Color of vaginal bleeding in PLACENTA PREVIA
BRIGHT RED
Rupture of fetal membranes with loss of amniotic fluid during pregnancy BEFORE 37 WEEKS
PREMATURE RUPTURE OF MEMBRANES
GOLD STANDARD of infection in Premature Rupture of Membrane (PROM)
24 HOURS
If more than 24hrs since ROM, there will be SEPSIS
What COMPLICATIONS should be watched out for in PROM?
INFECTION and CORD PROLAPSE
Medication to HASTEN LUNG MATURITY of fetus in Premature Rupture of Membrane
CORTICOSTEROID (BETAMETHASONE)
What should you NEVER do when there is cord prolapse due to PROM?
NEVER REINSERT THE CORD
What should you IMMEDIATELY do in case cord prolapse occurs due to PROM?
MOISTEN GAUZE WITH NSS AND AND COVER THE CORD
MANAGEMENT for Premature Labor
- BED REST
- IV THERAPY (hydration may stop contractions)
- TOCOLYTIC AGENTS
- COITUS RESTRICTION
Refers to pregnancy that EXCEEDS 42wks
POSTTERM PREGNANCY
MAIN COMPLICATION of Post term Pregnancy
MECONIUM ASPIRATION
Medication given to INITIATE cervical ripening in post term pregnancies
- OXYTOXIN
2. PROSTAGLANDIN GEL or MISOPROSTOL (to initiate cervical ripening)
Labor that is completed in FEWER THAN 3 HOURS
PRECIPITATE LABOR
Types of Breech Delivery:
Baby assumes SITTING POSITION with both BUTTOCKS and FLEXED FEET present to the cervix
COMPLETE
Types of Breech Delivery:
BUTTOCKS alone present to the cervix
FRANK
Types of Breech Delivery:
Either one or both FEET goes outside the vagina
FOOTLING
What is an EXPECTED FINDING in Breech Delivery?
MECONIUM STAINING
A condition in which VASOSPASM occurs during pregnancy in both small and large arteries
PREGNANCY INDUCED HYPERTENSION
CLASSIC SIGNS of Pregnancy Induced Hypertension (PIH)
H-P-E-V
- HYPERTENSION after 20th week AOG
- PROTEINURIA
- EDEMA
- VISION CHANGES
4 General Classifications of PIH
- Gestational Hypertension
- Mild Pre-eclampsia
- Severe Pre-eclampsia
- Eclampsia
Classification of PIH:
ELEVATED Blood Pressure (140/90mmHg)
NO Proteinuria
NO Edema
GESTATIONAL HYPERTENSION
Classification of PIH:
BP: 160/110mmHg
EXTENSIVE Edema
MARKED PROTEINURIA (3+ or 4+)
Epigastric Pain
Thrombocytopenia
SEVERE PRE ECLAMPSIA
Classification of PIH:
BP: 140/90mmHg
(+) PROTEINURIA
(-) EDEMA
MILD PRE ECLAMPSIA
Classification of PIH:
MOST SEVERE classification of PIH
GRAND MAL seizure or COMA occurs
ECLAMPSIA
MAIN GOAL of treatment for SEVERE Pre eclampsia
PREVENTION OF SEIZURE
DRUG OF CHOICE during Severe Pre eclampsia
MAGNESIUM SULFATE (decreases BP)
Recommended DIET to prevent Pre eclampsia
LOW SODIUM DIET
ADDITIONAL DRUGS given to pt experiencing Eclampsia aside from Magnesium Sulfate
FUROSEMIDE (diuretic)
DIGITALIS (digoxin)
Position of pt DURING seizure
TURN PATIENT TO SIDE
R: To promote drainage of saliva
Non-pharmacological Intervention to PREVENT seizure from occurring
PROVIDE A NON STIMULATING ENVIRONMENT (dim room, limit visitors)
What should always be prepared at the bedside of a pt with Eclampsia?
SUCTION MACHINE
HELLP Syndrome stands for
HEMOLYSIS, ELEVATED LIVER ENZYMES, LOW PLATELET (HELLP Syndrome)
CLASSIC MANIFESTATIONS of HELLP Syndrome
- PROTEINURIA
- EDEMA
- RIGHT UPPER QUADRANT TENDERNESS (due to inflammation of liver)
MANAGEMENT to correct LOW PLATELET in HELLP Syndrome
TRANSFUSION OF FRESH FROZEN PLASMA OR PLATELETS
Can EPIDURAL ANESTHESIA be done on a pt with HELLP Syndrome?
NO!
R: Low platelet count may increase possibility of BLEEDING at epidural site
A condition of abnormal GLUCOSE METABOLISM that arises during pregnancy
GESTATIONAL DIABETES MELLITUS
DIAGNOSTIC PROCEDURE to check for Gestational Diabetes Mellitus in a pregnant woman
50-g ORAL GLUCOSE CHALLENGE TEST
Management for Gestational Diabetes Mellitus
- DAILY CALORIE INTAKE OF ONLY 1,800 to 2,000kcal/day
- NO SIMPLE SUGARS AND SATURATED FATS
- EXERCISE
Why are ORAL HYPOGLYCEMIC AGENTS contraindicated for pregnant women?
IT IS TERATOGENIC
Instead of Oral Hypoglycemic Agents, what should be done to control GDM?
INSULIN THERAPY
MOST RELIABLE indicator of Fetal well-being
FHR VARIABILITY
FOUR RESPONSES of FHR Variability
A-E-L-V
- ACCELERATIONS
- EARLY DECELERATION
- LATE DECELERATION
- VARIABLE DECELERATION
Four Responses of Variability:
Temporary NORMAL INCREASES in FHR due to fetal movement, change in maternal position, administration of analgesic
ACCELERATIONS
Four Responses of Variability:
BEGINS and ENDS with contractions; occurs LATE in labor
Due to FETAL HEAD COMPRESSION
EARLY DECELERATION
Four Responses of Variability:
Has an UNPREDICTABLE occurrence;
May be due to FETAL CORD COMPRESSION
VARIABLE DECELERATION
Four Responses of Variability:
DELAYED until 30 to 40seconds AFTER the onset of contraction and continues beyond the end of contraction
UTEROPLACENTAL INSUFFICIENCY is present
LATE DECELERATION
Management for LATE DECELERATION
- STOP OR SLOW OXYTOCIN ADMINISTRATION
2. CHANGE POSITION TO LEFT SIDE LYING (Lateral)
If Late Decelerations PERSISTS or becomes ABNORMAL (absent or decreased), what should you do?
PREPARE FOR POSSIBLE PROMPT BIRTH OF INFANT
Management for VARIABLE DECELERATION
- POSITION LATERALLY OR ON TRENDELENBURG to relieve pressure on cord
VARIABLE DECELERATION = FETAL CORD COMPRESSION
Normal odor of Lochia
MUSTY
Foul smell = Infection
MOST COMMON CAUSE of Early Postpartum Hemorrhage
UTERINE ATONY (soft boggy uterus)
Pain upon DORSIFLEXION of foot on Postpartum pts indicate
(+) HOMAN’S SIGN = THROMBOPHLEBITIS
Management for THROMBOPHLEBITIS
- ANTIBIOTICS
2. ANTICOAGULANT: HEPARIN
ANTIDOTE for Heparin
PROTAMINE SULFATE
