Midterm Textbook Notes

Question 1

Describe monitoring of FHR/Contractions/Maternal VS after oxytocin admin

Answer 1

FHR:
Q15 minutes and with every change in dose during the first stage of labour
Q5 minutes during the active pushing phase of the second stage of labour.

Contractions
• Q15 minutes and with every change in dose during the first stage of labour
Q5 minutes during the second stage of labour

Maternal VS
• Monitor blood pressure, pulse, and respirations every 30 to 60 minutes and with every change in dose.

Question 2

Describe emergency measures with oxytocin admin

Answer 2

• dc oxytocin and notify MD
  • Turn patient onto lateral position.
  • Give IV bolus or O2 for maternal hypovolemia/hypoxia (if uterine rupture)
  • give nitroglycerin to decrease uterine activity.
  • Continue monitoring fetal heart rate and pattern and uterine activity.

Question 3

What does the bishop score measure (5)

Answer 3

Dilation
Effacement
Station
Cervical consistency (firmness)
Cervical position (anterior/posterior)

Question 4

What are maternal contraindications to tocolysis

Answer 4

Severe preeclampsia or severe gestational hypertension

Significant vaginal bleeding

Intrauterine infection (chorioamnionitis)

Cardiac disease

Medical or obstetrical condition that contraindicates continuation of pregnancy

Question 5

What are fetal contraindications to tocolysis

Answer 5

Gestational age of 37 weeks or more
Fetal demise
Lethal fetal anomaly
Evidence of acute or chronic fetal compromise

Question 6

What routes can glucocorticoids be given?

Answer 6

ONLY IM

Question 7

What is one nursing consideration with admin of glucocorticoids

Answer 7

Assess blood glucose levels. Pregnant patients with diabetes whose blood
sugar levels have previously been well controlled may require increased
insulin doses for several davs.

Question 8

Describe how lateral positioning of the mother can turn fetus

Answer 8

Facilitates internal rotation of fetus in a posterior position to an anterior posi-
tion (patient should lie on same side as fetal spine)

Question 9

Describe how hands and knees position of the mother can turn fetus

Answer 9

Turn from OP to OA position

Question 10

Which tendon reflexes are normal/slow/fast

Answer 10

Normal: +2
Slow: <2
Fast: >2

Question 11

Describe role of estrogen in the body

Answer 11

Inhibits secretion of FSH and LH

causes fat to deposit in subcutaneous tissues over the maternal abdomen, back, and upper thighs;

promotes enlargement of genitals, uterus, and breasts;

increases vascularity;

relaxes pelvic ligaments and joints;

interferes with folic acid metabolism;

increases level of total body
proteins;

promotes retention of sodium and water;

decreases secretion of hydrochloric
acid and pepsin;

decreases mother’s ability to use insulin

Question 12

Describe role of progesterone in pregnancy

Answer 12

Suppresses secretion of FSH and LH by the anterior pituitary;

maintains pregnancy by
relaxing smooth muscles, decreasing uterine contractility;

causes fat to deposit in subcutaneous tissues over the maternal abdomen, back, and upper thighs;

decreases person’s ability to use insulin

Question 13

DIC - description

Answer 13

Pathological clotting causing widespread internal and external bleeding - always triggered by a primary condition

Question 14

DIC - main concern

Answer 14

Decreased clotting factors
Hemorrhage

Question 15

DIC - Clinical manifestations

Answer 15

Signs of bleeding (gums, nose, petechiae, long bleeding time, hematuria, GI bleeds)

Tachycardia
Diaphoresis

Abnormal labs

Question 16

DIC - nursing care

Answer 16

Correct underlying cause (always a result of another disorder) e.g. pre-eclampsia, placental abruption.

See DIC flashcards

Question 17

Hyperemesis gravidarum - common treatments

Answer 17

IV therapy if no oral intake
Antiemetics, antacids, nutritional supplements

See hyperemesis gravidarum flashcards

Question 18

Which antiemetic is most commonly used in pregnancy

Answer 18

Diclectin