Ob Test 2 Review Flashcards
Postpartum hemorrhage
Causes are Uterine atony. Laceration. Hematoma retained placenta. Previous history. Placent précia Abruptio. Over distention large fat infants. Multiple GE infecting.
Depending on the cause. If it’s early. Massage the fundus. Bladder emptying. Give antibiotics. D C
Infants
of
Diabetic
mothers
–
scope
of
problem
in
a
nutshell
Newborns priority … Hypoglemecia. Resp distress. Hypocalemja. anomalies. They are fat and jittery.
Watch for hypoglycemia.
Resp distress
Thermo regulations. Feed the babe right away.
Characters on IBM
Characters on IBM
Prenatal drug exposure and
NAS; s/s,mgmt., nursing considerations, assessments andinterventions
Constant crying. Irritated. Overly sensitive. Hyperextension.
FAs. Fetal alcohol syndrome. •••••Abnormal Palmer creases. •••
Hypotonia. Irritably. Poor sucking.
Priority intervention. Monitor weight gains and feeding.
Swaddled babe. Avoid over stimulation Feed the babe
PKU s/s,
mgmt.,
nursingconsiderations
PKU is managed by diety.
Explain the most common
causes of early PPH,predisposing factors and management paying attention to priorities of care
Early sign. Increased pulse rate. Like from 88 to 120.
Caused by atony….
Massage fundus.
Empty bladder.
Usually distended stomach. More preg big babe.
Review
med
cards
r/t
hemorrhage
Med cards
Explain the
most common
causes of
Late
PPH,
predisposing
factors
and
mgmt.
of
Late pph are cAuded by infection. Or placenta retention.
Remove parts
Treat infection. Give antibiotics.
Give fluids. Promote rest.
Review hypovolemic
shock you should
know this from
M/S)
Hypovolemia shock first sign is tachycardia. Blood pressure follows. Decreased. Decreased urine output.
Replace fluids. Look for hemtomas or laceration. Monitor the lochia.
Different hemorrhage
Different hemorrhage
Subinvolution
Caused by retained parts. Over distention of uterine.
Thrombobletis thrombus
Check for homan’s sign. By dosflexing her feet forward.
Priority. Give oxygen. Bed rest
….But walk patient before. …..
Raise legs.
Table 29
Table 28
Endometritis
Abnormal cramping. Meds to give. Give pain medications first. Then antibiotics. Then stool softener and prenatal vitamins.
Hand washing is important
UTI. Mastitis
Uti…..no food to Increase. Alkalinity. Drink water. Pee. Medicine.
mastitis: continue breast feeding babe. Contact doc. Use antibiotics until dose is over. Warm compressions. Rest. Fluids I take. A void underwire bras. Wear supportive bra. Rest during acute phase. Hand washing. No use of soap on Breast.
Post depression.
Howcommon
is it? What
are riskfactors/predisposing
factors? s/s Impact
on family Mgmt.Nursing
care
for
Post depression.
Past 2 weeks. Not normal. Get help right away
Attend groups.
Shows less interes in srounding. Los of emotional. Unable to show love pleasure.
Differentiate
from Postpartum
Psychosis
and baby
blues Review Baby
Blues page
456
Psychosis and baby blues
Blues. Cry easily. Let them know it’s okay. Not excited. Not sleeping. It’s normal. Encourage them to rest wen baby sleeps. Accept help from others.
Psychosis. Drown children. Get crazy. Smother children.
Late Preterm babies who are they? What is risk for? List characteristics of Mgmt. Nursing assessment and care of common problems
Late preterm 34 to 37 weeks. Have more issues with Resp.
Preterm
infants vs LBW, VLBW, ELBW)
Scope of the problem Common causes Prevention Characterestics of PT. ingants Appearance,behavior
Signs. Lower abd cramping. Dull lower back pain. Pressure. Heaviness. Urinary frequ
Respiration
(nursing
interventions/mgmt.)
Respi in preterm
Therm reg in preterm
Temp
Fluids and electro control in preterm
Ff
Infection rubella.
1 rubella. You can breast feed even if u have vaccine. Don’t get preg. Avoid immunocompr people.
Skin
Skin
Pain
Pain
Stress in preterm a
Stress in preterm
Nutrition in preterms
Nitro
Respiratory distress syndrome. RDS
Tachpnea and retraction.
ROP
Rop
Ivh
Ivh
Nec
Nec
Post term
Post term
Ressucitayion steps
Venting
TTN
Ttn
MAS
MAS
Hyperbilirubinemia
–
risk
factors,
etiology,
mgmt.,
differentiate
pathologic
vs
physiologic;
caring
for
the
newborn
with
hyperbili
Breast feed babe 2-3 hours. Jaundance. Care during phototherapy. -monitor skin temp Reposition closely. Clver eyes with patches.
Monitoe for dehydration. Sensory depri.
Sepsis Sepsis
Neonatorum
–
s/s
in
newborn;
mgmt.,
table
30-
1
Sepsis
Review
Table
26-
1
and
nursing
careplan
26
Psyic
Pysic
Preterm labor.
Hydrate the mom. Complaining of pressure.
Caused by incompetent cervix
Uti
Bed rest. Fluid hydration. Order get mgso4. Procardia. Turbuterine. Niphedopine.
Prenatal. And regular prenatal care. Preconceptions care.
Risk for PTL. History of medical conditions. Multifetla preg. Anemia. 18 or 45 years.
Gbs
Strep
Gdm gestational Diabetes mellitus.
140 or higher first time elevated glucose.1hr test. Do another test ….. Aka Take further assessment/ testing .
On the second or third time if he glucose is elevated then it’s GDM. Just elevated blood glucose level.
Teaching.
Exercise. Diety modification. Diabetic diet. Glucose monitoring. Sings of infections.
Eclampsia
Seizures. Proteins. And hypertension.
Preeclampsia
S/s. Protein,Hypertenstion. Edema.
Worsening precl s/s ••• headache and blurred vision. Notify the physician.
Worsening preeclampsia causes bleeding in gums, petechia and purpura or DIC.
Pré existing diabetes
Diabetes
Amniotomy Procedure: How is it performed Amniotomy
Need a consent.
It is the artificial rupture of membrane. To induce labor. And urgenment labor.
It increase efficiency of contractions.
Before and after amiotomy •••assess fetal heart patten. ••••
Review patho of DM. What
are the effects of pregnancy on fuel metabolism? Early Pregnancy vs Late pregnancy. Understand the classifications of diabetes.
Values higher than 140 are consider GDM. First time. Tell patient values are high further testing is needed
Diabetes 1 … Insulin needs decrease in first 3 months because of increased insulin production. Therefore the patient will be hypoglycemic but patient does not increase the insulin dose because she will have enough insulin produced and used. Then increase need in the 2,3 semister.
Pitocin
Uterine hypersensitive should discontinue pitocin.
Repeative decelation. Discontiue pitocin.
Lay woman on the side.
Methegrine
Bp
Labor Induction and Augmentation
Labor
Cervical Ripening
Cervical ripe
External or Internal Version
Intern or exter
Operative device
Operative
Lung maturity in ptl
Lung maturity in ptl
Prolonged Pregnancy Complications
Mom/BabyMgmNursing
ConsiderationsNursing
Considerations
Prolonged preg
Prolapsed code
First nursing action.
Hips higher than head. Trendelenburg positions.
Uterine ruptur
Uterine ruptur
Trauma to a pregnant
woman….nursing
care
Priority is to rule out placenta Abruptio. It increase risk of miscarriage. Preterm and still Births. Evaluate mother and fetus.
Abnormal duration
Abnormal duration
Prolonged labore
Prolonged labor
Uterine infection.
For any infection. Hand washing is the key.
Premature rupture of membrane.
PROM
Question this. … Vaginal exams. No vaginal exams should be done. Increase risk for infection.
Monitor fetal heart rage. Mother vitals. Admin antibiotics.
Passanger
Passanger
Powers
Babe
Passage
Vagina
Prévia
Painless bright red vaginal bleeding. Soft relaxed no tender uterine. Fundal height might be larger than expected.
Placenta in lower uterine segment.
Low line placenta. Don’t bleed too mcuh.
No Manuel pelvic exams. They are contraindicated.
Pelvic rest. This is priority. Nothing in the vagina. No lifting big heavy things. Monitor the mom. Ultra sounds
Not cervix exam. Get ultra sound exam. Lay down mosty.
Hypovolemic. Get in IV for fluids.
More at risk for hemorrhage.
Abrupto placenta.
Painful and results in rigid and •••uterine tenderness ••••
Construction of vessles. Mostly caused by cocain.
High contraction with high resting tone
Late deceleration. Emergency situation. Call doctor. prepare the lady for c section. .
Should anticipate prescription of. Delivery of the baby.
Control bleeding. Deliver baby.
Overwied children. Over 4000 grams risk for
Hypoglycemia.
Clavicle fracture.
Comgeni defect.
Asphyxia
Trophoblast. Molar preg
Follow up interval. Cause cancer.
Mag sulfate.
Given due to preeclampsia. Look for rep rate of 10 or low as sign of toxicity. Loss of deep tendon reflex. Declaim heart rate of both. Irine out of 30 or less.
It is IV. Assess central nervous system. Urine out put. Reps Loc Tendon reflexes. For contractions. Colonus. Don't check if it's for contraction. Positive shows hyperactive brain about to seize. Check for Colonus. If for seizure. They see sports.
Varicose veins.
Wear panty hose. Support hose. Flat. Nonslip shoes. Do not wear upper knee high hose.
Hemorrhoids.
Avoid straining.
Place them in rectum
Use cold. Not hot. But cold. Packs of ice.•••••••Never warm or hot or heat ••••••
Threatened abortion.
Care. Watch for evidence of passing Tissue.
Count pads used.
Avoid sex.
…Strict bed rest is not required for the reminder of the pregnacy.
C section watch out.
Fetal heart should be in Normal range. 130 to 160.
If high or low. Contact provider. Possible distress of child.
Place patient in supine with a wegde under right hip after c section.
Notify provider if fever developed
Then on side and push up with arms to get out of bed.
Don’t life anything heaver than new born.
No abdominal excerise.
Most important. Give oxygen wen proving care for patient about to get c section.
Temp of 1004.
Before and after 24 hours.
Before it’s dehydration. Hydrate mother.
After is infection.
Episiotomy.
Priority. Is client pain level. A
Hematoma.
Sign. Is change in vital signs. Hypovolemia.
Apply ice reduce swelling. This is an action.
Transvaginal ultrasound sonography. D
Prob inserted in vagina. Covered with condom gel
Dysfunctional labor.
Dystocia. Difficult labor prolonged. Painful anexpwcted
Persistant non reassuring fetal heart rate.
Hypertonic contractions. Care. …..
Priority ….Provide pain relief.
Dystocia priority. Monitor fetal heat rate.
Methegrine.
Watch Bp. Treat post par hem.
Cause contraction.
Contraindicated in preeclampsia. Eclampsia and hypertension. Heart diesese. Pvd.
Ablrtiom.
Threatened. No dilation in cervix.
Inevitable. Dialation.
Incomplete. A large clot is passed.
Missed. Intact but dead.
Complete. Nothing inside.
Spontebous Abortion. Risk due to syphilis.
Drug addict babies.
Have exargerates reflex. Increased muscle tone.littke sleep.
Oxytocin contraindicated in
Positive stress test.
Jaundice before 6hr or 24
Is not normal. If noted get orders for buli levels.
