The High Risk Pregnancy And/or Delivery Flashcards
Medical management during ectopic pregnancy if patient is stable
Methotrexate
What is important to remember when administering methotrexate for ectopic treatment ?
Appropiate PPE (double glove)
Verify pt name , med and dosage w another nurse
Do not expel air from the syringe
How long is urine considered toxic for methotrexate ?
72 hours- so avoid getting urine on toilet sear and flush toilet twice w lid closed after voiding
Adverse effects of methotrexate
N&V
& transient abdominal pain
What should a pt refrain from when taking methotrexate ?
Drinking alcohol , taking vitamins w folic acid, using NSADIS, and avoid sunlight
For a mom with placenta previa that is stable with no fetal compromise. What can be given in order to speed up maturation of fetal lungs?
Corticosteroids
With someone who has gestational trophoblastic disease - what can be given IF hcg levels rise which indicate possible malignancy?
Methotrexate
What can be given for home management of a mom and fetus who is stable w placenta previa?
Corticosteroids for their lungs
C section prep for total or partial previa for heavy bleeding or deterioration of mother/fetus
Additional help (people)
Large bore 18g and consider second IV line
Blood on stand by or immediately available
NICU Team for baby
Conservative management if mild and fetus is <34 wks no sign of distress
Bed rest
Possible admin of tocolytic to reduce uterine activity
Corticosteroids to accelerate fetal lung maturity
Rogam for RH neg women
DIC causes
Placental abruption or prolonged retention of dead fetus
Condition characterized by endothelial damage
Severe preeclampsia and HELLP syndrome
Maternal sepsis
Amniotic fluid
Primary sources of iron
Meat, fish, chicken, liver, green leafy vegetables
Who should come into contact it’s varicella zoster virus t the hospital and what precautions are they on
Only immune stuff should come into contact with these patients
Airborne/contact
13- 20 wk gestation effect from varicella zoster virus
Limb hypoplasia
Cutaneous scars
Chorirentinits
Cataracts
Microcephalic
IUGR
5-2 days before birth effect from varicella zoster virus
Life threatening varicella infection congenital varicella syndrome
Group b strep positive test treatments
Cephazolin or penicillin 2 before birth
Clindamycin every 8 hours so at least 1 before birth
What is important to treat when a mom gets diagnosed with chorioamnionitis
Keep the fever down , babies heart rate will be high during fever so it will decrease once moms fever goes down
What is the issue with giving corticosteroids while mom has chorioamnioitis
Mom already has a count greater than 15,000 without it so if we give it then the WBC will be higher and its harder to track if infection is getting worse or not.
Why is antibiotic therapy good before or after birth when infection chorioamnioitis is identified?
Helps to prevent mom from getting endometritis
What are moms with GBS or STD at risk for
PROM
Risk for prolapse cord
What can be given to a mom with PROM who is less than 36 weeks
Corticosteroids, short term tocolytics, antibiotics to prevent infection ( 7 day course)
When a pt test negative for fetal fibronetin test
Pt has 1% chance of delivering in the next two weeks
What do we administer to moms who are coming in with signs of preterm labor
IV fluids and encourage hydration but we do have to watch out for fluid over load ( maternal resp distress - pulmonary edema)
What can delay pre term birth
Tocolytics
