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21 Cards in this Set
- Front
- Back
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What is hyperemesis Gravidarum?
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Excessive vomiting in 1st trimester (but more seen after the 1st trimester) that leads to dehydration, alkalosis, starvation & ultimately death of the mother and fetus
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What is the treatment for hyperemesis gravidarum?
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NPO, IV hydration, Gradual diet change, TPN if necessary (central line)
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What is a placenta previa?
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Placenta at the base of uterus. If completely unconnected then is placenta abruptio. Can cause a decrease in O2 for the baby. Painless bleeding. Pt must be c-sectioned.
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What are the predisposing factors for placenta previa?
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Prior hx of PP, multiple pregnancies, History of multiple births because of multiple implantation., Prior uterine scars because placenta will not implant on scar tissue.
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What are the symptoms of placenta previa?
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Sudden, painless vaginal bleeding that may occur near the end of 2nd trimester or beginning of 3rd. Bleeding may be hemorrhagic. The bleeding may stop but start again later.
There may be uterine cramping with the bleeding. Labor sometimes starts within several days after heavy vaginal bleeding. However, in some cases, bleeding may not occur until after labor starts |
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What are the nursing responsibilities for a patient with placenta previa?
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Bed rest, Monitor blood loss (pad count), Daily Non-stress tests., Perineal care, Education regarding signs and symptoms of labor, Emotional support
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What is placenta abruptio?
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Premature separation of the placenta. Emergency - it cuts the baby's O2 and nutrients. May be related to trauma to the abdomen.
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What are the symptoms of placenta abruptio?
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Dark venous blood. **Severe pain with bleeding, Abdomen rigid, hard, Sudden onset
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What are the nursing responsibilities for a patient with placenta abruptio?
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Prepare for an emergency C-Section, Check for Fetal heart sounds, No vaginal exam !!
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Brethine / Terbutaline complications:
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tachycardia. Antidote: Propanolol (beta blocker)
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What is PIH?
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Pregnancy Induced Hypertension - An incr in SBP > 30 mm/hg or an incr in DBP > 15 on at least 2 ocassions > six hours apart. There are two categories: Pre-eclampsia and eclampsia
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What are the characteristics of Mild Pre-Eclampsia?
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Seizure Management – Mg SO4, Safety Precautions – Padded tongue blade above bed, padded side rails., Get the baby out, Put pt on Mg SO4 – does on decrease BP, but stops seizure activity., After delivery, the pt can be on Mg SO4 for up to 24-48 hours., NEVER GIVE DIURETICS when pregnant and retaining fluids, Use position changes to increase urination, Give high protein diet (due to protein loss in urine), Reduce stimulation (lights, noise), to decrease seizure possibility, I/O, May give meds to decrease HTN
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What are the characteristics of eclampsia?
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Convulsions, Coma, More protein in the urine 1+, Edema – can lead to edema in the brain, s/s – epigastric pain (referred pain from the liver), An increase in reflexes.
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Postpartum Vital Signs
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"-HR: 50-60 is normal as large amounts of blood return to the maternal circulation after the placenta is born
-B/P: hypotension may indicate a hemorrhage -Resp: 16-20 -Temp: 100.4 is common during the first 24 hours after birth |
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Newborn VS
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"-Temp:
*Axillary: 97.7 - 99.5 *Rectal: 97.7 - 99.7 -HR: 120-160 -Resp: 30-60 -BG: 40-45" |
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Nutritional Needs of Lactating Mother
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-Calories: 2700 (500 more calories than were being consumed before pregnancy)
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Expected blood loss during childbirth (vaginal, CS)
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"-Vaginal Birth: 500-700cc
-C-section: 1000cc" |
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Physiologic Jaundice
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"-Occurs when bilirubin reaches 5-7
-Never present during the first 24 hours of life -Appears on the second or third day -Nomral in newborns -Levels begin to fall about a week after birth -Photo therapy may be used |
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Pathologic Jaundice
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-Occurs during the 1st 24 hrs of life
-bilirubin level > 1 or a total bilirubin that incr by > than 5 per day or is higher than 12 or persists after the second week -Due to abnormalities causing excessive destruction of R |
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Reflexes of newborn
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-Moro: allow head & trunk of baby to fall backward (arms & legs should extend & abduct
-Palmer grasp: when baby's hand is touched at the base of the fingers the hand closes into a tight fist -Plantar grasp: same as above except on touch |
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brethine / terbualine is:
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a bronchodilator primarily for asthma, but has been used to relax the uterine muscles
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