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241 Cards in this Set
- Front
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label of a high risk pregnancy may result in
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increased send of the vulnerability, stress related to diagnoses, ambivalence regarding the pregnancy, inability to accomplish the tasks of parenthood, and fearful for well being of the mother |
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Daily fetal movement count
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once a day for 60 minutes, 2 to 3 times daily for 2 hours or until 10 movements are counted, or 10 movements in a 12 hours period |
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indications for ultrasonography |
fetal heart rate activity, gestational age, fetal growth, fetal anatomy, fetal genetic disorders, placental position and function, adjunct to other invasive test |
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indications for MRI |
fetal structure and growth, placenta (position, density, and presence of gestational trophoblastic disease), quantity of amniotic fluid, maternal structures (uterus, cervix, adnexa, and pelvis, biochemical status of tissues and organs, soft tissue, metabolic, or functional abnomalies |
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Maternal complications of an Amniocentesis
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hemorrhage, fetomaternal hemorrhage, infection, labor, abruption placentae, damage to intestine or bladder, amniotic fluid embolism |
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fetal complications of an amniocentesis
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death, hemorrhage, infection, injury from needle, risks may be minimized by using ultrasound to direct the procedure |
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indications for use of an amniocentesis |
genetic concerns ( women over 35, family history of chromosomal abnormalities), fetal maturity (L/S and S/A ratios for lung maturity), fetal hemolytic disease |
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Chorionic villus sampling (CVS) |
earlier diagnosis and rapid results, performed between 10 and 13 weeks, removal of small tissue specimen from fetal portion of placenta (chorionic villi originate in zygote, tissue reflects genetic makeup of fetus) |
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Percutaneous umbilical cord sampling (PUBS) or cordocentesis |
direct access to fetal circulation, insertion of needle directly into the fetal umbilical vessel under ultrasound guidance |
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Alpha Fetoprotein |
maternal serum levels screened for neural tube defects (spina bifida) 80 to 85% of open NTDs and abdominal wall defects can be detected, recommended for all pregnant women |
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Multiple marker screens
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detects chromosomal abnormalities, increased risk for trisomy 21 (downs syndrome) |
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Coombs Test
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test for Rh incompability, detects other antibodies for incompatibility with maternal antigens
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Cell free DNA in maternal blood
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noninvasive, fetal Rh status, fetal gender, and paternally transmitted single gene disorders |
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indications for antepartal electronic fetal monitoring |
to determine if the intrauterine environment is supportive of the fetus |
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antepartal contraction stress test |
nipple stimulated contraction test, oxytocin stimulated contraction test, provides a warning of fetal compromise earlier then NST |
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Nurses role in the antepartal assessment |
education, support person, assist physician with procedures, perform non stress test, contraction stress test, BPPs, initial assessment |
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Diabetes mellitus can be successfully managed by |
a multidisciplinary approach, key is to an optimal outcome is strict glucose control |
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diabetes may be caused by either or both: |
impaired insulin secretion, inadequate insulin action in target tissues |
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gestational diabetes |
is any degree of glucose intolerance with onset or recognition during pregnancy |
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pre gestational diabetes |
occurs in women who have pre existing disease, complicated by vascular disease, retinopathy, or nephropathy |
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maternal risks with pregestational diabetes
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macrosomia, polyhydraminos, ketoacidosis, hyper/hypoglycemia
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fetal and neonatal risks with pre gestational diabetes
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sudden and unexplained stillbirth, congenital malformations, and other problems that cause significant neonatal morbidity |
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Antepartum care for pre gestational diabetes
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diet and exercise, insulin therapy, monitoring glucose levels, urine testing, determination of birth date and mode of delivery, complications requiring hospitalization, fetal surveillance |
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intrapartum care for pre gestational diabetes
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monitor patient closely, may require a c section |
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postpartum care for pre gestational diabetes |
insulin requirements decrease substantially, encourage breastfeeding, conception |
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intrapartum blood glucose recommendation |
75-120 |
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hyperthyroid signs and symptoms |
heat intolerance, diaphoresis, fatigue, anxiety, emotional liability, tachycardia and weight loss, goiter |
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risks with hyperthyroid |
pre eclampsia and heart failure |
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treatment for hyperthyroid |
propylthiouracil (PTU), and Methimazole (MM) |
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hypothyroid |
if untreated at risk for infertility and miscarriage |
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Maternal Phenylketoneuria (PKU)
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recognized cause of mental retardation caused by deficiency in enzyme phenylalanine hydrolase, toxic accumulation of phenylalanine in blood interferes with brain development and function |
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fetal risk with PKU
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microcephaly, cognitive impairment, congenital heart defects |
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what to avoid with PKU
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breast feeding due to high phenylalanine level in breast milk |
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major cardiovascular changes during pregnancy that affect women with cardiac disease are:
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increased intravascular volume, decreased systemic vascular resistance, cardiac output changes during labor and birth, intravascular volume changes that occur just after childbirth |
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signs of cardiac decompensation
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generalized edema, crackles in the lung bases, pulse irregularity |
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congenital cardiac disease
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atrial septal defect, ventricular septal defect, coarctation of the aorta, and tetralogy of Fallot
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Acquired cardiac disease
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mitral valve prolapse, mitral valve stenosis, aortic stenosis |
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maternal heart transplant considerations before pregnancy |
must be assess for quality of ventricular function and potential rejection of transplant, and conception should be postponed for 1 year after transplant |
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asthma
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at increased risk for postpartum hemorrhage |
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cystic fibrosis
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infants of mothers with cystic fibrosis will be carriers of the gene, with severe disease pregnancy is often complicated by chronic hypoxia and frequent pulmonary infections, exocrine glands produce excessive viscous secretions, problems with respiratory and digestive systems
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integumentary disorders induced by pregnancy
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melisma, vascular spiders, palmar erythema, striae gravidarum
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skin problems aggravated by pregnancy
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acne vulgaris (in the first trimester), pruritic urticarial papules and plaques, intrahepatic cholestasis |
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multiple sclerosis |
bed rest and steroids to treat acute exacerbations |
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Systemic lupus erythematosus |
immunosuppressive medications are not recommended during pregnancy, glucocorticoids used instead, efforts aimed at reducing risk of infection |
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Myasthenia gravis |
women generally tolerate labor well, may require forceps or vacuum during delivery |
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breastfeeding definitely contraindicated in women who continue to use |
amphetamines, alcohol, cocaine, heroin, and marijuana |
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before discharge of a mother with substance abuse: |
the home must be assessed for safe environment, someone to meet infants need if mother is unable to, family members or friends should become actively involved with mother before discharge, IF MOM IS POSITIVE FOR DRUGS IN LABOR, CASE WILL BE REFERRED TO CPS |
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gestational hypertension
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onset of hypertension without proteinuria after the 20th week |
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preeclampsia
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pregnancy specific condition, hypertension and proteinuria develops after 20 weeks in previously normotensive women, a vasospastic systemic disorder categorized as mild or severe |
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eclampsia |
seizure activity or coma in woman diagnosed with preeclampsia, no history or pre existing pathology, eclamptic seizures can occur before, during or after birth |
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high risk factors for preeclampsia
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family history, multifetal pregnancy, African American race, obesity, before 19 and after 40 years old, pre existing medical or genetic conditions |
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pathophysiology of preeclampsia |
mild to severe, caused by disruptions in placenta perfusion and endothelial cell dysfunction, placental itching, generalized vasospasm, reduced kidney perfusion |
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HEELP syndrome |
hemolysis (H), elevated liver enzymes (EL) low platelets (LP) |
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those associated with high risk for HELLP syndrome |
pulmonary edema, renal failure, liver hemorrhage or failure, DIC, placental abruption, acute respiratory distress syndrome, sepsis, stroke, fetal and maternal death
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physical exam findings with preeclampsia
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dependent edema, pitting edema, deep tendon reflexes, clonus |
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lab test for preeclampsia
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proteinuria |
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intrapartum care for severe gestational hypertension and severe preeclampsia |
magnesium sulfate, toxicity causes cardiac and respiratory distress, administer calcium gluconate or calcium chloride it overdosed, control BP, future health care |
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care and implementation of eclampsia
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immediate care, nursing action during a convulsion, postpartum nursing care. Prevention prenatal care for assessment and early interventions |
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chronic hypertension is associated with increased incidence
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placental abruption, superimposed preeclampsia, increased perinatal mortality, fetal effects ( growth restriction, preterm birth) |
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Antihypertensive drugs found in breast milk
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methylodopa or labetolol are the choices for women needing medication for hypertension and wishing to breastfeed |
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hyperemesis gravidarum
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excessive vomiting accompanied by dehydration, electrolyte imbalance, ketosis, and acetonuria, decrease sodium decreased potassium, put on B6, paroxetine, reglen, Zofran Category A- Diglecius |
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signs and symptoms of miscarriage |
painful cramping, bleeding |
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prior to 20 weeks of gestation a miscarriage is considered |
spontaneous abortion |
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ectopic pregnancy |
is the leading cause of fertility in the US, 95% occur in the fallopian tube, most located on ampulla, other sites include ovary, abdominal cavity, cervix |
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signs and symptoms of ectopic pregnancy |
abdominal pain, delayed menses, abnormal vaginal bleeding, cullens sign |
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testing for ectopic pregnancy |
elevated hCG, transvaginal ultrasound |
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hydatidadiform mole |
cause unknown, abnormal fertilization without a viable fetus (just a sac contents) |
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signs an symptoms of hydatidiform mole
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vaginal bleeding, significantly larger uterue |
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management of hydatidiform mole
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most pass spontaneously, suction curettage is safe, rapid and effective, induction of labor with oxytocin or prostaglandins not recommended |
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risk for placenta previa |
advanced maternal age, multiparity, smoking, living at higher altitudes |
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clinical manifestation of placenta previa |
painless bright red vaginal bleeding |
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risk for premature separation of placenta
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maternal hypertension, cocaine usage, trauma, smoking, history of placental abruption, PROM, thrombophilia's, multiples |
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cord insertion (succenturiate placenta)
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cord has divided into 2 or more lobes, fetal vessles run between the lobes, one or more lobes may remain attached after delivery, increased risk of hemorrhage |
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fibrinolytic system process
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fibrin split into fibrinolytic degradation products, circulation restored |
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what triggers DIC |
severe preeclampsia, HELLP, and gram negative sepsis |
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cystitis |
dysuria, frequency, and urgency |
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pyelonephritis |
develops most often in second trimester, hospitalization may be necessary |
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cholelithiasis |
if a pregnant woman has gall stone they must come out |
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surgical emergencies during pregnancy |
appendicitis, cholelithiasis, and gynecologic problmes (ovarian complications) |
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effect of trauma on pregnancy influenced by |
length of gestation, type and severity of the trauma, degree of disruption of uterine and fetal physiologic features |
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trauma during pregnancy; maternal physiologic characteristics |
requires strategies adapted for appropriate resuscitation, fluid therapy, positioning, assessments, and other interventions |
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preterm labor |
cervical changes and uterine contractions between 20 and 37 weeks of gestation |
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preterm birth
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birth occurring before the completed 37th week |
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late preterm birth |
34-36 weeks of gestation |
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signs of labor |
regular contractions, rupture of membranes, effacement, cervical dilation |
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tocolytics |
given after uterine contractions and cervical changes have occured |
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medications for suppression of uterine activity |
tocolytics, magnesium sulfate, terbutaline, nifedipine |
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promotion of fetal lung maturity give |
glucocorticoids, give 2 doses 24 hours apart, promote surfactant production |
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PROM, premature rupture of membranes |
prior of completion of 37 weeks, give glucocorticoids and mag sulfate to prolong pregnancy, give prophylactic antibiotics and frequent temperature checks
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chorioamnionitis |
bacterial infections of the amniotic cavity |
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signs of chorioamnionitis |
maternal fever, maternal and fetal tachycardia, uterine tenderness, foul odor of amniotic fluid |
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neonatal risk of chorioamnionitis
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pneumonia, bacteremia, spesis
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treatment for chorioamnionitis |
ATB, antipyretics for fever |
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risk for post term birth |
fetal marcosomnia, abnormal fetal growth, placenta dysfunction, decreased amniotic fluid |
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hypertonic uterine dysfunction
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too frequent contractions not causing cervical changes |
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hypotonic uterine dysfunction |
normal progression followed by inefficient uterine contraction |
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external cephalic version |
turn fetus from breech to vertex, after 37 weeks of gestation |
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internal version |
hand inserted into uterus and infant turned from breech to cephalic |
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elective induction |
legally have to be 39 weeks with no medical reason |
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cervical ripening |
cause softening and contractions, prostaglandins, balloon catheters, amniotic membrane striping |
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complications and risk of c sections
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aspiration, hemorrhage, atelectasis, endometritis, abdominal wound dehiscence, infection, UTI, bowel or bladder injuries, complications of anesthesia |
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preop care of c section |
NPO, blood test, vitals and FHR, GI medications, prophylactic antibiotics, SCD boots, |
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intraoperative care for c section |
support person, foley catheter (cant get up for 8 hours, increased risk of knicking bladder) |
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post op care of c section |
vitals q15 mins, dressing, fundus (checking to make sure not flaccid), pain management, breast feeding |
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VBAC |
low transverse incision ONLY, major risk of uterine rupture, has to be 6 to 12 months after delivery |
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meconium stained amniotic fluid |
result of hypoxia induced peristalsis, potential umbilical cord compression |
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thick mec |
pea soup, protects umbilical cord, prepare to resuscitate |
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thin mec |
yellow, amniotic fluid with streaks |
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shoulder dystocia
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anterior shoulder cannot pass under the pubic arch, caused by fetopelvic disproportion (mc Roberts maneuver moms knees to should, push uterus from top while MD pulls head out |
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prolapsed umbilical cord
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emergency c section (hand in there until or) trendelenburg and knee to chest position, will feel pulsing cord |
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Amniotic fluid embolus (DIC) |
acute onsent of hypoxia, hypotension, cardiovascular collapse, and coagulopathy |
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postpartum hemorrhage |
loss of 500ml or more blood after vaginal birth or loss of 1000ml or more of blood after c section, 10% change in hematocrit and need for transfusion |
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hemorrhagic shock
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hemorrhage causes vasoconstriction of vessels going to the organs (except brain and heart), can cause potential organ failure, acidosis and cellular death |
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idiopathic thrombocytopenic purpura
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autoimmune disorder where antiplatelet antibodies decrease the lifespan of platelets, management: control platelet, may need splenectomy |
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von willebrand disease |
type of hemophilia, woman is at risk for bleeding up to 4 weeks following birth, desmopressin administered |
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endometritis
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infection of the uterine lining |
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signs and symptoms of endometritis |
fever, increased pulse, chills, anorexia, nausea, fatigue, pelvic pain, uterine tenderness, foul smelling profuse lochia
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uterine displacement: |
no longer in anteversion with the cervix backward and upward |
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cystocele |
protrusion of bladder down into the vagina, need surgical repair |
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rectocele |
herniation of the anterior rectal wall through the vaginal fascia, need surgical repair |
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risk for postpartum depression |
women with history of anxiety and depression, younger age, unintended pregnancy, unmarried, martial discord, lack of social support, socioeconomic deprivation, lower education, substance abuse, complications of pregnancy or birth |
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breast feeding rates |
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when should you introduce baby food
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6 months |
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contraindication to breastfeeding
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infant galactosemaia-main ingredient in breastmilk, active Tb, HIV, cheom or radiation |
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minerals
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may need iron supplements for 4 months for exclusively breast fed babies |
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prolactin increases when.. |
placenta is expulsed due to decreased progesterone |
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lactogenesis |
decrease in progesterone, increase in prolactin, oxytocin causes milk ejection |
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how frequent should breastfeeding mothers feed |
8-12 times in 24hrs, or every 2-3 hours |
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output for effective breastfeeding |
5-7 wet diapers a day, and 2-3 stools a day in beginning |
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supplements, bottles, and pacificers |
decrease risk of SIDS, does not recommend until establishment of breastfeeding or 6 weeks old |
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formula feeding patterns
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15-30 ml each feeding for first week, every 3-4 hours |
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infant formula
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iron fortified ONLY |
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formula feeding nipples
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slow flow nipple to decrease air |
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complementary feeding |
earliest at 4 months, generally 6 months, over a couple days at a time to determine allergies |
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immature infant sphincter signs |
frequent spit ups
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prenatal period |
conception to birth |
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infancy period |
birth to 12 months, rapid motor, cognitive and social development |
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early childhood |
1 to 6 years, intense activity and discovery |
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middle childhood |
6 to 11/12 years, time a child starts puberty |
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birth weight doubles by |
4-7 months |
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birth weight triples by |
12 months |
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birth weight quadruples by |
2.5 years |
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birth length increased by
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50% by 12 months |
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height at age 2 is 50%
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of adult height |
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birth length doubles by |
4 years old |
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difficult child
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highly active, irritable, structured environment |
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slow to warm up child
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seems ok with repeated exposure |
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oral stage
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birth to 1 year |
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anal stage |
1 to 3 years |
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phallic stage |
3 to 6 years, genitals become interesting, recognize difference between gender |
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latency period |
6 to 12 years, acquisition of knowledge and vigorous play |
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genital stage |
greater than 12 years of age, sexual tension and pleasure |
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trust vs. mistrust |
birth to 1 year |
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autonomy vs. shame and doubt |
1 to 3 years |
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initiative vs. guilt |
3 to 6 years, vigorious intensive behavior, strong imagination |
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industry vs inferiority |
8 to 12 years, engage in tasks and achieve |
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identity vs role confusion |
12 to 18 years, appearance, and develop roles |
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piaget- sensorimotor |
birth to 2 years, simple learning takes place, holding a spoon |
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piaget preoperation |
2 to 7 years, egocentrism; unable to put self into place of others |
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piaget concrete operations |
7 to 11 years, increasing logical and coherent thought |
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piaget formal operations |
11 to 15 years, adaptable and flexible thought |
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preconvention level |
orients to levels of good/bad and right/wrong |
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conventional level |
concerned with conformity and loyalty (most law abiding, no gray areas) |
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post conventional, autonomous, or principled level
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general individual rights and standards become important |
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content of play
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social affective play, sense pleasure play, skill play, unoccupied behavior, dramatic or pretent play, games |
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social character of play
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onlooker play, solitary play, parallel play, associative play, cooperative play |
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disorders of the intrauterine environment |
IUGR, placental abnormalities |
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genetic disorders |
chromosome abnormalities, turner syndrome, down syndrome |
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role of the nurse in genetics |
collect family information for 3 generations on all kids, identify and refer, education |
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factors influencing development |
heredity, gender, interpersonal relationships, physical environment |
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grasping objects: |
2 to 3 months |
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transferring objects between hands: |
7 months |
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pincer grasps |
10 months |
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removing objects from container |
11 months |
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building tower of two blocks |
1 year |
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head control
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4-6 months |
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rolling over
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6 months: back to abdomen |
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sitting |
7 months |
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move from prone to sitting position |
10 months |
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crawling |
ages 6 to 7 months |
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creeping |
9 months |
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walking with assistance |
11 months |
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walking alone |
1 year |
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nutrition for 6 months and older |
introducing solids, but human milk or fortified formula should be the main form of nutrition |
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foods to avoid in infancy |
honey-avoid first 12 months due to botulism, cows milk- avoid first 12 months due to potential kidney effects |
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by ages 3-4 months nocturnal sleep lasts |
9-11 hours, breastfed infants awake more often |
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dental cleaning in infancy
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begins when primary teeth erupt, fluoride at 6 months |
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prevention of dental caries |
no bottle propping, no milk in bed, no fruit juices |
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mmR and varicella
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are the only live immunizations can not have until 12 months of age |
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menogoccial is require for all |
kids in public schools |
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contraindications for immunizations |
severe febrile, or immune compromised can not receive mmR or varicella |
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only oral immunization is
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rotovirus |
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vaccine adverse event reporting system (VAERS) |
is to report any adverse reactions after administration of any vaccine |
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vaccine information statements (VIS) |
information statements that must be given to parents before administration of given vaccines, updated information that must be given to parent of children being vaccinated |
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rear facing car seat for:
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first 2 years or child is 30lbs
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children with chronic or complex disease, the role of culture |
issues of culture, ethnicity and race affet access to services and follow through with recommendations and referral, interpreters familiar with language and culture should be used |
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five distinct patterns of coping |
competence and optimism, feels different and withdraws, is irritable, is moody and acts out, complies with treatment and seeks support
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promoting normal development in early childhood
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basic trust, separation from parents, beginning indepence |
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promoting normal development in school age children |
industry/activity |
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promoting normal development in adolescence
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developing independence/autonomy |
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cognitive impairment
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encompasses any type of mental difficulty or deficiency |
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diagnosis of cognitive impairment |
made after a period of suspicion by family or health professionals, in some instances, made at birth |
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causes of cognitive impairment |
intrauterine infection and intoxication, trauma, metabolic or endocrine disorders, inadequate nutrition, postnatal brain disease, chromosomal anomalies, prematurity, low birth weight, psychiatric disorders with onset in childhood, lead |
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nursing care of children with impaired cognitive function
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provide means of communication, establish discipline, encourage socialization, provide info on sexuality, help families with future care, care for the child during hospitalization |
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causes of down syndrome |
maternal age age 35 risk is 1 per 350 births, age 40 risk is 1 per 100 births |
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clinical manifestations of down syndrome
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square head with upward slant to eyes, flat nasal bridge, protruding tongue, hypotonia |
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physical problems with down syndrome
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congenital heart disease- (typicallyy cause of death), hypothyroidism, leukemia |
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causes of hearing impairment
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anatomic malformation, family history, low birth weight, ototoxic drugs, o2 administration, chronic ear infections, perinatal asphyxia, perinatal infections, cerebral palsy |
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hearing impairment manifestations in infancy
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lack of startle reflex, absence of reaction to auditory stimuli, absence of well formed syllables by age 11 months, general indifference to sound, lack of response to spoken words |
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hearing impairments in childhood |
profound deafness: likely to be diagnosed in infancy, if not detected in infancy, identified upon entry into school, abnormalities in speech, development, learning disabilities |
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preventive measure for hearing impairment
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treatment and management of recurrent otitis media, prenatal preventive measures (genetic testing, avoidance of ototoxic drugs, testing to rulee out syphilis, rubella, or blood incompatibility), avoidance of exposure to noise pollution |
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causes of visual impairment |
prenatal or postnatal infections, retinopathy or prematurity, trauma, postnasal infections, sickle cell disease, juvenile rheumatoid arthritis, tay sachs disease |
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nursing alert for visual impairment |
suspect visual impairment in a child of any age whose pupils do not react to light |
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Autism spectrum disorders |
complex neurodevelopmental disorder accompanied by intellectual and social alterations, verbal effects, repetitive and restrictive behavior patterns, four times as common in boys 1 per 100-150 children |
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causes of autism spectrum disorders (ASD)
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genetic disorder or prenatal and postnatal brain development, immune and environmental factors that may interact with genetic susceptibility |
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clinical manifestations of ASD
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peculiar and bizarre characteristics primarly in specific areas, socialization, communication, behavior, difficulty with eye and body contact, language delay diagnosis often delayed until 2 to 3 years of age |
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ASD family support
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frequently parents express guilt and shame, autism society of America is a good source of information, stress importance of family counseling |
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separation anxiety- protest phase |
crying and screaming, clinging to parent |
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separation anxiety- despair phase |
cessation of crying, evidence of depression |
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separation anxiety- detachment phase |
denial, resignation but not contentment, possible serious effects on attachment to parents after separation |
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when should you get a informed consent from a parent
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prior to providing care |
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oxygen in children always has to be
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humified |
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polyhydramnios
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poorly controlled diabetes mellitus, fetal congenital anomalies, (GI obstruction, twin twin transfusion syndrome) |
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oligohydramnios
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renal agenesis (potter syndrome), premature rupture of membranes, prolonged pregnancy, uteroplacental insufficiency, severe IUGR, maternal HTN |
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when can you detect fetal HR by ultrasound
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6 weeks by transvaginal |
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how to confirm fetal death |
lack of fetal heat motion along with the presence of fetal scalp edema and maceration and overlap of the cranial bones |
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why use MRI during antepartum |
fetal structure/growth, placenta (position, density and presence of gestational trophoblastic disease), quality of amniotic fluid, maternal structure (uterus, cervix, adnexa and pelvis) biochemical status of tissue/organs, soft tissue, metabolic, or functional anomalies |
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BPP includes |
AFV, FBM, fetal hr (non stress test), 8 or 10 with normal AFV is considered normal |
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normal AFI |
10 cm or greater with the upper ranger of normal around 25cm. less than 5 cm =olighydramnios, greater than 25cm= poly |
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reactive nonstress test
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two accelerations in a 20 minute period, each lasting at least 15 seconds and peaking atleast 15 bpm above baseline (before 32 w accel= rise 10bpm lasting 10 sec from onset to offset) |
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nonreactive stress test |
does not demonstrate at least two qualifying accelerations within a 20 min window |
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nipple stimulation test |
massage with warm cloth, when adequate contractions or hyperstimulation (contractions lasting more than 90 seconds or 5 or more in 10 minutes) stimulation should be stopped |
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hyperglycemia is most likely to be identified when
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2 hours post meal because blood glucose peak approximately 2 hours after a meal |
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how to take iron and levothyroxine |
different times of day because iron decreases absorption of T4 |
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poor maternal glycemic control before conception and during may be responsible for
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fetal congenital malformations and maternal complications such as miscarriage, infection, and dystocia caused by marcosomia |
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diet for preeclampsia
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60-70g protein, 1200mg calcium, 600 mcg folic acid 11-12mg zinc, 1.5g sodium, drink 6 to 8 glasses of water a day, avoid alcohol and tobacco and limit caffeine |
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diet for hyperemesis |
avoid an empty stomach, eat at least every 2 to 3 hours, high protein snack at bedtime, dry, bland low fat high protein foods, |
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signs and symptoms of placental abruption
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uterine tenderness or pain, uterine irritability, uterine contractions, vaginal bleeding, leaking of amniotic fluid or a change in FHR characteristics
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priorities of the pregnant woman after trauma
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resuscitate the woman and stabilize her condition first then consider fetal needs |
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hyperextension of the neck is |
avoided instead jaw thrust is used to establish an airway for the trauma victim |
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