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43 Cards in this Set
- Front
- Back
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signs of impending labor(6)
also referred to as premonitory signs |
lightening
Braxton-hicks contractions cervical changes, bloody show, ROM=rupture of membranes, a sudden burst of energy. |
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lightening
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(Ru pen)
fetus settle in to pevis ease of breathing increase urinary frequency |
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braxton-hicks contractions
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occur thoughout pregnancy,
irreggular, intermittent become strong enough to believe in labor(false labor) |
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cervical changes
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weakening and softening of cervix
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rupture of membranes means labor within?hours
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labor within 12-24hours
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when will preg women experience sudden burst of energy?
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24-48 hours before labor begins,
unknown cause caution not to exhaust themselves expend the energy during labor |
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late deceleration, first nursing action
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positioning pt on her left side
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why NST?
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evaluates the relation fo fetal movement to fetal HR
^ movement=^ HR |
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second stage of labor, nursing intervention?
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support the pt's pushing efforts(breathing,kept pt NPO nonpharmacological pain control with contraction, )
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when should oxytocin be decreased or stopped?
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cervix dilated to 6cm with contractions q2-3min=decrease
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why magnesium sulfate is given(IV)?
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stop preterm labor or labor needs to be delayed
TX for PIH |
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why pt need be close monitored when Magnesium sulfate is given?
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Affects the central nervous system of mather and fetus
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how to monitor s/s of toxicity of magnesium sulfate?
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1,CNS-monitor mother's reflexes(loss reflex= toxicity)
2,U/O:Leaves mother's body in her urine. monitored U/O (at least 30ml/hr)to ensure medicine does not build up in her bloodstream. 3, monitor HR(increased or arrhythmia), RR(<12 toxicity) |
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what is the antidote for magnesium sulfate toxicity
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calcium gluconate
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what is the action of Betamethason(Celestone Solupan), IM.
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"stimulates" fetal lung maturity
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woman active labor, blood test result Hep B surface antigen positive,
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untreated infection=neonate will have cirrhosis of liver or liver cancer in adulthood
so neonate needs immediate intervention |
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when should the mother receive Rubella if she's nonimmuned?
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before discharge
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mother Rh+
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no risk of incompatibility to neonate
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mother Rh-, father is Rh+
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risk of incompatibility to Rh+ neonate
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what is Rh disease?
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Rh incompatibility, one of the causes of hemolytic disease..
symptoms ranging from very mild to deadly. |
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what is hemolytic disease?
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a blood disorder that occurs when the blood types of a mother and baby are incompatible.
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when should RhIg given?
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RhIg should be given at 26 to 28 weeks gestation if the woman is D-negative. Each dose of RhIg lasts about 12 weeks. The mother will also be given RhIg within 72 hours of birth if the child is Rh positive.
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why Rh disease does not occur in first pregnancy
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because anti Rh+ antibodies do not exist in the first-time mother(only if the mother exposed to infant's blood during birth causes the development of antibodies)
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is Rh disease preventable?
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yes, treating the mother during pregnancy or soon after delivery
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what is RhIg()?
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immunization, IM injection
to prevent Rh+ sensitization with next pregancy |
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when should RhIg be given?
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26-28 wks pregnancy Each dose of RhIg lasts about 12 weeks. The mother will also be given RhIg within 72 hours of birth if the child is Rh positive.
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will RhIg destroy fetal Rh+ cells?
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no, because the RhIg doesnot cross the placenta.
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what are the s/s of resp distress that require immed. action by the nurse?
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nasal- flaring
chest-retractions expiratory- grunt |
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why Brethine is given to a premuture labor mother?
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Tx for preterm labor
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s/e of Brethine
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beta-mimetics pose a significant risk to
mother cardiovascular function -cardiac arrhythmias -tachycardia -palpitations -ischemia |
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what is the cause of variable deceleration? first nursing action?
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umbilical cord compression.
turn mother to her left side, may take pressure off the cord. |
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what presentation that causes hard back pain?
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ROP
right occipital posterior b/c heaviest part of fetal head. |
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what is meant by station?
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presenting part and the ischial spines
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what is meant by station?
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the presenting part and the "ischial spines"
marked as -5,-4,...0..+1,+2...+5 if fetus's head at ischial spine is called 0 station. |
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what is engagement?
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"largest dimension" of the presenting part passes through the "pelvic inlet"
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what is fetal position?
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presenting part to quadrants of "pelvis"
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what is fetal lie?
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fetal spine r/t to maternal spine
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during the period of transitionfrom fetal circulation to postnatal circulation, what normal assessment findings can be found
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functional murmurs(occasionally can be heard)
normal HR of 110-160(<110=cardio or resp. prob) |
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8cm dilated, multipara, begun to push, nursing action
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focus on breathing instead of pushing. "pant(=breath) and blow during contractions".
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when should pushing start or be encouraged?
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dilated 10cm
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9cm dilated, light-headed, tingling lips, nursing action priority
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cup her hands over her face and breathe in and out(need rebreathing of CO2)
pt hyperventilation=over concentration of O2. |
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A woman has a history of cocaine use and is admitted in active labor. At this point, the nurse's most immediate concern should be the possibility of
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abruptio placenta.
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During a vaginal exam of a woman in labor. Dilation, effacement & station are assessed. Effacement is
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shortening of cervical canal
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