final review
What is the appropriate nursing response to a parent who asks, "What should I do if my child cannot take a tablet?"
"Find out if the medication is available in a liquid form."
A nurse is explaining the physiological Hyperbilirubinemia to the parents of a neonate. Which statement made by one of the parents would demonstrate a correct understanding of the concept?
"In term infants, it usually appears after 24 hours."
A nurse is explaining physiological hyperbilirubinemia to parents of a neonate. Which statement made by one of the parents would demonstrate a correct understanding of the concept?
"in term infant it usually appears after 24 hours"
Shoulder dystocia
-Turtle sign o Relieved/tx by McRoberts maneuver and suprapubic pressure
Sperm count must be __ after vasectomy before having sex again
0
APGAR done when
1 and 5 min
5 ml
1 tspn
o Daily fluid maintain
10 kg or less: 100 mL/kg/day 10-20 kg: 1000 mL/day plus 50 mL/kg/day for every kilogram over 10 Over 20 kg: 1500 mL/ day plus 20 mL/kg/day for every kg over 20
Pitocin (oxytocin) drip is infusing with an infusion pump at a rate of 60 mL per hour. How many miliunits are administering per minute?
10 miliunits
abstinences is the only
100% of birth control
normal FHR
110-160
Anterior closes at
12-18 months
The healthcare provider orders ampicillin 100 mg/kg/dose for a newly admitted neonate. The neonate weights 1350 grams. How many mg should the nurse administer?
135 mg
What is the maximum safe volume that a neonate can receive in an intramuscular injection?
1mL
1g =
1mL , Used when weighing perineal pads for blood loss
For IM injections no more than
1mL per site 0.25kg = 250mL
the umbilical cord has..
2 arteries and 1 vein
late PPH
24 hours to 6 weeks of postpartum
Before epidural
500-1000 mL of fluids are bolus to prevent hypotension o If occurs: increase fluids after infusion
·It takes the vagina ___ weeks to regain normal size and contour
6-10 week
The posterior fontanel closes at
6-8 weeks
What is the hourly rate (in ml/hr) for fluid maintenance of a child weighing 19.5 kg according to the following fluid maintenance chart: <10kg — 100 ml/kg, 10-20 kg — 100 ml + 50 ml/kg for each additional kg between 10 and 20 kg, >20kg — 1500 ml + 20 ml/kg for each additional kg over 20 kg
61.4 ml/hr
· You have admitted a 10 month old child who has been diagnosed with moderate dehydration to the emergency department. While in the emergency room the child had 1 episode of vomiting and 2 episodes of diarrhea. The physician has ordered oral rehydration therapy for this child based on weight of 8.2 kg at 50 ml/kg, plus 100 ml for each episode of diarrhea and/or vomiting. What is the total volume to be administered orally? Additionally the physician has ordered IV maintenance fluids for the child according to the formula of 100ml/kg at what rate per hour would the pump be programmed over a 4 hour period?
710ml, 205 ml
Which women is a greatest risk for PPH?
A women with severe preeclampsia with mag sulfate adm who was induced for labor
Glucose
All infants get checked and assessed, maintain safe levels per institution policy
A mom brings her nine year old child to the pediatricians office for evaluation of the child's recent refusal to go to school. Which of the below questions should bea part of the nurses assessment? SATA. (ALL OPTIONS ARE CORRECT)
Any illness within the family? Has the child changed schools? Has there been a recent pet loss? How is your child doing in school? Does your child participate in any school sponsored extra-curricular activities?
A mom brings her nine y/o child to the pediatricians office for evaluation of the child's recent refusal to go to school. Which of the elbow questions should be a part o the nurses assessment? SATA
Any illnesses within the family?, has the child changed schools?, has there been a recent pet loss?, how is your child doing in school?, does your child participate in any school sponsored extra circular activites?
Which of the following signs pertaining to respirations indicate that the newborn is adapting to extrauterine life normally? SATA
Apnea for 10 seconds, obligatory nose breathing
The difference between physiologic and non-physiologic jaundice is that nonphysiologic jaundice
Appears during the first 24 hours of life
Bilirubin
Assess jaundice risk, ensure infant is feeding well, explain condition to parents
A nurse is caring for an adolescent who was admitted to the hospital's medical unit after attempting suicide by ingesting acetaminophen. Which interventions should the nuse incorporate into the client's care plan?
Assist client with bathing and grooming as needed, ask the client if he is currently having suicidal thoughts, inspect the client's mouth after giving oral medications, ask the clients parents if they keep firearms in their home
A nurse is caring for an adolescent who was admitted to the hospital's medical unit after attempting suicide by ingesting acetaminophen. Which interventions should the nurse incorporate into the client's care plan? SATA.
Assist w/ bathing and grooming as needed, Ask the client if he is currently having suicidal thoughts, Inspect the clients mouth after giving oral care, Ask the clients parents if they keep fire arms in the home.
The nurse administers vitamin K to the newborn for what reason?
Bacteria that synthesize vitamin K are not present in the newborn intestinal tract
PPH
Blood loss > 1000 mL with s/s of hypovolemia within 24 hours of delivery
· The nurse notes the following fetal HF tracing at >200, which of the following HCP orders would the nurse anticipate
CBC
hydrocephalus
Can be detected in utero. Can cause increased ICP. If the child is complaining of headache they need to get checked by doctor. Child will have a shunt placed to drain fluids, if tube is blocked it can cause blockage - so monitor for signs of increased ICP.
When on mag sulfate:
Check urine output hourly, serum mag every 4-6 hours, assess DTR and monitor for ankle clonus, have calcium gluconate on ordered and safety equipment on hand
The nurse is preparing to assist the primiparous client to the bathroom to void 6 hours after delivery. She states that she feels dizzy when sitting up on the side of the bed. The nurse explains that this is most likely a result of which of the following.
Decreased volume to the vascular system (orthostatic hypotension)
Latching problems
Dimpled checks during feedings, only nipple (not areola) is latched
What indicated a lack of bonding?
Doesn't make eye contact with the baby
IUD increase risk for
Ectopic pregnancy, spontaneous abortions, not infections after IUD has been in for months
Nagele's Rule
Est day of delivery: LMP- 3 months plus 7 days
GTPAL
G: Gravida: how many times pregnant before T: term: how many born at term or after 38 weeks P: preterm: how many born 20-37 weeks A: abortion: miscarriages/ abortions L: living: how many are living
What type of conversation might be expected from two 8 year old boys?
Girls are gross!
Molar pregnancy:
HCG testing frequency
Which of the following signs pertaining to respirations indicate that the newborn is adapting to extrauterine life normally. SATA
Inspiratory nasal flaring, apnea for 10 secs periods, obligatory nose breathing
The nurse has a 2-year-old boy sit in a "tailor" position during palpation for the testes. What is the rationale for this position?
It prevents cremasteric reflex.
· A neonate has been diagnosed with caput succedaneum. Which information should the nurse include while teaching the mother about caput succedaneum?
Keeping the infant hat on will help this to resolve
A neonate has been diagnosed with caput succedanum. Which information should the nurse include when teaching the mother about caput succedaneum?
Keeping the infant hat on will help this to resolve.
Seizure disorders:
Know how long child has to seize before diazepam can be administered Febrile seizures are not caused by epilepsy no diazepam. Just prevent seizure with Tylenol/Motrin or cool/tepid bath Epileptics need to be compliant w/ med and see doctor regularly When a seizure begins first thing to do is check time
Diet to prevent neural tube defects: SATA
Lentils, vitamin C, spinach, oranges, fortified cereals, folic acid
A spouse asks for help because his postpartum wife is depressed and unable to care for their newborn. Which response should the nurse make to the spouse
Let me get you some information about resources in the community to help
Cerebral Palsy
Modify the environment to the child's safety and development. Toys etc.
A child is being discharged from the hospital on insulin. The mother is apprehensive about giving the medication. What action by the nurse is most important?
Observe the mother while she administers an insulin injection.
A nurse is caring for a preterm infant who has a weak cry and is irritable. What action by the nurse is best?
Obtain a bedside glucose reading
·A pregnant women at 37 week gestation has had ruptured membranes for 26 hours, a c-section is performed for failure to progress. The FHR before birth is 180 with limited variability. At birth, the newborn APGAR score of 6 and 7 at one and 5 minutes, and noted to be pale and tachypneic. On a basic of maternal history, what nursing action would you anticipate carrying out?
Obtain a blood sample for CBC
a pregnant woman at 37 weeks gestation has had ruptured membranes for 26 hours. A c-section is performed for failure to progress. The FHR birth is 180 beats/min with limited variability. At birth, the newborn has an APGAR score of 6 and 7 at one and five minuets and is noted to be pale and tachypenic. On the basis of the maternal history, what NURSING ACTION would you anticipate carrying out:
Obtain blood sample for CBC.
Physiological jaundice
Occurs after the first 24 hours as a result of hemolysis of RBCS and liver immaturity
Increased ICP early signs infants: irritability, vomiting, high pitched cry, bulging Fontanels, poor feeding <—- SATA.
Older child increased ICP - Headache, vomiting, irritable, sleepy (late). CSF - contains glucose. Testing drainage for glucose can differentiate it from other fluids.
What to do with patient complaining of chest pain and dyspnea, potentially PE? SATA
Pain meds, call HCP, elevate HOB, give o2 , call code
A nurse is reviewing pediatric physical assessment techniques. Which statement about performing a pediatric physical assessment is correct
Physical examinations proceed systematically from head to toe unless developmental considerations dictate otherwise.
Which statements about performing a pediatric physical assessment are correct for a school-age child? SATA.
Physical examinations proceed systematically from head to toe. The physical examination is done only when the child is cooperative. Remove clothing and have the child put on an examination gown
Entrapment Neuropathy:
Pregnancy pain caused by the growing uterus pushing on different places (sciatic nerve)
Infants at risk for hypoglycemia
Preterm, late preterm, LGA, born to diabetic mothers, exposed to stressors, cold stress
A nurse is caring for an SGA newborn, what nursing action is more important?
Prevent hypoglycemia by early and frequent feedings
Compartment Syndrome
Pulselessness, pain, pallor, paresthesia/paralysis, poikiolthermia
Which of the following assessment data would the nurse recognize as adverse reactions to an opiod pain medication in the pediactric population? SATA
RR decreased from 28 to 12 over the last 30 mins, puritis, no bowel movement within the last 48 hours.
Which of the following assessment data would the nurse recognize as adverse reactions to an opioid pain medication in the pediatric population? SATA.
Respiratory rate decreased from 28 to 12 over the last 30 minutes, Pruritus, No BM w/in last 48 hours
What activity is appropriate for a 3 year old?
Riding tricycle
After teaching a group of parents about accident prevention for school age children, which of the following statements by the group would indicate the need for more teaching?
School age children are not influenced by their peers".
You are interacting with a 5 month old who is in to see the doctor for a sick visit. Which of the following is an example of appropriate communication development for this age?
She is bleeding consonant sounds together.
Myelomenigocele
Sterile moist gauze to cover area because they will be under radiant warmer Prone position Has to be delivered via c-section
A neonate has just been delivered without incident. Which symptoms could indicate that the newborn is not successfully adapting to extrauterine life? SATA
Subcoastal retractions, grunting, nasal flaring
A neonatal has just been delivered without incident. Which symptoms could indicate that the newborn is not successfully adapting to extrauterine life? SATA
Subcostal retractions, grunting, nasal flaring
Acquired Hypothyroidism (hashimotos)
Sudden weight gain
Pre-op:
Supporting head appropriately because there head is much larger than the body. Early and continuous patient education to patients. Small frequent feedings, monitor I/O, reposition head frequently w/ cushions
Entrapment Neuropathy: tell mom
Tell mom to change positions, yoga, stretching
Four hours after delivery of a healthy neonate of an insulin dependent diabetic women, the baby appears very irritable and has a high pitched cry, which nursing action has top priority?
Test for the blood glucose level
A nurse is preforming a Denver developmental screening test on a 4 1/2 year old child. What behaviors should the nurse expect the child to demonstrate? SATA
The child draws a person with at least 3 body parts, the child copies a circle that is closed, the child speaks clearly.
A nurse is performing a Denver developmental screening test on a 4 1/2 year-old child. What behaviors should the nurse expect the child to demonstrate? SATA.
The child draws a person with at least three body parts, The child balances on each foot for at least six seconds, The child copies a circle that is closed, The child speaks clearly
· Which of the following when done by a school-age child during return demonstration explemplifies that he understands the instructions for self administration of his metered-dose inhaler?
The child takes 5 deep breaths after squeezing the inhaler
Which of the following when done by a school-age child during return demonstration exemplifies that he understands the instructions for self sdministration of his metered dose inhaler?
The child takes 5 deep breaths after squeezing the inhaler.
Which statement is true about large for gestational age (LGA) infants?
They are prone to hypoglycemia, polycythemia, and birth injuries
Which assessment should the nurse perform last when examining a 5-year-old child?
Throat
Erythromycin eye ointment (EEO) used to treat bacterial infection from mom in vaginal deliveries
Treats gonorrhea and chlamydia but tell the parents its for bacterial infections
if a child is under 2
Use a apical for pulse check
veal chop
V: variable E: early A: accelerations L: late · C: cord compression · H: head compression · O: Okay · P: placental insufficiency
Which muscle should the nurse select to give a 6-month-old infant an intramuscular injection?
Vastus lateralis
postpartum psychosis
Very rare and dangerous to both mother and baby
Call provider for slow steady trickle because it indicates
a vaginal wall laceration which can only be treated with a surgical repair
Accelerations
an increase in FHR of at least 15 BPM lasting at lease 15 seconds
· You get an order asking for MS what should you do?
ask the provider what this means
SGAs
baby's weights falls below the 10th percentile
duration
beginning of contraction to the end of the same contractions
frequency
beginning of one contraction to beginning of the next contraction
Induction:
bring in someone in from ground 0 and start labor, something that starts labor, oxytocin is main drug along with amniotomy
Abruptio Placentae: tx
c -section
Magnesium Sulfate therapy: reverse agent
calcium gluconate
· A client at 40 wk gestation is admitted to the birthing unit during active labor, during her intake assessment she tells the nurse her membranes ruptured 26 hours age, initial assessment of the FHR ranges between 168-174, what is the priority nursing action?
check maternal VS
Augmentation:
comes in already in labor and speed the process along, something that makes labor stronger
Blood transfusion reaction:
coughing, itching, chills - stop infusion
RhoGAM: helps prevent
development of rH positive antibodies
Magnesium Sulfate therapy: used to tx
eclampsia, quieting uterine activity
for the past 8 hours, a 20 year old primigravida client in active labor with intact membranes has been experiencing regular contractions. The FHR is 136 bpm with good variability, after determining that the client is still in the latent phase of labor, the nurse should observe the client for?
exhaustion
Explore you own beliefs, values, realistic, religious beliefs and customs with
family planning
HGH deficiency
gaining weight normally then fall off the growth chart below 3rd percentile. Weight is normal but height stops. They must get daily hormone injections until growth plate closes. Once growth plate closes they can no longer get injections. The closer the child is to the growth plates closing - dosage will be increased
full bladder
hard to void after, discomfort, displaced uterus
APGAR includes
heart rate, Respiratory, muscle tone, reflex response, color
What is the best form of BC for a 15 year old that is not compliant with the pills
hormone implant ·
Liquid syringe medication should be measured properly not with
household spoons. Stick syringe in side of mouth - do not mix in bottles.
Two mothers were in the birthing suit together and one wants to know how the other one is doing, how should the nurse respond?
i am unable to disclose patients information
a NST is only positive when
if there is 2 accelerations within a 20 min period
Type 2 -
insulin resistance and insulin resistance. Can be managed w/ a healthy diet and exercise.
· Diabetes Mellitus - "sugar' diabetes. Type 1 -
juvenile/autoimmune. Pancreas secrets no insulin creatine insulin dependence. Avoid exercise during insulin peak. A reading alteration lasting 3-4 days needs an adjustment to insulin dosages. Alternate injection sites. When ketone level is high have child drink lots of water to pee it out w/ unlimited bathroom breaks. Draw up regular insulin first
Post-op:
keep on the side that was not operated on. Keep child at flat angle (Low HOB) to prevent vertigo/pain and help fluid drain. Then the HOB is gradually increased. Frequent VS Teach parent s/s of shunt blockage
o Miliunits is
mL/1000
Fetal tachycardia indicates
maternal fever
For incomplete abortions use
methotrexate
A women in labor has just received an epidural block, the most important nursing interventions is to?
monitor for hypotension and bradycardia
RhoGAM: give when
mother is - and baby is +
Involution of the uterus
o 1 cm per day o After 14 days fundus should be no longer palpable
Glucose challenge test
o 1 hour after ingesting 50g glucose solution o Non fasting o Done between 24-28 weeks
· What is the hourly rate (in ml/hr) for fluid maintenance of a child weighing 19.5kg according to the following fluid maintenance chart:
o 61.4mL/hr
Macrosomia
o >90th percentile o Weight > 4000g (8 lb 13 oz) o Common in babies born to diabetic mothers § Interventions: keep infant dry and covered, avoid contact with cold surfaces, keep away from drafts
Marfan syndrome
o At risk for cardiac issues and spontaneous pneumothorax o Characterized by tall slender body - long fingers and feet
Pathological jaundice
o Begins in first 24 hours o Tx with phototherapy o Caused by hemolytic disorders in the newborn
Diabetes Insipidus
o Condition where the kidneys cannot retain water. o Dark neck (acanthosis). o Treated with ddavp (desmopressin) an antidiuretic. o Can be given as a nasal spray instead of SQ. Child is at risk for fluid and electrolyte problems, puts child at risk for seizures
Nipple confusion
o Confusing pacifier with bottle
Congenital Hypothyroidism
o Gets automatically tested for at birth in metabolic screening. o Caused by aplastic or underdeveloped thyroid gland. o Level < 40mU/mL. o s/s: Lethargic, non alert, puffy face, not eating.
Pain - use FACES for most kids
o Neonates/infants: rapid changes in behavior. Distinctive movements , ex: pulling on ear, poor balance. o Toddlers:generalized restlessness. Guarding of site, excessive crying. o Preschoolers: cry and struggle. May deny pain. o School age: stiff body posture. Withdrawn. o Adolescents: can describe quantity and location of pain
Eclampsia:
o Preeclampsia with seizures o Mag sulfate is used to prevent seizures
Sprain
o RICE, wrap towards the heart o 1st 24 hours use is to decrease inflammation then alternate heat and ice (max 30 min and use a barrier for skin)
Diastasis recti:
o Splitting of the abdominal wall muscles due to the growing fetus o Women should not lift for at least 3 weeks or until HCP clears it
Infant feeding complication
o Tongue thrust, cleft lip/palate o In the NICU, heart defects, respiratory distress
Signs of labor:
o True labor results in cervical dilation and effacement, uterine contraction, bloody show, SROM, PROM § Yellow: breakdown of bilirubin, caused by incompatibility Green: meconium
Sleepy infants
o Unwrapping the blankets, placing the infant skin to skin with the mother o Talking the infants o Changing the diaper o Rubbing the baby's back
Prostaglandins
o Used for cervical ripening o Gels: Dinoprostone or prepidil, Dinoprostone or cervidil, Misoprostol (Cytotec). o Prostaglandin should be given cautiously to women who have asthma, glaucoma, ischemic heart disease, or pulmonary, hepatic, or renal disease. o The major adverse reaction to prostaglandin for induction is tachysystole that can reduce placental blood flow and fetal oxygen exchange. o The FHR and uterine activity should be monitored before prostaglandin insertion for a baseline and at least 30 minutes afterward for nonreassuring FHR patterns or excessive contractions.
Epiphyseal plate fractures
o an stunt growth, follow up appointments are very important to ensure appropriate healing
Casts
o don't stick anything in it o keep small objects/water away from cast (unless waterproof) o assess for odors (indicates necrosis) o elevate above level of heart o contact HCP immediately for numbness/tingling/discoloration (compartment syndrome)
Periodic accelerations are
okay
Juvenile Idiopathic Arthritis Gel
phenomenon - joints are stiff - knees, back, shoulder Stretch in the morning - wake up early enough to have time to stretch and move slow Can massage joints Crackers/ snack at bedside for morning meds (NSAIDS - but meds can vary) Swimming is a good sport - no high impact sports
latching
rooting reflex
Seizure precautions priority:
safety
For a teen that is getting surgery and is asking what the scar will look like -
show them pictures.
· Babies with galactosemia or lactase deficiency will need
special formula made o Don't automatically give baby soy
A full leg cast is the more developmentally detrimental to a toddler rather
than having parents that work outside the home.
Asymmetric growth restriction:
the head and length are normal and body
Symmetric growth restriction:
the infant is proportionately small
postpartum blues
the normal fluctuation of emotions after giving birth but last less than 2 weeks
PE and AFE are treated
the same
An asthmatic child can play in sports but they need to
tune their inhaler before activity and keep it with them
flat nipples
when squeezed it everts
When giving an injection to a child do not tell them there
will be a "stick" in there arm. Say "hurt" or "ouch".
is it expected to have a warm blanket for chills after delivery
yes
postpartum depression
· blues that last > 2 weeks Disabling disorder that affects the entire family
oxytocin
· diluted in an isotonic solution and given piggy back only
APGAR: heart rate
• Absent = 0 • Below 100 = 1 • 100 or greater = 2
APGAR muscle tone
• Limp = 0 • Minimal flexion of extremities; sluggish movement = 1 • Flexed body posture; spontaneous and vigorous movement = 2
APGAR reflex response
• No response to suction or gentle slap on soles = 0 • Minimal response (grimace) to suction or gentle slap on soles = 1 • Responds promptly to suction or a gentle slap to the sole with cry or active movement = 2
APGAR respiratory effort
• No spontaneous respirations = 0 • Slow respirations or weak cry = 1 • Spontaneous respirations with a strong, lusty cry = 2
APGAR color
• Pallor or cyanosis = 0 • Bluish hands and feet only = 1 • Pink (light skinned) or absence of cyanosis (dark skinned); pink mucous membranes = 2
Lacerations
o 1st superficial o 2nd fascia muscle o 3rd to anal sphincter o 4th into rectum § Redness, edema, ecchymosis, drainage, approximation
Stages of Labor
o 1st: when effacement and dilation occur, begins w/ onset of true contractions and ends with fully dilated cervix. § Latent phase 0-3cm § Active phase 3-7cm § Transition phase 7-10cm o 2nd: encompasses actual birth, begins w/ 10cm and ends w/ delivery of the infant o 3rd: placental stage
ACHES: women taking contraceptives
o A: abdominal pain o C: chest pain, dyspnea, hemoptysis, cough o H: headache, weakness/numbness of extremities, HTN o E: Eye problem o S: Severe pain or swelling, heat or redness of calf/thigh (DVT)
Type 1 diabetes:
o Absolute insulin insufficiency o Determined by tolerance test o Tx: is individual so monitor glucose level frequently o Insulin does not get automatically increased or decreased
Breastfed babies
o Are less likely to have allergies o Hind milk helps the infant gain weight o IgA gives the infant passive immunity from the mother helping fight infection o Have an increased risk of jaundice due to insufficient volume and ABO incompatibility
· Pt reports a splitting headache: SATA
o Assess vision changes or epigastric pain, perform NST, and check reflex and clonus
Gestation diabetes:
o Emergences during pregnancy o Usually develop middle of pregnancy when insulin resistance is most apparent o First tx with diet and exercise o Avoid insulin if possible
Group Strep B:
o Give penicillin before delivery o Swab tested at 36 weeks and if + will get 2 doses abx before delivery o If GBS status is unknown give 2 doses IV penicillin for mom before delivery and if baby is already born the baby will get abx too
preeclampsia
o HTN >140/90 with proteinuria
Glucose tolerance test:
o If challenge test is abnormal o Fasting o Draw a serum baseline fasting glucose o Then 1 hour, 2 hours, 3 hours, post 100 g of glucose solution
Placenta Previa:
o Implantation of placenta in lower uterus o Can be marginal, partial, or total o Causes painless bleeding in later half of pregnancy o Monitor I/Os, VS, vaginal bleeding, limit cervical exams, give betamethasone for fetal lung development
effects of diabetes on pregnancy:
o Increase risk of gestational HTN, increase risk of infection, maternal hypoglycemia, polyhydraminos, macrosomic infants, neonatal hypoglycemia and/or hyperbilirubinemia, respiratory distress in newborn.
chorioamnionitis
o Infection of the membranes o Cab can be a cuase and result of PROM
Epidural
o Monitoring VS very important since the #1 problem is hypotension o Assess bladder but will have a foley o Monitor temp
A clients membranes rupture, the nurse immediately detects the presences of a prolapsed umbilical cord, place the following nursing interventions in order as which they should be performed
o Moving the presenting part off the cord o Placed the pt in Trendelenburg position o Adm oxygen facemask o Checking the FHR o Call HCP
Discomforts of pregnancy:
o N/V keep crackers at bedside o Backache: good posture, limit excess weight gain, foot/arm rest, pillows pelvic floor exercises o Round ligament pain: good body mechanics, no sudden movements/position changes o Leg cramps: elevate legs often during the day to prevent cramps, to relieve extend legs
Abruptio placentae:
o Placenta detaches from uterine wall o Causes: strain by lifting or falling but is also correlated with cocaine use o Bleeding may be visible or concealed o Accompanied by pain, uterine tenderness, and uterine hyperactivity o s/s: increase in fundal height, painful rigid board like abdomen due to perpetual state of contraction o start 2 large bore IVs , need C-section
PPROM
o Preterm premature rupture off membranes occurs before 38 weeks of gestations
PROM
o Rupture of the sac before the onset of true labor
Abruptio Placentae:
o Separation of a normally placenta before the fetus is born caused by trauma, bleeding and formation of a hematoma on the maternal side of the placenta, bleeding can be visible or concealed
· Inverted nipples
o When nipple is squeezed it sucks back in o Use shells for women to wear to create a nipple
Vaginal discharge:
o assess the amount, type, and odor o Amount: scant, light, moderate, or heavy § Rubra: bright red § Serosa: light red § Alba: whitish brown
Spinal headache:
o result after spinal anesthesia block as a result of CSF leakage through the site of dural puncture. o Laying down relieves the headache and is unrelieved by medication. o Treated with bed rest, IV hydration, blood patch.
Abruptio Placentae: s/s
painful, rigid board like abdomen
Coitus interruptus
pullout method