Reproduction (L3T3)
fetal free cell DNA test
blood work exam
acrocyanosis
blueness of the extremities
mastitis
breast infection, sudden onset of flu like symptoms; localized breast pain and tenderness and a hot, reddened area on the breast that often resembles shape of a pie wedge -tx: antibiotics, but mother should be instructed to feed baby/pump frequently
HIV transmitted to baby by
breast milk
placenta previa assessment findings
bright red vaginal bleeding soft, relaxed, nontender uterus fundal height may be greater than expected for gestational age
anterior fontaneal closes
by 18-24 months diamond shaped
early decelerations cause
by fetal head compression, resulting from uterine contractions, vaginal exam or fundal pressure
Hydromorphone (Dilaudid)
c section-pca pump
What decreases milk supply?
cabbage leaves, cold showers, don't stimulate breasts
nifedipine
can be used safely without combining other agents to inhibit labor and maintain a pregnancy
oral contraceptives in smokers
can cause thrombophlebitis (blood clots in legs)
rh-
can only receive -
rh +
can receive + or -
accutane
category x drug
true labor
cervical change happening
PKU
checks for genetic disorders must not be completed earlier than first 24 hours, needs milk in system
vernix caseosa
cheesy substance covering the skin of the fetus
posterior fontaneal
closes by 6-12 weeks triangular shaped
DIC (disseminated intravascular coagulation)
clotting cascade is activated, resulting in the formation of clots in the microcirculation -risk factor: dead fetus syndrome, severe preeclampsia, hemorrhage
positive CST indicates
compromised fetus with late decelerations during contractions
accreta
condition in which the placenta attaches itself too deeply into the wall of the uterus but does not penetrate uterine muscle
IV fluids
contains electrolytes
preterm labor
contractions and cervical dilation between 20-36 weeks of gestation
hypertonic uterine contractions
contractions that last more than 2 minutes in duration
neonatal congenital syphillis s/s
copper-colored skin rash mucopurulent nasal drainage (snuffles)
variable decelerations rationale
cord compression
What is the most common opportunisitic infection of children infected with HIV?
cough
molar pregnancy long term care
could be cancer monitor for 1 year
preterm newborn respiratory distress assessment finding
cyanosis tachypnea retractions audible grunts
fetal fibronectin (FFN)
determine possible preterm labor between 22-34 weeks by inserting swab into vagina -believed that labor is within 2 weeks if positive -cannot have intercourse within 24 hours prior to testing
positive signs of pregnancy
diagnostic confirmations such as fetal heartbeat and ultrasound
dystocia
difficult birth, abnormal labor
infant weight at 5 months
double birth weight -triples birth weight around one year
tocolytics
drugs to stop preterm labor -should not be admin on long term basis, can cause birth defects
preterm labor s/s
dull backache and abdominal cramps
What happens in second stage of labor?
ends at the time of birth
hormone thought to cause n/v in first trimester
human chorionic gonadotropin (hCG)
oral contraceptives adverse
hypertension--don't take if this is preexisting condition
ectopic pregnancy s/s
hypotension abdominal pain (ruled out if ab pain is associated with bleeding or hypertension) smoking is risk factorq
ectopic pregnancy symptoms
hypotension abdominal pain vaginal bleeding
placenta previa
implantation of the placenta over the cervical opening or in the lower region of the uterus s/s: nontender uterus, painless bright red bleeding, abnormal fetal position, normal fetal hr
anhedonia
inability to experience pleasure
early sign of blood clot
increase in pulse rate
basal body temp
increases after ovulation
moro reflex
infant will extend the arms with the palms of the hand turned upward and then move the arms back to the body
chiroamnionitis
infection of placenta and amniotic fluid mom will be really hot
necrotizing enterocolitis
intestinal obstruction that is a concern for hospitalized preterm infants; inflammatory disorder of the gastrointestinal mucosa related to prematurity, hypoxemia and high solute feedings
opioid withdrawal in newborn
irritability and nasal congestion
internal monitor
iucp
Problem with hemorrhage
jeopardizes client's oxygen supply
hypoglycemia in infants
jitteriness poor feeding listlesness irritability low temp weak/high pitched cry hypotonia
newborn with respiratory distress syndrome
keep infant warm to maintain body temp at 98
bed rest
keeps pressure of the fetal head off the cervix -side lying position keeps gravid uterus from impeding blood flow through major vessels, thus maintaining uterine perfusion -lie on side with head raised by small pillow
stages of labor
labor (latent, active, transition)-ends with 10, 100% delivery-30 min-1 hr placenta 2-30 min postpartum
occlusion of aorta or vena cava intervention
lateral recumbent position
precipitous birth
length of labor is less than 3 hr from onset of contractions to birth of infant
low birth weight
less than 1500 g less than 1000g is extremely low birth weight
neonatal effect of maternal smoking during pregnancy
low birth weight
What should you not do with placenta previa?
manual pelvic exam/vaginal exam
placenta previa risk factors
maternal age >35 multiples (twins) already having baby drug use: cocaine/smoking surgery to uterus that leaves scarring
phototherapy interventions
monitor skin temp closely reposition newborn q2 cover eyes
uterine tachysystole
more than five contractions in 10 minutes, averaged over a 30-min window -usually on oxytocin or ripening agent
positive maternal titer for rubella
mother is immune to rubella, safe for toddler to receive vaccine
down sydnrome risk
mother older than 35
risks for preterm labor
multiple UTIs
Coomb's test (direct)
negative -positive results indicate the newborn's RBC have been coated with antibodies that are sensitized
cst
negative is good positive is bad
Group Beta or B Streptococcus (GBS)
universal screening of pregnant women at 35-37 weeks for GBS and intrapartum antibiotic for GBS carriers risk factors: maternal intrapartum fever, prolonged ruptured membranes 12-18 hrs, previous birth of infected newborn
s/e of betamimetics
unpleasant side effects of nervousness, tremors and palpitations--expected SE
where does implantation occur?
upper uterus (fundus)
pyelonephritis assessments
urine output temperature blood pressure uterine contractions
magnesium toxicity signs
urine output of 20ml/hr respirations of 10
ectopic pregnancy risks
use of fertility meds hx of chlamydia use of intrauterine device history of pelvic inflammatory disease (PID)
terbutaline
used to maintain pregnancy in preterm labor
methlergonovine
used to reduce postpartum hemorrhage
terbutaline (Brethine)
used to treat preterm labor, but does not reduce hypertension
dinoprostone
used when fetal death has occured to evacuate contents of uterus in an intrauterine fetal death for up to 28 weeks
biophysical profile (BPP)
uses a real-time ultrasound for visualization of physical and physiological characteristics of a fetus. 2 points for each: -body movements -fetal tone -fetal breathing -amniotic fluid volume -nst normal: 8/8
When to stop oxytocin?
uterine hyperstimulation late decelerations of fetal heart rate (fetal distress)
abruptio placentae assessment finding
uterine tenderness
assessing client with abruptio placentae
uterine tenderness and increased fetal activity boardlike abdomen
Misoprostol (Cytotec):
vaginal or PO, 6 hours apart Help efface
newborn IM injection
vastus lateralis
mottled skin intervention
warm the environment
gestational week 37-delivery
weekly
multipara
woman who has had two or more pregnancies resulting in a successful delivery
nullipara
woman who has not had a birth at more than 20 weeks gestation
caput succedaneum
Crosses the suture lines
hypotonic labor contractions
short, irregular, and weak--usually occur during active phase of labor
oozing around IV site
sign of abruptio placentae with pt entering into DIC
circumoral pallor
sign of cardiac pathology and indicates need for further assessment by PCP; not expected in newborn (white area around mouth)
greenish-brown amniotic fluid
sign of meconium in utero
hydatidiform mole
resembles bunch of grapes molar pregnancy benign neoplasm pos preg result, not true pregnancy uterus is larger than expected age ADMIN RHOGAM-given in miscarraige/abortion
early decelerations
result from pressure on fetal head during contraction
mom is not immune to rubella
retest rubella during pregnancy if titer is less than 1:8
Terbutaline (Brethine)
tocolytic used to treat preterm labor, but does not reduce hypertension side effects: cardiopulmonary decompensation including chest pain and palpitations
external monitor
tocotransducer
shortest phase of stage 1?
transition phase and contractions are very intense and long in duration
tonic neck reflex
turning the head to one side, extending the arm and leg on that side, and flexing the limbs on the opposite side
late decelerations rationale
ulteroplacental insufficiency
c section atelectasis
ribcage is not compressed and released during birth
low lying placenta
risk for painless bleeding
avoided in total placenta previa
routine vaginal exams
oligomenorrhea
scanty menstruation
variable decelerations occur
umbilical cord becomes compressed, reducing blood flow between placenta and fetus
Betamethasone (Celestone)
Stimulates surfactant production, does not affect labor process or contractions Accelerates fetal lung maturity in premature labor (28-32 weeks) if labor can be inhibited for 48 hours IM injection, 2x 24 apart
oxytocin (pitocin)
Stimulates uterine contractions used for maternal hemorrhage bolus to get uterus to contract
amniocentesis
-detect for genetic disorders -needle into uterus to get fluid
physiological changes in first trimester
-fatigue -morning sickness -breast enlargement
Which mechanism does a newborn use to maintain their body temp?
-flexed fetal position -brown fat metabolism -peripheral vasoconstriction
neonate bath
-immerse neonate fully except head in tub -measures body temp w/in 2-4 hours before giving bath -use cleansing agents w/ neutral pH and minimal dyes while giving the bath
need for NST
-over 35 -hx of stillbirth -diabetes, htn--risk for placental insufficiency
rhogam
-recommended for women w/ Rh- blood type, given around 28 weeks and possibly again after birth if mom is negative and baby is positive
Imipramine
TCA (Tricyclic antidepressants) SE: dizziness, fatigue, H/A, vomiting, dry mouth
Sertaline (zoloft)
-take at night? (I have seen both, Goss says may take any time) -Causes sexual dysfunction but no sedation, cause insomnia -adverse effect: serotonin syndrome can occur with St. John's Wort, MAOIs and Dextromethorphan (cough med)
unruptured tubal pregnancy
-unilateral abdominal pain -history of untreated chlamydia
how fast does infant grow?
.5-1in/month
ischial spine
0 mark on station
abortions
# of abortions and/or miscarriages (1-19 weeks)
living
# of living children at time
para
# of pregnancies carried to the 20th week
gravida
# of pregnancies, including miscarriages and/or abortions -primigravida -multigravida
preterm
# of preterm deliveries (20-37 weeks)
term
# of term deliveries (38-42 weeks)
placenta sides
'Shiny" Schultze (baby) "Dirty" Duncan-dull/dirty red and rough side from mom
station
-3 to +3
abruptio placentae risk factors
-associated with overdistention of uterus (multiple gestations). A short umbilical cord, physical trauma, and increased maternal age and parity are risk factors
HIV in pregnancy
-can be passed to fetus
cervical changes during pregnancy
-cervical tip becomes soft -volume of cervical muscle increases -elasticity of cervical collagen-rich connective tissue increases
Nifedipine (Procardia)
Tocolytic therapy Can be used safely without combining other agents to inhibit labor and maintain a pregnancy Calcium channel blocker Patient may be sent home with PO
stage 4 of labor
1-4 hours after the delivery of the placenta
minimum fetal movement
10 movements usually in 2-3 hours is minimum
normal hemoglobin in women
11.6-15
newborn heart rate
110-160
newborn hr
110-160
fetal heart tones
110-160 bpm
hgb
12-14
normal hemoglobin women
12.1-15.1
What week does uterus rise out of pelvis into abdomen?
12th week
platelets
150,000-400,000
When does quickening happen?
16-20 weeks
length
17-22in (44-55cm)
When does the fontanelle close?
18 months
BPP normal score
8-10 <6 is at risk for asphyxia and premature birth
Newborn temperature
97.7 F to 99.3 F (36.5 C to 37.3 C)
newborn temperature
97.7-99.5
lithium severe toxicity
>2.5 mEq/L above interventions and add dialysis Convulsions Oliguria Death
umbilical cord newborn
2 arteries, 1 vein if 2 vessels it can be associated with congenital anomalies
When can corticosteroids be used in labor?
24-36 weeks to promote lung maturity
nuchal cord
Umbilical cord around the fetal neck.
normal weight gain in pregnancy
25-35 lbs (normal BMI 18.5-24.9)
recommended iron intake
27 mg/day
when to receive rhogam
28 weeks and again within 72 hours after childbirth if she is sensitive -will receive if there was any chance of mixing blood types (wreck, miscarriage/abortion)
pica
associated with iron deficiency anemia -ingestion of nonfood substances
mom is rubella immune, risk for baby? (does blood type matter?) (RH positive, type 0 blood)
baby is not at risk
Methylergometrine (Methergine)
Used to reduce postpartum hemorrhoids First assessment is to check blood pressure before giving med, may elevate BP after admin Contraindicated for clients with peripheral vascular disease, cardiovascular disease, hypertension, preeclampsia or eclampsia
lochia alba
Yellowish, white cream color. Lasts approx 11 days-6 weeks postpartum
Coombs test
a blood test to diagnose hemolytic anemias in a newborn indirect-mom direct-baby positive-bad (rare) negative-good
Colostrum
a specialized form of milk that delivers essential nutrients and antibodies in a form that the newborn can digest -milk comes in 2-5 days
coombs test
a test for the presence of anti-Rh factor antibodies in the blood (this is often given to pregnant women that are Rh- to see if they will mount an immune response against the blood of their fetus)
Hepatitis B
3 part series, first is IM at birth vastus lateralis
newborn respirations
30-60
newborn head circumference
33-35cm
What is the increase of caloric intake in first tri of pregnancy?
340 (w/ normal BMI) (450 cal increase during 3rd tri)
normal body temp for neonate
36.5-37.5
hct
37-47%
braxton hicks
begin in 2nd tri not in distinct pattern helps with effacement
cephalohematoma
bleed that does NOT cross suture lines
metrorrhagia
bleeding between periods of less than 2 weeks
amnioinfusion rationale
a volume of warmed, sterile, normal saline or ringer lactate solution is introduced into the uterus transcervically through an intrauterine pressure catheter to increase the volume of fluid when oligohydraminos is present. It is a procedure during labor. It is used to change the relationship of the uterus, placenta, cord and fetus to improve placental and fetal oxygenation. Instilling an isotonic glucose-free solution into the uterus helps to cushion the umbilical cord to prevent compression or dilute thick meconium
FAS s/s
abnormal palmar creases craniofacial abnormalities intrauterine growth restriction cardiac abnormalities respiratory distress
labor dystocia
abnormally slow or protracted labor
cocaine use risk
abruptio placentae
amenorrhea
absence of menstruation
late decelerations
administer oxygen
presumptive signs of pregnancy
amenorrhea breast changes urinary frequency -subjective data reported to HCP
stage 1 of labor, during active phase, the cervix dilates?
4-7cm
Therapeutic Magnesium Sulfate Level
4-8 mg/dL
RBCs
4.2-5.4 million/mm
newborn glucose level
40-69
adequate hydration in newborn
6-12 diapers -stool/meconium passed in first 48 hours
wbcs
5,000-10,000
normal wbc
5000-10000
weight
5lb8oz-8lb14oz (2500-4000g)
respiratory rate within 3 min of birth
60
fetal fibronectin test
A vagina swab that tests the protein found in the secretion. Determines who is at risk for PTL
hypomenorrhea
an unusually small amount of menstrual flow during a shortened regular menstrual period
teratogen
any factor that can cause a birth defect
APGAR
appearance, perfusion, grimace, appearance, respiration
preeclampsia interventions
assess bp check urine for protein assess deep tendon reflexes teach importance of keeping track of daily weight
amniotomy
AROM-artificial rupture of membranes
lithium advanced toxicity
Advanced toxicity: hospitalization, stop med, bowel irrigation Seizures, coma Ataxia Stupor Large amounts of dilute urine Greater ECG changes Clonic movement: repeated, jerky Severe hypotension Blurred vision Tinnitus Severe diarrhea Diaphoresis weakness
Amitriptyline
Antidepressant and nerve pain reliever
Clozapine
Atypical antidepressant Adverse: BBW: agranulocytosis, drowsiness, dizziness, GI symptoms, NMS (neuroleptic malignant syndrome), bradycardia, dose-dependent seizures, cardiac arrest Nursing considerations: infection risk, must have WBC >=3500 baseline ECG and VS Teach patient to change positions slowly Monitor BP, P OD: CNS and respiratory depression
estrogen-progestin oral contraceptives s/e
bloating, nausea, breast tenderness adverse effects: dizziness, chest pain, calf tenderness
How do SSRIs work?
block reuptake of serotonin
tubal ligation
blocking the fallopian tubes to prevent fertilization from occurring
Bupropion
Blocks reuptake of serotonin Zyban: smoking cessation Wellbutrin: depression s/e: headache, weight loss, insomnia Don't double up on missed doses Never crush, chew, cut
Terbutaline (brethine)
Bronchodilator Steroid for baby's lungs in preterm labor Used to maintain pregnancy in preterm labor Not with unmanaged DM
rubella titer
Detects antibodies for the virus that causes German measles; if titer is 1:8 or less, the woman is not immune; requires immunization after birth; and woman is advised to avoid people with undiagnosed rashes
bishop score
Determines maternal readiness for labor by evaluating whether the cervix is favorable by rating cervical dilation, effacement, consistency, position, and station -9 or higher for first time moms -5 or higher for veterans
Citalopram
Dry mouth, nausea, drowsiness, insomnia, diaphoresis (drug book)
lithium early toxicity
Early toxicity Sx: hold med, check blood level and potentially adjust dose Confusion Coarse hand tremors GI upset ECG changes Sedation Hyperirritability of muscles
erythromycin
Given in both eyes within 1 hour of birth Do not wash eyes before, do not flush after Prevents opthalmia neonatorum=blindness
GTPAL
Gravida, Term, Preterm, Abortions, Living
newborn weight loss
HCP should be notified of newborn's weight loss--acceptable weight loss is 10% or less in the first 3-5 days of life
medroxyprogesterone (Depo Provera)
IM shot offered after childbirth as a birth control method that lasts 3 months Not a method intended for long term birth control due to effects on bones Associated with breakthrough bleeding
Phytonadione (Vitamin K)
IM, helps NB develop clotting factors vastus lateralis sterile gut
stage 1 of labor includes which phases
Latent (early labor), active and transition
Magnesium sulfate
Muscle relaxer/CNS depressant Se: flushing, dizziness, feel like on fire, blurred vision IV med Normal range 1.7-2.2 Laboring mom want above 3.3 Therapeutic range for magnesium sulfate is 4-7mEq/L? Toxic >8 Adverse effects: INS depression, decreased urine output, flushing, extreme muscle weakness Antidote: Calcium gluconate (IVP, give fast) Foley for strict I's and O's Reduce neonatal resp distress
Carbost tromethamine (Hemabate)
Not with asthma Keep refrigerated SE: diarrhea, n/v, H/A, HTN, fever, tachycardia Give anti-diarrhea
oxycodone-acetaminophen (Percocet)
Opioid Analgesic
Benzocaine (Dermaplast)
Pain relieving/numbing spray from vaginal birth
Babinski reflex
Reflex in which a newborn fans out the toes when the sole of the foot is touched; may have an underlying nervous system or brain condition that's causing your reflexes to react abnormally; immaturity of CNS
hyperbilirubinemia
excessive level of bilirubin (bile pigment) in the blood above 5mg/dL shown as jaundice strict is and os
menorrhagia
excessive menstrual bleeding
vitamin k
facilitate clotting in neonate
cephalopelvic disproportion
failure to progress in labor
BPP
fetal breathing movements gross body movements fetal tone reactive fetal HR qualitative amniotic fluid volume
bipolar disorder in kids
find tool frequency, intensity, number, duration
bipolar nutrition
finger foods high cal
variability
fluctuations in baseline fetal heart rate
deficiencies caused by oral contraceptives
folic acid vitamin c vitamin b6 vitamin b12
nonstress test (NST)
for antepartum evaluation of fetal well being performed during third trimester. noninvasive test that monitors the fhr to fetal movement. a doppler transducer(used to monitor the fhr) and a tocotransducer(used to monitor uterine contractions) are attached externally to a client's abdomen to obtain tracing strips. client pushes a button when she feels the fetus move.
magnesium sulfate
for preeclamptic parents in pre term labor. provides neuroprotection to fetus and prevents seizures in mother
third stage of labor
from birth of baby to delivery of placenta
stage 2 of labor begins with...
full dilation of cervix (10cm) and ends with full delivery of baby
SSRIs (Citalopram & Sertaline)
given for depression, anxiety, PTSD report more energy w/o change in depression-risk for suicide slow onset, slow taper off, 2-4 weeks for full effect monitor VS bc can affect BP serotonin syndrome/overdose: never mix SSRI (sweaty, hot fever, rigid muscles, restlessness and agitation, increased DTRs, increased heart rate) side effects: nausea, weight gain, suicide risk incresed
calcium gluconate
given to reduce magnesium toxicity
dexamethasone
glucocorticoid that stimulates the production of fetal lung surfacants which are needed for fetal lung maturity; admin is started 48 hours before expected birth
What happens when the placenta separates during the third stage of labor?
gush of blood
Prostaglandin E2 (Cervadil):
has a string like a tampon, benefit is it can be removed if needed
early decelerations rationale
head compression
Bishop score
helpful in deciding how successful a scheduled induction would be 8-spontaneous labor likely 6-7-unlikely spontaneous labor <5 less likely spontaneous labor, unsuccessful induction
folic acid
helps for the neural tube, can prevent major birth defects of baby's brain (anencephaly) and spine (spina bifida) take at least 400 mcg
pulse ox test
helps to detect critical congenital heart disease
Huntington disease
nerve cells in brain break down over time worst case scenario affects breathing affects men and women manage symptoms onset between 30-50
placenta previa s/s
nontender uterus and bright-red bleeding -as cervix dilates, overlying placenta separates from uterus and begins to bleed
prolapsed cord
nurse needs to relieve pressure
probable signs of pregnancy
objective data such as cervical changes ex: Goodell's sign (softening of cervix)
variable decelerations
occur if umbilical cord becomes compressed, reducing blood flow between placenta and fetus
Where does implantation occur?
on top of uterus -important because that is the place that the placenta develops
vaginal infection from Candida albicans
pain, itching, thick, white vaginal discharge
dysmenorrhea
painful menstruation
preterm labor symptoms
pelvic pressure or feeling that the fetus is pushing down
APGAR Scoring
performed at 1 and 5 minutes after birth -2 points for each activity, pulse, grimace, appearance, respiration -if <7 at 5 minutes, repeat every 5 min for up to 20 minutes
lochia serosa
pinkish to pinkish brown last from day 4 to day 11
First nursing action when umbilical cord is protruding from vagina
place client in Trendelenburg's position
chlamydial affects in newborn
pneumonia preterm birth conjunctivitis (pink eye)
effect of overdistended urinary bladder during labor
predisposes client to uterine hemorrhage after birth
rubella vaccine teaching
pregnancy needs to be avoided for 1-3 months -vaccine is subc -exposure to immunosuppressed individuals needs to be avoided -hypersensitivity reaction can occur if client has allergy to eggs
abruptio placentae s/s
premature placental separation s/s: abdominal rigidity, tetanic uterus, dark-red bleeding, firm abdomen, tender uterus, extended fundal height
abruptio placentae
premature separation of placenta from uterine wall after 20th week of gestation and before the fetus is delivered -associated with conditions characterized by poor uteroplacental circulation, such as hypertension, smoking, and alcohol/cocaine use
risk factors of diabetes in pregnancy
preterm birth hypertension cesarean birth
complications w/ excessive weight gain during pregnancy in adolescents
preterm labor cesarean delivery postpartum obesity
primigravida over 35 risks
preterm labor multiple gestation chromosomal anomalies bleeding in in first tri
erythromycin
prevents an infection called ophthalmia neonatorum from occurring after birth in a newborn born to a woman with an untreated gonoccocal infection
postterm newborn
profuse scalp hair parchmentlike skin creases covering the entire soles
classic signs of preeclampsia
proteinuria hypertension
gestational week 28-36 appt
q2 weeks
bottle feeding
q3-4 hours take 1oz on day 1 then 2-3oz/feeding
gestational week 1-27 appt
q4 weeks
fasciculation
rapid continuous twitching of resting muscle without movement of limb
variable decelrations
rapid onset of less than 30 seconds w/ rapid return to FHR baseline
foods to avoid during pregnancy
raw shellfish herbal supplements soft scrambled eggs
Diphenhydramine (Benadryl)
reaction to epidural
accelerations
reassuring sign and usually occur w/ fetal movement
Misoprostol (Cytotec):
rectal administration contract
lochia rubra
red lasting 3 days abnormal-large clots, foul odor
hydatidiform mole s/s
slight painless vaginal bleeding and a larger than expected uterus, gestation hypertension
indomethacin
slows/halts uterine contractions
thrombophlebitis risks
smoking, varicose veins, obesity, hx of thrombophlebitis, women older than 35/more than 3 pregnancies, c section
couvade syndrome
somatic symptoms experienced by the father during pregnancy simulating those of the pregnant mother
ibuprofen (motrin)
standing order for inflammation
moro reflex aka
startle reflex
stage 3 of labor
starts with full delivery of baby and ends with full delivery of placenta
alcohol use in pregnancy
stillbirth spontaneous abortion intellectual disabilities
Palmar grasp reflex
stroke the inside of infant's hand w/ an object and assessing if hand closes around object helps assess palmar grasp reflex
partial abruptio placentae s/s
sudden sharp localized pain and small amounts of dark-red bleeding caused by some degree of placental separation
150ml urine
suggest urinary retention
iron
supplement for blood iron rich foods: red meat, dark leafy vegetables, dried fruit, iron fortified cereals, bread, pasta, peas
prevention of retinopathy of prematurity (ROP)
support neonate's oxygen saturation while providing minimal FiO2
episiotomy
surgical incision of the perineum to enlarge the vagina and so facilitate delivery during childbirth
preeclampsia s/s
swelling of the face blurred vision epigastric discomfort
spontaneous abortion risks
syphilis, toxoplasmosis, rubella
pyelonephritis
systemic illness that can progress to maternal sepsis, preterm labor and premature delivery
Tricyclic antidepressant
take at bedtime
MAOIs: Phenelzine (Nardil)
take in the morning with atypical depression, MAOI's are treatment of choice used for severe depression when other drugs have failed s/s: lightheadedness, dizziness, orthostatic hypotension, hypertensive crisis with: OTC cold and weight remedies, foods containing tyramines-aged cheeses, fermented and dried foods, red wine, beer, figs, avocado, chocolate (diet 2 weeks before and after) risk for massive htn risk (h/a), avoid tyramine avoid other anti-depressants (TCAs, SRNIs, SSRIs) increased suicide risk
quad screen
test in first trimester measures HCG, estriol, inhibin A and AFP
Lithium
therapeutic .8-1.2 acute mania: 1-1.5 toxic level 2.0 mEq/L, severe is 2.5 report tinnitus Can be increased by NSAIDS or diuretics Salt based med so don't want to increase/decrease sodium intake/consistent sodium intake may take 1-3 weeks side effect: weight gain, h/a, lethargy, recent memory loss, n/v, ab pain, fine hand tremors, leukocytosis avoid excessive caffeine consume 2500-3000+mL fluid/day can take with valproic acid b/c of weight gain pt with CHF diuretic meds will compete with sodium balance=toxicity
discontinued syndrome
think they are better but will have problems-agitation, confusion, hyperreflexia, tremors-look ill and hyped up