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