TEST 3
Betamethasone
(Celestone) of the best steroids for Neonatal complications such as respiratory distress; intraventricular hemorrhage and decreasing neonatal death.
Dinoprostone
(Cervidil) - This is used to promote ripening.
Insulin
A maternal side effect of steroids for neonates are a temporary glucose intolerance which may require an increased ____ dose.
Tocolytics
Act on uterine muscle to cease contractions. Used to stop preterm labor. Terbutaline sulfate (Brethine), ritodrine HCl (Yutopar), nifedipine (Procardia), magnesium sulfate
Hypotonic
Active phase of labor; contractions are low amplitude; few than 2-3 contractions in 10 minutes; irregular pattern; cervical dilation less than 1 cm /hour; overstretching of uterus, large fetus, multiple gestations; hydramnios; bladder distinction.
Oligohydramnios
Amniotic fluid <500 mL
Calcium gluconate
An antagonist to magnesium sulfate toxicity.
Procardia
Blocks calcium move into muscle cells (medication for pre-term labor)
Fertility medications
Clomiphene, Menotropins and Choriogonadotropin Alfa are _____ ______ that are used to increase the likelihood of conception in an infertile woman.
Corticosteroids
Decreases the incidence and severity of of neonatal respiratory distress syndrome; decreases incidence of neonatal intraventricular hemorrhage and decreases incidence of neonatal death.
Bishop score
Determines maternal readiness for labor by evaluating whether the cervix is favorable by rating cervical dilation, effacement, consistency, position, and station
Cervidil
Directly softens and dilates the cervix.
Hypertobic
Does not fully relax
Beta adrenergics
Drugs given for pre-term labor patients. These inhibit uterine muscle activity.
Prostaglandins
Help stimulate uterine contractions.
Indocin
Inhibits prostaglandins (medication for pre-term labor)
Dystocia
Leading cause of primary c-sections
PROM
Nitrazine paper; ferning and ultrasound are used to verify?
PPROM
Preterm premature rupture of membranes (before 37 weeks)
Hypotonic
Relaxes too much
Ripe
Short, centered and soft means the cervix is?
Terbutaline
Side effects such as cardiovascular: wide pulse pressure, dysrhythmias, chest pain, tachycardia; respiratory: dyspnea, pulmonary edema; central nervous system: tremors, restlessness and headache and metabolic: such as hyperglycemia and hypokalemia are associated with:
Nifedipine
Side effects such as flushing of skin, headache, transient increase in maternal and fetal HR; postural hypotension and lightheadedness
mifepristone
This can induce elective abortion.
Methylegonovine
This is an oxytocin ergot alkaloid used to reduce postpartum uterine hemorrhage.
Indomethacin
Which medication has the opposite effect of misoprostol?
Magnesium sulfate
____ _______ toxicity depresses respiration. It is essential to establish a baseline respiratory rate before initiating therapy.
7
_____ or less Bishop score means cervix needs to be ripened.
dystocia
difficult labor
Amnioinfusion
introduction of a solution into the amniotic sac; an isotonic solution is most commonly used to relieve fetal distress
Fetal distress
lack of oxygen to the fetus because of decreased blood flow through the placenta or umbilical cord
Cervical ripening
the process of softening and thinning the cervix by artificial means >8 success vaginal delivery. <7 cervical ripening needed.
oligohydramnios
too little amniotic fluid
Dinoprostone
(Cervidil) This can only be given vaginal and used to induce an abortion.
Dinoprostone
(Cervidil) This is a synthetic derivative of naturally occurring prostaglandin E2. This is used for cervical ripening when there is an obstetric need for labor induction.
Dinoprostone
(Cervidil). A pregnant client has labor pains; however, upon assessment, the nurse finds that the cervix is not dilated. Which medication would the nurse identify that could be used to promote labor?
Misoprostol
(Cytotec) is an oral medication used to induce an abortion.
Dexamethasone
(Decadron) another popular steroid for Neonatal complications.
Indomethacin
(Indocin) This is used to maintain a pregnancy during preterm labor.
IUFD
(Intrauterine fetal demise) the fetus dies before birth. Applied to fetuses over 20 wks gestation
Methylergonovine
(Methergine) This helps prevent postpartum hemorrhage.
Methylergonovine
(Methergine) This reduces postpartum hemorrhage.
Cytotec
(Misoprostol) this is a Synthetic PGE1 and is given orally or vaginally. This ripens the cervix.
Oxytocin
(Pitocin) This enhances labor when uterine contractions are weak and ineffective.
Oxytocin
(Pitocin) This is used as an injection; it is used to induce labor at or near full-term gestation.
Oxytocin
(Pitocin) this is generally used to induce and enhance labor after 20 weeks gestation.
Nifedipine
(Pro cardio) This is a calcium channel blocker used to maintain pregnancy during preterm labor.
Nifedipine
(Procardia) this may be used to stop or slow preterm labor and relax the uterus
Water intoxication
A client in labor is receiving an oxytocin infusion. Which alteration in client status would the nurse recognize as an adverse reaction resulting from prolonged administration.
Dinoprostone
A pregnant client is diagnosed with intrauterine fetal death at 36 weeks gestation. The cervical exam reveals a closed cervix that is 30% effaced. What would be the medication of choice for labor induction?
Terbutaline
A tocolytic drug given as part of management of Prolapsed Cord to inhibit UC.
Vertex
Any presentation other than this can lead to Dystocia.
ROM
Be on the lookout for this when variable declarations are noted.
Kernicterus
Bilirubin encephalopathy, a form of brain damage resulting from unconjugated bilirubin entering the brain. Characterized by lethargy, poor feeding, vomiting, irregular respiration, perhaps death
8
Bishop score of _____ means favorable cervix.
Hypertonic
Contractions are erratic and poorly coordinated; contractions are ineffective; usually in latent phase; More than 1 uterine pacemaker is firing; usually stops at 2-3 cm; leads to decreased placental persuasion
Uterine Hyperstimulation
Contractions greater than 5 per 10 minutes.
2,000
Hydramnios is over ______ mL of amniotic fluid
Unripe
Long, posterior and firm means the cervix is ?
Blood pressure
Methylergonovine causes constant uterine contractions and may cause the ____ _____ to rise.
Abortion
Misoprostol (Cytotec) and Dinoprostone (Cervidil) are given during the second trimester to induce an. _________.
Indomethacin
Most common PSI (which helps stop Uterine Contractions), short term, may cause headache; dizziness; and GI upset. Fetal Side effects: constriction of FETAL DUCTUS ARTERIOSUS and impairs fetal renal function which decreases amniotic fluid.
3rd stage
Most exposure of maternal blood to fetal blood occurs when? This is when the placenta separates.
20 weeks
Oxytocin (Pitocin) is generally used to induce and enhance labor after 20 weeks gestation.
Prolapsed cord
S/S such as fetal bradycardia and decelerations immediately following ROM.
Induction
Stimulation of uterine contractions by medical or surgical means. These include IV therapy, bed rest, continuous monitoring, increased pain and need for analgesia and epidurals.
Prolapsed cord
The cord slips down after ROM-can be compressed between fetus and the pelvis.
Knee-chest
Therapeutic management of prolapsed cord include this position along with Trendelenburg along with hips elevated, side-lying.
Variable
These decelerations appear as the shape, duration and degree of fall below baseline rate are variable: V, U and W shaped. The rise and fall in rate is abrupt.
Prostaglandin synthesis inhibitors
These help stop Uterine contractions.
Oxytocin
This acts open the uterine myofibrils to contract/initiate or reinforce labor. Must be given IVPB. Titrate until labor established. Monitor for side effects of Hyper-Stimulation, late decals, rapid progress water intoxification and hypotension.
Hydramnios
This can be a cause of proplased cord because of large amount of fluid exerting pressure in pushing the cord down.
Water intoxification
This causes a pounding maternal pulse; increased maternal blood pressure; moist respirations-Rales; the rate of infusion should be decreased when depression of FHR occurs.
Indomethacin
This drug is given for hydramnios (fluid over 2000 ml) because it causes decreased urine output.
Oxytocin
This has an antidiuretic effect, acting to reabsorb water from glomerular filtrate possibly causing water intoxication
Folic acid
This helps prevent fetal neural tube defects.
Ritodrine
This is a beta adrenergics for preterm labor patients.
Terbutaline
This is a beta adrenergics for preterm labor patients.
Nifedipine
This is a calcium channel blocker that is used to maintain a pregnancy in preterm labor.
Hyperstimulation
This is a major concern of Cytotec
Dinoprostone
This is a medication a nurse would anticipate administering to a client admitted for labor induction.
Mifepristone
This is a progesterone antagonist used along with misoprostol to induce abortion.
Dinoprostone
This is a prostaglandin derivative used to dilate the opening of the cervix.
Dinoprostone
This is a prostaglandin that stimulates uterine contractions to promote the progression of labor.
Misoprostol
This is a prostaglandin used to induce uterine contractions and promote abortion.
Dinoprostone
This is a uterine stimulant indicated for the uterine evacuation of fetal remains.
Clomiphene
This is indicated for female infertility in some clients.
Oxytocin
This is used to aid in uterine contractions during childbirth.
Indomethacin
This is used to maintain a pregnancy in preterm labor by inhibiting prostaglandin activity.
Tenormin
This medication is contraindicated in mothers because this medication highly concentrates in breast milk.
Hypotonia
This occurs with Magnesium Toxicity because of skeletal and smooth muscle relaxation.
Heparin
What medication can cause osteoporosis in a client during pregnancy.
Tenormin
What medication would the nurse identify to be discontinued for a lactating mother being treated for heart problems.
Misoprostol
What oral uterine stimulate would the nurse identify as an alternative to oxytocin?
Nifedipine
What tocolytic agent can be used safely without combining with other agents to inhibit labor and maintain a pregnancy.
Carbamazepine
Which medication is safe for nurses to administer to a lactating woman but may cause teratogenic effects when administered to pregnant clients.
Respiratory rate
Which nursing assessment is a priority assessment prior to initiating an infusion of magnesium sulfate for a client with preeclampsia.
Intravaginal
Which route would the nurse administer Dinoprostone for the termination of a pregnancy.
Ffn
glycoprotein "glue" found in plasma and produced during fetal life. It is produced by the chorion. It acts like a glue to attach the membrane to the uterine wall. (If positive means there is a great chance of membrane rupture within 7-14 days.
macrosomia
large-bodied baby commonly seen in diabetic pregnancies
Turtle sign
retraction of the delivered head against the maternal perineum
Tocolytic
there are no clear first-line ___ drugs fto manage preterm labor; may prolong pregnancy for 2 to 7 days while steroids can be given for fetal lung maturity. These drugs are given usually if less < 34 weeks.
Therapeutic amniocentesis
type of amniocentesis used to remove a large amount of amniotic fluid around a fetus suffering from polyhydramnios
PROM
women beyond 37 weeks' gestation but not term.