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.