Childbirth notes 1.txt

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Anonymous
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264548
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Childbirth notes 1.txt
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2014-03-01 18:35:52
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Childbirth notes
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Childbirth notes 1
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  1. Insulin in pregnancy
    First trimester-decrease; second and third-increase; labor and postpartum decrease
  2. Risk of DM for pregnancy
    PTL, tissue injury or hemorrhage, preeclampsia, infections, ketoacidosis, polyhyadramnios, hyperglycemia and hypoglycemia
  3. Risk of DM on fetus/neonate
    fetus death (IUFD), congenital malformations, fetal macrosomnia, birthinjuries, neonatal hypoglycemia
  4. Insulin acts as a
    growth hormone causing the fetus to produce excess glycogen, protein and adipose tissue and leading to increased fetal size
  5. Cardiac decompensation
    heart cannot maintain sufficient cardiac output. Increased SOB, abnormal breath sounds, fatigue, faint, edema
  6. Care of the pregnant woman with cardiac disease
    anticoagulants, antidysrhythmics, antiinfectives, drugs for HF, pain meds to reduce cardiac workload and reduce risk of tachy; avoid abrupt positional changes, vaginal birth, O2
  7. How to position mother with heart issues?
    Side with head and shoulders elevated
  8. Anemia and complications of
    reduces blood’s oxygen carrying capacity, increases the heart’s workload and can lead to CHF; reduces the woman’s abilify to tolerate blood loss during birth and increases risk of complications such as infection
  9. Treatment of anemia
    good prenatal care, folic acid supplementation, frequent labs, check for infections, fetal surveillance to detect growth, transfusion may be necessary
  10. Meds and epilepsy
    should only take one anticonvulsant med at lowest dose that is effective; meds can cause neural tube defects
  11. Nursing care for epilepsy
    consult with neuro pre pregnancy, reduce adverse effects of anticonvulsants in fetus, prevent generalized seizures (dark, cool room; side rails up), assist with fetal monitoring
  12. Treatment of cholecystitis in pregnancy
    usually postponed until after delivery
  13. When is surgery done for cholecystitis
    if woman has obstructive jaundice, gallstone pancreatitis or suspected peritonitis
  14. Marijuana’s effect on fetus
    tremors, exaggerated moro reflex, IUGR
  15. Cocaine’s effect on fetus
    placental abruption, PTL, precipitous birth, tremulousness, irritability, poor feeing, hyperactivity to environmental stimuli
  16. Meth’s effect on fetus
    PTL, LBW, abnormal sleep, agitation, IUGR, small head, hemorrhage, < nutrient supply, agitation, diaphoresis
  17. Opiates’ (heroin) effect on fetus
    IUGR, PROM, infection, breech, PTL, hypoxia in utero, SAB, stillbirth, meconium aspiration, increased risk for SIDS
  18. Smoking during pregnancy
    decrease placental perfusion and low birth weight
  19. Alcohol abuse during pregnancy
    leading cause of mental retardation and birth defects
  20. Marijuana during pregnancy
    neonate’s size
  21. Signs of HELLP
    hemolysis, elevated liver enzymes, low platelets
  22. Betamethasone
    given to baby to help improve lungs
  23. What is HELLP
    sudden increase in intraabdominal pressure including a seizure could lead to rupture of a subcapsular hematoma resulting in internal bleeding and hypovolemic shock
  24. Hydralyzine
    control BP
  25. Cervical ripening
    if gestation is >34 weeks
  26. Steroids to stimulate fetal lung maturation
    if gestation is less than 34 weeks
  27. Do not palpate
    ABD in HELLP
  28. Nursing care and HELLP
    monitor BP, assess wt, I/O, labs, JVD, cap refill, peripheral pulses, CHF, temp
  29. Signs and symptoms of HELLP
    hyperactive DTRs, headache, altered LOC, edema, visual changes bleeding
  30. What does DIC do
    causes widespread external or internal bleeding and clotting

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