Childbirth notes 2.txt

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Childbirth notes 2.txt
2014-03-02 11:13:04
Childbirth notes

Childbirth notes 2
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  1. Preterm baby
    before completion of the 37th week; at risk because organ systems are immature and lack adequate reserves of bodily nutrients; hard to maintain body temperature; can find due to fetal fibronectins by vaginal swab; birth defects, IUGR
  2. Term baby
    happy baby
  3. Post term baby
    extends beyond the end of week 42 of gestation, meconium stained amniotic fluid, increased risk of meconium aspiration, low APGARs; dry and cracked peeling skin; long nails; loss of fat
  4. Clinical manifestations of ectopic pregnancy
    ABD pain, delayed menses, abnormal bleeding occurring 6-8 weeks after last menses; if ruptures, may have referred shoulder pain; may have signs of shock and Cullen’s sign
  5. Definition of ectopic pregnancy
    implantation of a fertilized ovum in an area outside the uterine cavity (95% in fallopian tube)
  6. Signs and symptoms of hydatidiform mole
    bHCG levels higher than expected; ultrasound showing vesicles and absence of fetal sack, uterus larger than expected for date; vaginal bleeding; excessive nausea and vomiting; early development of preeclampsia; dark brown blood; check HCG levels for at least a year
  7. Care for woman in precipitous labor
    priority is to promote fetal oxygenation and maternal comfort; left side lying position (slows fetal descent and promotes fetal oxygenation); mom gets O2, IV fluids; pant through contractions; keep baby at same level as uterus until cord is clamped; stop Pitocin; nurse remains with woman
  8. Complication of meconium in amniotic fluid
    development of meconium aspiration syndrome; a severe form of aspiration pneumonia
  9. Nursing interventions for prolapsed cord
    hips higher than head (knee chest), trendelenburg, hips elevated with pillows, side lying, relieve pressure manually; vaginal or cesarean birth
  10. Tocolytic
    suppress premature labor
  11. Signs of placenta previa
    sudden onset of painless uterine bleeding in the last half of pregnancy
  12. Signs of placental abruption
    bleeding, uterine tenderness, uterine irritability, ABD or low back pain, high uterine resting tone
  13. Home nursing care for placental previa
    assess color and amount of vaginal discharge/bleeding; assess fetal activity (kick counts); assess uterine activity; vaginal rest
  14. Inpatient care for placental previa
    assess bleeding; evaluate s/s of PTL; periodic EFM
  15. Important placenta previa
    until location and position of placenta are verified by ultrasound, no manual exams and administration of oxytocin should be postponed to prevent strong contractions that could result in sudden placental separation and rapid hemorrhage
  16. Nursing care for placental abruption
    assess for signs of a concealed hemorrhage; educate; monitor for signs of shock; monitor fetus; side lying position, HOB flat, limit activity; fluid replacement; prepare for surgery