Exam 3 Nuggets
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Anterior Pituitary releases......which
- prepares breasts
Posterior Pituitary releases.....which
- causes milk ejection and increases UC
When a laboring mom is in pain she will increase her respirations and their depth....which increases tidal volume causing
hyperventilation and respiratory alkalosis
What does estrogen do to the liver?
- causes an increase in alkaline phosphate and cholesterol....but
- a decrease in albumin
What does Progesterone do to the gallbladder?
decreases it's tone so less emptying which causes an increase in bile salts causing gallstones and pruritus
Risks of having bile salt retention
- premature passing of meconium
- stillborn birth
What does the growing fetus do to the ureters?
compresses them causing an obstruction....UTI
Hep B vaccine rules
- given as prophylactic babies if mom has positive titer
- **delay dose till baby is 40 weeks post conception
Who gets HBIG....and how is it given
Given ONLY to mom's who have antibodies for HBSAG or have developed Hep B during pregnancy
- *IM within 12 hours of birth (ASAP)
- *Bathe baby before giving (prevention of inoculation)
Rubella vaccine rules
- don't give during pregnancy cuz it crosses the placenta
- Give after delivery to protect subsequent unborn children
- *Pt Ed-don't get prego for 3 months after injection
Vitamin K rules
given by IM within first hour of deliver and BEFORE circumcision if a boy
- given within first 1 hr. after birth
- hold tube horizontally
- wipe excess after 1 minute
What is IV solution is run with an epidural?
Lactated Ringers 500-1000 mL Bolus
With all epidurals watch for....
- decreased BP
- decreased RR
- increased HR
How is Nubain given?
through the IV and injection is given at the start of the contraction
For Nubain what are the RR #'s that signal respiratory depression?
- Mom <12/min
- Newborn <30/min
Narcan helps with 2 things
respiratory depression and pruritus
How is cytotec (synthetic prostaglandin) administered?
tablet placed intravaginally for induction ripening
tablet placed intrarectally for pp hemorrhage
How are prostaglandins administered to ripen the uterus (even though most facilities don't use this any more)
gel placed on cervix
What is prepadil used for?
cervical ripening and stimulation of contractions
syringe of gel is placed in the cervix
lie flat for 20 min after insertion to prevent leakage and monitor FHT's for 30 min after insertion
If a person is getting a c section what will they have?
a spinal block at T6-T7
How is Betamethasone givern?
IM q24hr x 2 doses
How is Terbutaline given?
How much does a lactating mom increase her calories?
- first 6 months by 330 calories
- next 6 months 400 calories
Name the 2 hormones that are suppressed during pregnancy and why?
FSH and LH....don't need to ovulate
thinning of lower uterine segment
flexing of uterus against cervix
Pregnancy test type and when given?
- 1 week post ovulation
How do you help with n/v
- eat dry crackers/toast before getting out of bed
- eat carbs/proteins q3h
- eat foods with ginger or peppermint
- take prenatal vitamins at bedtime
- take V. B6 or antihistamines
How do you help with heartburn?
- eat small meals q3h
- avoid spicy foods
- chew gum
- eat a tbsp. of cream prior to eating
- don't eat before bed
- walk or sit up after meals for 1-2 hrs
- don't take antacids high in sodium or calcium
antacids high in sodium
antacids high in calcium
sodium-alka seltzer and baking soda
calcium-tums and alka mints
How do you help decrease urinary frequency
- decrease fluids in the evening
- avoid caffeine
- perform kegels....practice by stopping the flow of urine mid stream
How can you help with constipation
- reduce intake of sweets
- fold a towel and use as a foot rest when using the toilet to help avoid straining
How can you help with leg cramps?
- elevate legs often during the day
- avoid foods high in phosphorous
- check with dr. about taking extra ca or mag
Emotional Response to pregnancy by trimester
1st-uncertainty, ambivalence, focus on self
2nd-focus on fetus, body image and sexuality changes
3rd-protection of baby, increased dependence and acceptance of fetus as separate but dependent
Physical validation to pregnancy by trimester
1st-no obvious signs of fetal growth
3rd-fetal growth, discomfort, decreased maternal activity
Role changes by trimester to pregnancy
1st-seeks safe passage
2nd-seeks acceptance of fetus and role as a mother
3rd-prepares for birth
involves observing and copying the behaviors of other women who are prego or already moms in an attempt to discover what the role is like
searches for opportunities to hold or care for infants in the presence of another person. Looking to receive validation from an observer especially her partner or mom
mental images of how the infant will look and what characteristics he or she will have, can be fearful about the bad things that can happen
internalized view of a "good" mothers behavior, this process implies that the women has explored the role of mother long enough to develop a sense of herself in the role and to be able to select behaviors that reaffirm her sense of herself fulfilling the role
Looking for a role fit
sense of sadness that she will never again be a care free woman without a child
What is a Pudendal block used for?
cutting the perineum to prepare for forceps
What is the side effect of a subarachnoid epidural injection?
rapid intense motor and sensory block....loss of sensation
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