FAMILY FINAL

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Author:
vanwin
ID:
273018
Filename:
FAMILY FINAL
Updated:
2014-05-03 18:45:02
Tags:
Family OB PEDI NURSING
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Description:
UT Tyler Nursing
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  1. Positive indications of pregnancy (4)
    • auscultation of fetal heart tone
    • ultrasound
    • doppler
    • palpation of fetus by HCP
  2. GTPAL
    • gravida
    • term
    • preterm
    • abortion
    • living
  3. Expected pregnancy weight gain
    • Under weight: 28 - 40lbs
    • normal weight: 25-35lbs
    • over weight: 15-25lbs
    • obese: at least 7 - 15lbs
  4. Cervical cerlage
    • surgical closing of cervix to prevent spontaneous abortion and keep pregnancy
    • can be removed at termed for vaginal birth or kept in for cesarean
    • can still have preterm labor
  5. Abruptio Placentae; patho & manifestation
    • Early detachment of placenta from uterine wall
    • board like uterus
  6. Risk factors of Abruptio Placentate (6)
    • HTN
    • smoking
    • cocaine
    • multigravida
    • trauma/MVA
    • hx of abruptio
  7. Magnesium Sulfate
    MoA
    Therapeutic levels
    • MoA: CNS depressant
    • therapeutic level: 4-8
  8. Magnesium toxicity symptoms(5) & antidote
    • decrease deep tendon reflex
    • decrease muscle tone/ respiratory rate
    • slurred speech
    • nausea
    • decreased LOC

    calcium gluconate
  9. Bacteria Vaginosis
    • "fishy" odor with discharge
    • treat with flagyl
  10. 1st trimester ultrasound (5)
    • transvaginaly b/c pregnancy is still low in the abdomen
    • fetal viability
    • specimen for chroionic villi samplic
    • defects
    • gestational age
  11. 2nd trimester ultrasound nursing considerations
    • may need full bladder
    • assess abnormal findings
  12. Ultrasound advantages vs disadvantages
    advantage: safe, fast

    disadv: cost
  13. Doppler ultrasounds vs color ultrasound
    doppler: for pregnancies with high risk factors

    color: easier to visualize structures & vessels
  14. Alpha Feto Protein, what & when
    • found in fetal plasma, can cross placental barrier (MFAP)
    • increases with fetal age
    • 16 -18 wks
    • if abnormal; amniocentesis is recommended
  15. AFP adv vs disadv
    adv: fast, easy, early detection

    disadv: reassuring test does not promise healthy baby, not diagnostic
  16. Multiple Marker screening
    indications
    includes
    • MFAP
    • HcG
    • unconjugated estriol

    detects trisomy 18&21
  17. Chorionic Villus Sampling
    indicates
    when
    dx: fetal chromosomal & metabolic DNA abnormalities

    between 10-13
  18. Chorionic villus sampling
    advantages
    disadvanges
    • advantages: fast, safe in first trimester
    • disadvanges: cost, possible pregnancy lost
  19. Amniocentesis 2nd trimester
    • ideal time
    • check RH sensitization
    • evaluate abnormal FAP
  20. Amniocentesis 3rd trimester indicates (3)
    • reduce fluids
    • hemolytic dz
    • determine lung maturity
  21. Amniocentesis considerations (2)
    fetal monitoring 30-60 mins after

    mom can resume activities after 24hrs
  22. Amniocentesis
    advantages
    disadvantages
    adv: easy, little risk for fetus

    disadv: small window, slow results
  23. non-stress test indicates
    adequate fetal oxygenation, with or without movements
  24. Non-stress test results
    • Non reassuring: nothing in 40 mins or longer
    • reassuring: 15 by 15 or 10 by 10 before 32wks
  25. Vibroacoustic stimulation
    sound on fetal head for 3sec in 1 min up to 3x
  26. Contraction Stress test contraindications (4)
    • risk of preterm labor
    • preterm rupture of membrane
    • hx of uterine surgeries
    • placenta previa
  27. Biophysical profile consists of
    • NST (not needed if all below are reassuring)
    • fetal muscle movement
    • fetal muscle tone
    • fetal breathing movements
    • amniotic fluid
  28. Kick count parameters
    • 10 in 12hrs
    • or 3 in 1hr
  29. How to attain FHR baseline
    • not during uterine contraction
    • avg of 10 mins
    • round to nearest 5
    • time 2min intervals
  30. FHR variability (4)
    • absent: non reasuring
    • minimal
    • moderate: good
    • marked
  31. VEAL CHOP COIT
    • Variable →    Cord compression
    • Early→         Head compression
    • Accelerated→   Okay
    • Late→         Placental insufficiency

    • Change position
    • O2
    • IV bolus
    • Turn off pitocin
  32. True vs False Labor
  33. False contraction Teaching
    • call hcp if contraction doesn't stop
    • observe for signs of bleeding
    • drink fluids
  34. Stages of Labor
    • First: 0cm - 10cm
    • second: 10cm - birth
    • third: birth to delivery of placenta
    • 4th: recovery
  35. 1st Stage of Labor
    • Latent: contractions 5-30mins apart, happy
    • Active: contractions 3-5mins apart, increased fatigue & seriousness
    • transition: 2-3mins apart, bloody show, irritable
  36. 2nd stage of labor nursing considerations
    • comfort measures
    • watch fetal heart monitor
  37. Epidural
    advantages
    disadvantages
    contraindications
    • adv: patient is conscious, little risk to fetus
    • disadv: timing,
    • contraindications: coagulopathies
  38. Epidural nursing considerations
    • turn mom to side
    • put in foley
    • watch fetal heart monitor
  39. Third stage of labor nursing considerations
    • no longer than 30 mins
    • observe lochia * lengthening of cord
  40. 4th stage of labor consideration (2)
    • watch lochia
    • fundus at midline
  41. Preterm Premature rupture of membrane
    breakage &/or leakage of amniotic fluid before labor and before 37wks
  42. Cardiac Catheterization Nursing Considerations
    • NPO before
    • keep legs raised 4-6hrs after
    • assess distal sites
  43. Patent Ductus Arteriosus treatment
    Indomethacin to close or cardiac cath for shunt to occlude
  44. Coartion of the aorta manifestation
    • LHF
    • poor lower extremity pulses
    • low CO
    • r/t constriction of aorta
  45. Coartion of Aorta treatment
    • diuretics
    • digoxin
    • prostaglandin to keep aorta open
  46. Post op pediatric Cardiac cath care
    • VS until stable
    • Heart rate & respiratory count for 1min
    • lung auscultation Q1H
    • observe for hypothermia

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