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Prolapsed cord, Uterine rupture, Amniotic fluid embolism Perimortem Cesarean, Intimate Partner Viole
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prolapsed cord
s/s
displacement of cord in front of presenting part
visible cord
palpable cord
fetal bradycardia
Nursing considerations of a woman with a prolapsed cord
check FHT's at ROM and after nxt contraction
D/C pit
vaginal exam for palpable cord
If find a prolapsed cord I....
exert upward pressure on presenting part
call for help
knee chest position
admin O2
*if protrudes vagina, place sterile moistened gauze over it
S/S of uterine rupture
abdominal pain/tenderness
chest pain
hypovolemic shock
fetal distress
absent FHTs
cessation of UC's
What causes a uterus to rupture
previous uterine incision
blunt trauma
intense labor contractions
Intrauterine manipulation (forceps/IUPS)
How do you treat a woman whose uterus has ruptured?
c section
volume replacement
O2
Amniotic Embolism
when amniotic fluid is drawn in to maternal circulation and is carried to the lungs causing obstruction and vasoconstriction
S/S of amniotic fluid embolism
abrupt respiratory distress
heart failure
circulatory collapse
DIC
What causes amniotic fluid embolism?
ROM
strong labor with tetanic contractions...causing high intrauterine pressure forcing amniotic fluid in to open uterine or cervical veins
How do you prevent amniotic fluid embolism?
prevent tetanic contractions AROM
no Jacuzzi after ROM
Perimortem Cesarean 4 minute rule
when a mom crashes during birth CPR is not initiated until 4 minutes after she has been down
Infertility
the inability to conceive after 1 year of regular intercourse (2-3x/week) without contraception.....OR
any involuntary inability to conceive at the time desired
What causes impotence/abnormal erections
CNS dysfunction from....
drugs like antihypertensives
psych disturbances
chronic illnesses like DM
What causes abnormal ejaculation...can be slow, absent or retrograde in to the bladder
from DM
neuro surgery impairing nerves
drugs-antihypertensives, psychotropic
anatomic abnormalities
alcohol
illicit drugs
Varicocele
Bag of Worms
blocked ducts carry sperm to penis and changes temperature of ducts carrying the sperm
Turner's Syndrome
failure of ovaries to respond to the pituitary gland....complete or partial absence of the secondary sex chromosome
causing infertility (ovaries cant make eggs or female hormones) and endocrine issues
to have kids must adopt or have an egg donated
How do you treat Turners Syndrome
growth hormone started at 2-5yo
hormone replacement started at 12-15yo...and continued to prevent CAD and osteoporosis
Klinefelter's Syndrome
sex linked male defect...they have an extra X chromosome....female characteristics
How is infertility evaluated?
Semen analysis is first...no sex for 3 days before
need more than 1 specimen
delivered to Dr. within 2 hrs
What do you look at to see if a woman has fertility issues?
Good hx and exam
look ovulation prediction measurement
pelvic US looking at organ structure, ovarian follicles and relase of ova
Hysterosalpingography-xray of uterus and tubes with contrast
Postcoital test to see how sperm reacts to cervical mucus
How can you tell a woman is ovulating?
temperature starts to increase 14 days prior to period starting.
increase is 0.3-0.5 degrees
When should a woman start breast self exams?
20s
When do you do a breast self exam?
one week after her start of period cuz it is less glandular, most comfortable
done every month
Clinical Breast exam rules
20's and 30's a part of a regular health exam <3 years
40's it should be done every year
Baseline mammogram done at age...... then.....and older q 1yr
Mammogram shows
abnormalities of breast
Breast US shows
picture of the tissues in the breast, and areas closest to the chest wall.....which is hard to see on a mammogram
Breast MRI
used for special higher risk populations....NO RADIATION in this test
When should pelvic exams start?
once becomes sexually active or 21 yo or if have symptoms of a disorder like amenorrhea or STD
3 stages of pap smear
Bethesda System
WNL
Squamous cells
Glandular cells...adenocarcinoma
what happens if cellular changes are found on a pap smear?
evaluate further with colposcopy and biopsy
treat with cryotherapy
excise a part of the cervix
rarely....hysterectomy
Author
foxyt14
ID
274368
Card Set
Prolapsed cord, Uterine rupture, Amniotic fluid embolism Perimortem Cesarean, Intimate Partner Viole
Description
OB Final
Updated
5/14/2014, 2:50:14 AM
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