High Risk Pregnancy

Question 1

What are Hydralazine maternal/fetal effects?

Answer 1

Mom: tachycardia, headache, palpitations
Baby: tachycardia, late decels

Question 2

What are Hydralazine nursing indications?

Answer 2

Check bp, check urinary output, place mom in side lying position

Question 3

What are Labetalol Hydrochloride maternal/fetal effects?

Answer 3

Mom: Lethargy, fatigue, sleep disturbances, orthostatic hypotension
Baby: None

Question 4

What are Labetalol nursing indications?

Answer 4

Do not use for women with asthma, or heart problems.

Question 5

What are Methyldopa maternal/fetal effects?

Answer 5

Mom: Sleepiness, postural hypotension, constipation
Baby: After 4 months will have positive coombs test

Question 6

What are Methyldopa nursing indications?

Answer 6

Check bp, check urine output, place mom in side lying position

Question 7

What does Methyldopa, Hydralazine, Nifedepine, and Labetalol treat?

Answer 7

Hypertension in pregnant mom

Question 8

What are Nifedipine maternal/fetal effects?

Answer 8

Mom: Headache, flushing, tachycardia
Baby: None

Question 9

What are Nifedipine nursing indications?

Answer 9

• Don’t give with magnesium sulfate
• Don’t give sublingually because hypotension can become profound
  Same indications as hydralazine
• Will relax uterus (acts as a tocolytic)

Question 10

The presence of which substance in vaginal secretions may indicate an increased risk for premature rupture of membranes (PROM)?

Answer 10

Fetal Fibronectin

Question 11

What is the procedure for a Non-stress test?

Answer 11

Mom connected to a fetal heart monitor. Test will last for 20 mins. We are looking for 2 elevations in FHR from baseline of 15 beats for 15 seconds. There should be 2 of those elevations within the 20 mins to be deemed reactive.

Question 12

What is the procedure for a Contraction stress test?

Answer 12

Mom connected to a fetal heart monitor. Oxytocin will be given IV to stimulate contractions. Look for late decelerations in baby. We want the test to be negative for late decels.

Question 13

What does VEAL CHOP MINE stand for?

Answer 13

-Variable acceleration -Mother changes position
-Early acceleration -Intervention not needed
-Acceleration. -No intervention needed
-Late acceleration. -Execute actions
-Cord compression
-Head compression
-Okay
-Placental insufficiency

Question 14

What do late decelerations indicate?

Answer 14

Placental insufficiency

Question 15

What are signs and symptoms of hypoglycemia?

Answer 15

Cold, shaky, clammy, sweaty

Question 16

What are signs and symptoms of hyperglycemia?

Answer 16

Hot, dry, polyphagia, polyuria, polydipsia

Question 17

What drugs speed up lung maturity of infant?

Answer 17

Betamethasone, Dexamethasone

Question 18

What are nursing indications for corticosteriods?

Answer 18

They spike blood sugar so monitor it.

Question 19

Time frame for fasting blood glucose?

Answer 19

60-105

Question 20

Time frame for glucose 1 hour post meal?

Answer 20

<140

Question 21

What are the rapid acting insulins?

Answer 21

Humalog (Lispro)
Novolog (Aspart)

Question 22

What is a short acting insulin?

Answer 22

Regular Humalin

Question 23

What is the onset, peak, and duration of Regular (humalin) insulin?

Answer 23

Short staffed nurses went from 30 patients to (2) 8 patients
Onset:30 min
Peak: 2 hours
Duration: 8 hours

Question 24

Which disease will have ketones in urine?

Answer 24

Gestational diabetes

Question 25

Which disease will have protein in the urine?

Answer 25

Preeclampsia

Question 26

What blood pressure reading can signal preeclampsia?

Answer 26

Systolic over 30 Diastolic over 15

Question 27

What are the hallmark signs of preeclampsia?

Answer 27

Headache, blurred vision, overactive reflexes, protein in urine, edema

Question 28

What are some preeclampsia risk factors?

Answer 28

Gestational diabetes, obesity, hx of hypertension, family hx, first pregnancy, age under 18, age over 30

Question 29

What are some interventions for preeclampsia?

Answer 29

Bedrest in lateral position, seizure precautions, magnesium sulfate, hydralazine, lobetalol, nifedipine, methyldopa, pad side rails, limit sodium intake, maintain quiet environment

Question 30

What are magnesium sulfate nursing indications?

Answer 30

- Monitor for mag toxicity - Monitor respiratory status - Start a foley prior to mag admin - Calcium gluconate at bedside

Question 31

Mag toxicity signs?

Answer 31

-Low RR -Low urine output -Low deep tendon reflexes

Question 32

When do we give Rhogam IM injection to mom?

Answer 32

Once at 28 weeks, again 72 hours after birth

Question 33

What is Methotrexate?

Answer 33

Dissolves ectopic pregnancy by dissolving rapidly dividing cells