NCLEX: MATERNINITY/OB Flashcards
(42 cards)
Low FHR
‣BAD!
<110
‣when FHR stays the same and doesn’t change
‣Treatment: LION (Left Side, IV, O2, Notify!)
Late Decelerations
‣BAD!
‣ when HR slows down near the end or after a contraction
Variable Decelerations
‣Very BAD!
‣caused by prolapsed cord
‣Tx: push postion
High FHR
> 160
‣No BIG deal
‣document/take mom’s temp (may have a fever)
High baseline variability
‣Good! & document
‣when fetal HR is always changing
Early decelerations
‣when baby heart slows before or at the beginning of a contraction
‣Fine/document
VEAL
CHOP
MINE
- Variable Decelerations
- Early Decelerations
- Accelerations
- Late Decelarations
1.Cord Compression
2. Head Compressions
3. Okay
4. Placental Insufficiency
- Maternal Repositioning
- Intervention not necessary
- No intervention needed
- Evaluate why
‣stop pitocin
‣give O2
‣reposition mom
‣possible C-section in persistent
Stage #2: Delivery of the Baby: Order
- deliver the HEAD
- suction the mouth then the nose
- check for a nuchal cord (around the neck)
- deliver the shoulders and the body
- the baby must have an ID band on before it leaves the delivery area
Stage #3: Delivery of the PLACENTA
‣make sure its intact
‣make sure the cord has 3 vessels (AVA: 2 arteries & 1 vein)
Stage #4: Recovery
4 things you do, 4 times per hour
1.VS (checks for signs of SHOCK: BP↓ HR ↑, pale, cold & clammy)
2.check the FUNDUS; if its boggy, massage it… if its displaced, you catheratize!
3.check the PADS: if bleeding excessively, she will SATURATE a pad 15 mins or less
4.ROLL her over (check for bleeding underneath her)
Postpartum Assessment: BUBBLEHEAD
‣every 4-8 hours
‣B: breasts
‣U: uterine fundus; needs to be firm; if boggy, massage! needs to be midline; if not, cath them… height to fundus related to the belly button: fundal height = days postpartum.. 4th postpartum day: 4 below on the 4th day..
‣B: bladder
‣B: bowel
‣L: lochia; rubra (1st; red), serosa (2nd;pink) & alba (3rd;white)
‣E: episiotomy
‣H: hemoglobin & hematocrit
‣E: extremity check; looking for thrombophlebitis; bilateral calf circumference measurements
‣A: affect
‣D: discomfort
capcut succedaneum
crosses sutures (symmetrical)
‣Refers to the swelling, or edema, of a newborn’s scalp soon after delivery. It appears as a lump or a bump on their head. This condition is caused by prolonged pressure from the dilated cervix or vaginal walls during delivery.
cephalohematoma
is a traumatic subperiosteal haematoma that occurs underneath the skin, in the periosteum of the infant’s skull bone.
terbutaline
tocolytic (stops labor); causes maternal tachycardia
magnesium sulfate
tocolytic (stops labor); causes HYPERmagnesemia; LOWERS heart rate, BP, reflexes, respiratory rate & LOC!
Parameters for titrating mag sulfate
respirations ABOVE 12; it’s okay… if BELOW 12; slow the mag down! reflexes: we WANT +2.. if it’s +1; slow it down.. +3; speed it up.
oxitocic
stimulate & strengthen labor!
oxytocin pitocin
(BIG thing to remember; it can cause uterine hyperstimulation - longer than 90 seconds & closer than every 2 minutes; if you see this, back off your PICC!)
Methergine
to prevent or treat excessive bleeding after childbirth
-raises BP
Betamethasone
steroid* helps fetal lung maturation
-given to the mother
-it’s is given IM
-it is given BEFORE the baby is born
servant “surfactant”
helps with fetal lung maturation
-it is given to the baby
-it is given trans-tracheal (blown in through the trachea; nebulizer)
-it is given AFTER the baby is born
Naegle’s Rule
take the first day of the LMP
Add 7 days
Subtract 3 months
Total weight gain during pregnancy
25-31 lbs
1st trimester weight gain
1 lb per month (3 lbs total for first trimester)
2nd/3rd trimester weicht gain
1 lb per week
