L&D 3

juniperk's version from 2017-11-18 16:41


Question Answer
What are 3 predisposing factors for preterm labor?1. Diabetes, cardiac disease, preeclampsia, and placenta previa 2. Infection, especially UTI 3. Overdistention of uterus due to multiple preg
What is gestational hypertension?1. BP elevation occurs for the first time after midpregnancy. 2. There is no proteinuria
What is transient hypertension?1. Gestational hypertension, with no other signs of preeclampsia, is present at time of birth. 2. It resolves by 12 weeks after birth.
What is preeclampsia?1. It is a pregnancy-specific syndrome that usually occurs after 20 weeks’ gestation (except with gestational trophoblastic disease [hydatidiform mole]). 2. It involves gestational hypertension plus proteinuria
What is HELLP syndrome?Hemolysis, elevated liver enzymes, low platelets
What is Terbutaline used for? antidote?To stop preterm labor contractions. Betablocking agent such as propranolol [Inderal])
What is Magnesium sulfate used for? antidote?CNS depressant administered to a preeclamptic client to prevent seizures. calcium gluconate
What are the 3 things Nifedipine (Procardia) is used for? •Calcium channel blocker •Relaxes smooth muscles of uterus by blocking calcium •Used as a firstline tocolytic or to continue treatment after stabilization with magnesium sulfate
What is Indomethacin (Indocin) used for? Relaxes uterine smooth muscle by inhibiting prostaglandins.
What are the 3 toxic symptoms for magnesium sulfate?respirations <12/min, absence of DTRs, or urine output <30 mL/hr
What is the major side effect of tocolytic drugs?Tachycardia
What is eclampsia?Seizures (with no known cause, like epilepsy) occur in a woman with preeclampsia.
What is chronic hypertension? Hypertension has been observed before pregnancy or is diagnosed before the 20th week of gestation (with the exception of hydatidiform mole).
Preeclampsia is characterized by a BP of what?BP of ≥140/90 mm
9 Risk factors associated with preeclampsia are:1. Age under 17 years or above 35 years 2. Low socioeconomic status 3. Poor protein intake 4. Previous hypertension 5. Diabetes (gestational or preexisting) 6. Multiple gestations 7. Hydatidiform mole 8. Prior pregnancy with preeclampsia 9. Family history (mothers or sisters with preeclampsia)
What are 5 signs and symptoms of HELLP?history of malaise, epigastric or right upper quadrant pain, nausea, and vomiting.
Antepartum- What are 5 ways at home the patient can manage preeclampsia?1. Bed rest with bathroom privileges. 2. Have client weigh herself daily and report >2 lb/ week gain. 3. Teach client to test urine daily for protein. 4. Provide client with list of signs to report 5. Teach prescribed diet- High protein, limited salt intake
When a client with preeclampsia begins labor, what are 4 ways to control the amount of stimulation in the labor room?1. Keep nurse-to-client ratio at 1:1. 2. If possible, put client in darkened, quiet private room. 3. Keep client on absolute bed rest, side-lying and with side rails up. 4. Disturb client as little as possible with nursing interventions
If convulsions or seizures do occur, what should the nurse do? (5 steps)1. Stay with client and use call button to summon help. 2. Turn client onto side to prevent aspiration. 3. Do not attempt to force objects inside mouth or put fingers into woman’s mouth. 4. Administer O2 at 10 L/min by face mask and have suction available. 5. Give magnesium sulfate as prescribed
The client can convulse up to how long after delivery?48 hours
What are the 6 signs for a mother with cardiac disease experiencing cardiac decompensation?a. Increasing fatigue b. Dyspnea c. Feeling of smothering d. Dry, hacking cough e. Racing heart f. Swelling of feet, legs, and fingers
Antepartum- What type of diet should a cardiac mother have?high iron, high protein, and adequate calorie intake
Intrapartum- What are 4 ways to maintain cardiac perfusion?a. Put client in semi-Fowler, side-lying position. b. Prevent Valsalva maneuvers, even during second stage (obstructs left ventricular outflow). c. Avoid hypotension if epidural anesthesia is used. d. Avoid use of stirrups in delivery room (can cause popliteal vein compression and decreased venous return).
What happens in the post partum period that can pose a serious problems to the new mother with cardiac disease?Normal diuresis that causes increased cardiac output.
Which blood thinner can cross the placenta? Which one is preferred?Coumadin may not be taken during pregnancy due to its ability to cross the placenta and affect the fetus. Heparin is the drug of choice; it does not cross the placental membrane.

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