Maternity Orientation (Everything after NB PA + Info)

Chronic HTN

what is described as any HTN before 20 weeks gestation

Gestational HTN

what is described as started pregnancy w/ no issues until after 20 weeks

Preeclampsia/Eclampsia

what is described as severe form of HTN causing organ disfunction

Eclampsia

what is the most severe hypertensive disorder that can lead to seizures

Nulliparous, BMI >30, Family Hx, >35 yoa

what are the four things that put one at a moderate risk for HTN disorders during pregnancy

HTN w/ previous, Mutligravida, chronic HTN, kidney disease, DM, autoimmune conditions

what are the 7 things that put one at a high risk for Gestational HTN

Hemoconcentration

what means HTN changes more of the plasma from the blood vessel out causing everything in the vessel to become

Pitting edema, facial swelling

what are some S&S's of cardovascular system changes

Regular BP Monitoring, Regular weight monitoring, Pulses

what are the three Nursing interventions done for a mothe with Cardiovascular system changes

Proteinuria, Decreased urinary output, Kidney failure

what are the three Urinary system changes that could occur for a pregnant mother

I&O

what is the nursing intervention for Urinary system changes in a mother

24h urine collection, protein/creatinine ratio, serum uric acid

what are the three lab tests for a patient with Urinary system changes

Pulmonary edema, Acute Respiratory Syndrome

what are the two respiratoy systems changes that could occur in a mother

Ease of breathing, auscultation, RR, Pulse Ox

what are the four nursing assessments for a mother with respiratory system changes

Hepatic Failure

A pregnant mother is at a risk for what failure in relation to the Hepatic and GI system

Upper right abd pain, epigastric pain, Shoulder pain, N/V

what are the four S&S's for syspected hepatic failure

Cerebral swelling/hemorrhage, seizures, stroke

what are the three neurological system changes that could occur in a mother

Cerebral swelling

what is the leading cause of death in preeclamptic patients

Persistent HA, Vision Changes, Brisk reflexes, Clonus, Slurred Speech, Numbness/tingling

what are the six S&S's of neurological system changes in a mother

Clonus

what is very slow and jerky foot movement back to normal position after raising the foot

Postpartum Hemorrhage

what is described as >1,000 mL or cumulative blood loss or any amount of bleeding accompanied by S&S of hypovolemia within 24 hours of delivery

Postpartum Hemorrhage

what is the 2nd most common cause of maternal mortality

Uterine atony

what is it called when the uterus is not contracting like it should

Screening, QBL, Active management of 3rd stage labor

what are the three things done to prevent postpartum hemorrhage

Pitocin, Methergine, Hemabate, Cytotec, TXA

what are the five Postpartum hemorrhage meds,

Auditory Brainstem Response

what is the best test available for newborns and infants up to 6 months of age that can provide info about the softest level of sound the ear can heare

Otoacoustic emissions

what is a miniature earphone and microphone are placed in the ear and sounds are played and a response is measured

Pass/Negative

≥95% in either extremity with ≤3% difference between the upper and lower extremity is considered a pass

Fail/Positive

Saturations

Gravida

# of pregancies

term up to 37 weeks

what does the T stand for in the GTPAL score and what is the time period

Premature b/t 20-37 weeks

what does the P in the GTPAL score stand for and what is the time frame

Abortion before 20 weeks

what does the A stand for in the GTPAL score and what is the time frame

Living children (current living)

what does the L stand for in the GTPAL score

para

what is the term for the # of births after 20 weeks

How well the baby tolerated birth

what does the APGAR score evaluate

Activity

what does the A stand for in APGAR

Pulse

what does the P stand for in APGAR

Grimace

what does the G stand for in APGAR

Appearance

what does the second A stand for in APGAR

Respiration

what does the R stand for in APGAR

7 or above

what is the APGAR score we want to see in all babies

1 min after birth, 5 min after birth, and 10 if needed

how often should we be checking the APGAR scores

45mg/DL

what is the normal BG levels for a baby for the first 24hrs being alive

25 mg/DL

in the first 24hr if the BG goes below what will they have to go to the NICU

>50mg/DL w/ goal of 55 mg/DL

what is the normal BG levels after 24 hours

35 mg/DL

if the BG is below what after the first 24 hours will they need an IV glucose

Check dilation progress

what is the intervention for early decels

Move mom

what is the intervention for variable decels

delivery

what is the intervention for late decels

Active stage

which stage of labor is described as:

- 4-7cm dilated

-3-5min lasting 45 sec CTXN

- CTXN moderate to strong

Transition

which stage of labor is described as:

- Delivery is imminent

- 8-10cm dilated

- 45-90 sec contraction

- Pt complaining to bear down or push

Second Stage

which stage of labor is described as:

- Baby is not out

- Pushing phase

Third Stage

Which stage of labor is described as:

- Baby is now born

- Waiting for placenta

Fourth Stage

which stage of labor is described as:

-Baby is out

-Placenta is out

-Recovery phase begins

Spontaneous, Assisted

what are the two types of Vaginal Deliveries

Planned, Unplanned

what are the two types of Cesarean deliveries

Shoulder Dystocia

what is described as a failed delivery of the shoulder with gentle downward traction

Macrosomia, Maternal DM, Hx of px, induction of labor, Vacuum/Forceps

what are the five risk factors for shoulder dystocia

Brachial Plexus Palsy, Clavicle fracture, Facial Nerve injury, Intraventricular hemorrhage, death

what are the five fetal complications of shoulder dystocia