Please study the following content for the final. This list may not be inclusive of all
topics on the exam.
1) Fill in/study these guides: Reproductive C... [Show More] ancers, STIs, and Contraceptives.
-Mastitis: start feeding on breast that isn’t sore
-Low transverse scar, previous c-section main concern is rupture
2) Review OB meds:
magnesium sulfate—Relaxes smooth muscle to stop irritability and arrests uterine
preterm contrxns. Also used as seizure prophylaxis – Assess V/S, DTR, LOC, monitor
I&O, CALCIUM GLUCONATE READY IN CASE OF EMERGENCY,
Side fx: hot flash, flushing, diaphoresis, IV site burning, perineal warmth
TOXICITY: RR < 12, absent DTR, double vision, slurred speech, maternal
hypotension/bradycardia, cardiac arrest
oxytocin: Make uterus cramp—MONITOR FOR WATER INTOX—helps control
bleeding from placental site, administer analgesics for comfort, monitor v/s and
fundus
Methylergonovine: tx of PP hemorrhage by tonic contrxn (do not use w BP)
Terbutaline: Tx for preterm labor, relaxes smooth muscle (check that pt HR < 120,
hold if higher)
Side fx: tremors, anxiety
3) Topics:
a) difference between physiologic and pathologic jaundice and
causes
-Anything about when jaundice starts, check age. If <24 hours its always pathological. If
greater than 24 hr could be either
-Prevention: early feeding, bowel movements.
-Tx: phototherapy
Physiologic: STARTS AFTER 24 HR. Normal, usually resolves w/o tx. Often due to
immature liver, OFTEN PEAKS BETWEEN DAY 2-3
Pathologic: May occur in first 24 HR, MOM/BABY BLOOD NOT COMPATIBLE, baby can
become anemic, baby possibly septic.
b) client education on gestational diabetes, effects on newborn
-Gestational diabetes: A1- No meds, A2- meds needed, 3 meals/day + 2 snacks,
encourage bedtime snacks, never skip meals, < 50% cals from carbs à Can cause LGA
baby
-Class F or higher = poor perfusion, likely to see smaller baby.
c) Manifestations and nursing care for:
Sepsis: heart murmur, lethargy, hypothermia, poor feeding, hypoglycemia, we
will see immature WBC
-Broad spectrum IV abx
-Initiate breastfeeding immediately
NAS: Seizures, high-pitched cry, jitters
Tx: morphine
**hypoglycemia in newborns:
Tx- oral feedings, if not tolerated 10% dextrose in water may be needed
Can be asymptomatic, monitor BS within 30 min of birth and continue hourly
monitoring
➔ We want baby to have adequate thermoregulation
➔ Early carbohydrate feedings as appropriate
➔ Monitor serum glucose levels frequently first 24-48 hours
➔ < 35- 45 is hypoglycemic
d) fetal assessment tests: NST, early genetic assessments, and fetal
heart patterns (VEAL CHOP MINE)
110-160 normal FHR
NST: MOST WIDELY USED FETAL ASSESSMENT TEST 3RD TRIMESTER
Ø Continuously monitor fetal heart rate for 20-40 minutes
• Why: Variability and accelerations (increases) in FHR show good
brain oxygenation
• Non-invasive, NO risks
Ø Wake up the fetus! Vibroacoustic stimulation or fetal scalp stimulation
-ABSENT: REQUIRE IMMEDIATE INTERVENTION, change position, ↑IV rate, give mom 8-10
L O2
-minimal: REQUIRE IMMEDIATE INTERVENTION, change position, ↑IV rate, give mom 8-
10 L O2
-Moderate: normal, reassuring 6-25 BPM
-MARKED: Movement, more up/down, wiggly
e) compare postpartum depression, blues, and psychosis.
Depression: hx anxiety, depression, 1 in 5 women, irritability, fatigue,
frustration, HA, stomachache, indecisive, social withdrawal, substance use, 2
wk-6 mo (SOMATIC)
Blues: 1 wk-10 days, still eating/sleeping, mostly tired and emotional, SELF
LIMITING
Psychosis: 2 wk PP, depression, delusions, thoughts of harming self or child,
PSYCHIATRIC EMERGENCY perform suicide assessment
<6 months grieving is normal ….. >6 months grieving is not normal (they need
help)
***f) instructions for clients with anemia during pregnancy.
- H/H greatest indicator of iron levels in bloodstream. Good items to add to
diet: spinach, liver, legumes, peas, quinoa, turkey
g) leading causes of maternal mortality in US?
PP Hemorrhage: often caused by uterine atony, if uterus is boggy we must
make it contract.
First step:
STOP THE BLEEDING
CHECK UTERUS AND MASSAGE!
Firm massage of fundus – do not stop until uterus firm!
Express clots from uterus
Empty bladder – indwelling catheter helps check for hypovolemia
Oxytocin IV/IM— othe [Show Less]
