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Essentials of Maternity, Newborn, and Women's Health Nursing, 5th Ed., Ricci, 2020 | Registered Nurse (RN) School Study Aid


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14 - Nursing Management During Labor and Birth
14 Picmonics to Learn | 26 mins

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Early Decelerations
Cause
Fetal Head Compression
Occurs During
Uterine Contractions
Placement of Internal Mode of Monitoring
Vaginal Examination
Fundal Pressure
Considerations
Normal Pattern
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1 min
Morphine
Mechanism
Opioid Receptor Agonist
Indications
Pain
Myocardial Infarction
Side Effects
Nausea and Vomiting
CNS Depression
Biliary Colic
Constipation
Increased Intracranial Pressure (ICP)
Pupillary Constriction
Hypotension
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2 mins
Naloxone (Narcan)
Mechanism
Competitive Opioid Receptor Antagonist
Indications
Opioid Induced CNS Depression
Side Effects
Severe Nausea and Vomiting
Excitable State
Opioid Withdrawal Symptoms
Considerations
Repeated Dosing Often Required
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1 min
Butorphanol
Indications
Migraine
Severe Pain
Labor
Mechanism of Action
Partial Agonist at Mu and Full Agonist at Kappa Receptors
Less Respiratory Depression
Side Effects
Withdrawal Symptoms
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1 min
Local Anesthetic Overview
Indications
Minor Procedures
Epidurals
Mechanism of Action
Blocks Na+ Channels
State Dependent
Combined with Vasoconstrictors
Infected Tissue Requires Higher Dose
Drugs
Esters
Amides
Side Effects
Arrhythmias
Cardiotoxicity
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1 min
Decelerations (and Accelerations) Overview
VEAL CHOP
Variable Deceleration
Cord Compression
Early Deceleration
Head Compression
Acceleration
Okay
Late Deceleration
Placental Insufficiency
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2 mins
Late Decelerations
Cause
Uteroplacental Insufficiency
Occurs During
Disruption of Oxygen Transfer to Fetus
Considerations
Abnormal Pattern
Interventions
Discontinue Oxytocin
Oxygen with Non-Rebreather (8-10 L/min)
Side-lying Position
Elevate Legs
Increase Rate of IV Solution
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2 mins
Variable Decelerations
Mechanism
Umbilical Cord Compression
Occurs During
Abnormal Cord Position
Considerations
Transition Phase
Interventions
Oxygen with Non-Rebreather (8-10 L/min)
Change Maternal Position
Discontinue Oxytocin
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2 mins
Meperidine (Demerol)
Mechanism
Opioid Receptor Agonist
Indications
Moderate to Severe Pain
Post Anesthesia Shivering
Side Effects
Tremors
Constipation
CNS Depression
Sedation
Considerations
Short Term Administration
Increased Risk Serotonin Syndrome
Does NOT cause Miosis
Renal Failure Increases Toxicity Risk
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2 mins
IV Anesthetics
Barbiturates
Benzodiazepines
Respiratory Depression
Hypotension
Ketamine
NMDA Receptor Antagonist
Hallucinations
Opioids
Propofol
Potentiates GABA-A
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2 mins
Promethazine (Phenergan)
Mechanism
Histamine H1 Receptor Antagonist
Weak Dopamine Antagonist
Indications
Nausea and Vomiting
Motion Sickness
Side Effects
Respiratory Depression
Sedation
Anticholinergic Effects
Extrapyramidal Symptoms
Considerations
Use Large Bore IV
Monitor for Tissue Necrosis
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2 mins
Diazepam (Valium)
Indications
Anxiety
Seizures and Status Epilepticus
Muscle Spasms
Alcohol Withdrawal
Side Effect/Assessment
Dizziness/Vision Changes
Confusion/Amnesia
Urinary Incontinence
Behavioral Changes
Respiratory Depression
Antidote
Flumazenil (Romazicon)
Nursing Considerations
Fall Precaution
Do Not Stop Abruptly
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2 mins
APGAR Score
1 and 5 Minutes
Appearance
Pulse
Grimace
Activity and Muscle Tone
Respiration
Total Scores
Gentle Stimulation
Oxygen
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2 mins
Fever
Flushed skin, warm to touch
Chills
Sweating
Change in LOC
Provide adequate fluids
Monitor Electrolytes and Fluid
Monitor vital signs, esp temperature
Remove excess clothing and blankets
Sponge bath with tepid water
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2 mins

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