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NUR113 Unit 2
RhoGam [Rho(D) Immune Globulin]
Indications
Antepartum Prevention at 28 weeks
Suppress Antibody Production
Mechanism of Action
Lysis of Fetal RBC in Maternal Bloodstream
Side Effects
Myalgia and Lethargy
Considerations
Negative Coombs Test
Standard Dose 300 mcg
Microdose 50 mcg
Blood Product
2 mins
Postpartum Hemorrhage
Mechanism
Uterine Atony
Lacerations
Retained Placenta
Signs and Symptoms
Bleeding
Hypotension
Boggy Uterus
Considerations
Oxytocin
Bimanual Compression of Uterus
Surgery
Blood Transfusion
2 mins
Postpartum Infection
Diagnosis
Fever > 100.4F After 24 Hours (38 C)
Risk Factors
Multiple Vaginal Examinations
Vaginal Trauma
Prolonged Rupture of Membranes
Cesarean Birth
Anemia of Pregnancy
Retained Placental Fragments
Poor Health Status
3 mins
Postpartum Nursing Assessment
BUBBLE - LE
Breasts
Uterus
Bladder
Bowels
Lochia
Episiotomy (Laceration)
Lower Extremities
Emotions
3 mins
Oxytocin (Pitocin)
Mechanism of Action
Increase Uterine Contractions
Indications
Labor Induction
Control Postpartum Hemorrhage
Side Effects
Uterine Rupture
Water Intoxication
Contraindications
Fetal Lung Immaturity
Cervix Not Ripened
Active Genital Herpes Infection
Considerations
Use Lowest Dose
IV Pump
3 mins
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
1 min
Discomforts of Pregnancy - First Trimester
Breast Tenderness
Supportive Bra
Nausea and Vomiting
Frequent Small Meals
Urinary Frequency and Urgency
Frequently Empty Bladder
Leukorrhea
Perineal Pad
Ptyalism
2 mins
Discomforts of Pregnancy - Second Trimester
Supine Hypotension
Side-lying Position
Food Cravings
Heartburn (Pyrosis)
Constipation
Moderate Exercise
Varicose Veins
Elevate Legs
Backache
Pelvic Tilt Exercise
Considerations
Nutrition
2 mins
Discomforts of Pregnancy - Third Trimester
Shortness of Breath (SOB)
Rest Periods
Return of Urinary Frequency and Urgency
Empty Bladder Regularly
Leg Cramps
Stretching Exercises
Ankle Edema
Elevate Legs
2 mins
Lab and Diagnostic Tests During Pregnancy
Complete Blood Cell Count
Blood Typing
Rubella Titer
Hepatitis B
HIV Testing
Urinalysis
Diabetes
Pap Smears
2 mins
Ectopic Pregnancy
Signs and Symptoms
Lower Abdominal Pain
Delayed Menses
Abnormal Vaginal Bleeding
Shock
Referred Shoulder Pain
Cullen Sign
Considerations
Methotrexate
Surgery
RhoGAM
2 mins
Ovulatory Hormones II - Luteal Phase
Days 15-28
Corpus Luteum
Secretes Progesterone
Negative Feedback inhibits FSH and LH
No pregnancy forms Corpus Albicans
Stops Estrogen Secretion
Endometrial Sloughing - Menses
GnRH secretion produces new follicular phase
2 mins
Amniocentesis
Mechanism
Transabdominal Puncture
> 14 weeks gestation
Indications
Genetic and Congenital Anomalies
Fetal Hemolytic Disease
Fetal Lung Maturity
Complications
Miscarriage
Hemorrhage
Infection
Considerations
RhoGAM (Rh Immune Globulin)
2 mins
Lab and Diagnostic Tests During Pregnancy (Other Visits)
Diagnosis
10-13 Weeks
Offer Chorionic Villus Sampling (CVS)
15-18 Weeks
Quad Screen
18-20 Weeks
Ultrasound
Anatomic Screening
24-28 Weeks
One-Hour Glucose Challenge Test
35-37 Weeks
Streptococcus Agalactiae
3 mins
Lab and Diagnostic Tests During Pregnancy (1st Visit)
Diagnosis
Complete Blood Count (CBC)
Blood Typing and Rh
Rubella
HIV
Hepatitis B
Tuberculosis Skin Mantoux Test (PPD)
Sexually Transmitted Infections
Chlamydia
Neisseria gonorrhoeae
Syphilis
Pap Smears
Urinalysis
Sickle Cell Screening (If Indicated)
2 mins
Preeclampsia Assessment
After 20 Weeks of Pregnancy
Mild
Hypertension > 140/90
Proteinuria or End-Organ Dysfunction
Severe
Hypertension > 160/110
Progressive Renal Insufficiency
Vision Changes
HELLP Syndrome
Pulmonary Edema
2 mins
Preeclampsia Interventions
Side Lying Position and Bedrest
Antihypertensives
Magnesium Sulfate
Labor Induction
1 min
Eclampsia
Mechanism of Action
Increased Central Nervous System Irritability
Signs and Symptoms
Hyperreflexia
Positive Ankle Clonus
Headaches
Visual Disturbances
Epigastric or RUQ Pain
Seizures
Coma
Considerations
Don't Leave Bedside
Magnesium Sulfate
2 mins
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