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Amy Shared "N425" - 18 Picmonics

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N425

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
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
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
Mechanism of Labor
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation (Restitution)
Expulsion of Infant
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2 mins
Induction of Labor
Indications
Premature Rupture of Membranes
Danger to Fetus or Mother
Prolonged Gestation
Contraindications
Placenta Abnormalities
Transverse Fetal Position
Prolapsed Umbilical Cord
Active Genital Herpes Infection
Transfundal Uterine Incision
Hemorrhage
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3 mins
True vs. False Labor
Bloody Show
True Labor
Regular, Strong Contractions
Progressive Effacement and Dilation
Engagement of Presenting Part
False Labor
Irregular Contractions
Cervix Soft
No Engagement of Presenting Part
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2 mins
Terbutaline (Brethine)
Mechanism of Action
Beta-2 Agonists
Indications
Asthma
Tocolytic
Side Effects
Tremor
Tachycardia
Pulmonary Edema
Hypokalemia
Hyperglycemia
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2 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
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3 mins
Presumptive Signs of Pregnancy
Amenorrhea
Fatigue
Urinary Frequency
Nausea and Vomiting
Breast Changes
Quickening
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1 min
Probable Signs of Pregnancy
Goodell Sign
Chadwick Sign
Hegar Sign
Positive Serum and Urine Sample
Braxton Hicks Contractions
Ballottement
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2 mins
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
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1 min
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)
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2 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)
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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
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3 mins
Quad Screen Results Interpretation
Markers
AFP
Estriol
hCG
Inhibin A
Associations
Increased hCG + Inhibin A (HIgh)
Down Syndrome
Decreased hCG + Estriol + AFP (Low HEAp)
Edward Syndrome
Increased AFP
Neural Tube Defects
Abdominal Wall Defects
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2 mins
Prenatal Nutrition
Prenatal Vitamins
Iron Supplement 30 mg Daily
Folate/Folic Acid 400 mcg Daily
Appropriate Weight Gain Recommendations
340 Calorie Increase
25 gram Protein Increase
Foods and Substances to Avoid
Coffee, Alcohol, Tobacco
Fish Containing High Mercury Levels
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3 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
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2 mins

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