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Maternity Newborn Exam #3
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
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
Pain Assessment
Types of Pain
Types of Pain
Acute Pain
Acute Pain
Chronic Pain
Chronic Pain
OPQRST Mnemonic
OPQRST Mnemonic
Onset
Onset
Provoking or Palliative
Provoking or Palliative
Quality
Quality
Radiation
Radiation
Severity
Severity
Timing
Timing
Nursing Considerations
Nursing Considerations
Subjective Findings
Subjective Findings
Objective Findings
Objective Findings
Reassessment of Pain
Reassessment of Pain
2 mins
Fever
Flushed skin, warm to touch
Flushed skin, warm to touch
Chills
Chills
Sweating
Sweating
Change in LOC
Change in LOC
Provide adequate fluids
Provide adequate fluids
Monitor Electrolytes and Fluid
Monitor Electrolytes and Fluid
Monitor vital signs, esp temperature
Monitor vital signs, esp temperature
Remove excess clothing and blankets
Remove excess clothing and blankets
Sponge bath with tepid water
Sponge bath with tepid water
2 mins
APGAR Score
1 and 5 Minutes
1 and 5 Minutes
Appearance
Appearance
Pulse
Pulse
Grimace
Grimace
Activity and Muscle Tone
Activity and Muscle Tone
Respiration
Respiration
Total Scores
Total Scores
Gentle Stimulation
Gentle Stimulation
Oxygen
Oxygen
2 mins
Eye Medication Administration
Procedure
Procedure
Supine with Neck Hyperextended
Supine with Neck Hyperextended
Wash Away Crusts
Wash Away Crusts
Cotton Ball on Cheekbone
Cotton Ball on Cheekbone
For Ophthalmic Drops
For Ophthalmic Drops
Instill Drops into Conjunctival Sac
Instill Drops into Conjunctival Sac
Repeat if Missed or Patient Blinks
Repeat if Missed or Patient Blinks
5 Minutes Before 2nd Medication
5 Minutes Before 2nd Medication
For Ophthalmic Ointment
For Ophthalmic Ointment
Thin Stream Along Inner Edge
Thin Stream Along Inner Edge
Inner Canthus to Outer Canthus
Inner Canthus to Outer Canthus
2 mins
Vitamin K1 (Phytonadione)
Mechanism
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Synthesizes Clotting Factors II, VII, IX, X
Indications
Indications
Hypoprothrombinemia
Hypoprothrombinemia
Newborn Prophylaxis
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Bleeding from Warfarin Overdose
Side Effects
Side Effects
Shock
Shock
Kernicterus
Kernicterus
Cardiac Arrest
Cardiac Arrest
Considerations
Considerations
Bile Salts required for Intestinal Absorption
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
Increased Risks with IV Administration
2 mins
Intramuscular Medication (IM) Administration
Risks
Risks
Injury to Nerves, Bone, and Blood Vessels
Injury to Nerves, Bone, and Blood Vessels
Sites
Sites
Deltoid
Deltoid
Vastus Lateralis
Vastus Lateralis
Ventrogluteal
Ventrogluteal
Nursing Considerations
Nursing Considerations
Selection of Needle Length
Selection of Needle Length
Aseptic Technique for Drawing Up
Aseptic Technique for Drawing Up
Z-Track
Z-Track
90 Degree Angle
90 Degree Angle
Max Amount (2-5 mL Adult, 1 mL Child)
Max Amount (2-5 mL Adult, 1 mL Child)
Techniques to Reduce Pain
Techniques to Reduce Pain
2 mins
Ergocalciferol (Vitamin D2)
Mechanism
Vitamin D2
Indications
Hypoparathyroidism
Rickets
Hypophosphatemia
Side Effects
Fatigue
Constipation
Hypercalcemia
Kidney Stones
2 mins
Breastfeeding
Benefits
Complete Nutrition
Antibody Protection
Bonding
Convenient
SIDS Risk Reduced
Possible Enhanced Cognitive Development
Long-Term Health Benefits
2 mins
Depression Assessment
Physical Changes
Anergia
Self Neglect
Decreased Libido
Vegetative Signs
Mood
Sad Affect
Worthlessness
Guilt
Anger and Irritability
Cognitive
Ineffective Problem Solving
Slowed Thinking
1 min
Atypical Antipsychotics
Indications
Schizophrenia
Mechanism of Action
Unknown Mechanism
Side Effects
Seizures
Prolonged QT Interval
Agranulocytosis
Weight Gain
Fewer Extrapyramidal Side Effects
Fewer Anticholinergic Side Effects
2 mins
Urinary Tract Infection Prevention and Treatment
Prevention
Shower after Sex
Urinate after Sex
Wipe front to Back
Treatments and Considerations
I and Os with Daily Weights
Increase Water Intake
Antibiotics
Avoid Caffeine
Dr Appointment in 2 Weeks
Void every 2 - 4 hours
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
3 mins
Heparin (Unfractionated)
Mechanism of Action
Suppresses Coagulation
Indications
Deep Vein Thrombosis (DVT)
Pulmonary Embolism
Side Effects
Hemorrhage
Heparin-Induced Thrombocytopenia (HIT)
Considerations
Monitor aPTT
Preferred (Safe) During Pregnancy
Antidote
Protamine Sulfate
2 mins
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
2 mins
Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)
Mechanism
Smooth Muscle Contraction
Vasoconstriction
Indications
Migraine
Postpartum Hemorrhage
Side Effects
Nausea and Vomiting
Severe Hypertension
Tachycardia
Considerations
2nd Line Agent
2 mins
Carboprost (Hemabate)
Mechanism
Prostaglandin F2-alpha Analog
Smooth Muscle Contraction
Indications
Postpartum Hemorrhage
Abortion
Side Effects
GI Distress
Hypertension
Fever
Bronchoconstriction
Considerations
Identify Cause of Fever
2 mins
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