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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
1 min
Decelerations (and Accelerations) Overview
VEAL CHOP
Variable Deceleration
Cord Compression
Early Deceleration
Head Compression
Acceleration
Okay
Late Deceleration
Placental Insufficiency
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
3 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
2 mins
Mechanism of Labor
Engagement
Descent
Flexion
Internal Rotation
Extension
External Rotation (Restitution)
Expulsion of Infant
2 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
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 Nursing Assessment
BUBBLE - LE
Breasts
Uterus
Bladder
Bowels
Lochia
Episiotomy (Laceration)
Lower Extremities
Emotions
3 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
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
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
Hyperemesis Gravidarum
Signs and Symptoms
Excessive Vomiting
Significant Weight Loss
Dehydration
Hypotension
Electrolyte Imbalance
Interventions
Antiemetics
Frequent Small Meals
IV Therapy
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
Positive Signs of Pregnancy
Fetus on Ultrasound
Fetal Heart Rate by Doppler or Fetoscope
Fetal X-ray
Fetal Movements
1 min
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
Pregnant Cardiac Patient Assessment
Mechanism
Cardiac Decompensation
Signs and Symptoms
Frequent Cough
Dyspnea
Palpitations
Excessive Fatigue
Pulse > 100 bpm
Crackles
2 mins
Pregnant Cardiac Patient Interventions
Prenatal
Monitor for Cardiac Decompensation
Stool Softener
Calcium Channel Blockers
Labor
ECG Monitor
Open Glottis Pushing
Pulmonary Artery Catheter
No Beta-Adrenergic Medications
Penicillin Prophylaxis
Postpartum
Stress on Heart
2 mins
Pregnant Diabetic Patient Interventions
First Trimester
Increase Insulin then Decrease
Metformin
Nutrition
Exercise
Second Trimester
Increase Insulin
More Likely to Develop Hypoglycemia than Hyperglycemia
Third Trimester
Double or Quadruple Insulin
Early Delivery
Postpartum
Drastically Decrease Insulin
Monitor Neonate for Hypoglycemia
3 mins
Prenatal Care
Prenatal Visits
Vital Signs, FHR
Fundal Height
Urine Dipstick
Weight
Prenatal Screening
Laboratory Testing
2 mins
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