Podcast
Questions and Answers
Which medication is used to relieve shortness of breath and anxiety in acute heart failure situations by reducing preload and afterload?
Which medication is used to relieve shortness of breath and anxiety in acute heart failure situations by reducing preload and afterload?
- Furosemide
- Metoprolol
- Digoxin
- Morphine (correct)
A patient is prescribed digoxin. What electrolyte level should be closely monitored due to the risk of digitalis toxicity if it is too low?
A patient is prescribed digoxin. What electrolyte level should be closely monitored due to the risk of digitalis toxicity if it is too low?
- Magnesium
- Calcium
- Sodium
- Potassium (correct)
What is the primary action of nitrates in treating heart failure?
What is the primary action of nitrates in treating heart failure?
- Increasing heart rate
- Vasodilation and reduced afterload (correct)
- Decreasing blood pressure
- Promoting blood clotting
Which medication is classified as a positive inotrope and is used to improve the heart's ability to pump blood?
Which medication is classified as a positive inotrope and is used to improve the heart's ability to pump blood?
What is the purpose of administering aspirin to a patient with a cardiac condition?
What is the purpose of administering aspirin to a patient with a cardiac condition?
Which of these medications stops the heart and resets it, and is used to treat severe supraventricular tachycardia (SVT)?
Which of these medications stops the heart and resets it, and is used to treat severe supraventricular tachycardia (SVT)?
What is the expected outcome of administering atropine to a patient?
What is the expected outcome of administering atropine to a patient?
What is the primary concern associated with fluid volume overload in heart failure patients?
What is the primary concern associated with fluid volume overload in heart failure patients?
What nursing intervention is most appropriate for a patient experiencing fluid volume overload?
What nursing intervention is most appropriate for a patient experiencing fluid volume overload?
For which heart condition is verapamil, a calcium channel blocker, typically prescribed?
For which heart condition is verapamil, a calcium channel blocker, typically prescribed?
Prior to administering digoxin, what crucial nursing action must be performed?
Prior to administering digoxin, what crucial nursing action must be performed?
What is a potential adverse effect of heparin administration that necessitates close monitoring?
What is a potential adverse effect of heparin administration that necessitates close monitoring?
In the context of heart sounds, what physiological or pathological condition could cause a murmur?
In the context of heart sounds, what physiological or pathological condition could cause a murmur?
When auscultating heart sounds, at which anatomical location should the stethoscope be placed to best hear the mitral valve?
When auscultating heart sounds, at which anatomical location should the stethoscope be placed to best hear the mitral valve?
What does the acronym MONA stand for in the initial management of a patient presenting with chest pain?
What does the acronym MONA stand for in the initial management of a patient presenting with chest pain?
A patient is receiving heparin therapy. Which laboratory value requires careful monitoring to assess the effectiveness of the heparin?
A patient is receiving heparin therapy. Which laboratory value requires careful monitoring to assess the effectiveness of the heparin?
A pregnant patient is diagnosed with gestational diabetes. What potential complication can poorly controlled blood glucose levels lead to for the mother?
A pregnant patient is diagnosed with gestational diabetes. What potential complication can poorly controlled blood glucose levels lead to for the mother?
What is a potential risk for a neonate born to a mother with gestational diabetes?
What is a potential risk for a neonate born to a mother with gestational diabetes?
During pregnancy, which of the following instructions should be emphasized to a patient with gestational diabetes?
During pregnancy, which of the following instructions should be emphasized to a patient with gestational diabetes?
During labor, the healthcare provider notes variable decelerations on the fetal heart rate monitor. What is the most likely cause of this pattern?
During labor, the healthcare provider notes variable decelerations on the fetal heart rate monitor. What is the most likely cause of this pattern?
What event characterizes the third stage of labor?
What event characterizes the third stage of labor?
Which of the following is a risk factor for preterm labor?
Which of the following is a risk factor for preterm labor?
Following delivery, a nurse notes that the patient has saturated one perineal pad with blood within 15 minutes. Approximately how much blood loss does this indicate?
Following delivery, a nurse notes that the patient has saturated one perineal pad with blood within 15 minutes. Approximately how much blood loss does this indicate?
What is a contraindication in a patient diagnosed with placenta previa?
What is a contraindication in a patient diagnosed with placenta previa?
What is the priority nursing intervention for a patient experiencing placental abruption?
What is the priority nursing intervention for a patient experiencing placental abruption?
A pregnant patient presents with dark red vaginal bleeding and a rigid, board-like abdomen. Which condition does this presentation most likely indicate?
A pregnant patient presents with dark red vaginal bleeding and a rigid, board-like abdomen. Which condition does this presentation most likely indicate?
A newborn exhibits cyanosis of the trunk. What does this assessment finding indicate?
A newborn exhibits cyanosis of the trunk. What does this assessment finding indicate?
What is the primary purpose of administering magnesium sulfate to a pregnant woman with severe pre-eclampsia?
What is the primary purpose of administering magnesium sulfate to a pregnant woman with severe pre-eclampsia?
What acronym is used to remember the signs of magnesium toxicity?
What acronym is used to remember the signs of magnesium toxicity?
A patient receiving magnesium sulfate has a decreased urinary output. Why is it important for the nurse to report this finding?
A patient receiving magnesium sulfate has a decreased urinary output. Why is it important for the nurse to report this finding?
What is the primary action of terbutaline when administered to a pregnant woman experiencing preterm labor?
What is the primary action of terbutaline when administered to a pregnant woman experiencing preterm labor?
A pregnant woman is diagnosed with pre-eclampsia. What is a hallmark sign of this condition?
A pregnant woman is diagnosed with pre-eclampsia. What is a hallmark sign of this condition?
Which of the following findings differentiate stage 1 class 1 placental abruption from all other types?
Which of the following findings differentiate stage 1 class 1 placental abruption from all other types?
During stage 2 placental abruption, which VS change would lead you to believe the Pt. requires intervention?
During stage 2 placental abruption, which VS change would lead you to believe the Pt. requires intervention?
In rare cases of pre-existing diabetes in pregnancy, researchers can use one distinct piece of information to determine if the gestational diabetes has resolved itself postpartum. What is this piece of information?
In rare cases of pre-existing diabetes in pregnancy, researchers can use one distinct piece of information to determine if the gestational diabetes has resolved itself postpartum. What is this piece of information?
The diastolic blood pressure must be greater than what value in order for a pregnant patient to be diagnosed with pre-eclampsia?
The diastolic blood pressure must be greater than what value in order for a pregnant patient to be diagnosed with pre-eclampsia?
A patient with gestational diabetes is scheduled for a cesarean section. What factor in her history most significantly increases the risk of postpartum hemorrhage?
A patient with gestational diabetes is scheduled for a cesarean section. What factor in her history most significantly increases the risk of postpartum hemorrhage?
Which medication would likely be used in the event of magnesium sulfate toxicity?
Which medication would likely be used in the event of magnesium sulfate toxicity?
Which of the following is the primary mechanism by which beta-blockers like metoprolol reduce myocardial oxygen demand?
Which of the following is the primary mechanism by which beta-blockers like metoprolol reduce myocardial oxygen demand?
What is the intended therapeutic effect of administering loop diuretics like bumetanide (Bumex) or furosemide (Lasix) to a patient with heart failure?
What is the intended therapeutic effect of administering loop diuretics like bumetanide (Bumex) or furosemide (Lasix) to a patient with heart failure?
Which class of medications, often used in conjunction with loop diuretics, works to eliminate excess fluid and manage fluid balance in heart failure patients?
Which class of medications, often used in conjunction with loop diuretics, works to eliminate excess fluid and manage fluid balance in heart failure patients?
If a patient with heart failure is taking digoxin, what signs and symptoms might suggest digitalis toxicity?
If a patient with heart failure is taking digoxin, what signs and symptoms might suggest digitalis toxicity?
Which of the following describes the action of ACE inhibitors in the management of heart failure?
Which of the following describes the action of ACE inhibitors in the management of heart failure?
How does aspirin contribute to the management of cardiac conditions?
How does aspirin contribute to the management of cardiac conditions?
What is the primary mechanism of action of calcium antagonists in treating certain cardiovascular conditions?
What is the primary mechanism of action of calcium antagonists in treating certain cardiovascular conditions?
Which medication is used to treat severe supraventricular tachycardia (SVT) by stopping the heart and resetting it?
Which medication is used to treat severe supraventricular tachycardia (SVT) by stopping the heart and resetting it?
A patient presents with bradycardia. Which medication would the nurse anticipate administering?
A patient presents with bradycardia. Which medication would the nurse anticipate administering?
What is the underlying cause of fluid volume overload in heart failure patients, according to the provided information?
What is the underlying cause of fluid volume overload in heart failure patients, according to the provided information?
Prior to administering digoxin, the nurse should assess which vital sign?
Prior to administering digoxin, the nurse should assess which vital sign?
Which of the following laboratory values should be closely monitored in a patient receiving heparin therapy?
Which of the following laboratory values should be closely monitored in a patient receiving heparin therapy?
A patient with atrial fibrillation is prescribed heparin. What is the primary reason for administering this medication?
A patient with atrial fibrillation is prescribed heparin. What is the primary reason for administering this medication?
Which heart valve is best auscultated at the apex of the heart in the 5th intercostal space, midclavicular line?
Which heart valve is best auscultated at the apex of the heart in the 5th intercostal space, midclavicular line?
Which of the following is the fundamental concern associated with gestational diabetes for the pregnant patient?
Which of the following is the fundamental concern associated with gestational diabetes for the pregnant patient?
Following delivery, what specific maternal complication is heightened due to an enlarged uterus caused by gestational diabetes?
Following delivery, what specific maternal complication is heightened due to an enlarged uterus caused by gestational diabetes?
A neonate born to a mother with gestational diabetes is at risk for which of the following complications?
A neonate born to a mother with gestational diabetes is at risk for which of the following complications?
What is the primary reason a newborn of a mother with gestational diabetes is at risk for respiratory distress?
What is the primary reason a newborn of a mother with gestational diabetes is at risk for respiratory distress?
During prenatal education for a patient with gestational diabetes, which aspect should be emphasized?
During prenatal education for a patient with gestational diabetes, which aspect should be emphasized?
During labor, variable decelerations are noted on the fetal heart rate monitor. What intervention might the nurse implement?
During labor, variable decelerations are noted on the fetal heart rate monitor. What intervention might the nurse implement?
Which stage of labor constitutes the delivery of the placenta?
Which stage of labor constitutes the delivery of the placenta?
Assess the following patient data: pt under 18, hx of drug use, twins. Based on patient data, what is the patient at risk for?
Assess the following patient data: pt under 18, hx of drug use, twins. Based on patient data, what is the patient at risk for?
What is the best position for a patient with placenta previa?
What is the best position for a patient with placenta previa?
What is the most important assessment when a patient is diagnosed with placental abruption?
What is the most important assessment when a patient is diagnosed with placental abruption?
Which of the following assessment findings would lead the nurse to believe that the patient needs intervention in placental abruption stage 2?
Which of the following assessment findings would lead the nurse to believe that the patient needs intervention in placental abruption stage 2?
A newborn's assessment reveals cyanosis of the trunk. What does this finding indicate?
A newborn's assessment reveals cyanosis of the trunk. What does this finding indicate?
What is the therapeutic intent of administering magnesium sulfate to a pregnant woman diagnosed with severe pre-eclampsia?
What is the therapeutic intent of administering magnesium sulfate to a pregnant woman diagnosed with severe pre-eclampsia?
Why is it crucial for a nurse to promptly report decreased urinary output in a patient receiving magnesium sulfate?
Why is it crucial for a nurse to promptly report decreased urinary output in a patient receiving magnesium sulfate?
A pregnant patient is receiving terbutaline. What is the primary goal of this medication?
A pregnant patient is receiving terbutaline. What is the primary goal of this medication?
What blood pressure measurement defines the threshold for diagnosing pre-eclampsia in a pregnant woman?
What blood pressure measurement defines the threshold for diagnosing pre-eclampsia in a pregnant woman?
A patient with gestational diabetes delivers via cesarean section. Which historical factor presents the greatest risk for postpartum hemorrhage?
A patient with gestational diabetes delivers via cesarean section. Which historical factor presents the greatest risk for postpartum hemorrhage?
What is the antidote medication you would administer for magnesium sulfate toxicity?
What is the antidote medication you would administer for magnesium sulfate toxicity?
Which of the following actions should the nurse implement after administering Adenosine?
Which of the following actions should the nurse implement after administering Adenosine?
Lab values for creatinine are impacted by which of the following patient determinants?
Lab values for creatinine are impacted by which of the following patient determinants?
What is the significance of auscultating S1 heart sounds?
What is the significance of auscultating S1 heart sounds?
Your patient has a heart murmur; this is due to:
Your patient has a heart murmur; this is due to:
Which valve is best auscultated at the pulmonic site?
Which valve is best auscultated at the pulmonic site?
What is a main teaching point for a patient taking positive inotropes?
What is a main teaching point for a patient taking positive inotropes?
A patient vomits 300 mL emesis. What impact would that have on their potassium levels?
A patient vomits 300 mL emesis. What impact would that have on their potassium levels?
During auscultation, the LUB sound symbolizes:
During auscultation, the LUB sound symbolizes:
A patient is diagnosed with Class 1 placental abruption. What are the common findings?
A patient is diagnosed with Class 1 placental abruption. What are the common findings?
Which acronym can you use to remember the signs and symptoms of magnesium TOXICITY?
Which acronym can you use to remember the signs and symptoms of magnesium TOXICITY?
Which medication would be MOST appropriate for a patient experiencing symptomatic bradycardia?
Which medication would be MOST appropriate for a patient experiencing symptomatic bradycardia?
A patient with heart failure is prescribed bumetanide (Bumex). The nurse should emphasize which dietary modification to counteract a potential side effect of this medication?
A patient with heart failure is prescribed bumetanide (Bumex). The nurse should emphasize which dietary modification to counteract a potential side effect of this medication?
A pregnant patient at 32 weeks gestation is diagnosed with placenta previa. What intervention is CONTRAINDICATED for this patient?
A pregnant patient at 32 weeks gestation is diagnosed with placenta previa. What intervention is CONTRAINDICATED for this patient?
Which assessment finding would differentiate a Class 1 placental abruption from other classifications of placental abruption?
Which assessment finding would differentiate a Class 1 placental abruption from other classifications of placental abruption?
A patient at 28 weeks gestation presents with painless, bright red vaginal bleeding. The uterus is soft and non-tender. What condition is MOST likely?
A patient at 28 weeks gestation presents with painless, bright red vaginal bleeding. The uterus is soft and non-tender. What condition is MOST likely?
A patient is receiving magnesium sulfate for severe pre-eclampsia. Which finding requires IMMEDIATE intervention?
A patient is receiving magnesium sulfate for severe pre-eclampsia. Which finding requires IMMEDIATE intervention?
Which statement is MOST accurate regarding the use of terbutaline in preterm labor management?
Which statement is MOST accurate regarding the use of terbutaline in preterm labor management?
Following delivery, a patient saturates one perineal pad in 10 minutes. What is the BEST initial nursing action?
Following delivery, a patient saturates one perineal pad in 10 minutes. What is the BEST initial nursing action?
After administering adenosine for SVT, the nurse should prioritize which action?
After administering adenosine for SVT, the nurse should prioritize which action?
A primigravida patient with gestational diabetes is scheduled for a cesarean section. Which historical factor MOST significantly elevates her risk of postpartum hemorrhage?
A primigravida patient with gestational diabetes is scheduled for a cesarean section. Which historical factor MOST significantly elevates her risk of postpartum hemorrhage?
Flashcards
Beta Blockers (e.g., Metoprolol)
Beta Blockers (e.g., Metoprolol)
Slows heart rate, decreases contraction force, lowers blood pressure, and reduces myocardial oxygen demand.
Loop Diuretics (e.g., Bumex, Lasix)
Loop Diuretics (e.g., Bumex, Lasix)
Increases urine production to reduce fluid overload, alleviating lung congestion and peripheral edema, thus easing shortness of breath.
Morphine in Acute Heart Failure
Morphine in Acute Heart Failure
Reduces preload and afterload, easing the heart's workload and improving symptoms in acute situations.
Positive Inotropes (e.g., Dopamine, Dobutamine)
Positive Inotropes (e.g., Dopamine, Dobutamine)
Signup and view all the flashcards
Digitalis Glycoside (Digoxin)
Digitalis Glycoside (Digoxin)
Signup and view all the flashcards
RAAS Inhibitors (ACE inhibitors)
RAAS Inhibitors (ACE inhibitors)
Signup and view all the flashcards
Nitrates
Nitrates
Signup and view all the flashcards
Aspirin
Aspirin
Signup and view all the flashcards
Calcium Antagonists
Calcium Antagonists
Signup and view all the flashcards
Atropine
Atropine
Signup and view all the flashcards
Adenosine
Adenosine
Signup and view all the flashcards
Fluid Volume Overload
Fluid Volume Overload
Signup and view all the flashcards
Verapamil
Verapamil
Signup and view all the flashcards
Heparin for AFib
Heparin for AFib
Signup and view all the flashcards
First Heart Sound (LUB S1)
First Heart Sound (LUB S1)
Signup and view all the flashcards
Second Heart Sound (DUB S2)
Second Heart Sound (DUB S2)
Signup and view all the flashcards
Heart Murmurs
Heart Murmurs
Signup and view all the flashcards
MONA (for acute cardiac issues)
MONA (for acute cardiac issues)
Signup and view all the flashcards
Heparin
Heparin
Signup and view all the flashcards
Gestational Diabetes
Gestational Diabetes
Signup and view all the flashcards
Variable Decelerations in Fetal Heart Rate
Variable Decelerations in Fetal Heart Rate
Signup and view all the flashcards
Stage One of Labor
Stage One of Labor
Signup and view all the flashcards
Stage Two of Labor
Stage Two of Labor
Signup and view all the flashcards
Stage Three of Labor
Stage Three of Labor
Signup and view all the flashcards
Stage Four of Labor
Stage Four of Labor
Signup and view all the flashcards
Postpartum Hemorrhage (PPH)
Postpartum Hemorrhage (PPH)
Signup and view all the flashcards
Placenta Previa
Placenta Previa
Signup and view all the flashcards
Placental Abruption
Placental Abruption
Signup and view all the flashcards
Tocolytics
Tocolytics
Signup and view all the flashcards
Pre-Eclampsia
Pre-Eclampsia
Signup and view all the flashcards
Magnesium Sulfate
Magnesium Sulfate
Signup and view all the flashcards
Magnesium Toxicity
Magnesium Toxicity
Signup and view all the flashcards
Study Notes
Cardiac Medications and Electrolytes
- Beta blockers (Metoprolol) slow heart rate, decrease contraction force, lower blood pressure, and reduce myocardial oxygen demand.
- Loop Diuretics (Bumex, Lasix) increase urine production to reduce body fluid, alleviate lung congestion and peripheral edema, relieving shortness of breath.
- Thiazide diuretics eliminate excess fluid and can be combined with loop diuretics for fluid management.
- Morphine relieves shortness of breath and anxiety in acute situations by reducing preload and afterload, easing heart workload.
- Positive inotropes (Dopamine/Dobutamine) enhance the heart's pumping ability, increasing cardiac output and systolic blood pressure; Dopamine is used for bradycardia.
- Digitalis Glycoside (Digoxin) increases contraction force and slows heart rate; potassium levels must be monitored as hypokalemia can lead to digitalis toxicity and dysrhythmias, indicated by a yellow tint.
- RAAS inhibitors (ACE inhibitors) lower blood pressure and resistance, preventing further heart remodeling in heart failure patients.
- Nitrates vasodilate, relax blood vessels, and reduce resistance, easing heart's pumping effort and reducing afterload.
- Aspirin limits clotting by decreasing platelet adherence.
- Calcium antagonists dilate arterioles, reducing systemic vascular resistance.
Medications List
- Heparin, Plavix, TPA, Digoxin, Bumex, Losartan, Lisinopril, Captopril, Enalapril, Carvedilol, Spironolactone, Nitroglycerine, Dopamine, Levophed, Epinephrine, Labetalol, Amiodorone (arrhythmias), Adenosine (severe SVT), Atropine, Morphine
Specific Medications
- Atropine is administered for bradycardia.
- Dopamine is administered for heart failure.
- Adenosine stops and resets the heart (SVT); requires medical supervision ("SEEN" by doctor).
- Amiodarone is a regular heart medication that can be taken at home.
Fluid Volume Overload
- Fluid volume overload occurs when there is excessive water in the bloodstream.
- In heart failure, the RAAS cycle brings excessive water into the blood.
- Nursing interventions for fluid volume overload include loop diuretics, adjusting infusion rates, and administering heart failure medications.
Medications (Examples)
- Verapamil: antiarrhythmic calcium channel blocker for AFib to maintain normal sinus rhythm
- Digoxin increases contraction force and slows heart rate; apical pulse must be checked for 1 minute before administration, holding if below 60 BPM.
- Heparin is used to reduce thrombus formation or embolization in atrial fibrillation.
- Lidocaine is used for VTach and MI.
Heart Sounds
- S1 (LUB) is the first heart sound, caused by the closure of the AV valves during systole (Diastole-Open ).
- S2 (DUB) is the second heart sound, caused by the closure of semilunar valves.
- Murmurs are turbulent blood flow that can be physiological (e.g., anxiety, pregnancy) or pathological (valve deformities/dysfunction).
Auscultation of Heart Sounds
- Mitral valve sounds are best heard at the apex of the heart, 5th intercostal space, midclavicular line.
- Tricuspid valve sounds are best heard at the left sternal border, fourth intercostal space.
- Pulmonic valve sounds are best heard at the base of the heart, second intercostal space.
- Aortic valve sounds are best heard at the second intercostal space, right sternal border.
MONA
- Morphine: To relieve pain.
- Oxygen: To increase oxygen levels.
- Nitro: To relax arteries and increase blood flow to the heart.
- Aspirin: To thin blood.
Respiratory & Perfusion
- Heparin prevents blood clots but can cause thrombocytopenia (low platelets). 3L per day
Normal Values
- BUN: 10-20 mg/dL
- Creatinine (serum): 0.5-1.3 mg/dL (gender and age-related)
- Hemoglobin: 12-18 g/dL (gender-related)
- Potassium: 3.5-5.0 mEq/L
- Heparin: PTT 60-80 seconds
Acute OB: Gestational Diabetes
- Gestational diabetes is glucose intolerance with onset during pregnancy, usually in the second or third trimester.
Concerns for Mom
- Poorly controlled blood glucose can lead to pre-eclampsia, increased risk of infection, higher likelihood for cesarean delivery.
- Large baby can lead to lacerations or tears during vaginal delivery, enlarged uterus could lead to postpartum hemorrhage.
- Increased risk of developing T2DM later in life.
Concerns for Baby
- Large birth weight (macrosomia), neonatal hypoglycemia, respiratory distress, and long-term metabolic issues.
- Shoulder dystocia could lead to fracture, nerve damage, or brain damage.
- Respiratory distress is caused by hyperinsulinemia interfering with surfactant production.
Hyperglycemia Symptoms
- Polydipsia, polyphagia, polyuria, nausea, abdominal pain, flushed dry skin, fruity breath.
Hypoglycemia Symptoms
- Nervousness, headache, weakness, irritability, hunger, blurred vision.
- Due to glucose crossing the placenta and entering the baby's bloodstream as insulin does not and leads to hypoglycemia after birth
Teaching
- Monitor glucose closely during pregnancy with DM education on medications.
- Teach the patient about diet and exercise.
- Emphasize glucose control for the well-being of the baby.
Decelerations
- Variable decelerations indicate cord compression and require moving the mom.
Stages of Labor
- Stage one: cervix dilates.
- Stage two: baby is delivered.
- Stage three: placenta is delivered.
- Stage four: after placenta delivery, monitor uterus and for bleeding.
Causes of Preterm Labor
- Multifetal gestation, history of previous premature deliveries, maternal obesity or underweight, family history of preterm birth.
- Uterine anomalies, advanced or very young maternal age, smoking or drug use during pregnancy.
Postpartum Hemorrhage (PPH)
- Excessive bleeding can occur after a C-section due to uterine atony, retained placental fragments, or injury to blood vessels.
- Prompt medical attention is necessary, potentially requiring medication, compression, or surgery.
- Saturation of a pad indicates approximately 1000ml blood loss; blood loss >1000ml in vaginal birth and hemorrhage after c-section is >500ml loss.
Placenta Previa
- The placenta partially or completely covers the cervical os.
- Risk factors: age over 35, previous C-section, multiparity, uterine injury, cocaine use, previous D&C, endometrial ablation, prior placenta previa, infertility treatment, multiple gestations, previous induced surgical abortion, smoking, previous myomectomy to remove fibroids, short interval between pregnancies, hypertension, or diabetes.
- Identification: painless bright red bleeding during 2nd or 3rd trimester; soft, relaxed, non-tender uterus with normal tone; reassuring FHR; normal vitals (unless significant blood loss); decreasing urinary output could mean blood loss.
- Interventions: refrain from vaginal exam, place mom in left lateral position to reduce pressure on inferior vena cava (compression impedes blood flow), and prepare for cesarean section.
Placental Abruption
- Premature separation of the placenta from the uterus; can be complete or partial.
- Occurs after 20 weeks/3rd tri. Leading cause of maternal death and significant fetal mortality.
- Risk factors: hypertension, blunt force trauma, cocaine use, previous abruption, smoking, multifetal pregnancy, prelabor membrane rupture.
- Symptoms: dark red vaginal bleeding, rigid abdomen.
- Treatment: bed rest, delivery, IV fluids, and blood products.
Four Classes of Abruption
- Class 0: diagnosed after delivery.
- Class 1: minimal or no signs of bleeding, normal vitals, slight uterine tenderness, no fetal distress.
- Class 2: no to moderate bleeding, uterine pain with tetanic contractions, VS changes (tachycardia, orthostatic BP), fetal distress, abnormal clotting labs/low fibrinogen.
- Class 3: no to heavy vaginal bleeding, rigid uterus, signs of maternal shock, fetal demise.
Pregnancy
- Infection spreads to the vaginal vault.
- Acrocyanosis is normal; truncal cyanosis is abnormal.
Medications: Mag Sulfate, Terbutaline
- Magnesium sulfate (tocolytic) is used for preterm labor and severe pre-eclampsia (seizure prophylaxis).
- Terbutaline (tocolytic) is used for preterm labor.
Pre-Eclampsia
- Elevated blood pressure after 20 weeks gestation; may also develop postpartum.
- Signs: hypertension (>140/90 mmHg), proteinuria, pitting edema in extremities, hands, face.
- Magnesium sulfate is administered to prevent seizures (eclampsia) and promote vasodilation to lower blood pressure as an added benefit.
Magnesium Toxicity
- Watch for signs of magnesium toxicity using the BURP acronym:
- Blood pressure decreases.
- Urine output decreases. (Report Urine Output)
- Respiratory rate decreases.
- Patellar reflex absent.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.