Maternal Newborn Care: Key Insights

maternal newborn proctored exam 2023 patient bleeding with placenta previa avoid vaginal exam during nonstress test, FHR is 130 w/o accelerations when to use an acoustic stim on abdomen for 3 seconds mom is rubella non-immune positive for beta hemolytic strep blood is type O negative give client rubella immunization after delivery client with polyhydramnios baby might have GI anomalies adverse effect of mag sulfate feeling of warmth throughout the body low back pain during latent phase of labor apply counter pressure to lower back during contractions first trimester sign/symptom to report to provider swelling of the face first trimester sono teaching will need a full bladder for exam mag sulfate clients to report to provider client that has absent deep tendon reflexes medication for herpes simplex virus type two Acyclovir possible complications following amniocentesis hemorrhage how often to increase oxytocin IV during a normal labor Increase rate every 30-60 minutes client on oxytocin and late decelerations start move client to lateral position care for HIV client for baby bathe baby before skin to skin contact client had boggy uterus and BP of 142/92, what nursing actions? withhold methylergnovine 0.2 mg orally (can raise BP) what labs increase during pregnancy RBC counts a client that should be able to auscultate FHR client that has felt quickening for first time placenta previa s/s painless vaginal bleeding jaundice phototherapy actions before you begin close newborns eyes under eye shields adverse effect of combined oral contraceptives depression cytotec/misoprostol uses ripening/softening/opening cervix how to minimize pain during heel stick on newborns place baby skin to skin on mother Kleihauer-Betke test used to detect fetal blood in maternal circulation (may indicate placenta abruption) a cause of abruptio placenta recent cocaine use s/s of severe pre-eclampsia blurred vision causes for increase urinary output gestational diabetes with hyperglycemia amniocentesis complications leakage of amniotic fluid / preterm labor newborn signs of hypoglycemia weak high-pitched cry lethargic tremors/jitteriness BG of 40 or less irregular respiratory effort seizures hispanic cultural practices for clients postpartum protect feet and head from cold air pregnant client with seizure turn head to side and admin o2 postpartum client with hypovolemic shock massage fundus to expel clots and promote contractions s/p c-section priorities watch the amount of lochia, greatest risk is postpartum hemorrhage nonstress test teachings press the button each time fetal movement is detected postpartum rubella immunization teachings avoid getting pregnant for at least one month after immunization food to increased vitamin B12 fortified soy milk expected finding on newborn after nuchal cord petechiae (tiny red spots) cytomegalovirus teachings droplet, transmission through newborn saliva and urine 1/2 maternal cholelithiasis (gallstones) nutritional teachings baked chicken - not fried foods 32 weeks gestation fundal measuring +/- 2 cm so should be 30-34 cm only or report to provider client on mag sulfate, what is an adverse reaction? 20 ml/hour urine output (normal is 30 ml/hour) d/c breastfeeding instructions feeds 15-20 mins per breast feeds at least every 3 hours postpartum risk for infection episiotomy is a risk for infection client s/p epidural and has hypotension turn client to her side postpartum fundal massage steps lie on back with knees flexed hand on top of fundus, and symphysis pubis upper hand to compress fundus downward amniocentesis purposes genetic or congenital disorders (not just sex of baby) Medoxyprogesterone for conception teachings increase calcium intake one possible cause of postpartum hemorrhage retained placental fragments cytomegalovirus infection can cause newborn to have what hearing loss Babinski reflex run your finger from heel to toe and baby's toes will fan out first action after delivery ID band before vit K, eye ointment and weight postpartum hypovolemic shock s/s cool and clammy first trimester vomiting and nausea eat foods that are served at cool temps precipitus labor less than 3 hours of labor can cause postpartum hemorrhage Dinoprostone (Cervidil) -cervical ripening; produces contractions, dilation & effacement of cervix, and verify informed consent was obtained before giving third trimester client that is seeing floating spots prioritize seeing client first mag sulfate can prevent what seizures when to perform the 1-hour glucose test 24-28 weeks gestation when to hold terbutaline (to prevent preterm labor) maternal hypotension maternal labs during mag sulfate administration serum medication levels what should client report during meg sulfate administration? muscle weakness 2/2