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Sunday, February 8, 2009

Maternal & Child Nursing: Intrapartum Disorder Nursing Review

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Port-wine-colored amniotic fluid isn't normal and may indicate abruptio placentae.

A fetal blood pH less than 7.2 is an indication of fetal hypoxia. During labor, a fetal pH range of 7.2 to 7.3 is considered normal.

Dizziness, circumoral numbness and slurred speech indicate anesthesia overdose.

The average length of time a primigravida neds to push is approximately 2 hours.

A late deceleration is U-shapred and occurs after the first half of the contraction, indicating uteroplacental insufficiency.

A steady trickle of blood on the perineal pad of a client with a well-constracted uterus may indicate a vaginal, cervical or perineal laceration.

Normal short-term variability - 2 to 3 beats per amplitude -- is the single most reliable indicator of fetal well-being on an EFM strip.

Oxytocin has an antidiuretic effect; prolonged I.V infusion may lead to server fluid retention, resulting in seizures, coma and even death.

The initial action immediately following the birth of the baby is drying the infant to stabilize the infant's temperature. Aspiration of the infant's nose and mouth occurs at the time of delivery.

A nontreponemal test screens the client for syphilis. The positive test result, along with the lymphadenopathy and rash, indicate that the client has secondary syphilis.

Ritodrine (Yutopar) and other beta-adrenergic agonists may cause tacycardia, hypotension, brocial dilation, increase plasma volumn, increased cardiac output, arrhythmias, myocardial ischemia, reduced urine output, restlessness, headache, nausea, and vomiting.

Variable decelerations are decreases in fetal heart rate that aren't related to the timing of contractions.

Primigravidas will efface and then dilate, while multigravidas will efface and dilate at the same time.

For an epidural block, the nurse should anticipate that the anesthesiologist will inject a local anesthetic agent into the epiduarl space, located between the dura mater and the ligamentum flavum in the lumbar region of the spinal column.

When administering a spinal block, the anesthesiologist injects the anesthetic agent into the subarachnoid space.

Internal EFM can be used only after the client's membranes rupture, when the cervix is dilated at least 2 cm and when the presenting part is at least at -1 station.

Etidocaine (Duranest) is least likely to cross the placenta.

Direct fetal scalp electrode placement is the most accurate way to assess FHR. Documentation should include the time the electrode was placed, the name of the physician or nurse practioner who performed the procedure, and the FHR.

Based on research, the latent phase may be considered prolonged if it exceeds 20 hours in a nulliparous client or 14 hours in a multiparous client.

During the second stage of labor, the nurse should assess the strength, frequency, and duration of contractions every 15 minutes.

Fetal position refers to the relationship of the fetus's presenting part to the mother's pelvis.

Fetal posture refers to "attitude"

Presentation refers to the part of the fetus at the cervical os.

Lie refers to the relationship of the fetal long axis to that of the mother's long axis.

The normal for the fetal hear rate is 120 to 160 beats/minute. Tachycardia is defined as a fetal heart rate greater than 160 beasts/minute for more than 10 minutes.

Ritodrine reduces frequency and intensity of uterine contractions by stimulating B2 receptors in the uterine smooth muscle. Its the drug of choice when trying to inhibit labor.

Oxytocin should be discontinued when contractions occur less than 2 minutes apart or last longer than 90 seconds.

Fetal heart rate variability most reliably indicates uteroplacental and fetal perfusion; an average variablity of 5 to 10 beats per minute is considered acceptable.

Oxytocin administration causes stronger, more uncomfortable contractions, which peak more abruply than spontaneous contractions.

Because magnesium has chemical properties similar to those of calcium, it will assume the role of calcium at the neural muscular junction.

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