Student Nurse Laura

Orem – "creative effort of one human being to help another human being."

Some ABC’s of OB Notes

Posted by Laura on March 28, 2010

Asthma

Avoid morphine for woman with asthma who is in labor.

Cancer

Malignant melanoma: the only cancer that crosses the placenta to the fetus.

Cycle of Violence

Phase 1—building: increased tension, anger, blaming, and arguing

Phase 2—battering: hitting, slapping, kicking, choking, use of objects or weapons; sexual abuse; verbal threats and abuse

Phase 3—calm state (may decrease over time): batterer may deny violence, state he was drunk, say he’s sorry, and “promise it will never happen again,” returns to phase 1.

Fetal Maturity— Assessment

Phosphatidyl glycerol is more accurate indicator of fetal lung maturity in women who are diabetic.

Gestational Diabetes—Assessment the 3 P’s

Polydipsia

Polyphagia

Polyuria

Heart Failure—Assessment

Heart rate is the most sensitive and reliable indicator of impending heart failure.

HELLP Syndrome

Hemolysis

Elevated Liver (enzymes)

Low Platelets

HELLP Syndrome—Complication

Hypoglycemia: ≤ 40 mg/dL

Hypoglycemia can lead to maternal mortality.

Hydatidiform Mole or GTD

Complete H. mole: only condition that can lead to maternal cancer.

Hypertension—Definition

Systolic: 30+ mm Hg above baseline

Diastolic: 15+ mm Hg above baseline

Infections

Vaginitis: avoid douching during pregnancy.

STDs in the U.S.: highest prevalence among teens.

AIDS in the U.S.: fourth leading cause of death among women of reproductive age.

Insulin Requirements in Pregnancy

Trimester one: ↓

Trimester two: ↑

Trimester three: ↑

Postpartum: ↓

Placenta Previa

Vaginal examinations contraindicated with undiagnosed vaginal bleeding.

Pre-eclampsia

Proteinuria differentiates pre-eclampsia from other pregnancy-induced hypertension (PIH) states.

• Pre-eclampsia is a disorder of hypovolemia.

• Home care may eliminate the need for hospitalization

RHoGAM—Give RhoGAM to:

1. RhoGam is given to Rh- mother who gives birth to Rh+ neonate.

2. Rh- mother after spontaneous or induced abortion (> 8 wk).

3. Rh- mother after amniocentesis or chorionic villous sampling (CVS).

4. Rh- mother between 28 and 32 wk gestation.

RhoGAM and Rubella Titer

Since RhoGAM is an immune globulin, rubella vaccination, given at about the same time, may not “take”; rubella titer needs to be redone at 3 mo.

TORCH Infections

Toxoplasmosis

Other (hepatitis A virus [HAV], hepatitis B virus [HBV], group B streptococcus [GBS])

Rubella

Cytomegalovirus (CMV)

Herpes type 2

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