VATI Maternal Newborn Nursing

VATI Maternal Newborn Nursing Learning points 1. Assessment of fluid and electrolyte status a. Daily weights are the most accurate assessment of fluid and electrolyte status b. Fluid balance chart – I/O c. Serum chemistry 2. Polyhydramnios a. An excessive amount of amniotic fluid in the amniotic sac b. Symptoms i. Difficulty breathing ii. Swelling of the lower extremities iii. Swelling of the vulva iv. Constipation, heart burn v. Feeling huge or tightness in the belly c. Risks i. Preterm contractions and possible preterm labor ii. Premature rupture of the membrane iii. Fetal malposition iv. Prolapsed cord v. Uterine atony vi. Abruptio placentae 3. Oligohydramios a. deficiency of amniotic fluid in the amniotic sac b. Symptoms i. Rapid growth of the uterus ii. Measurements of size smaller than dates iii. Abdominal discomfort iv. Decreased fetal movement v. Uterine contractions vi. Abnormal findings on fetal monitor including fetal distress c. Risks i. Cord compression ii. Preterm birth iii. Meconium stained fluid iv. IUGR 4. Poractant – alfa a. Porcine lung surfactant – Used to treat neonatal respiratory distress syndrome b. Route is intratracheal 5. Betamethasone a. Give when infant is born too early and lungs are not fully developed. It speeds up the development of the lungs prior to birth. 6. Nifedipine – Calcium Channel Blocker a. Relaxes the muscles of the heart and blood vessels b. Avoid grapefruit and grapefruit juice c. Side effects – orthostatic hypotension, peripheral edema, flushing, muscle cramps, shortness of breath, tingling in the hands and feet 7. Terbutaline a. Given for preterm labor – prevents or slows contractions of the uterus b. Decrease in potassium levels c. Adverse Reactions i. Cardiac arrhythmia, tachycardia, anxiety, tremors, insomnia, dyspnea, diaphoresis 8. Kernicterus a. Occurs due to a build up of bilirubin in the infant’s blood b. Early signs are jaundice c. Symptoms may include i. Drowsiness/lack of energy ii. Uncontrollable or very high-pitched shrill crying iii. Fever iv. Trouble feeding v. Limpness or stiffness of the whole body vi. Unusual eye movements, motor development and movement vii. Muscle spasms or reduced muscle tone viii. Seizures or convulsions 9. Hydatidiform mole a. Growth of the chorionic villi gives rise to multiple cysts b. Symptoms i. Dark brown to bright read bleeding during the 1st trimester ii. Severe nausea vomiting iii. Vaginal passage of grapelike cysts iv. Pelvic pressure or pain 10. Biophysical profile a. Fetal tone b. Reactive fetal heart rate c. Qualitative amniotic fluid 11. A prominent clitoris and labia minora are signs of premature infant