Maternal Child Health NUR 2633 Final Exam 4 Study Guide

Maternal Child Health NUR 2633 Final Exam 4 Study Guide 1. Dysmenorrhea – a common complaint with women – what are the nonpharmacological and pharmacological treatments. • Dysmenorrhea- painful menses • Non pharmacological-heat, exercise, increase calcium • Pharmacological- NSAIDs 2. Obstetrical issues – pregnancy risks - Know Naegle’s Rule – to establish gestational age • Naegle’s Rule is first day of last missed period subtract 3 months add 7 days and add one year • Fundal height(14 weeks just above the symphysis), 12 weeks embryonic stage organ development, 10-12 weeks heart tones, movement starts at 16 weeks multigravida, 18 weeks primigravida 3. Poor nutrition, drugs, HTN, DM are all issues of perfusion – what will the fetal result be. • IUGR are large head skinny not much brown fat had poor perfusion • Small for gestational are proportional have brown fat • Macrosomic- body as big as head, worried about birth injuries they usually come from uncontrolled diabetic, Poor lung maturity, hypoglycemic(jittery, lethargy) • Meconium staining- post dates because of stress 4. Anemia becomes a problem in pregnancy – can you discuss the maternal and fetal risks • Most pregnant women have anemia, normal phenomenon, plasma volume goes up not RBC volume so women become anemic, iron supplements • Constipation- they are already constipated and then the iron supplements make them even more, exercise water calcium orange juice no laxatives fiber stool softener • HTN, edema, proteinuria. Subjective signs are headache, gastric pain, swelling, blurred vision. Organs effected are brain, hear, liver and kidneys. • Nursing interventions- DTRs, vitals every hour, respiratory rate, lung sounds, urine output, put Foley in, bedrest • Magnesium sulfate is used to relax muscles, vessels. The blood vessels are tight and the blood pressure goes up. If we don’t treat this seizures will happen. Hypoxia, IUGR, small baby. 6. Pre- term labor – define it; signs and symptoms, treatment modalities and nursing interventions. • Labor that begins before 37 weeks, regular contractions that cause cervical 5. Hypertension – preeclampsia has specific symptoms – please know these as well as treatment modalities and nursing interventions – keep In mind Magnesium Sulfate, nursing interventions change • Nursing interventions- bedrest, hydration(500ml LR bolus), fetal monitor, left side, UA(UTI can cause uterine irritability) • 2cm 80% effaced what should the doctor order? Terbutaline, a tocolytic that stops contractions and delays the labor process, side effects- maternal tachycardia, baby’s HR goes up too. If this is not working, we then use Magnesium sulfate. Mag is given to relax the uterus, smooth muscle relaxant, give her 4g bolus over a 15-20 min timeframe, then 2g maintenance dose. • If we send her home-pelvic rest nothing in the vagina, this can stimulate contractions. Semen is prostaglandin, which can start labor. • Betamethasone is for lung maturity, we need 24 hours for it to work. 7. Diabetes Mellitus – Type 1, Type 2 and Gestational DM all have issues that are common to all and specific to each. Note the concerns specific to each, management and fetal surveillance • Type 1- no insulin production, fetal anomalies, risk to baby developing, insulin levels go down in the first trimester, the need rapidly increases • Type 2- usually diet controlled, if not she needs insulin, macrosomic baby because sugar crosses the placenta insulin does not • GDM- diabetes only in pregnancy 8. Define Macrosomia – and what are the