Magnesium Sulfate signs of toxicity Respiratory rate < 12
Absent deep tendon reflexes
Altered LOC
Pulmonary edema, chest pain
Severe hypotension
Severe muscle weakness
Urine output <25-30mL/hr
Antidote: calcium gluconate
eclampsia When preeclampsia progresses to seizure activity
mag sulfate is the drug of choice for a patient with Eclamptic seizures
before seizure Seizure precautions should be in place prior to the seizure
Padded siderails
Suction equipment tested and ready to use
Oxygen equipment tested and ready to use
Have a emergency birth pack in room if available
Ensure emergency meds are available on the unit
During a seizure Note the time and onset
Call for help
Do not leave the bedside
Observe and record seizure activity
after seizure Lower the head of bed
,Turn patient to their side
Check airway, breathing , and pulse
Suction as needed
Start magnesium drip per Dr.order
Check fetal and uterine status
Decision is made about timing and route of birth (not a automatic c section)
Provide low stimulation environment
Factors affecting labor 5 P's: Passenger, Passageway, Powers (Forces), Position of the
Laboring Woman, Psychologic response
Passenger Fetus and placenta
Passageway Birth canal
Powers Contractions
Factors affecting labor At least 5 factors affect the process of labor and birth .. 5 ps
The first p: passenger The movement of the passenger (fetus) through the birth canal is
determined by several factors:
The size of fetal head
Fetal presentation
Fetal lie
Fetal attitude
Fetal position
, Passenger presentation Presentation : the part of the fetus that enters the pelvic inlet first
and leads through the birth canal
3 main types of presentation Cephalic
Breech
Shoulder
Passenger: fetal lie The relation of the spine of the fetus to the spine of the mother
Passenger attitude (flexion/posture) The fetus assumes a characteristic posture (attitude) in
utero.
Normal attitude is called general flexion
General flexion Chin flexed on the chest
Thighs flexed on the abdomen
Legs flexed at knees
Arms crossed over thorax
Umbilical cord lies between arms and legs
*second P - PASSAGEWAY Maternal pelvis and soft tissues
-pelvis
-lower uterine segment
-cervix
-perineal muscle
-vaginal
*second P - PASSAGEWAY - bony pelvis 2 parts of bony pelvis: true & false