Foundations of Maternal Newborn Nursing Ch 25, 26, 29,30
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| Signs/Symptoms of Preeclampsia | systolic BP >= 140mmHg or diastolic BP >= 90mmHg that develops after 20wks gestation and is accompanied by proteinuria >0.3g in a 24 hr. urine collection (random urine dipstick is usually >=1+)
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| Eclampsia | Progression of preeclampsia- HTN complicated by generalized seizures that cannot be attributed to other causes.
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| Genetic Risk factors for pregnancy induced hypertension (PIH) | Family history of PIH,
Mother or sister who had preeclampsia
Expectant father previously fathered a pregnancy in another woman who had the disorder
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| Fetal Risks of PIH | Prenatal death(ie IUGR), persistent hypoxemia/acidosis(reduced maternal blood flow to placenta). Pulmonary edema, circulatory/renal failure, intracranial hemorrhage(risks assoc. with preeclampsia/eclampsia.
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| Maternal Risks of PIH | Aspiration may cause maternal morbidity after an eclamptic seizure.
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| pharmacological agents used in treatment of PIH | Anti-hypertensive meds- systolic BP is >= 160mmHg or diastolic BP is >=110mmHg.
Hydralazine(Apresoline)(popular-less risk). Used to relaxe arterial smooth muscle to reduce blood pressure.
Niphedipine, B-blocker, Calcium channel blockers
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| Anti-convulsants given to prevent seizures | Magnesium Sulfate (most common)
Dilantin
Diphenylan
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| When giving anti-hypertensive meds to a woman on magnesium sulfate, monitor for _______. | Hypotension
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| Signs of dehydration in a newborn | Urine output <2 ml/kg/hr
Urine specific gravity >1.010
Weight loss greater than expected
Dry skin and mucous membranes
Sunken anterior fontanelles
Poor skin tugor
Blood: elevated Na+, protein, and hematocrit levels
Hypotension
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| Signs of overhydration in a newborn | Urine output > 5ml/kg/hr
Urine specific gravity <1.002
Edema
Weight gain greater than expected
Bulging fontanels
Blood: decreased Na+, protein,& hematocrit levels
Moist breath sounds
Difficulty breathing
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| Daily calorie intake for preterm infants | 105-130 kcal/kg/day
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| Average healthy preterm infant should gain approximately _____g/kg/day. | 15-20 g/kg/day
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| Aspirate the stomach contents to measure the residual amount in the stomach every _____ before tube feedings. | 2-4 hours
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| Preterm infants may need ____ kcal/oz instead of ______kcal/oz for term infants to meet their requirements | 24 kcal/oz, 20 kcal/oz
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| Signs of lack of readiness for breastfeeding | fatigue, bradycardia, tackypnea, or apnea
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| Respiratory distress syndrome in preterm infants is caused by | insufficient production of surfactant
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| By ______ weeks, production of surfactant is usually mature enough to enable the infant to breathe normally outside the uterus. | 34-36 weeks
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| Signs of Respiratory Distress Syndrome (RDS) in infants | Tachypnea, Tachycardia, Nasal flaring, chest retractions, Cyanosis, Audible grunting of expiration, Breath sounds decreased, Rales may be present
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| Postmaturity Syndrome | The infant may not receive the appropriate amount of oxygen and nutrients and may be SGA
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| Skin condition of postterm infant | May appear thin with loose skin folds, cracked peeling skin, and meconium stain
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| Symptoms of Postmaturity Syndrome | Alert and wide-eyed, Worried face
Thin with loose skin, little subcutaneous fat
Little-no lanugo and vernix caseosa, Abundant hair
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| Signs of Recent Cocaine Use | Diaphoresis, high BP, irregular respiration, Dilated pupils, increased body temperature
Sudden onset of severely painful contractions
Fetal tachycardia, excessive fetal activity
Angry, caustic, abusive reactions and paranoi
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| Vague somatic complaints | Anxiety, depression, panic attacks, sleeplessness, anorexia
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| Placenta Previa | placenta is coming out first--> baby doesnt get oxygen
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| Abruptio placenta | Placenta separates prematurely RIGID BOARD-LIKE ABDOMEN
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