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Antepartum & Newborn

Foundations of Maternal Newborn Nursing Ch 25, 26, 29,30

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+)
Eclampsia Progression of preeclampsia- HTN complicated by generalized seizures that cannot be attributed to other causes.
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
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.
Maternal Risks of PIH Aspiration may cause maternal morbidity after an eclamptic seizure.
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
Anti-convulsants given to prevent seizures Magnesium Sulfate (most common) Dilantin Diphenylan
When giving anti-hypertensive meds to a woman on magnesium sulfate, monitor for _______. Hypotension
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
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
Daily calorie intake for preterm infants 105-130 kcal/kg/day
Average healthy preterm infant should gain approximately _____g/kg/day. 15-20 g/kg/day
Aspirate the stomach contents to measure the residual amount in the stomach every _____ before tube feedings. 2-4 hours
Preterm infants may need ____ kcal/oz instead of ______kcal/oz for term infants to meet their requirements 24 kcal/oz, 20 kcal/oz
Signs of lack of readiness for breastfeeding fatigue, bradycardia, tackypnea, or apnea
Respiratory distress syndrome in preterm infants is caused by insufficient production of surfactant
By ______ weeks, production of surfactant is usually mature enough to enable the infant to breathe normally outside the uterus. 34-36 weeks
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
Postmaturity Syndrome The infant may not receive the appropriate amount of oxygen and nutrients and may be SGA
Skin condition of postterm infant May appear thin with loose skin folds, cracked peeling skin, and meconium stain
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
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
Vague somatic complaints Anxiety, depression, panic attacks, sleeplessness, anorexia
Placenta Previa placenta is coming out first--> baby doesnt get oxygen
Abruptio placenta Placenta separates prematurely RIGID BOARD-LIKE ABDOMEN
Created by: amysfenton