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Tocolytic therapy

Used to suppress uterine activity and relax the uterus in cases of preterm labor or tachysystole (dysfunctional labor) long, difficult, or abnormal labor, caused by various conditions associated with the five factors affecting labor Rapid or sudden labor of less than 3 hours beginning from onset of cervical changes to completed birth of neonate (Cephalopelvic Disproportion) Condition in which the infants head is of such a shape, size, or position that it cannot pass through the mothers pelvis Turning the fetus to a vertex position by exertion of pressure on the fetus externally through the maternal abdomen Artificial rupture of the fetal membranes (AROM), using a plastic AmniHook or surgical clamp Hormone produced by the posterior pituitary that stimulates uterine contractions and the release of milk in the mammary gland (let-down reflex) Indications: IV induction of labor at term IV facilitation of threatened abortion IV, IM PP control of bleeding after expulsion of the placenta Action: stimulates uterine smooth muscle, producing uterine contractions similar to those in spontaneous labor Nursing Considerations: monitor maternal BP and HR and fetal HR continuously

Dystocia

Precipitous labor

CPD

Externalcephalic version Amniotomy

Oxytocin

Episiotomy

Surgical incision of the perineum at the end of the second stage of labor to enlarge the vaginal outlet, facilitate birth, and avoid laceration of the perineum Umbilical cord lies below the presenting part of the fetus; may be frank (visible) or occult (hidden, rather than visible) Condition in which the head is born but the anterior shoulder cannot pass under the pubic arch to complete the birth of the entire fetus A letdown feeling, accompanied by irritability and anxiety, which usually begins 2-3 days after giving birth and disappears within a week or two Depression occurring within 6 months of childbirth, lasting longer than PP blues and characterized by a variety of symptoms that interfere with ADLs and care of baby Excessive bleeding after childbirth; traditionally defined as a loss of 500+ or more after a vaginal birth and 1000+ ml after a cesarean birth

Prolapsed umbilical cord Shoulder dystocia

PP blues

PPD

PP hemorrhage

Uterine atony

Relaxation of uterus; leads to PP hemorrhage. Failure of the uterine muscle to contract firmly. Irregular tear of wound tissue; in OB - tear in perineum, vagina, or cervix during childbirth Retention of all or part of the placenta in the uterus after birth

Lacerations

Retained placenta

Inversion

Uterus is turned inside out so that the fundus intrudes into the cervix or vagina, caused by a too vigorous removal of the placenta before it is detached by the natural process of labor Failure of the uterus to reduce to its normal size and condition after pregnancy (Hemorrhagic shock) Peripheral blood flow is inadequate to return sufficient blood to the heart for normal function, particularly oxygen transport to the organs or tissue Inflammation of a vein with secondary clot formation Obstruction of a blood vessel by a clot that has become detached from its site of formation Infection in a breast, usually confined to a milk duct, characterized by influenza-like symptoms and redness and tenderness in the affected breast Total unconjugated serum bilirubin concentration in the blood is elevated. Values are abnormal based on gestational age, days of life, and the babys general physical condition. S/S: yellow discoloration of the skin, mucous membranes, sclera, and various organs; caused by bilirubin levels that rise steadily over the first 3-4 days, peak around day 5, and decrease thereafter. Yellow discoloration of the body tissues caused by the deposit of bile pigments Usually first noticeable within 24 hours after birth; caused by some abnormal condition such as an Rh or ABO incompatibility and resulting in bilirubin toxicity Bilirubin encephalopathy involving the deposit of unconjugated bilirubin in brain cells, resulting in death or impaired intellectual, perceptive, or motor function and adaptive behavior Yellow tinge to skin and mucous membranes in response to increased serum levels of unconjugated bilirubin; not usually apparent until after 24 hours Bacterial infections of the bloodstream

Subinvolution Hypovolemic shock

Thrombophlebitis Thromboembolism

Mastitis

Hyperbilirubinemia

Jaundice Pathologic jaundice Kernicterus

Physiologic jaundice Sepsis

Hydrocephalus

Accumulation of CSF in the subdural or subarachnoid spaces; caused by overproduction (rare) of CSF or a decrease in reabsorption Excessive number of digits

Polydactyly

Syndactyly

Malformation of digits, often seen as a fusion of two or more toes to form one structure Anomalous positioning of urinary meatus on undersurface of penis or close to or just inside the vagina Defect in which the urethral canal terminates on the dorsum of the penis or above to clitoris (rare) Congenital deformity in which portions of the foot and ankle are twisted out of a normal position Newborn birth weight <2500 g (5 lb, 8 oz) (Intrauterine growth restriction) Fetal undergrowth of any cause, such as deficient nutrient supply or intrauterine infection, or associated with congenital malformation; birth weight below population 10th percentile corrected for gestational age Uterine contractions causing cervical changes that occur between 20 and 37 weeks of pregnancy Birth in which forceps are used to assist in delivery of the fetal head

Hypospadias

Epispadias

Clubfoot

LBW

IUGR

PTL

Forceps-assisted birth Vacuum-assisted birth VBAC

Birth involving attachment of a vacuum cup to fetal head and using negative pressure to assist in birth of the fetus Giving birth vaginally after having had a previous cesarean birth

Cesarean section

Birth of a fetus by an incision through the abdominal wall and uterus Action: stimulates fetal lung maturation by promoting release of enzymes that induce production or release of lung surfactant Indication: to prevent of reduce the severity of neonatal RDS by accelerating lung maturity in fetuses between 24 and 34 weeks of gestation Dosage and Route: 12 mg IM for 2 doses 24 hrs apart Adverse Effects: pulmonary edema, may worsen materal condition (DM, HTN)

Betamethasone

MgSO4

Indications: anticonvulsant associated with severe eclampsia or preeclampsia, PTL Route: IV or piggyback Nursing Considerations: Monitor for over exaggerated reflex responses, vitals, neurologic status, I & O

Rh incompatability

condition that develops when a pregnant woman has Rh-negative blood and the baby in her womb has Rh-positive blood Complication that can occur with excessive use of Pitocin / Oxytocin during labor induction. The uterus may contract too frequently (more than four to five contractions in 10 minutes), the contractions may last too long, or the uterus may not relax enough between contractions. It can cause a decrease in the flow of blood containing oxygen from the mother to the baby and can cause hypoxia and acidosis in the baby. It can also cause uterine rupture which is a life threatening condition for the mother and baby. Death of the mother or the baby can occur. Condition resulting from decreased pulmonary gas exchange, leading to retention of CO2. Most common causes are prematurity, perinatal asphyxia, and materal DM. S/S: audible respirations or grunting, nasal flaring, and retractions (Birth-acquired herpes, congenital herpes) Newborns can become infected in the uterus, passing through the birth canal, and PP from kissing or other contact with mouth sores Developmental dysplasia of the hip is a congenital (present at birth) condition of the hip joint. It occurs once in every 1,000 live births. The hip joint is created as a ball and socket joint. In DDH, the hip socket may be shallow, letting the "ball" of the long leg bone, also known as the femoral head, slip in and out of the socket. The "ball" may move partially or completely out of the hip socket.

Uterine hyperstimulation

RDS

HSV

Dysplasia of the hip

Anxiety in pregnancy Risks of drug therapy in pregnancy Substance abuse during pregnancy Postpartum birth Postpartum bleeding and nursing assessment Birth trauma injuries

Infants of diabetic mothers Perinatal hypoxia HIV Group Beta Strep (GBS) Alcohol

Methadone

Cocaine

Tobacco

Withdrawal

GI anomalies

Nursing diagnoses and the nursing process