Intro to Maternity & Pediatric Nursing Lecture Notes

Intro to Maternity & Pediatric Nursing Lecture...

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Page 1 OB Nursing Intrapartum 01/28/09 1 st time mom need to come to the hospital when contractions are regular and 5 minutes apart. 2 nd time mom and thereafter needs to come to the hospital when contractions are regular and 10 minutes apart. (Because the road has already been paved) OR If they start to bleed. discharge, can be brown (textbook def.)) (Truth: red) Mucous plug falls out when cervix starts to dilate (@ 2cm) ***Toco-monitor- leads on fundus- measures contraction. Pg. 121 fig. 6-4 I= Increment A= Acme D= Decrement Frequency- Time between the beginning of one contraction to the beginning of the next contraction. * Must be longer than two minutes!!* Duration- beginning of a contraction to the end of that contraction. * should last no more than 90 seconds!!* Interval- time between contractions (uterine relaxation). * Should be at least 60 seconds. No sooner!!* Intensity- strength of contraction. The higher the peak the stronger the contraction. -If any of these #s are off, it increases the risk of uterine rupture. Page 2 Pg. 135 1. Early Deceleration: drop in baby’s Heart rate, in the early part of
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a contraction, This is a reassuring pattern (by the end of the contraction, the heart rate returns back to baseline). Normal finding- due to fetal head compression (stimulates vagal response) 2. Late Deceleration: drop in baby’s HR, in the late part of a contraction, (@ the peak or 30 seconds into contraction) After the uterus is relaxed, baby’s HR stays low. Will not go back up to baseline. Non-reassuring pattern. Could be caused by: Uteroplacental insufficiency (UPI): reduced blood flow (supply) from the placenta. (fetal hypoxia/acidosis) 3. Variable Deceleration: Drop in baby’s HR, occurring anytime during a contraction ( HR will be seen @ 60-70 bpm) W, V, and U shaped patterns. (Bad, Worst, Non-reassuring pattern) Could be caused by: Cord Compression Nuchal Cord (cord @ baby’s neck) Nursing Intervention for Deceleration: *Early: Nothing *Late: (L) side, administer O2 (10-12L/min. face mask),Discontinue pitocin drip, Call Dr. *Variable: Trendelenburg position or any position where the hips are higher than the head. (Knee-Chest position)-> Helps to relieve the pressure placed on the cord. (L) side, administer O2 (10-12L/min. face mask),Discontinue pitocin drip, Call Dr. Intensity can be measured by feeling the fundus. Walk fingers from
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side until you reach the center-> Feels like a rock. Types of intensity upon palpation: 1. Mild: Firm but some indention (nose) 2. Moderate: (chin) 3. Firm: (forehead) Contractions during the 1 st stage of labor causes cervical dilation. Pain caused by cervical dilation. Page 3
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Intro to Maternity & Pediatric Nursing Lecture...

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