Loading dose of 4 6 g over 20 min Maintenance of 2ghr o Monitor vitals labs

Loading dose of 4 6 g over 20 min maintenance of 2ghr

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Loading dose of 4 – 6 g over 20 min Maintenance of 2g/hr o Monitor vitals & labs Reversal Agent
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o Calcium gluconate Keep at bedsid TURN ON SIDE GIVE OXYGEN Stop Pitocin or mag Stop meds or slowing way down depending on orders Crank fluids up Biophysical profile: what do scores mean, why done? Biophysical Profile 8/8 is great score healthy <8 o Full term and 2-3 score get baby out Contraction stress test vs. non-stress test: How to evaluate, when done, why done Stress Test Putting stress on baby by causing contractions Oxytocin or nipple stimulation or if she’s already having contractions Put on monitor for 20 minutes Do not want to see any decelerations o Slowing of fetal HR Negative = good Non-Stress Test Mom is put on fetal HR monitor for 20 minutes Want to see 2+ accelerations o Increased by 15 bpm & lasts 15+ seconds Positive = good Cerclage: what is it, why used, patent education on when to call doctor/seek care Used to prevent preterm labor For hx of cervical incompetence to keep from opening o Used in women w/hx of cervical issues Prophylactic cervical cerclage o Surgical reinforcement of cervix Strengthens & prevents premature cervical dilation Around 12-14 weeks Remove around 37 weeks Activity restriction following Risks of using drugs when pregnant, stimulants Withdrawal Fetal alcohol syndrome
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Feeding problems CNS dysfunction ADD Language abnormalities Low birth weight Delayed growth / development Poor bonding SIDS Deficits in attention, cognition, memory, & motor skills Seizures Nursing interventions for decreased maternal BP, drop in FHR Reposition mom o Don’t want flat on back, cuts off O2; lay on left side for best perfusion Shut Pitocin off Bolus fluids Oxygenate mom Scalp stimulation of baby If all else fails C section Shoulder dystocia: S/S, risk factors for having Head is out but shoulders are stuck behind mom’s pelvic bone Mom pushed for >2 hours & baby’s not out yet? o Suspect this Risk o Gestational diabetes o Obese mothers o Macrosomia Baby >4000 g o o Dysfunctional labor Atypical uterine contractions prevent normal process of labor & progression Hypotonic
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o Weak, inefficient, or absent Hypertonic o Excessively frequent, uncoordinated, strong intensity w/inadequate uterine relaxation Baby gets stuck o Assessment Risk factors Post-date Macrosomia o Baby >4,000 grams o Usually caused by diabetes Mom short & overweight Uterine abnormalities Mom >40 Cephalopelvic disproportion o Fetal head larger than maternal pelvis Congenital anomalies Fetal malpresentation / malposition Multifetal pregnancy Hypertonic / hypotonic uterus Maternal fear, fatigue, or dehydration Inappropriate timing of analgesics or anesthesia Expected findings Lack of progress in dilation, effacement, or fetal decent during labor
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