Activate LD code team Rapid sequence intubation Stabilize with O2 IV fluids and

Activate ld code team rapid sequence intubation

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Activate L&D code team Rapid sequence intubation Stabilize with O2, IV fluids, and blood products Continuous FHR monitoring Prep emergency delivery Multiple Gestation o Risks during pregnancy and delivery process Complications of Multiple Gestation
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QUIZ 6 STUDY GUIDE Maternal: o Anemia o Hydramnios o Preeclampsia o Preterm labor o Postpartum hemorrhage o Cesarean delivery Fetal o Malpresentation o Placenta previa o Abruptio placentae o Premature rupture of the membranes o Prematurity umbilical cord prolapse o Intrauterine growth restriction o Congenital anomalies o Increased risks for shared placentas and/or chorionic sacs Placental Abruption (Abruptio Placentae) o Try a concept map!!! (Risk factors, findings/assessments/monitoring and nursing care/management & interventions/ medications (hehe, just kidding, there are none ). o Premature separation of normal placenta from uterine wall o Placental abruption is initiated by hemorrhage into the decidual basalis—bleeding into here results in hemorrhage and placental separation o A hematoma forms that leads to destruction of the placenta adjacent to it. o The separation may be partial or total and can be classified as: Grade 1: mild Grade 2: moderate Grade 3: severe o Bleeding with placental abruption is almost always maternal o Risk factors History of previous abruption HTN, preeclampsia Eclampsia Abdominal trauma Drug use, cigarette smoking PPROM Thrombophilia Uterine anomalies, fibroids Short umbilical cord Increased parity, AMA o Signs and Symptoms Severe abdominal pain (sharp, stabbing, high in fundus) Uterine contractions Uterine tenderness Hypertonus (hard, board-like uterus) Tense, Painful Vaginal bleeding (unless concealed)
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QUIZ 6 STUDY GUIDE Dark vaginal non-clotting bleeding may or may not be present If separation is in the center of the placenta, then blood may be trapped between the placenta and decidua, concealing the hemorrhage. A concealed hemorrhage occurs in about 10% abruptions. This results in uterine tenderness and abdominal pain. If separation occurs at the edge of the placenta, then the blood usually escapes externally Port-wine colored amniotic fluid Nausea and vomiting Signs of hypovolemic shock when 25-30% of maternal blood loss has occurred Fetal distress on the monitor o Management Emergency. Immediate c-section if birth not imminent 18 gauge IV access O2 via mask, fetal monitoring, maternal VS, lateral positioning, labs, blood transfusion (have 2 Packed RBCs available) Labs: CBC Fibrinogen levels Platelet count PT/PTT Fibrin degradation products (sx of DIC) o Difference between concealed and visible bleeding Placenta Previa o o Definition- Occurs when the placenta attaches to the lower uterine segment near or over the internal cervical os instead of the body/fundus of the uterus o Risk factors Endometrial scarring Previous placenta previa Prior c-section Abortion involving suction curettage Multiparity or short pregnancy interval
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