Primipara woman who has had one birth at more than 20

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Primipara- woman who has had one birth at more than 20 weeks gestation regardless of whether infant was born alive or dead. Multipara- woman who has had two or more births at more than 20 weeks gestation Stillbirth- fetus born dead after 20 weeks gestation BIRTH HISTORY T: Term, number of pregnancies delivered at 37 weeks or later P: Preterm, number of pregnancies delivered between 20 and 37 weeks A: Abortion, number of pregnancies ending in spontaneous or therapeutic abortion L: Living, number of currently living children OB STUDY COMPANION 2 PRIORITY NURSING DIAGNOSIS FOR LABOR PATIENT Acute pain will always be a priority nursing diagnosis for a laboring patient having pain with contractions. PITOCIN (OXYTOCIN) L ● Pitocin given at the time or immediately after birth and is given to contract the uterus and minimize bleeding. L ● Can be given intramuscularly or via IV infusion
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L ● Effective method of initiating uterine contractions L ● Associated risks: doserelated, tachysystole of uterus, uterine rupture, and water intoxication RUPTURED MEMBRANES If it has been longer than 24 hours since membranes have ruptured then there is a risk of infection. ● Artificial rupture of membranes requires at least 2 cm of cervical dilation. SLEEP STATES 1. Habituation newborn’s ability to process, respond to complex stimulation such as bright lights. The newborn’s ability to diminish or shutdown innate responses to specific repeated stimuli, such as a rattle, bell, light, or pinprick to heel. 2. Orientation ability to be alert to, follow, and fixate on complex visual stimuli, prefers human face & high contrast. Orientation to the environment is determined by an ability to respond to cues given by others and a natural ability to fix on and to follow a visual object horizontally and vertically. Inability or lack of response may indicate visual or auditory problems. DISCHARGE TEACHING FOR WET DIAPERS Infants should have wet diapers at least 6 times per day. Contact physician if no wet diapers for 1824 hours and fewer than 68 wet diapers per day after 4 days of age. ABNORMAL RESPIRATIONS FOR NEWBORNS Normal respiratory rate of 3060 breaths/min L ● Nasal flaring nostrils widen when the newborn breathes, attempt to decrease airway resistance L ● Grunting on expiration partial closure of the glottis during expiration (attempt to maintain lung volume and allow for adequate gas exchange) L ● Retractions a sign that someone is working hard to breathe. The areas below the ribs, between the ribs, and in the neck sink in with each attempt to inhale. CORD CARE 1. Keep clean with soap and water or alcohol 2. Will fall off in one to two weeks Clamp is removed within 2448 hours of birth, keep cord clean and dry, make sure to fold diaper down. Wash hands with clean water and soap. Keep cord dry, exposed to air and clean cord and skin around the base. Clean 23 times daily with each diaper change. Do not give tub baths until the cord falls off. Fold diapers below umbilical cord to air dry. Check cord daily for odor & redness. Expect tenderness around the cord and report signs of infection. Never pull cord or attempt to loosen.
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  • Winter '19
  • Melissa DuVall
  • Obstetrics, Hypoxia

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