NR 327 Exam 1 Study Guide
Pitocin: Induces labor, augments labor, and controls bleeding after the placenta is delivered by
clamping down the uterus. Causes uterus contract.
Magnesium Sulfate: Stop seizures, given with pre-eclampsia. Relaxes smooth muscles of the
uterus. 4-6 g over 30 minutes. Could have cardiovascular collapse, no drive to breathe, listen to
breath sounds for pulmonary edema, Q 5 minutes until bolus is done, check for the next few
hours, monitor urine output.
Antidote for Magnesium Sulfate: Calcium gluconate; reverses magnesium sulfate actions
Ferrous sulfate: To correct or preventIron deficiency anemia. Take in the morning without
food. Vitamin C increases absorption of iron. Do not take with dairy products. Iron causes
constipation and dark stools.
Cytotec: To induce labor, augment labor, and to control bleeding after the placenta is delivered
by clamping down the uterus. Causes low level uterinecramping and causes cervical ripening;
shortens and softens cervix to allow it to open up.
Betamethasone: Corticosteroid used to treatcontractionsthat are causing changes in the cervix, for
of infection, or for preterm premature rupture of membranes (pPROM; < 37 weeks); delays labor.
Also used to promote fetal lung development in moms that are at risk for pre-term labor or birth;
helps with surfactant production.
Ephedrine: To prevent low blood pressure with a spinal anesthesia; to increase blood pressure
with hypotension. It is a vasopressor; constricts blood vessels. Can also be given for shock.
,Folic Acid: To prevent neural tube defects. Taken prior to pregnancy as well as during because
much of the organogenesis occurs before the missed menstrual period.
Standards of Care for OB:
Cultural/communication considerations in OB:
Health beliefs
Health maintenance during pregnancy
Belief in fate
Preventing Illness
Restoring health
Modesty
Female genital cutting
Communication: May look down, be silent, avoid eye contact, male speaks on behalf, no
male care givers, Hispanic and Native American woman reserved and quiet educate about
pain control.
Teaching and learning for OB:
Preconception care:Taking folic acid to prevent neural tube defects; spina bifida.
Oligohydramnios:Too little amniotic fluid, may need to do an amnioinfusion.Kidney function,
cord compression < 400 mL
Polyhydramnios:Too much amniotic fluid, may need to do an amniocentesis. Gestational
diabetes, tracheal esophageal fistula, Risk factors: Cord accident, cord prolapse, >2,000 mL
Placental implantation:Occurs between 6-10 days after conception.
, Twins:
Monozygotic Twins (Identical Twins): The union of a single ovum and spermatozoon
that later divide into two. Twin to twin transfusions and cord accidents.
Monoamniotic-Monochorionic: One sac and one placenta
Monochorionic-Diamniotic: Two separate sacs and one placenta.
Dizygotic twins (Fraternal/Non-identical twins):Fertilization of two different eggs with
two different sperms. During ovulation two mature eggs (ova) are expelled and are
fertilized by two different sperm.
Diamniotic-Dichorionic: Two separate sacs and two fused placentas.
Diamniotic-Dichorionic: Two separate sacs and two separate placentas.
Hormones of pregnancy:
Estrogen:Causes increased vascularity of the mucous membranes of the upper
respiratory tract. As the capillaries become engorged, edema and hyperemia develop
within the nose, pharynx, larynx, and trachea. This congestion may cause nasal and sinus
stuffiness, epistaxis (nosebleed), and deepening of the voice. It also causes edema of the
eardrum and Eustachian tubes may result in a sense of fullness in the ears. Also bleeding
gums, ptyalism (excess production of saliva), and decreased bladder tone.
Progesterone: Keeps uterus and blood vessels relaxed and accommodates increased
blood volume that increases cardiac output but not the BP. Allows the bladder to hold
more urine because it relaxes it and causes urine stasis. Keeps them gregnant.
Human chorionic gonadotropin hormone (hCG): Elevations expected during
pregnancy. Increases the availability of glucose to the fetus. Prepares breasts for
lactation.
Pitocin: Induces labor, augments labor, and controls bleeding after the placenta is delivered by
clamping down the uterus. Causes uterus contract.
Magnesium Sulfate: Stop seizures, given with pre-eclampsia. Relaxes smooth muscles of the
uterus. 4-6 g over 30 minutes. Could have cardiovascular collapse, no drive to breathe, listen to
breath sounds for pulmonary edema, Q 5 minutes until bolus is done, check for the next few
hours, monitor urine output.
Antidote for Magnesium Sulfate: Calcium gluconate; reverses magnesium sulfate actions
Ferrous sulfate: To correct or preventIron deficiency anemia. Take in the morning without
food. Vitamin C increases absorption of iron. Do not take with dairy products. Iron causes
constipation and dark stools.
Cytotec: To induce labor, augment labor, and to control bleeding after the placenta is delivered
by clamping down the uterus. Causes low level uterinecramping and causes cervical ripening;
shortens and softens cervix to allow it to open up.
Betamethasone: Corticosteroid used to treatcontractionsthat are causing changes in the cervix, for
of infection, or for preterm premature rupture of membranes (pPROM; < 37 weeks); delays labor.
Also used to promote fetal lung development in moms that are at risk for pre-term labor or birth;
helps with surfactant production.
Ephedrine: To prevent low blood pressure with a spinal anesthesia; to increase blood pressure
with hypotension. It is a vasopressor; constricts blood vessels. Can also be given for shock.
,Folic Acid: To prevent neural tube defects. Taken prior to pregnancy as well as during because
much of the organogenesis occurs before the missed menstrual period.
Standards of Care for OB:
Cultural/communication considerations in OB:
Health beliefs
Health maintenance during pregnancy
Belief in fate
Preventing Illness
Restoring health
Modesty
Female genital cutting
Communication: May look down, be silent, avoid eye contact, male speaks on behalf, no
male care givers, Hispanic and Native American woman reserved and quiet educate about
pain control.
Teaching and learning for OB:
Preconception care:Taking folic acid to prevent neural tube defects; spina bifida.
Oligohydramnios:Too little amniotic fluid, may need to do an amnioinfusion.Kidney function,
cord compression < 400 mL
Polyhydramnios:Too much amniotic fluid, may need to do an amniocentesis. Gestational
diabetes, tracheal esophageal fistula, Risk factors: Cord accident, cord prolapse, >2,000 mL
Placental implantation:Occurs between 6-10 days after conception.
, Twins:
Monozygotic Twins (Identical Twins): The union of a single ovum and spermatozoon
that later divide into two. Twin to twin transfusions and cord accidents.
Monoamniotic-Monochorionic: One sac and one placenta
Monochorionic-Diamniotic: Two separate sacs and one placenta.
Dizygotic twins (Fraternal/Non-identical twins):Fertilization of two different eggs with
two different sperms. During ovulation two mature eggs (ova) are expelled and are
fertilized by two different sperm.
Diamniotic-Dichorionic: Two separate sacs and two fused placentas.
Diamniotic-Dichorionic: Two separate sacs and two separate placentas.
Hormones of pregnancy:
Estrogen:Causes increased vascularity of the mucous membranes of the upper
respiratory tract. As the capillaries become engorged, edema and hyperemia develop
within the nose, pharynx, larynx, and trachea. This congestion may cause nasal and sinus
stuffiness, epistaxis (nosebleed), and deepening of the voice. It also causes edema of the
eardrum and Eustachian tubes may result in a sense of fullness in the ears. Also bleeding
gums, ptyalism (excess production of saliva), and decreased bladder tone.
Progesterone: Keeps uterus and blood vessels relaxed and accommodates increased
blood volume that increases cardiac output but not the BP. Allows the bladder to hold
more urine because it relaxes it and causes urine stasis. Keeps them gregnant.
Human chorionic gonadotropin hormone (hCG): Elevations expected during
pregnancy. Increases the availability of glucose to the fetus. Prepares breasts for
lactation.
