Term
At the prenantal visit obtain basic historical information about the woman and family concerning----------? (3) |
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Definition
diseases, surgeries, and deaths |
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Term
Ask if the pt. has been treated for--------?(9) |
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Definition
kidney or bladder problems;high BP;heart disease;rheumatic fever; hypo or hyper thyroidism;DM; allergies to any foods, drugs, or environmental substances; or STDs |
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Term
Ask if the pt. has been exposed to any ___ since b4 becoming pregnant. |
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Definition
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Term
Also remember to ask if the pt has ever received_____or_____; and if the pt _____. |
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Definition
Blood or blood products: smokes |
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Term
Request the approximate date of the last _____ and results. |
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Definition
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Term
Gather data about menstrual pattern such as_____(5) and if any ____ are used. |
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Definition
age of onset,duration and frequency, date of last full cycle,any bleeding since;
contraceptives |
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Term
Take an obstetric history including____(6) |
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Definition
previous live births,stillbirths,miscarriages orinduced abortions,c-sections, or if Rho(d) immune globulin (RhoGam)was needed for incompatibility. |
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Term
If any previous deliveries were premature obtain info about___(4) |
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Definition
age of gestation, survival of child, suspected cause, or infection. |
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Term
Obtain a nutritional history including___(8) |
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Definition
pts usual wt;how much wt gained or lost in th epast 3 months;favorite foods;foods she avoids;how often does she eat;what has she eaten in the last 3 days;does she take a vitamin, mineral or herb products;cultural food practices to be observed during preganacy. |
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Term
Psychosocial culture history including ___ (6) |
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Definition
how does she feel about the pregnancy; cultural practices to follow during pregnancy; what makes up her support group; employment status;level of education, economic status. |
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Term
Take a med. history including___(5) |
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Definition
any prescribed, OTC, herbals;alcohol and street drugs, |
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Term
If she is not currently taking any meds. ask whether any have been taken over the past___ |
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Definition
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Term
Include _(7)__ in the physical exam |
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Definition
ht and wt; BP (hx of hypertension?); heart rate (take for one full min);respirations;temp;urine specimen;cbc |
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Term
Assessment done at routine visits during pregnancy includes: (6) |
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Definition
wt; bp;p; resp;abd measurement including fundal height and fetal heart sounds;any problems or concerns |
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Term
The pregnant woman who does not experience complications is usually examined ___for the first 6 months;every___in the 7th and 8th month; and ____in the 9th month. |
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Definition
monthly;every 2 weeks; weekly |
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Term
S&S of potential obstetric complications are: (10) |
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Definition
infection;hyperemesis gravidarum;miscarriage;abortion;preterm labor;premature membrane rupture;GDM;hypertension;intrauterine fetal death; and HELLP syndrome (hemolysis elevated liver enzymes and low platelet count) |
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Term
Assess the status of the fetus by___(5) |
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Definition
fetal movement counts, contraction stress testing, biophysical profile, ultrasound, or amniocentesis. |
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Term
When giving magnesium sulfate for pregnancy-induced hypertension (PIH) be sure to assess____(6) |
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Definition
deep tendon reflexes; respiratory status;sedation level;I&O; seizure precauctions and cardiac status |
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Term
___ is the antidote for mag sulfate. |
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Definition
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Term
After delivery the VS should be checked ____ |
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Definition
every 15 mins for the first hour or until stable then every 30 mins for the nest 2 hrs |
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Term
After delivery inspect the ___ and note any abnormal swelling or bruising |
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Definition
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Term
Assess the fundal ___ &___ every 15 mins for 1 hr and then every 30 mins for the next 4 hrs. |
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Definition
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Term
Describe the amount of ___ and the color and presence of clots every ___ mins for 1 hr; every___ for the next 4 hrs; and ___ for the next 12 hrs. |
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Definition
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Term
Assess breasts for ___&___ approx.3-4 hrs postpardum |
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Definition
colestrum/breastmilk; engorgement/discomfort |
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Term
Assessment of the neonate includes___(4) |
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Definition
patent airway;umbilical cord is observed till pulsation ceases then clamped;apgar at 1 and 5 mins;rapid gestational age assessment |
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Term
There are four primary clinical indications for the use of uterine stimulants |
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Definition
induction or augmentation of labor; control of postpardum atony and hemorrhage;control of post surgical hemorrhage (c-section);induction of therapeutic abortion. |
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Term
____ using a uterine stimulant like___ may be used in cases where cont. of the pregnancy is considered to be greater risk to the mother or fetus than the risk assoc. with induced labor. |
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Definition
Induction of labor;oxytocin |
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Term
A Hx of___(5)__ may indicate the need to induce labor. |
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Definition
precipitous labor and delivary; postterm pregnancy;prolonged preg. with placental insufficency;prolonged rupture of membranes;pregnancy induced hypertension |
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Term
Vaginal inserts,gels and PO forms of _____are being tested as adj. therapy to help ripen the cervix |
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Definition
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Term
In general ____ should not be used to hasten labor.The type and force of contraction induced may be harmful to the mother or fetus. |
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Definition
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Term
In occasional cases of ___ there is a prolonged latent phase of cervical dilation or arrest of descent through the birth canal. |
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Definition
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Term
___&____ may be useful in cases of dysfunctional labor. |
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Definition
low dosages of oxytocin and continuous fetal monitoring |
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Term
After delivery the uterus sometimes remains___&___ |
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Definition
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Term
____or____ may be used in cases of post pardum atony or hemmorrhage |
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Definition
continued iv low-dose oxytocin or IM inj. of ergonovine or methylergonovine |
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Term
Occasionally oral doeses of ___or___ are admin. for a few days after delivary to assist in uterine involution. |
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Definition
ergonovine oor methylergonovine |
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Term
Various dosage forms of ___ or ____ may be effective in eveacuating uterine contents. |
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Definition
prostaglandins or hypertonic(20%)sodium chloride |
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Term
Uterine smooth muscle is not very responsive to ____stimulation until late in the thirs trimester so it isn't indicated in therapeutic abortion. |
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Definition
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Term
Regardless of the stage of pregnancy stimulans such as ____or__ may be prescribed after the uterus is emptied to control bleeding and maintain uterine muscle tone. |
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Definition
ergonovine or methylergonovine |
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Term
____ is a natural chemical in the body that causes uterine and GI smooth muscle stimulation. |
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Definition
Dinoprostone (prostaglandin E2) |
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Term
Dinoprostone also plays an active role in ___and ___unrelated to uterine muscle stimulation. |
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Definition
cervical softening and dilation(cervical ripening) |
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Term
In higher doses dinoprostone increases ____&____ of contractions |
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Definition
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Term
Dinoprostone is used to start and continue___. |
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Definition
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Term
In large doses dinoprostone is used to expel uterine contents in cases of___(4) |
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Definition
intrauterine fetal death;benign hydatidiform mole;spontaneous miscarriage;and 2nd trimester abortion. |
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Term
Occasionally dinoprostone and ___are used together to shorten the duration of time required to expel uterine contents. |
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Definition
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Term
The primary therapeutic outcomes assoc. with dinoprostone therapy are:(2) |
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Definition
cervical softening and dilation b4 labor and evacuation of uterine contents |
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Term
What is the premed assessment for dinoprostone(4) |
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Definition
baseline VS, every half hour after initiation of therapy;assess state of hydration;assess uterine activity including discharge;chk for antiemetic and anyidiarrheal meds ordered. |
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Term
Side effects to expect with dinoprostone therapy |
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Definition
nausea, vomiting, diarrhea,fever |
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Term
Temp elevations to ____ occur within __to__ and continue for up to 6 hrs. with dinoprostone |
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Definition
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Term
___does not inhibit dinoprostone-induced fever |
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Definition
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Term
side effects to report with with dinoprostone therapy are |
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Definition
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Term
______is a synthetic prostaglandin E used to prevent nonsteroidal antiinflammatory drug induced ulcer disease. |
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Definition
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Term
The ____also induce uterine contractions in the pregnant uterus. |
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Definition
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Term
misoprostol is not approved by the ___ as a cervical ripening agent, induction of labor,or Tx of serious postpardum hemorrhage with uterine atony. |
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Definition
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Term
Misoprostol is used in combo with____ as an abortifacient. |
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Definition
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Term
Misoprostol should not be used to induce labor in women with a Hx of ___ |
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Definition
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Term
therapeutic outcomes of misorostol therapy are: |
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Definition
cervical softening and dilation;induction of active labor;reduction of postpardum hemorrhage in th presence of uterine atony;evacuation of uterine contents |
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Term
Premed assessment of Misoprostol (4) |
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Definition
baseline VS monitored every half hr;state of hydration;uterine activity& discharge;antemetic & antidiarrheal meds |
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Term
Rare adverse effects of misoprostol may include__ |
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Definition
uterine hyperstimulation with subsequent fetal hypoxia,uterine rupture,amniotic fluid embolism |
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Term
____&__produce more sustained contractions than oxytocin and are used in small doses in postpardum pts.to control bleeding and maintain uterine firmness. |
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Definition
ergonovine & methylergonovine |
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Term
the primary therapeutic outcome assoc with ergonovine and methylergonovine therapy is |
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Definition
reduced postpardum blood loss |
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Term
premed assessment for ergonovine and methylergonovine is |
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Definition
base VS and amount and characteristics of discharge,fundal height and contractility |
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Term
side effects to expect with ergonovine and methylergonovine are |
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Definition
nausea,vomiting,abd cramping, |
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Term
SE to report with methylgonovine and ergonovine are |
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Definition
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Term
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Definition
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Term
hypertension and headaches may develop in pts.who have received ___followed by a dosage of ergonovine or methylergonovine |
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Definition
caudal or spinal anesthesia |
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Term
oxytocin is a hormone produced in the __ and stored in the ___ |
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Definition
hypothalamus;pituitary gland |
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Term
when oxytocin is released it stimulates the smooth muscles of____ |
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Definition
uterus;mammory glands and blood vessels |
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Term
oxytocin is the drug of choice for ___and ___ |
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Definition
inducing labor and for augmentation of uterine contractions |
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Term
oxytocin is routinely admin. immediately postpardum to control___&__ |
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Definition
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Term
Therapeutic outcomes assoc with oxytocin therapy are |
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Definition
initiation of labor;support of uterine contractions and control of potpardum bleeding |
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Term
SE to expect with oxytocin therapy are |
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Definition
uterine contractions nausea and vomiting |
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Term
Contractions longer than ___ require the flow rate of the oxytocin to be slowed or discontinued |
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Definition
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Term
SE to report with oxytocin therapy are |
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Definition
fetal distress,hypertension,hypotension,water intoxicaton, dehydration,postpardum hemorrhage. |
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Term
___aka ___ are used primarily to delay or prevent preterm L&D in selected pts. |
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Definition
uterine relaxants aka tocolytic agents |
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Term
Tocolytic agents act by inhibiting ___ |
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Definition
uterine muscle contractions |
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Term
Tocolytic agents are most commonly used to inhibit labor for __ to __ |
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Definition
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Term
Mag sulfate is used primarily to inhibit___or control____ |
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Definition
premature labor;seizures assoc with preeclampsia |
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Term
when mag sulfate is used as an anticonvulsant or to inhibit labor blood levels shoild be maintained at __to__ |
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Definition
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Term
at levels aprrox 5-8 to mEq/L pts begin to show signs of __ |
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Definition
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Term
Therapeutic outcomes expected with mag sulfate are; |
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Definition
arrest of preterm labor;elimination of seizure activity |
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Term
premed assessment for mag sulfate is |
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Definition
base Vs;mental status;deep tendon reflexes;I&O; have calcium gluconate or calcium gluconate with Iv admin equip available; base serum mag level; fetal heart rate ,uterine activity monitoring |
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Term
Se to report with mag sulfate |
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Definition
deep tendon reflexes,I&O,VS,confusion,overdose |
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Term
Infants born to mothers who receive magnesium sulfate must be monitored for |
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Definition
hypotension,hyporeflexia and resp. depression |
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Term
The primary therapeutic outcome assoc. with terbutaline therapy is___ |
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Definition
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Term
Se to report with terbutaline sulfate |
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Definition
tachycardia,palpitations hypertension,hypotension,tremors,nervousness,anxiety,restlessness,headache, nausea, vomiting dizziness, hyperglycemia,electrolyte imbalance. |
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