NURB 331: For exam 3
NURB 331: For exam 3 NURB 331
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This 3 page Class Notes was uploaded by Kelsey Forbeck on Tuesday October 11, 2016. The Class Notes belongs to NURB 331 at University of Indianapolis taught by Professor Rairdon in Fall 2016. Since its upload, it has received 2 views. For similar materials see Lifespan 1 in NURSING at University of Indianapolis.
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Date Created: 10/11/16
NURB 331: Lifespan 1 Medical surgical disorders Cardiovascular Disorders o Cardiovascular disease classification: Class I- asymptomatic without limitation of physical activity Class II- symptomatic with slight limitation of activity Class III- symptomatic with marked limitation of activity Class IV- symptomatic with inability to carry any physical activity without discomfort o Heart transplantation Women are still able to have babies They should wait about a year after the transplant to conceive Why? Because of the increase blood volume and work of the heart during pregnancy o Cardiovascular disorder care management Antepartum Therapy is focused on minimizing the stress on the heart Taught s/s of cardiac decompensation Infections treated promptly Bed rest Given cardiac meds as needed Anticoagulant therapy Testing for fetal lung maturity o We care about the fetal lung maturity because women with cardiac disorders are at high risk for preterm labor and we want to make sure the baby’s lungs will be ready Nutrition counseling Intrapartum Put mom’s on left side to put less work on the heart Minimize anxiety to put less stress on the heart Penicillin prophylaxis may be ordered for class II or higher to protect against bacterial endocarditis in labor and early PP Oxytocin can be safely used for induction Vaginal birth is recommended o Deliver in side lying position o Open glottis pushing o Avoid Valsalva maneuver (bearing down) This can put more stress and workload on the heart and cause further problems o Oxygen should be on hand o Episiotomy and vacuum may be considered at this point DO NOT USE STIRRUPS Post-partum Monitoring for cardiac decompensation is ESSENTIAL Swan Ganz (constant monitoring) or ABG (CO2, PH, HCO3) They are allowed to breast feed o Cardiac Decompensation Basically means it’s not pumping like it’s supposed to The woman may be experiencing fatigue or dyspnea with usual activities, feeling of being smother, cough that is frequent, and feeling like her heart is racing The blood going back up into the body may come off as swelling Objective signs for nurses: Irregular, weak, rapid pulse (greater than or equal to 100 bpm) Heart murmurs Progressive generalized edema Crackles of base of lungs Rapid respirations greater than 25
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