NARM (Varney's, Heart + Hands 2015) Already Graded A

NARM (Varney's, Heart + Hands 2015) Already Graded A Universal Precautions Use barrier protection. Use gloves: blood/culture collection, delivery, handling newborn, soiled items. Wash hands and contact Dr if contaminated. Use sharps container. Never recap sharps. Polyhydramnios Excess amniotic fluid. Large fundal height at 28wks increasing through preg. Associated with: multiple gestation, Rh incompatible, diabetes. Fetal anomalies - atresia of the esophagus, hydrocephaly, anencephaly or spina bifida. D.x. fluid thrill Uterine distension: Preterm labor, uterine dysfunction, placental abruption, PP hemorrahge. Fetal malpresentation + cord prolapse. Hospital birth reco'd. AFI greater than 24. Contraindicated herbs during pregnancy Blue cohosh. Goldenseal. Cotton root bark. Ephedra. Pennyroyal. Birthroot. Oligohydramnios Reduced amniotic fluid. Associated with: S.G.A., I.U.G.R., Postdatism. Fetal mortality due to IUGR, postmaturity syndrome, congenital anomalies. Cord compression. fetal distress and hypoxia in labor. + hydration, and r/o other problems. AFI less than 5.0 Large uterus measurement for dates Polyhydramnios, mulptiples, L.G.A Multiple Pregnancy / twins Large for dates fundal measurements. Palpate many parts. R/o L.G.A dx: 28-32 wks. Two heartbeats. Ultrasound. Dizygotic - fraternal. Two eggs and two sperms. Two placentas and two sacs. Monozygotic - identical. One egg and one sperm. One placenta and one or two sacs. Risks: anemia. Nutrition. Rest. TTTS. Cord prolapse. Hypoxia. Placenta abruption. PP hemorrhage. CPD (cephalopelvic disproportion) is the greatest risk in a breech birth because ... after the body is born, the head might not fit through the pelvis. Breech risks CPD - leads to fetal hypoxia - leads to mortality. Cord prolapse. To deliver breech safely at home Frank or Complete. Anterior or Transverse position. Well-flexed head. Gynecoid pelvis. Average sized baby. Newborn with HBV+ mom Needs a Hep B vaccines - HBV and HBIG - within 12 hrs of birth. Can an HIV+ mom breastfeed? No - infection can be transmitted through breastmilk GBS profylaxis during labor Penicillin, ampicillin or cefazolin q 4hrs through the hours of labor before birth. Observe newborn 48hrs for s/s GBS Most fetuses are in vertex position by 35-36 wks gest