Maternity and Women's Health Care, 12th Ed., Lowerdermilk, Perry, Cashion & Aldon, 2020 | Registered Nurse (RN) School Study Aid
Mitral Stenosis
- Murmur Follows Opening Snap
- Late Diastolic Murmur
- Enhanced by Expiration
- Low-Pitched Rumbling
- Dilation of Left Atrium (LA)
- Recurrent Attacks of Rheumatic Fever
Cardiovascular Effects of Beta-Blockers
- Cardiac Myocytes and Vasculature
- Decrease cAMP
- Decreases SA and AV Node Conduction Velocity
- Lower Blood Pressure
- Decrease O2 Consumption
- Decreases Mortality Post-MI
Systemic Effects of Beta-Blockers
- Respiratory
- Bronchoconstriction
- Metabolic
- Decreased Insulin
- Decreased Glycolysis and Lipolysis
- Eye
- Reduces Intraocular Pressure
Urinary Tract Infection Prevention and Treatment
- Shower after Sex
- Urinate after Sex
- Wipe front to Back
- I and Os with Daily Weights
- Increase Water Intake
- Antibiotics
- Avoid Caffeine
- Dr Appointment in 2 Weeks
- Void every 2 - 4 hours
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Oxytocin (Pitocin)
- Increase Uterine Contractions
- Labor Induction
- Control Postpartum Hemorrhage
- Uterine Rupture
- Water Intoxication
- Fetal Lung Immaturity
- Cervix Not Ripened
- Active Genital Herpes Infection
- Use Lowest Dose
- IV Pump
PT/PTT Lab Values
- Prothrombin Time (PT)
- 10-14 seconds
- Activated Partial Thromboplastin Time (PTT or aPTT)
- 25-35 seconds
Calcium Channel Blockers (Verapamil and Diltiazem)
- Slows AV Conduction
- Angina Pectoris
- Arrhythmias
- Essential Hypertension
- Bradycardia
- Hypotension
- Constipation
- Peripheral Edema
- Gingival Hyperplasia
- Medication Education
Beta Blockers
- "-olol" suffix
- Decreases Heart Rate and Contractility
- Decreases Peripheral Vascular Resistance
- Decreases Renin Release
- Hypertension
- Heart Failure
- Angina Pectoris
- Asthma and Heart Block Patients
- Assess Blood Pressure and Heart Rate
- Masking Signs of Hypoglycemia
- Do Not Stop Abruptly
Mitral Regurgitation
- Holosystolic
- Blowing Murmur
- Loudest at Apex
- Radiates toward Axilla
- Louder by Squatting
- Hand Grip
- Expiration
Pregnant Cardiac Patient Assessment
- Cardiac Decompensation
- Frequent Cough
- Dyspnea
- Palpitations
- Excessive Fatigue
- Pulse > 100 bpm
- Crackles
Aortic Stenosis
- Age-related Calcifications
- Bicuspid Aortic Valve
- Crescendo-decrescendo Murmur
- Systolic Murmur
- Ejection Murmur
- Ejection Click
- Radiates to Carotids and Apex
- Pulsus Parvus et Tardus
- Syncope
- Helmet Cells
Endocarditis Assessment
- Infection of Inner Layer and Valves
- Fever
- Fatigue
- New or Changed Murmurs
- Roth's Spots
- Splinter Hemorrhages
- Janeway Lesions
- Osler's Nodes
- Heart Failure
- Embolization
Endocarditis Interventions
- IV Antibiotics
- 4-6 Weeks
- Anticoagulants
- Good Hygiene
- Closely Monitor
- Antibiotic Prophylaxis
- Dental Procedures
- Invasive Procedures
INR Lab Value
- 0.8-1.2 Normal Range
- Warfarin
- 2.0-3.0
Heart Failure Interventions
- Echocardiogram
- Invasive Hemodynamic Monitoring
- High Fowler's Position
- Oxygen
- Advanced Airway
- Diuretics
- Beta Blockers
- Angiotensin II Receptor Blockers (ARBs)
- ACE Inhibitors
- Digoxin (Lanoxin)
- Pacemaker
Pregnant Cardiac Patient Interventions
- Monitor for Cardiac Decompensation
- Stool Softener
- Calcium Channel Blockers
- ECG Monitor
- Open Glottis Pushing
- Pulmonary Artery Catheter
- No Beta-Adrenergic Medications
- Penicillin Prophylaxis
- Stress on Heart
Angiotensin-Converting Enzyme (ACE) Inhibitors
- "-pril" Suffix
- Block Renin Angiotensin-Aldosterone System (RAAS)
- Hypertension
- Heart Failure
- Dry Non-productive Cough
- Hypotension
- Dizziness
- Possible Hyperkalemia
- Angioedema
- Slowly Change Position
- Do Not Stop Abruptly
Digoxin (Lanoxin)
- Increases Inotropy
- Heart Failure
- Atrial Fibrillation
- Bradycardia
- Fatigue
- Heart Block
- Heart Rate Below 60
- Hypokalemia
- Monitor for Toxicity and Visual Changes
- Digibind
Lidocaine
- Blocks Na+ Channels
- Ventricular Arrhythmia
- Anesthetic
- Paresthesias
- Seizures
- Respiratory Depression
- Drowsiness
- Anesthetic Effects Extended with Epinephrine
Sodium Nitroprusside (Nitropress)
- Venous and Arterial Dilation
- Hypertensive Crisis
- Cyanide Toxicity
- Thiocyanate Toxicity
- Hypotension
- Short Term Administration
- Light Sensitive, Use Container
- Continuous BP Monitoring
Heparin (Unfractionated)
- Suppresses Coagulation
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Protamine Sulfate
Warfarin (Coumadin)
- Inhibits Clotting Factors
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- PT/INR Levels
- Observe for Bleeding
- Pregnancy
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
Methylergonovine (Methergine) and Ergotamine (Ergot Alkaloids)
- Smooth Muscle Contraction
- Vasoconstriction
- Migraine
- Postpartum Hemorrhage
- Nausea and Vomiting
- Severe Hypertension
- Tachycardia
- 2nd Line Agent
Terbutaline (Brethine)
- Beta-2 Agonists
- Asthma
- Tocolytic
- Hypotension
- Tremor
- Tachycardia
- Pulmonary Edema
- Hyperglycemia
Sickle Cell Anemia Assessment
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
Sickle Cell Anemia Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
Asthma Assessment
- Triggers (Cold air, Dander, Dust, Infection, Mold, Pollen, Smoke)
- Shortness of Breath (SOB)
- Tachypnea and Tachycardia
- Wheezing
- Diaphoresis
- Accessory Muscles
- Decreased Pulmonary Function Tests
Asthma Implementation and Education
- Oxygen
- Corticosteroids
- Ipratropium (Anticholinergic)
- Albuterol
- Inhaler/nebulizer
- Pulse Oximetry
- Pursed Lip Breathing
- Carry Inhaler
- Rinse Mouth after Inhaler
- Identify Trigger (Cold Air, Dander, Dust, Infection, Mold, Pollen, Smoke)
Cystic Fibrosis Assessment
- Thickened Mucus
- Recurrent Pulmonary Infections
- Pulmonary Congestion
- Pancreatic Insufficiency
- Steatorrhea
- Fat-Soluble Vitamin Deficiencies
- Salty Taste to Skin
- Meconium Ileus
- Delayed Growth and Poor Weight Gain
Cystic Fibrosis Interventions
- Bronchodilators
- N-Acetylcysteine (Mucolytics)
- Inhaled Hypertonic Saline
- Early Antibiotics
- Dornase Alfa (Mucolytic Agent)
- Postural Drainage with Percussion
- Fat Soluble Vitamin Supplements
- Pancreatic Enzymes with Every Meal
- High Protein, High Calorie Diet
- Added Dietary Salt
- Glucose Monitoring
Acute Respiratory Distress Syndrome (ARDS) Assessment
- Damaged Alveolar-Capillary Membrane
- Restlessness
- Dyspnea
- Refractory Hypoxemia
- Decreased PaO2
- Diffuse Pulmonary Infiltrates
- Atelectasis
- Pulmonary Hypertension
Acute Respiratory Distress Syndrome (ARDS) Interventions
- Closely Monitor Patient
- ABG's (Arterial Blood Gases)
- Oxygen
- Assess for O2 Toxicity
- Mechanical Ventilation
- PEEP
- Assess for Pneumothorax
- Permissive Hypercapnia
- High Mortality Rate
Seizure Interventions
- Maintain Airway
- Side-lying Position
- Support Head
- Move to Floor
- Benzodiazepines
- Never Restrain
- No Objects in Mouth
- Document Details
Seizure Precautions
- Reduce Environmental Stimuli
- Identify Triggers
- Aura
- Pad Side Rails
- Bed Lowest Position
- Oxygen and Suction Available
- Monitor Therapeutic Drug Levels
Carbamazepine (Tegretol)
- Inactivates Na+ Channels
- Seizures
- Bipolar Disorder
- Trigeminal Neuralgia
- Nystagmus
- Ataxia
- Hepatotoxicity
- Blood Dyscrasias
- Water Retention
- Stevens-Johnson Syndrome
- Avoid Grapefruit Juice
Phenobarbital (Barbiturates)
- Barbiturate
- Seizures
- Ataxia
- Paradoxical Excitement
- Fatigue/Drowsiness
- Monitor Plasma Levels
- High Potential for Abuse
Phenytoin (Dilantin)
- Blocks Na+ Channels
- Tonic-clonic Seizures
- Ataxia
- Nystagmus
- Sedation
- Gingival Hyperplasia
- Purple Glove Syndrome
- Hirsutism
- Rash
- Anemia
- Individualized Dosing
Valproic Acid (Depakote)
- Blocks Na+ Channels
- Increases GABA Concentration
- Tonic-clonic Seizures
- Bipolar Disorder
- Migraine Prophylaxis
- Hepatotoxicity
- Blood Dyscrasias
- GI Distress
- Tremor
- Pancreatitis
Multiple Sclerosis Assessment
- Nerve Fiber Demyelination
- Motor Issues
- Cerebellar Signs
- Fatigue
- Paresthesias
- Spasticity
- Urinary Incontinence
- Optic Neuritis
- Women Between 20-50 Years Old
- Relapse and Remission of Symptoms
Multiple Sclerosis Interventions
- Corticosteroids
- Interferon Beta
- Dimethyl Fumarate (Tecfidera)
- Fingolimod (Gilenya)
- Mitoxantrone (Novantrone)
- Natalizumab (Tysabri)
- Increase Exercise
- Identify Triggers
Systemic Lupus Erythematosus (SLE) Assessment
- Multisystem Inflammatory Disorder
- Malar Rash
- Discoid Rash
- Arrhythmias
- Arthritis
- Hemolytic Anemia
- Seizures
- Glomerulonephritis
- Periods of Exacerbation and Remission
- Diagnosed by ANA (Anti-nuclear antibody assay)
Systemic Lupus Erythematosus (SLE) Interventions
- Avoid Sunlight
- Glucocorticoids
- Methotrexate
- NSAIDs
- Hydroxychloroquine
- Azathioprine
- Monitor for Renal Failure (ARF)
- Manage Pain
Myasthenia Gravis Assessment
- Weakness with Muscle Use
- Diplopia
- Ptosis
- Dysphagia
- Difficulty Speaking
- Fatigue
- Cholinergic Crisis
- Overmedicated
- Myasthenic Crisis
- Not Enough Medication
- Respiratory Muscle Paralysis
Cholecystitis Assessment
- RUQ Pain
- Referred Shoulder Pain
- Clay Colored Stools
- Jaundice
- Nausea and Vomiting
- Dyspepsia (Indigestion)
- Fever
- Increased WBCs
- Fatty or Spicy Foods
- Ultrasound
Cholecystitis Causes
- Gallbladder Inflammation
- Female
- Fair (Caucasian)
- Fat (Obese)
- Fertile (Pregnant)
- Forty (Advanced Age Over 40)
- Flatulence
Cholecystitis Interventions
- Supportive Therapy
- Antibiotics
- Low Fat Diet
- NG Tube
- Analgesics
- Lithotripsy
- Cholecystectomy
- T Tube
Pyelonephritis Assessment
- Ascending Urethral Bacteria
- Dysuria
- Fever
- Fatigue
- Flank Pain
- Costovertebral Tenderness
- Nausea and Vomiting
Pyelonephritis Interventions
- Urinalysis
- NSAIDs
- Antibiotics
- Increase Fluid Intake
- Avoid Catheterization
- Urosepsis