Nursing 209

N209: Reproductive Health Study Guide o Placental insufficiency (preeclampsia, hypertension, renal disease, antiphospholipid antibody syndrome, and preexisting long term diabetes) o Postmaturity o Chronic maternal hypoxia (pulmonary or cardiac disease) o Maternal malnutrition o Pregnancy resulting from ART • Complications: o Asphyxia o Meconium aspiration o Hypoglycemia o Hypothermia • Each uterine contraction slows signs and symptoms; tops placental perfusion may show labor intolerance if placental insufficiency is present Respiratory Distress Syndrome • Also referred to as hyaline membrane disease • Occurs more commonly in gestational age under 37 weeks • Without adequate surfactant, increased airway pressure is needed to open the alveoli • Without increased pressure, atelectasis occurs leading to pulmonary edema • When the baby works too hard to breathe, muscle fatigue can occur with resulting respiratory acidosis from CO2 buildup • Complications: o Intraventricular hemorrhage o Tension pneumothorax o Bronchopulmonary dysplasia o Sepsis o Death Testing for Fetal Lung Maturity • Done via amniocentesis • L/S ratio (lecithin/sphingomyelin ratio) should be greater than two o A presence of PG (phosphatidyl glycerol), which indicates possible lung maturity • Foam stability test: Amniotic fluid is combined with ethanol and shaken o The greater the stability of the foam produced, the more surfactant present • Prevention: o With anticipated delivery at 24-34 weeks, give two doses of Betamethasone 12mg IM, 24 hours apart o Induces surfactant production

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