SHIVERING
HYPERREFLEXIA
INCREASED TEMP
VITALS SIGN INSTABILITY
ENCEPHALOPATHY
RESTLESSNESS
SWEATING

Encourage the client to engage in maternal positioning on the left lateral side, semi-Fowler’s position
Supine position only with the placement of a wedge under one of the client’s hips to tilt the uterus and avoid supine hypotension syndrome

Thicken infants formula with 1 tsp to 1 tbsp rice cereal per 1 oz formula.
Avoid foods that cause reflux (caffeine, citrus, peppermint, spicy or fried foods)
Position the child with the head elevated after meals.
Place infants supine to sleep, rather than prone

Therapeutic effect: 1-3 weeks
Suicide prevention (1 week) once med is started
Serotonin Syndrome & NMS
Take with food
Can cause sexual dysfunction
Increase risk of seizures (concurrent use w/ SSRIs)

HTN, myocardial infarction, stroke Diabetic retinopathy
Diabetic neuropathy DKA: HHS: (Hyperglycemic Hyperosmolar state)

Aggression to people and animals
Destruction of property
Deceitfulness or theft
Serious violations of rules
**On MH Exam: coming from a large family - multiple siblings.**

Blunt external abdominal trauma (car crash, maternal battering)
Cocaine use resulting in vasoconstriction
Maternal hypertension (chronic or gestational)
Previous incidence of abruptio placentae
Premature rupture of membranes
Multi fetal pregnancy

Check capillary glucose every 4 to 6 hr for at least the first 24 hr.
Keep dextrose 10% in water at the bedside in case the solution is unexpectedly ruined or the next bag is not available. This will minimize the risk of hypoglycemia with abrupt changes in dextrose concentrations.
NEVER ABRUPTLY STOP TPN
SPEEDING UP/SLOWING DOWN RATE IS CONTRAINDICATED

Contraindicated for patients with HTN
Methylergonovine contracts the uterus and is used for emergency intervention for serious postpartum hemorrhage.
Use with caution with maternal history of severe renal or hepatic disease, and sepsis.
Use only after delivery, and not during labor.
Administer methylergonovine IM after passage of placenta (IV administration is reserved for emergencies). Can be administered orally every 6 to 8 hr for one week to promote uterine involution.

ABC’s BITCH- easy as 1,2,3 - HOB UP, OXYGEN, VITALS, CALL Surgeon if needed
● Place the client in semi-Fowler’s or Fowler’s position to promote chest expansion and to maximize ventilation.

Low BP (possible orthostatic hypotension)
Decreased Pulse BRADYCARDIA
Decreased Temp
Find downy hair on face/back: lanugo
amenorrhea
Poor skin turgor, mottled skin

RR: 30 - 60/min short periods of sleep apnea less than 15 seconds
HR: 110-160 brief fluctuations above and below range depending on baby activity.
BP: 60-80 systolic & 40 to 50 diastolic
Temp: 97.7-99.5
O2: 93%-95%
Head Cir: 32-36.8 cm
Weight: 2500-4000 grams
Glucose: 40-60 mg/dL

Monitor for fluid and electrolyte imbalance (metabolic acidosis: low obstruction; alkalosis: high obstruction).
Maintain intermittent suction as prescribed
Assess NG patency & placement
Irrigate ever 4 hour or as prescribed
Monitor/Assess gastric output
Monitor nasal are for breakdown
Provide oral hygiene every 2 hours

Small, frequent dosing ensures consistent plasma levels.
● Clients have less lag time between identified need and delivery of medication, which increases their sense of control and can decrease the amount of medication they need.
● To prevent inadvertent overdosing, the client is the only person who should push the PCA button.

nonblanchable erythema of intact skin

Anergia (lack of energy)
Anhedonia (lack of pleasure in normal activities)
Anxiety
Reports of sluggishness (most common), or feeling unable to relax and sit still
The client most often looks sad with blunted affect.
Poor grooming and lack of hygiene.
Socially isolated, showing little or no effort to interact
Slowed speech, decreased verbalization, delayed response

Folic acid should be taken to decrease the risk of neural tube defects such as spina bifida

ROUTE OF TRANSMISSION: Blood
Influenza‑like manifestations
Fatigue
Decreased appetite with nausea
Abdominal pain
Joint pain
Fever
Vomiting
Dark‑colored urine
Clay‑colored stool
Jaundice

NRRN - No River Runs North
Draw: Clear b4 Cloudy

POLYDIPSIA (EXTREME THIRST)
POLYPHAGIA (EXTREME HUNGER)
POLYURIA (LARGE VOLUME OF DILUTE URINE)
WEIGHT LOSS
WARM/DRY SKIN
DEHYDRATION (WEAK PULSE, LOWER SKIN TURGOR)
FRUITY BREATH
KUSSMAUL RESPIRATIONS (HIGHER RATE & DEPTH)
N/V
WEAKNESS
LETHARGY
INSULIN
ORAL HYPOGLYCEMIC AGENTS (TYPE 2 ONLY)
GOAL THERAPY - HBA1C - < 7%

Primary interventions focus on suicide prevention through the use of community education and screenings to identify individuals at risk.
Secondary interventions focus on suicide prevention for an individual client who is having an acute suicidal crisis. Suicide precautions are included in this level of intervention.
Tertiary interventions focus on providing support and assistance to survivors of a client who completed suicide.

Apgar is the initial newborn assessment

Can occur due to the absence of GI peristaltic activity caused by abdominal surgery or other physical trauma (Hypokalemia and hypomagnesemia can also cause this).
Monitor bowel sounds.
● Encourage ambulation.
● Advance the diet as tolerated when bowel sounds or flatus are present.
● Administer prokinetic agents (metoclopramide), as prescribed.
● The client can have an NG tube inserted to empty stomach contents

Potassium depleting diuretics
Complications
Dehydration
HYPO (sodium, potassium, chloride, calcium, mg: know S/S)
Hypotension
HYPERglycemia
Ototoxicity
↓ HDL
↑ LDL
Hypovolemia
IV infuse @ 20 mg/min to AVOID HYPOTENSION
SLOW PUSH OVER 1 MINUTE (20 mg is one minute, 40 mg is two minutes, etc.)

-Pt in sitting or high fowlers
-Check nares for blockage
-Measure the tube
-Lubricate the tube( water-soluble)
-Ask the pt to hyperextend the neck and breathe through the mouth
-Insert the tube gently through the nostril advance as the pt swallows
-Instruct the pt to tilt head forward drink water and swallow
-Confirm with x-ray
-Secure the tube to the nose and pts gown