NAACOG's clinical issues in perinatal and women's health nursing
-
Historically, the risks associated with drugs in breast milk were not a major clinical concern. The small percentage of infants who were breastfed and the low use of drugs in postpartum women stimulated little interest in studying medication use in the breastfeeding mother. However, explosive growth in the number of new pharmacologic agents, concerns over environmental contaminants, and a significant increase in breastfeeding, dramatically altered the interest in this clinical issue. ⋯ However, medical professionals too often simply discourage breastfeeding when this situation arises. This short review examines factors that determine whether a drug that enters breast milk poses a risk to the breastfeeding infant. A series of questions and practical decisions are presented that should enable nurses and other health care providers to more effectively address the issue of medication use in a breastfeeding woman.
-
NAACOGS Clin Issu Perinat Womens Health Nurs · Jan 1992
Cardiopulmonary resuscitation during pregnancy.
Cardiopulmonary arrest during pregnancy, although relatively rare, poses a unique challenge to the obstetric nurse. Resuscitation measures attempt to restore maternal hemodynamic stability and promote fetal well-being. ⋯ This chapter reviews significant physiologic alterations in pregnancy that have an impact on resuscitation and cardiopulmonary resuscitation (CPR) algorithms for selected pulseless rhythms. As critical care capabilities continue to develop within obstetric units, it is reasonable to predict that obstetric nurses will face this challenge with increasing frequency.
-
NAACOGS Clin Issu Perinat Womens Health Nurs · Jan 1992
Case ReportsPrinciples in hemodynamic assessment.
Use of invasive hemodynamic monitoring provides more thorough assessment of hemodynamic function and may reveal abnormal data before the development of adverse clinical signs and symptoms. The obstetric nurse caring for critically ill patients is responsible for understanding the principles associated with hemodynamic monitoring and interpretation of data to better plan and implement nursing care.
-
Pulmonary embolism is the leading cause of maternal death in the United States. Amniotic fluid embolism (AFE) represents the least preventable and most lethal of complications. AFE has a reported mortality of 86% and an associated fetal demise of 50%. ⋯ The mainstays of treatment are oxygenation, maintenance of cardiac output, and correction of coagulopathy. The prognosis for the patient experiencing AFE remains bleak because the course of the disorder is largely unpredictable, and AFE cannot be corrected. Only supportive measures can be given.
-
NAACOGS Clin Issu Perinat Womens Health Nurs · Jan 1992
Humanizing the intensive care unit experience.
When the pregnant woman becomes critically ill, it is essential that she and her fetus receive the care that a specialized intensive care unit (ICU) provides. This unit is the setting for an expert medical, nursing, and technical staff to use sophisticated, state-of-the-art equipment for intensive monitoring and the immediate life-saving interventions that may be necessary. ⋯ Obstetric critical care can benefit from the data in the critical care literature that addresses family and patient needs in an ICU. Obstetric literature and past experiences in implementing family-centered maternity care also can be used to identify the need for humane care and to enhance the ICU experience.