NAACOG's clinical issues in perinatal and women's health nursing
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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.
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Pulmonary hypertension may be primary, of unknown etiology, or secondary to existing cardiorespiratory disease. In general, the prognosis is poor, but the superimposed physiologic changes of pregnancy, labor, and delivery may produce a lethal condition. ⋯ If the choice is to continue the pregnancy, a well-coordinated intensive management plan is necessary. This plan should include midsecond trimester hospital admission of the patient, continuous hemodynamic monitoring during the intrapartum period and immediately after delivery, and preferably elective induction with hemodynamically stable epidural anesthesia for labor and delivery.
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NAACOGS Clin Issu Perinat Womens Health Nurs · Jan 1992
Technical aspects of hemodynamic pressure monitoring.
Invasive hemodynamic pressure monitoring may be used in the care of the critically ill pregnant woman. The critical care obstetric nurse must have a thorough understanding of the indications for monitoring and interpretation of acquired data and must develop the skills necessary to operate and trouble-shoot the related equipment. This article provides a review of technical aspects of a hemodynamic pressure monitoring system.
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The United States ranks 20th in infant mortality among industrialized nations. This exceptionally high mortality rate primarily is attributable to the low-birth-weight rate. A reduction in infant mortality will require prevention of low-birth-weight births. Risk factors, social issues, and preventive services must be identified to effectively address the prevention of low-birth-weight births.
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Neurologic emergencies during pregnancy are not encountered often but contribute significantly to maternal mortality. This chapter reviews neurologic emergencies with an emphasis on pathophysiology and related nursing care for patients with epilepsy, status epilepticus, eclampsia, intracranial hemorrhage, increased intracranial pressure, ischemic stroke, myasthenia gravis, autonomic hyperreflexia, Wernicke's encephalopathy, and chorea gravidarum.