MATERNITY / NEWBORN

question

What is the name of the rule used to expected date of birth (EDB)?
answer

NAEGELE’S RULE
question

Explain Naegele’s rule?
answer

Find the last menstrual period (LMP). Add 7 days, deduct 3 month = EDB (expected date of birth) or due date
question

How long is typical gestation period?
answer

280 days / 40 weeks
question

If clients first day of last menstrual period was January 17, when is her EDP?
answer

Count forward 7 days: January 24 / Back 3 months: October 24 / EDP: October 24
question

chemical markers associated with pregnancy. These markers are found in urine and blood, and pregnancy tests require sampling one of these substances. produced by the trophoblast cells of the fertilised ovum (blastocyst). What is it?
answer

HUMAN CHORIONIC GONADOTROPIN (hCG)
question

After about a week after implatation, the ovum (ZYGOTE) has reach over 100 cells is known then as a?
answer

BLASTOCYST
question

How long after fertilization, the blastocyst will be called a FETUS?
answer

8 weeks after fertilization: FETUS
question

Signs of pregnancy can be generally categorized as?
answer

1. Presumptive 2. Probable 3. Positive signs of Pregnancy
question

What is the definition of Presumptive signs?
answer

Signs that suggest but do not positively confirm pregnancy and could be due to other conditions
question

What are the Presumptive signs?
answer

Absence of menstruation / N&V / Breast changes / Urinary frequency / Fatigue / Quikening
question

What is the definition of Probable signs?
answer

Strong indicators of pregnancy, not likely but still possibly due to other conditions
question

What are the Probable signs?
answer

Abdominal enlargement / Chadwick’s sign (Bluish tinge of vulva and vagina) / Hegar’s sign (softening of lower uterine segment) / Goodell’s sign (softening of cervix) / Ballotement (rebound mvt of floating fetus) / Braxton-Hicks contractions (irregular painless contractions) / Palpation of fetal outline / Positive pregnancty test (hcG)
question

What is the definition of Positive signs of Pregnancy?
answer

Signs definately confirming pregnancy
question

What are the Positive signs of Pregnancy?
answer

Fetal Heart tones / Fetal movement felt by examiner / Ultrasound evidence of fetus
question

How long is the Embrionic stage?
answer

The first 8 weeks
question

When does the heart appear and begins to beat?
answer

By the 4th week
question

When do the lungs begin to develop?
answer

By the 6th week
question

All organs are formed by?
answer

The end of the 8th week
question

Since the first 8 weeks is dividing cells that form the embrio, what should the mother most watch out for?
answer

The embrio will be susceptible to Teratogenic effects of substances such as OTC meds, caffeine, drugs, smoke… The first 8 wks are the most dangerous
question

When can the fetus be born at the earliest with a good chance of survival?
answer

By the 35th week
question

Fundal height is a measure of the size of the uterus used to assess fetal growth and development. It is measured from the top of the uterus to the top of the pubic bone in centimeters. It should match the fetus’ gestational age in weeks within 1 to 3 cm, e.g., a pregnant woman’s uterus at 26 weeks should measure 23 to 29 cm. This is valid from 24 weeks. What is the name of this method?
answer

MCDONALD’S rule or method
question

What is amniocentisis used for?
answer

(bet 15 to 17 wks) to rule out genetic defects, neural tube defect
question

What is the most common way to assess fetal lung maturity?
answer

THE LECITHIN-SPHINGOMYELIN RATIO (l/s)/ A result of 2:1 indicates lung maturity
question

Amniocentisis is also sometimes done late in pregnancy to assess?
answer

Fetal lung maturity by finding a substance called phosphatidyl glycerol (pg) which means fetal lung maturity
question

When do you administer RhoGam?
answer

If client is Rh negative, administer RhoGam / for instance after an amniocentisis (post procedure) as prescribed because of the possibility of maternal Rh isoimmunization.
question

What is Hyperemesis Gravidarum?
answer

Severe persistent nausea during pregnancy with and unknown cause.
question

Symptoms of Hyperemesis Gravidarum?
answer

Persistent vomiting / rapid pulse / decreased urinary output / low grade fever / weight loss
question

What is PIH?
answer

Pegnancy Induced Hypertension or PIH also called Pre-eclampsia
question

S/s of PIH or mild preeclampsia?
answer

BP is 140/90 or above / Edema is 1+ pitting / Proteinuria is 1+ or 2+ or higher / Swelling of face, hands, and feet
question

What to implement for precautions in a hopitalized woman with PIH?
answer

Seizure precautions such as side rails up / lights dimmed down / padded environment / encourage woman to lie of left side to reduce BP
question

S/s of severe preeclampsia?
answer

BP of 160/110 or higher / Extensive generalized edema / Proteinuria of 3+ or 4+ or higher / Headache, visual disturbance, abdominal pain
question

With worsening of PIH, the classic s/s of headache, blurred vision, epigastric pain, decreased urine output, and n/v, the women might be in a seizure state or eclampsia and will be at risk for?
answer

Fatal pulmonary edema / organe failure / Cardiac failure / cerebral hemorrhage
question

What is the first line of drug therapy for PIH?
answer

Magnesium Sulfate
question

Magnesium sulfate signs of toxixity to watch for?
answer

Dereased resp rate of less than 8 to 10 / absenses of reflexes / decreased urinary output (less than 30ml/hr)
question

What to do in case of Magesium sulfate toxixity?
answer

Admister the antidote Calcium Gluconate
question

abnormal implentation of pacenta near, partially covering, or completely covering the cervical os or cervix?
answer

PLACENTA PREVIA,usually detected after onset of painless vaginal bleeding / Placental Previa can be marginal, partial or total
question

Main S/S of Placenta Previa?
answer

Painless vaginal bleeding
question

A major concern is where the placenta seperates from the uterus. Ofter a life threatening emergency?
answer

ABRUPTIO PLACENTA
question

Most common risk factor for ABRUPTIO PLACENTA?
answer

HIGH BP during pregnancy / others are previous hx, smoking, drinking, trauma fr car accidents for instance.
question

Unlike Placenta Previa, ABRUPTIO PLACENTA is?
answer

EXTREMELY PAINFUL as blood is released into the uterus and abdominal cavity.
question

What is a complication of Abruptio placenta?
answer

placenta detachment of more than 50% usually leading to hemorrhage and fetal death
question

What is a complication of both Abruptio placenta and Placenta previa?
answer

Disseminated Intravascular Coagulopathy or DIC / S/S of DIC include bleeding of gums and injection sites, rapid pulse, skin may have purple areas or purpla.
question

What is DYSTOCIA?
answer

A difficult or abnormal labor
question

What is MOLDING?
answer

Molding is the process of when the skull of fetus overlaps on itself in order to pass through birth canal. It is possible cos’ of flexible sutures in the skull. Baby will have conehead for a while.
question

What does the 1st stage of labor include?
answer

1. LATENT PHASE (O to 4cm cervix dilation) / 2. ACTIVE PHASE (4 to 8cm) / 3. TRANSITION PHASE, contraction coming q min and 1/2 to 2 mns and lasting 60 to 90 sec (8 to 10cm)
question

What is the 2nd stage of labor?
answer

THE EXPULSION STAGE: full cervical dilation and ends with birth of baby, most dangerous phase for fetus, contractions are intense and frequent
question

What is the 3rd stage of labor?
answer

PLACENTAL STAGE, begins after fetus is delivered and ends with placenta expulsion.
question

What is the 4th stage of labor?
answer

THE RECOVERY STAGE: 1st 4hrs after delivery of placenta.
question

What should be done before performing LEOPOLD’S MANEUVER (manual maneuvers)?
answer

Ask pt to empty bladder / Place small rolled towel under right hip
question

What are late decelarations? and are they normal?
answer

Late decelarations (occur after a contraction begins and continues after contraction is over) are when the fetal heart rate slows down during movement or contractions and is NOT NORMAL
question

What are the interventions for late decelarations?
answer

Turning pt on her left side / Admister Oxygen at 8 to 10liters per min / IV fluids for blood volume
question

What is an healthy fetal reaction to movement?
answer

An accelaration of 15 beats per minute in response to movement and is a reasuring sign
question

What do late decelerations suggest?
answer

Fetal Anoxia / Uteral placental insuficiency
question

When are late decelarations usually noted?
answer

In pts with PIH / Pts w DIABETES / Pt got an over stimulation from OXYTOCIN / Past due date / Abuse of drugs / Placenta Previa / Abruptio placenta
question

Complications of Ruptured Membranes?
answer

Infection (esp after 24hrs) / Fetal Distress / Cord Prolapse
question

Preterm Labor is onset of contractions and dilations prior to?
answer

37 weeks of gestation
question

What are TOCOLYTICS?
answer

Medications used to suppress preterm labor (anti-contraction medications or labour repressants)
question

What is BETAMETHASONE used for in preterm labor?
answer

Betamethasone is used to accelerate fetal lung maturity (corticosteroid)
question

What is MAGNESIUM SULFATE given for?
answer

To depress uterine contractility / monitor urine output, BP, reflexes and respirations with magnesium sulfate
question

What orther medications are used to suppress labor?
answer

CALCIUM CHANNEL BLOCKERS like: NEFEDIPINE and PROSTAGLANDINS INHIBITORS
question

3 complications for the fetus in preterm labor?
answer

Respiratory Distress / Hyperbilibirunimia / Infection
question

What is the definition of POST TERM LABOR?
answer

Over 42 weeks gestation
question

What happens to the placenta in porst term babies?
answer

Placenta stop working efficiently
question

Risks of port term babies?
answer

Asphyxia / Meconium aspiration / Dysmaturity syndrome / Respiratory distress
question

What happens to the amnioatic fluid between 40 and 42 wks gestation?
answer

Amniotic fluid declines dramatically (OLYGOHYDRAMNIOS)increasing likelihood of hypoxia from fetal cord compression
question

Medication used to induce labor?
answer

OXYTOCIN
question

Neonatal complications of post term labor and delivery?
answer

HYPOGLYCEMIA / POLYCYTHEMIA / HYPERBILIRUBINEMIA / IMPAIRED THERMOREGULATION
question

What happens to the HR of fetur during a cord prolapse?
answer

Bradycardia to the fetus / Prolapse cord is a medical emergency / give mother oxygen to supply fetus / be prepared for emergency caesarian
question

Ways to stimulate labor?
answer

1. Amniotomy (rupture of amniotic sac with amnihook) 2. Insertion of either prostaglandin gel or laminaria for cervical ripening 3. IV oxytocin to initiate or intensify contractions
question

Oxytocin has some antidiuretic properties, so watch for the followint signs of water intoxication?
answer

Headache / blurred vision / Increased BP, RR / Rales / Wheezing / Coughing
question

In the porstpartum time (6wks after delivery), what do u call the shrinking of uterus back to its prepregnancy state?
answer

INVOLUTION
question

How many days after delivery should we see lochia rubra? lochia serosa? and lochia alba?
answer

LOCHIA RUBRA: 2-3 days after del / LOCHIA SEROSA (pink/brownish): 3-10 days / LOCHIA ALBA (yellow/white): 10 days to 6 weeks
question

Why is diaphoresis or heavy perspiration is to be expected for the first few days after delivery?
answer

Because she is expelling the extra fluid she accumulated during the pregnancy.
question

What is PPH?
answer

Pospartum Hemorrhage or PPH is a complication after birth. PPH is losing 500ml after a vaginal delivery or 1000ml after a caesarian delivery.
question

Most common cause for PPH? and intervention?
answer

Uterine Atony from retained placental tissue / Intervention includes manual fundal massage squeezing uterus to stop hemorrhage (one fist in vagina) ouch..
question

Medications to control PPH?
answer

IV Oxytocin (produced uterine contractions)
question

Apart from PPH, what is common possible postpartum complication?
answer

Infection (mastitis, endometritis, UTI, wound infections..)
question

S/s of postpartum infection?
answer

Fever above 100.4 (38C) / Chills / Tachycardia / N&V / Anorexia / Fatique / Headache
question

Apart from PPH, Infection, what is the 3rd most common pospartum complication?
answer

THROMBOPHLEBITIS: venous inflammation, clot formation in vein lumen, usu in legs, superficial or deep veins, DVT
question

List the 5 areas of the Apgar Score and possible scores?
answer

1. Heart rate 2.Respirations 3.Muscle Tone 4.Reflex Irritability 5.Color / Each area is scored a 0 or 1 or 2 / The whole Apgar score can be between 0 and 10 / Apgar is considered good if between 8 to 10 / A score bet 5 and 7 indicates newborn needs further stimulation / A score of 4 or below indicates serious circulatory pbs or respiratory depression
question

What are the firs medications the nurse will give the infant?
answer

Vitamin K in the thigh IM (so the infant has clotting factors right away) / Erythromycin (prevents blindness if exposed to gonorrhea) / First immunization (Hep B)
question

What is Convection?
answer

Heat loss to cool air
question

What is Radiation?
answer

Heat loss to cool objects without touching
question

What is Evaporation?
answer

Heat loss by fluid on newborn that turns to vapor
question

What is Conduction?
answer

Heat loss to cooler surfacs by direct contact
question

What is Milia?
answer

Tiny white bumps or small cysts on skin, usu face, will disappear on their own.

Get instant access to
all materials

Become a Member