MATERNITY / NEWBORN – Flashcards

Unlock all answers in this set

Unlock answers
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 an explanation on any task
Get unstuck with the help of our AI assistant in seconds
New