Assessments Flashcards
GTPAL
Gravidity (# times preggies)
Term births (37-42)
Preterms (20-37)
Abortions (prior to week 20)
Living youngsters
Apgar
Appearance
Pulse
Grimace
Activity
Respiration
GBS leads to…
Sepsis
PNA
Meningitis
GBS RFs
Premature
ROM >18 hrs
Mom fever during labor
Previous infant with GBS
GBS during pregnancy
Young
African American
GBS tx and testing guidelines
Vaginal/rectal swab week 35-37
Abx if RF and no culture
IV Penicillin G during labor
Guidelines for FHR Assessment
Initial 10-20 min continuous FHR assessment
Then intermittent auscultation q30m for low risk / q15m for high risk
In stage 2: q15/q5
Fetal tachy early sign of…
Hypoxemia
Fetal tachy due to…
Mom infection, hyperthyroidism, drugs, dehydration
And hypoxemia
What causes fetal bradycardia?
Mom supine
Hypoxia
Meds
Mom hypotension
Fetal cardiac arrhythmias
Congenital heart block
Idiopathic
Cord prolapse
Rapid fetal descent
Minimal variability due to…
Hypoxemia
CNS depressants
Neurologic injury
Accelerations due to…
Fetal movement
Contractions
Early deceleration due to…
Head compression
Variable compression due to…
Cord compression
Late deceleration due to…
Placenta insufficiency / hypoxemia
Prolonged deceleration due to…
Disruption in fetal oxygen supply
What can cause cord prolapse? (Plus additional risk factors)
Water breaking before baby in birthing canal (AROM)
SGA (small baby for gestational age)
IUGR (intrauterine growth restriction)
Unengaged fetal part
Polyhydraminos (too much amniotic)
Multiple gestation
Fetal attitude
Relation of body part
Biggest example: chin flexion or extension
Preferred lie
Longitudinal
True labor characteristics
Regular contractions
Cervical change
Fetus engagement
BOW may break
Changing positions doesn’t matter
Also: contractions felt in lower back
Fake labor characteristics
Irregular contractions
Braxton Hicks (at top of uterus)
Cervix not changed
Fetus not engaged
No ROM or bloody show
Lying down stops sensation
Membrane assessment
“TACO”
Time of rupture
Amount of amniotic fluid
Color of fluid
Odor
Tests for ROM confirmation
Fern
Amnisure
Labs for preggies
CBC (WBC, platelet, H&H, RBC)
Type and screen (Rh status)
RPR for syphilis
GBS
Mom VS postpartum
Fever 24 hours (dehydration)
Baseline BP (with 48 hr ortho hypo)
RR 16-24
Pulse 50-100
Lochia types
Rubra - red, 1-3 days
Serosa - pinkish, old blood and serum
Alba - white/yellow, bacteria and leukocytes
BUBBLEHE
Breasts
Uterus
Bladder
Bowels
Lochia
Emotions
Homan’s sign for DVT
Episiotomy / lacerations
Signs of bladder distention
Fundus shift
Increased lochia
Bladder discomfort and bulge
Frequent voidings <150 mL
10 Apgar
Active, HR over 110, reflexes, pink all over, good resp and crying
Normal newborn VS
HR 110-160
RR 30-60
Temp 97.7 - 99.5
BP 50-75 / 30-45
Ss newborn respiratory distress
Grunting
Nasal flaring
Ribs retracting
Color changes
Normal blood work in newborns
Elevated WBC
Elevated RBC, H and H
Platelets normal
How many times newborn pee?
6-8 x / day
