ATI Flashcards
FHR
acceleration
Means baby is moving and healthy
The baby has an adequate oxygen supply
Gonorrhea?
characteristic
Usually no manifestation
if untreated cause infertility
reported to health department
Gonorrhea
expecting findings
lower abdominal pain
greenish charge
pain urination
Absence of condom used
(STIs)
Candidiasis?
Yeast infection
Not STIs
no report
Candidiasis
expecting findings
Thick, white, lumpy discharge
DM
Trichomoniasis?
most common STD
no report
Trichomoniasis
expecting findings
Greenish discharge
Pain in urination
Absence of condom use
Baby bathe
Head to toe
Clean to dirty
so the diaper area is last
Hair last
a) increase folic acid intake to?
b) fluid intake up to?
c) protein to?
a) 600mcg
b) 3L
c) 71g
Weight gain
weekly limit?
0.5 kg(1lb)per week is ideal
BUN normal level?
6 to 24 mg/dL
25mg/dL =hydration
urine ketones
should be positive or negative?
Should be negative which means no risk for hydration
Calcium gluconate
what used for?
reverse the toxicity of Magnesium sulfate
Oxytocin
contraindication
late decelerations
indicative of uteroplacental insufficiency
Misoprostol?
What used for?
induce contractions to begin labor
Misoprostol
administer?
can administer oxytocin no sooner than 4 hr
remain on the side position for 30 to 40 min after the insertion
should avoid administering aluminum hydroxide and magnesium coating antacids with this
1hr glucose test
normal range
should less than 140mg/dL
Hematocrit/ HCT
range
should be greater than 33%
Erythromycin
against ophthalmia neonatorum
Prevents gonorrhea and chlamydia in newborns
Don’t give a pacifier until
breastfeeding is established,
3-4 weeks
Facial swelling or generalized edema can be?
HTN or preeclampsia
Feet swelling is ok
a) Normal pregnancy weight gain?
b) Obese gain?
a) 25-35lbs or 11.3 to 15.9 kg
b) 15 to 20lb
Clean newborn’s ears with?
the corner of wet washcloth
No Q-tips
Leukorrhea is normal or abnormal?
Normal
Ca gluconate when to use?
magnesium sulfate toxicity
Terbutaline
smooth muscle relaxer to inhibit uterine contractions in premature labor
Indomethacin
Smooth muscle relaxer. Stops preterm labor
Bacterial vaginosis(BV)
most common vaginal infection. Treat with metronidazole or clindamycin cream.
HCG for?
positive pregnancy test
Nitric oxide
improve oxygenation for babies with respiratory distress syndrome.
Naloxone is for
opioid reversal
Protamine sulfate reverses?
the effects of heparin
Flumazenil reverses
the effects of benzodiazepines.
Do not use fetal scalp electrode when mom has what disease?
HIV
This increases the fetus’s exposure to HIV. Doppler, BPP, and NST are all safe
Methylergonovine
a uterotonic medication that causes sustained (持続)contractions.
magnesium sulfate toxicity
RR >12
muscle weakness
depressed deep-tendon reflexes
Oxytocin ADRs
Water intoxication 中毒
nurse should monitor urinary output.
HTN is also adverse effect, monitor BP.
Cardiac dysrhythmias are adverse effect, monitor pulse rate
PID increases the risk of
Pelvic inflammatory disease
ectopic pregnancy
Moro reflex should be gone by?
4 months of age.
Older than 4 months may indicate a neurological disorder
Amniotomy
known as artificial rupture of membranes
assess the FHR
Assess temp every TWO hours after rupture of the membranes
Limit vaginal exams to avoid infection
During latent stage
pain management
use counter pressure to the sacral area for pain management.
labor 1st stage
latent phase
0-3cm
5-30 mins
30-40secs
labor 1st stage
Active phase
4-7cm
3-5mins
40-70secs
labor 1st stage
Transition
8-10cm
2-3mins
45-90secs
Magnesium sulfate to for preeclampsia?
is lower BP and minimize risk of seizures
The McRoberts maneuver
done to resolve shoulder dystocia.
Central cyanosis
tachypnea, nasal flaring, retractions, and grunting.
NST
healthy sing?
if it is reactive
If non-reactive further testing (BPP)
Screening for chlamydia is doing during
pelvic exam, not amniocentesis
Breech means
fetus is upright and presenting feet of buttocks
Mentum
means fetus has fully extended the head and is presenting with the chin
A rash during phototherapy for bilirubin
This is temporary and does not need treatment
For hypotension
intervention
put the client in a lateral position Increase IV fluids
Admin O2 at 10-12 L/min via nonrebreather face mask
Admin a vasopressor to?
increase BP
hyperemesis gravidarum
expecting findings
ketonuria due to inadequate dietary intake
Hypokalemia is expected as well as weight loss and dehydration
Sudden onset of abdominal pain in a laboring
client who had previous c-sections
a manifestation of uterine rupture. Do a c-section!
occipital brow means
babies chin is untucked
can cause prolonged labor, forceps or vacuum assisted birth, or c-section.
precipitous labor proceeds
abnormally fast, onset of labor to delivery is under 3 hours.
Have the client drink WHAT before the NST test?
OJ
Should raise the client’s blood glucose level and help promote fetal movement.
480 mL of urine in 24 hours is OK or
not? ok.
NOT ok
30mL/hour is acceptable = 720/24 hours.
Reduced urine is a priority for preeclampsia
first visit
what test should be done?
Get a rubella titer
Get blood type and Rh factor
Blurred vision
is not always normal
manifestation of hypertension or preeclampsia
Platelets
low value indicated?
150,000 to 300,000
preeclampsia or HELLP syndrome
increase BUN may indicate
BUN should be within 10 to 20 baby
Mom range is 6 to 24 mg/dL
preeclampsia or HRLLP syndrome
acrocyanosis in 24hr ok?
Yes
posterior fontanel larger than the anterior fontanel
NO!
anterior fontanel is larger
folic acid intake
Fluid intake up to
protein
Lactation moms add ?? calories
600mcg.
3L,
71g
450 to 500 calories/day to their pregnancy diet
1st trimesters gain
2nd and 3rd gain
4lb(1.8kg)
12lb(5.4kg) each
38 weeks of gestation
weight gain of 2.2kg is OK?
NO!
is above the expected/ 0.5 kg per week is ideal
Leopold maneuvers
-first, determine which fetal part is in the uterine fundus
-fetal butt should in the uterine fundus
Hyperemesis gravidarum
A severe type of nausea and vomiting during pregnancy
Oxytocin
contraindication
late decelerations are indicative of uteroplacental insufficiency
Ectopic pregnancy
Lower abdominal pain on one side, virginal spotting, delayed period
Cocaine used in labor
-Risk for abruption placenta
Misoprostol
- induce contractions to begin labor
-The nurse can administer oxytocin no sooner than 4 hr after the last dose of misoprostol
-should void before administered
-they shou
Ferrous sulfate
education
increase daily intake of fluid and fiber
-medication can cause constipation
Circumcision
Monitor every?
Do not use?
every 4 hr for bleeding or infection
DO NOT use a baby wipe
DO NOT use soap water till after it heals
-clean with plain warm water to remove urine and feces.
Exercise
check your pulse every 10 mins during exercise. If pulse greater than 140/min. then STOP!
-exercise for 30 min
Probable sign
-means examiner can observe=objective
-Goodell’s sign
-Ballottement sign
-Chadwick’s sing
-Quickening sing
Pregnancy test
-test should be use the first morning void
Vaginal birth 6 hr ago, heavy vaginal bleeding
massage the pt’s fundus BEFORE applying O2 face mask
Amniotic fluid embolism
-when a pregnant person gets amniotic fluid into their bloodstream just before, during or immediately after childbirth
Terbutaline
ADR
is hypokalemia so pt will have blood test to check
Contraindication of oral contraceptive
Cholecystitis
-bladder disease is a contraindication
Hypertension
Migraine headaches
Levonorgestrel
is emergency contraceptive take within 72hr after unprotected sex
Fetal position
occiput anterior is best for deliver
Iron intake
27 mg/day
Oligohydramnios
requires further fetal assessment using electronic fetal monitoring
a disorder of amniotic fluid resulting in decreased amniotic fluid volume for gestational age.
1hr glucose test greater than
140mg/dL is not normal
130-140 is positive
Terbutaline ADRs?
increase HR
Relax muscle— bronchodilation
hypokalemia
Magnesium sulfate cause NB to what?
Respiratory depression
Oxygen therapy for premature?
what is a complication?
Retinopathy
blindness
Oxytocic is given?
When pt had increased lochia rubra
boggy fundus to promote constrictions
Postpartum
Pre-eclampsia
Common findings so not need STAT actions are?
High BP
1+ proteinuria
Contraction that last for 60 seconds each with a 4 mins rest between contraction.
Means?
should measure interval from the beginning of one contraction to the beginning of the next one.
so this means contraction is 5 min apart
A nurse is preparing to admin naloxone to a NB.
Why?
because the mom had IV narcotics admin during labor
Oxytocin contraindication?
Active genital herpes
intrauterine growth restriction needs to Oxytocin
IUD contraindication?
menorrhagia=Heavy periods
sever dysmenorrhea=Menstrual cramps
history of ectopic pregnancy
isolette?
a clear plastic enclosed crib that maintains a warm environment for a new baby
hydatatldiform mole
rare mass or growth tumor that forms inside the womb (uterus) at the beginning of a pregnancy
DO NOT become pregnant for at east 1 year
admin Iron IM
using what method?
Z track
betamethasone
does not affect the NB’s ability to maintain?
dose not affect?
Then what effect?
body temp
VS
Decrease blood glucose
genital herpes pregnancy
need to have c-section prior to the onset of labor
Neonatal abstinence syndrome
Exaggerated reflex
Tachysystole
More than five contractions per ten minutes over the course of 30 minutes
If the patient is experiencing tachysystole?
decrease the dose of oxytocin
Oxytocin can cause tachysystole
what about terbutaline?
No
Iron supplement
a) ADRs
B) avoid what beverage?
c) take with what beverage?
a) constipation
b) Milk and caffeine
c) OJ
Calcium
recommend dose
1000mg/day
dark green leafy vege is good source
BPP
what should include?
Fetal breathing movement
Fetal tone
Amniotic fluid volume
a) Indirect Coomb’s test
b) Kleihauer-Betke test
a) Rh antibodies in mom’s blood
b) positive KB test means there is fetal blood in the maternal circulation.
Lecithin/sphingomyelin(L/S) ration
Fetal lung maturity
Deep tendon reflexes of 3+ or greater can indicate?
preeclampsia and should be reported to the provider
Pt breast is soft, is this OK?
Yes,
Stat at day 3 and becoming full at day 5
insertion of an intrauterine pressure catheter, why need it?
to monitor INTENSITY of contraction
frequency, intensity and duration
vacume-assised vaginal deliver
NB has a high risk of developing jaundice
Placenta previa
findings
High fundal height
painless bleeding
bright red
