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OB > Chapter 5: Letitia Richford Cord Prolapse and Nonreassuring Fetal Status > Flashcards

Chapter 5: Letitia Richford Cord Prolapse and Nonreassuring Fetal Status Flashcards

1
Q

What are some components of preconception care?

health considerations

A
  • chronic disease mgmt
  • medications and herbals
  • vaccines
  • infectious diseases
  • reproductive history (preg, sti, surgery)
  • genetic conditions/family hx
  • personal hx
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2
Q

what are some components of preconception care?

behavioral considerations

A
  • nutrition (folic acid, diet, exercise)
  • contraception
  • tobacco, alcohol, substance use
  • family structure/personal relationships
  • intimate partner violence
  • environmental exposures or hazards
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3
Q

inevitable abortion

A
  • YES TO EVERYTHING
  • vaginal bleeding and cramping
  • cervix dilated
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4
Q

threatened abortion

A
  • vaginal bleeding
  • NO cervical dilation
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5
Q

missed abortion

A
  • NO TO EVERYTHING
  • preg no longer developing and not viable
  • NO bleeding, cramping, cervical dilation
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6
Q

septic abortion

A
  • from intrauterine infection
  • fever, chills, abd pain, bleeding, discharge, tachycardia, tachypnea
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7
Q

incomplete abortion

A
  • YES TO EVERYTHING
  • vaginal bleeding, cramping, cervical dilation
  • stuff remains in cervix or uterus
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8
Q

RhoGam

why, when

A
  • prevent mom’s antibodies from attacking baby
  • 28 weeks to all mothers that are Rh-
  • Postpartum if baby is Rh+ and mom Rh-
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9
Q

Rhogam 50 ug dosage when

A

within 72 hr of abortion prior to 13 wks

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10
Q

RhoGam 300 ug dosage when

A
  • abortion after 13 wks
  • 28 wks gestation
  • within 72 hr of delivery
  • within 72 hr of trauma or invasive procedure
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11
Q

RhoGam dosage higher than 300 ug when

A

if mother’s exposure to Rh+ blood is higher than 15mL

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12
Q

fetal movement kick counts methods

A
  • 10 kicks/2 hr at rest
  • 10 kicks/12hr normal activity
  • 4 kicks/1 hr at rest
  • 10 kicks/25 min if 22-26 wks
  • 10 kicks/35 min if 37+ wks
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13
Q

what does a birth plan include?

A

preferences at birth
* support person
* water breaks by self or assissted
* rest or walk
* intermittent or continuous fetal monitoring
* nonpharm or pharm pain mgmt
* breastfeed or formula
* circumcision or intact
* who cuts cord

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14
Q

what should a client bring to the hospital?

A
  • changes of maternity clothes
  • massage stuff
  • bluetooth speaker
  • nursing bra
  • mints
  • socks
  • travel toiletries
  • nightgown
  • phone charger
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15
Q

reasurring fetal status

A
  • 2 accelerations over 20 min
  • no late/variable decelerations
  • mod variability
  • HR 110-160
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16
Q

nonreassuring fetal status

A
  • fetal bradycardia
  • minimal or absent variability
  • prolonged deceleration
  • usually from lack of O2, cord prolapse
17
Q

nonreassuring fetal status interventions

A
  • change maternal position (knee chest or trendelenburg)
  • IV fluids increase
  • O2
  • turn off oxytocin
  • sterile vaginal exam (if cord palpated, elevate presenting part off maternal pelvis, call for help)

If C-section delayed:
* keep cord moist
* maybe tocolytic like terbutaline
* fill bladder

18
Q

postoperative c-section orders (8)

A
  • vitals: q15, q30, q1 hr, q4 hr, q8 hr
  • fundus, lochia
  • pain and analgesia
  • incision care
  • IV administration (oxytocin, fluids
  • I&O
  • activity
  • serum testing and injection (kleihauser-belke for Rhogam)
19
Q

Milia

A
  • little white bumps across face
  • normal finding that resolves in few weeks and don’t hurt
20
Q

late preterm infant gest

A

34-36^6/7 weeks

21
Q

late preterm infant risks

A
  • hypoglycemia
  • hypothermia
  • hyperbilirubinemia
  • feeding problems
  • respiratory issues (resp distress, tachypnea, pulmonary HTN)
  • apnea
22
Q

late preterm infant assessments

A
  • BG levels (norm 45-80 mg/dL)
  • temperature (norm 97.7-99.32 F) and no baths until stable
  • transcutaneous bilirubin
  • latch and feeding
  • resp assessment
23
Q

hypoglycemia in infants risk factors

A
  • LGA or small for gestational age
  • mother w gestational diabetes
  • preterm infant
  • stress at birth (cold stress, asphyxia)
24
Q

hypoglycemia signs in infants

A
  • jitteriness
  • high pitched cry
  • breathing issues
25
Q

respiratory distress signs in infants

A
  • nasal flaring
  • tachypnea
  • grunting
  • cyanosis
  • intercostal and subcostal retractions
  • seasaw breathing
  • A and B: apnea and bradycardia
26
Q

risk factors for hyperbilirubinemia

A
  • prematurity
  • poor feeding
  • excessive breastfeeding
  • increased RBC production or breakdown
  • cold stress and acidosis
  • hemotoma
  • jaundice in first 24 hrs after birth
  • maternal ingestion diazepam, salicylates, sulfonamides
27
Q

delivery room newborn assessments (6)

A
  • APGAR at 1 and 5 minutes
  • vital signs
  • measurements
  • sex determination
  • muscle tone
  • crying and breathing
28
Q

delivery room newborn interventions (4)

A
  • erythromycin 0.5% ointment
  • vit k injection
  • breastfeeding attempt
  • blood glucose
29
Q

transitional period newborn assessments in first 4-6 h (6)

A
  • temp 97.7-99.32 F
  • HR 120-160 bpm
  • pink and acrocyanosis color
  • tone
  • RR 40-60 breaths/min
  • BG 45-80 mg/dL
30
Q

after transition and until discharge newborn assessments (6)

A
  • vitals q8 h
  • head to toe in 24 hrs
  • BG (45-80 mg/dL)
  • transcutaneous bilirubin or serum
  • breastfeeding latch/swallow/duration of feeding 2x/day
  • stool and void in first 24 hr
31
Q

predischarge newborn assessments

A
  • BG after 24 hrs (norm 45-80 mg/dL)
  • pulse ox between 24-48 hrs
  • min 2 successful feeds
  • hearing test
  • vitals signs norm for at least 12 hrs
  • 1 void and stool within 12 hrs
32
Q

predischarge newborn interventions

A
  • first hepB vaccine
  • follow up with pediatrician scheduled within 48 hr
  • car seat challenge test
  • educate to feed baby every 3 hours if preterm infant

OB (7 decks)

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