Exam 1 Flashcards
1
Q
Maternal-Newborn Nursing
A
the promotion and maintenance for optimal family health to ensure cycles of optimal child-bearing or child-rearing
family centered
2
Q
The Basic Unit of Society
A
Family
3
Q
Types of Families
A
Binuclear (divorsed), nuclear (married), single parent, same sex
4
Q
Birth Rate
A
number of live births in one year/1000 population
5
Q
Infant Mortality Rate
A
number of deaths of infants younger than 1 year/1000 live births
6
Q
Maternal Mortality Rate
A
number of maternal deaths form births and complications of pregnancy, child birth, and puerperium
1st 42 days after termination of pregnancy/100k births
7
Q
Healthy People 2030
A
- reduce maternal mortality rate
- reduce rate of infant mortality
- reduce rate of preterm births
- increase proportion of women delivering live births and having a healthy weight prior to pregnancy
- increase proportion of women who are screened for postpartum depression ar postpartum checkup
- increase proprtion of infants who are breastfed
8
Q
Nurse Practice Act
A
defines the rules and safe parameters
1. scope of practice
2. standards of care
3. standards for educational programs
4. licensure requirements
5. grounds for disciplinary actons
6. enforced by state board
9
Q
Scope of Practice
A
range in services and care provided by nurse via state requirements
ex: RN vs NP
10
Q
Scope of Care
A
promotes consistency and ensures quality nursing care and outcomes
minimum legal acceptance
11
Q
Evidence-Based Practice
A
based on nursing and research to provide quality, safe client care
12
Q
State Board of Nursing
A
hospitals have own set of policies for nurses
can limit scope of practice but never expand
13
Q
Professionsal Negligence/Malpractice
5 Reasons
A
- duty
- breach of duty
- foreseeability
- causation
- injury or harm
14
Q
Informed Consent
A
person’s agreement to allow something to happen based on full disclosure ot risks, benefitsm alternatives, and consequences of refusal
failure to claim - claim of battery
15
Q
HIPAA
A
minimalize exclusion of preexisting conditions, designate rights for those who lose other health coverages, eliminate medical underwriting in group plans including privacy rule
16
Q
Privacy Rule
A
right of patients to keep personal info from being disclosed
17
Q
Cultural Competence
A
acknowledging, respecting, and appreciating ethnic, cultural, an linguistic diversity
18
Q
Encultuation
A
socialization into one’s primary culture as a child
19
Q
Acculturation
A
culture of minority is gradually displaced by culture of dominant cultural group
20
Q
Assimulation
A
process by which a person or group’s language or culture resembles those of another group
21
Q
Ethnocentrism
A
conviction that values and beliefs of ones’ own cultural group are best or only acceptable one
22
Q
Autonomy
A
respect right to self determination, independent decision making
23
Q
Fidelity
A
keep promises
24
Q
Justice
A
fairness
25
Beneficence
positive actions to help
26
Nonmaleficence
avoid causing harm
27
Veracity
truth telling
28
Paternalism
provider makes decisions on diagnosis, therapy, and prognosis
29
Fundal Massages
lower hand underneath in cupped position above pubic synthesis, upper hand at fundus
upper hand rotates while lower hand supports
muscles will contract
30
Breastfeeding
important in 1st hour
removal of colostrum
skin-to-skin and allowing baby to smell milk
31
Attachment
| Breastfeeeding
baby uses jaw and tongue to massagae nipple, goes far back into mouth
one hand on breast, one hand on baby's head
problems with attachement - remove milk early to make supply
32
Breast Milk
| Breastfeeding
hand in "C" shape, press back, compress, relax
33
Calories
| Breastfeeding
frequent, small feedings
bright yellow stools expected at day 5
34
C-Section
| Breastfeeding
placed skin-to-skin in operating room
35
Small/Early Babies
| Breastfeeding
below 6lbs or 37 wks
may be sleepy, still offer milk even if it is through hand expression and with a spoon
36
Shaken Baby Syndrome
shake baby back and forth
cause severe vision, behavioral, or developmental problems
convulsions, seizures, loss of consciousness and vision, not breathing, pale, poor feeding, vomiting
37
Antepartum
pregnant women before onset labor
38
Intrapartum
time of labor and childbirth
39
Postpartum
6-8wk time period after delivery of baby and placenta
reproductive system returns to non-pregnant state
40
Involution
pelvic reproductive organs return to approximate pre-pregnancy size, position, and function
takes about 6wks, fastest on day 3-4
risk of hemorrhage
41
Quick Involution Factors
non-complicated L&D process, breastfeeding, early ambulation, complete expulsion of placenta
42
Slow Involution Factors
multiple gestations, c-section, polyhydraminos, retained placenta, full bladder, multiple pregnancies, prolonged labor
43
Placental Detachment
uterus has rapid contractions to vasoconstrict (pinch off) blood vessels as the site of placental attachment - controls bleeding
44
Protein Catabolism
uterine muscle cells decrease in size (6wks)
45
Exfoliation
placental site healing, sloughing off dead tissue in form of lochia
46
Uterine Atony
boggy uterus 1-2hrs after birth
47
Normal Descent of Uterus
1cm / 1 fingerbreadth per day
nonpalpable by day 10-14
48
Afterpains
| Involution
intermittent uterine contractions, more uncomfotable in multiparous women
happens during breastfeeding with release of oxytocin
49
Lochia
postpartum uterine discharge classified according to appearances and contents
50
Lochia Rubra
day 1-3
red with small clots
pad saturation in 50 minutes or less - excessive
51
Lochia Serosa
day 3-10
pale pink/brown
52
Lochia Alba
day 10-14
yellow to white
53
Cervix
| Postpartum
flabby, thin, protrudes into vagina
closes in 1 wk
54
Vaginal Walls
| Postpartum
smooth and swollen, can be ecchymotic (bruised)
55
Vagina
| Postpartum
returns to pre-pregnant state
may have edema and small lacerations
56
Kegels
strengthen perineal muscles
57
Dyspareunia
vaginal dryness in painful intercourse because of decreased estrogen
58
Menstral Flow Postpartum
70% return in 9-12wks
7wks for non-nursing mothers
1st cycle - non-ovulatory because of elevated prolactin
59
Cardiac Output and Blood Volume
increase - hypervolemia
CO returns after 12wks of delivery
60
Diuresis
urinate a lot because of decrease in aldosterone and Na retention
61
Diaphoresis
sweating a lot
62
Fibrinogen
protein responsible for blood clotting - must monitor for blood clots after birth
63
Walking and Urinating Postpartum
critical, bladder tone diminished
decrease UTI susceptibility
64
Neurological Effects Postpartum
lack of feeling in legs
dizziness and headache
disconfort and fatigue
symptoms of carpal tunnel syndrome
65
Endocine Effects Postpartum
sharp decrease in estrogen and progesterone, lactation begins
estrogen = prolactin inhibiting hormone
66
Musculoskeletal Effects Postpartum
relaxin hormone relaxes pelvic ligaments and joints within pregnancy
joints may feel altered
abdomen wall - weakened and maybe separated (diastasis recti)
67
Gastrointestinal Effects Postpartum
very hungry and thirsty
bowel tone - sluggish
go on high fiber diet or use laxatives
68
Integumentary Effects Postpartum
melanocyte decreases
cholasma and linea nigra gradually fades
striae fades to silvery lines
spider nevi and palmar erythema disappear
69
Immune System Effects Postpartum
Rubella, Rhogam, Coombs test
70
Rh Factors with Rh- mom and Rh+ baby
Coombs test - negative = mom is not sensitized to it
300mcg of RhoGam in first 72 hours after delivery
71
Why it is necessary to give mom RhoGam shot
prevent maternal antibody production from Rh+ antigens
if blood mixes = cause problems in future pregnancies
72
Rubella Vaccine
administer to nonimmune mother
safe for nursing mothers
avoid pregnancy for 1 month
never want to give it to pregnant mom since it is a live vaccine
73
Lactation
synthesis, release, and ejection of milk through ductal system
inhibitory with high levels of progesterone and estrogen
74
Colostrum
rich in nutrients, protein, antibidies, immune cells
75
Traditional Milk
2-5 days after delivery
rich in fat and protein
76
Mature Milk
10-15 days after delivery
77
Let Down Reflex
milk ejected though ductile system through neurohormonal reflexes
infant sucking = stimulates oxytocin from posterior pituitary
milk ejection = stimulates prolactin from anterior pituitary
78
Breastfeeding Benefits for Baby
antibodies, increases intellecual development
79
Breastfeeding for Mom
involution, decrease hemorrhage, increase expenditure of calories, decrease risk of osteoporosis, breast cancer, ovarian cancer, increse attachement
80
Common Breastfeeding Positions
football, lying down, cradling, across lap
81
Rubin's Restorative Phases
Taking in
Taking hold
Letting go
82
Taking In
| Rubin's Restorative Phases
dependent, absorbing experiences of labor, need rest, comfort, and nutrition
83
Taking Hold
| Rubin's Restorative Phases
independent, attend to infant's needs, want to learn about how to care for child
84
Letting Go
| Rubin's Restorative Phases
interdependent, redefine new role
85
Positive Attachement
touching, holding, kissing, cuddling, talking, singing, "en face" position
86
Malattachment
refusing to look at infant, no touch, no holding, no naming, negative comments, refusing to respond to infant cues
87
Malattachment Interventions
rooming in, skin-to-skin in en face position, providing praise and support
88
Baby Blues
3-5 days after delivery
80% of women
changes in hormones can make mom feel sad, irritable, and confused
89
Postpartum Assessment
determine physiological needs: vitals
intrapartum history
need for immunizations
educational/cultural/religious/language/DV
90
Vital Signs
elevated temp (100.4) in first 24 hrs
postpartum shivers common
pulse: 60-100, may see slight bradycardia from the increased CO in preg
if tachycardic: may be infection
BP should be normal
91
Orthostatic Hypotension
BP decreases after lying down for long period and standing rapidly
92
C-Section Assessment
stool softeners, early ambulation, incision: REEDA
93
REEDA
| C-Section Assessment
redness, edema, ecchymosis, discharge, approximation
94
Pulmonary Infections Postpartum
use of narcotics and immobility
95
Postpartum Focused Assessment (BUBBLE HEB)
breasts, uterus, bladder, bowels, locia/lacerations, episotomy
hemmorhoids, emotions, bonding
96
Intimate Partner Violence
pattern of coercive control, imbalance of power
hostile, demanding, answering for patient
97
Types of Abuse
emotional/psychological, verbal, physical, sexual, financial, spiritual
98
Violence Against Women Statistics
1/4 women in US will be in abusive relationship
battering is the most common form of injury
1/3 attempt suicide
1/3 of ER visits are DV related
99
Cycles of Violence
tension building
explosion
honeymoon
100
Tension Building
| Cycle of Violence
abuser is critical and bully
victim feels some control, but walking on eggshells
101
Explosion
| Cycle of Violence
physical or emotional violence
victim feels helpless
102
Honeymoon
| Cycles of Violence
apologetic abuser, very romantic
103
Batterers
90-95% men
personal entitlement, charming, angry, very attentive to victim in hospital
104
Screening for DV
private space, non-judgemental
direct and indirect questions
105
Newborns' and Mothers' Health Perception Act (NMHPA)
| Preparing for Discharge
minimum federal standards for health plan coverage and minimum stay
48hrs for uncomplicated vaginal birth
96hrs for uncomplicated C-section
106
Criteria for Discharge - Mother
1. stable vitals
2. right lochia
3. firm fundus
4. adequate urine output
5. surgical wounds healing
6. ambulates with minimul discomfort
7. adequate pain control
8. family support
9. Rh status known
107
Criteria for Discharge - Newborn
1. stable vitals for 12 hrs
2. passed urine and stool spontaneously
3. 2 successful feeds
4. no abnormalities upon physical exam
5. no bleeding and circumcision for 2hrs
6. jaundice is managed
7. Hep B administered or appointment made
8. appointment with PCP
9. congenital cardiac heart defect screening
10. hearing screening
108
SIDS
sudden death in 1st year of life
most occur 2-4 months old
109
Triple Risk Model
| SIDS
vulnerable infant, critical development period, stressors
110
Safe to Sleep
firm mattress, no soft objects in crib, no smoking, right temperature, sleeping close but not with, in supine position
111
Ovulation
egg is released from ovary and uterus thickens
112
Ovary
contains oocytes in a folicle
113
GnRh
gonadotropin-releasing hormone
released from hypothalamus to stimulate FSH and LH
114
Anterior Pituirary Hormones
FSH and LH
115
Ovarian Hormones
estrogen and progesterone
116
FSH and LH in Ovary
promote folicle growth and oocyte maturation, estrogen production, primes endothelium to thicken
117
Rise of Estrogen on LH
surge of LH secretion, also surges progesterone to increase
118
Rise of LH Effect
trigger ovulation and a formation of a corpus luteum
119
Corpus Luteum
yellow hormone-secreting body in the female reproductive system
secretes estrogen and progesterone
maintains endothelium if pregnancy occurs
120
Effects of Progesterone and Estrogen on FSH and LH
progesterone and estrogen inhibit FSH and LH
121
Uterine Cycle
menstural phase
proliferate phase
secretory phase
ischemic phase
122
Menstural Phase
| Uterine Cycle
3-6 days, starts on first day of flow
uterus sheds
progesterone and estrogen are low
123
Proliferate Phase
| Uterine Cycle
end of menses to ovulation (day 14)
influenced by outside factors and hypothalamus changes: stress, diet, sleep
high in estrogen, stimulating endometrium to fill with blood
increase in cervical mucus, thin and less acidic
124
Secretory Phase
| Uterine Cycle
after ovulation
progesterone increases, endometrium swells to prepare for a fertilized ovum, estrogen decreases
if fertilization does not occur, estrogen and progesterone decrease, vasoconstriction
125
Ischemic Phase
| Uterine Cycle
blood supply to the endothelium sloughs and blood escapes with tissues and mucus
does not happen if fertilization occurs
estrogen and progesterone decrease
126
Ovarian Phase
follicular phase
luteal phase
127
Follicular Phase
| Ovarian Cycle
with menstrual and proliferate phase
developing viable follicles for ovulation
estrogen is secreted by follicles and surges to the end of this phase - leads to positive feedback on LH leading to luteal phase
128
Luteal Phase
| Ovarian Cycle
with secretory an ischemic phase
ovum released from follicle - follicle turns into corpus luteum
LH and FSH decrease, progesterone and estrogen increase to prepare uterine lining
129
Conception
union of sperm and ovum
sperm: 48-72hrs
ova: 12-24hrs
130
Fertilization
sperm penetrates outer layer of ovum
develops embryo
72hr critical time
occurs in ampulla of fallopian tube
131
3 Factors of Fertilization
ability of egg and sperm to mature
ability of sperm to reach ovum
ability of sperm to penetrate ovum
132
Estrogen and Fallopian Tubes
increases contractility
have peristalis and cilia
133
Capacitation
sperm penetrating ovum
sperm has to stay in genital tract for 4-6 hours to fertilize because of this
134
Ovum Once Penetrated
outer later changes to prevent other sperm from attaching
if more than one do, embryonic death
tail detaches, head largens, 2 nuclei move and fuse
135
Zygote
fertilized ovum with unique genetic material
secretes HCG
136
Zygote and Placenta Secrete
hCG
137
Function of hCG
maintain corpus luteum to secrete progesterone
138
Pre-Embryonic Period
begins with fertilization
rapid cell division
zygote implants in upper posterior part of uterus (lining is thickest and best blood supply)
becomes blastocyst
139
Embryonic Period
rapid organ formation
susceptible to teratogens
3 germ layers
embryonic membranes: chorion and amnion
umbillical cord and placental development
140
Chorion
outermost layer closest to uterine lining
141
Amnion
smooth membraine that lines fluid-filled space
fills with amniotic fluid
prevent umbillical cord compression
142
Amniotic Cavity
cusion, movement, temperature, protection
143
Umbilical Cord
2 arteries with deoxygenated blood from fetus to placenta
1 vein supplying O2 and nutrients
Wharton's Jelly to insulate and protect
144
Placental Functions
transport and exchange: serves as lungs, GI, liver, passive immunity
hormone secretion: hCG, estrogen, progesterone, hPL
145
First Trimester: Fetus
| Conception to 12wks
face more human
reflexes
spontaneous movement
heartbeat
45g, 3 1/2in
susceptible to teratogens
sex distinguished
146
Second Trimester: Fetus
| 13wks-26wks
very active
lanugo present (hair)
vernix caseosa coats skin (white biofilm)
brown fat forms
lungs form with alveoli and surfactant
eyes open and are sensitive to light
700-800g, 10in
147
Third Trimester: Fetus
| 27wks-Birth
increase in subcutaneous fat
bones are soft and flexible
increase in muscles
respiratory and circulatory systems are functioning
lanugo and vernix may disappear
maternal antibodies transferrred
head down position
148
Estrogen
secreted in ovaries then placenta
increases uterine growth
increases support of breast development
increases uterine blood flow
prevents further follicular development during pregnancy
relaxes pelvic ligaments
149
Progesterone
secreted in corpus luteum then placenta
relaxes smooth muscles
reduces gastric motility
relaxes blood vessel walls
supports and maintains uterine lining for implantation of developing embryo
decreases prostaglandin production
150
hCG
secreted from placental cells
prevents involution of corpus luteum
peak at 9-10wks
151
Relaxin
secreted in corpus luteum and small amounts in placenta
decreases uterine contractility
relaxes connective tissues
152
hPL
secretes in placenta
makes glucose available for fetus
growth promoting and lactogenic
153
Prolactin
secreted in the anterior pituitary
promotes development of breasts and supports lactation
lactation inhibits estrogen
154
Melanocyte Stimulating Hormone
secreted in anterior pituitary
produces hyperpigmentation
155
Oxytocin
secreted in posterior pituitarty
stimulates uterine contractions
stimulates milk ejection reflex
156
Aldosterone
secreted in the adrenals
conserves Na and maintains fluid balance
157
Cortisol
secreted in adrenals
active in metabolism of glucose and fats
may help prevent rejection of pregnancy because of anti-inflammatory effect
158
Thyroxine
secreted in thyroid
stimulates basal metabolic rate
159
FSH
secreted in anterior pituitary
initiates maturation of ovum and suppressed during pregnancy
160
LH
secreted in the anterior pituitary
stimulates ovulation of mature ovum in non-pregnant state
161
Prostaglandins
secreted in cell membrane
stimulates smooth muscle contractility
influences onset of normal labor with oxytocin
promotes cervical ripening
162
Fundal Height at the 12th, 20th, and 36th Week
palpated just above the pubic symphysis
level of umbilicus
at xiphoid process
163
McDonald's Rule
fundal height = gestational age between 22wks and 34wks
164
Heger's Sign
| Uterus Changes
softening of lower part of uterus
165
Braxton Hicks Contractions
irregular and intermittent contractions about 4mo into pregnancy
166
Goodell's Sign
softening of the cervix
167
Chadwick's Sign
increased vascularituy to cervix and vagina - turns purple
168
Leukorrhea
vaginal secretions that are white and thick
ph down to 4/5
169
Breasts in Pregnancy
tingling/tenderness
increased vascularity
areola darkens, Montgomery tubercles enlarge
170
Blood Volume in Pregnancy
increases 1500mL
171
RBC in Pregnancy
increase 20-30% for increased iron
172
Coagulation in Pregnancy
increased fibrinogen, clot easier
173
WBC in Pregnancy
increase 45-50%
174
BP in 2nd Trimester
goes down because of systemic vascular resistance
175
Hemorrhoids in Pregnancy
enlargement of uterus puts pressure on pelvic and femoral vessels, interferes with venous blood return
176
Supine Hypotensive Sign
lying supine allows fetus to put pressure on vena cava - reduces blood flow to right atrium
feeling of faintness, BP lowers
177
Respiratory System in Pregnancy
more need for O2, stable rate
estrogen relaxes ligaments for better chest expansion
may see epitaxis (nosebleeds)
178
GI and Pregnancy
N/V from increased hCG
cardiac sphincter tone and gastric motility decreases leading to acid reflux
constipation because decreased gastric motility and increased water absorption
gallstones from increased cholesterol in bile
ptyalism and PICA
179
Renals and Pregnancy
ureters: hyperplasia and hypertrophy
urine rate low - leads to UTIs
increased urinary frequency
nocturia
180
Musculoskeletals and Pregnancy
cartilage loosens
lordosis
carpal tunnel syndrome: edema in perpheral nerves
181
Endocrines and Pregnancy
basal metabolic rate increases
thyroid increases
pancreas increases insulin
182
Skin and Pregnancy
warm and flushed from increased circulation
stretch marks: striae gravidarum
hyperpigmentation
melasma/cholasma: on face
183
Hair and Pregnancy
hair is in a resting phase
fewer hairs fall out
184
Hyperemesis Gravidarum
excessive vomiting
risk of dehydration, electrolyte balance
185
Gestational Diabetes
glucose intolerance or not secreting enough insulin
186
Maternal Role Attachment
interaction and development process occurring overtime where mother becomes attached to infant, acquires competence in care-taking tasks in role, express pleasure and gratification in role
187
First Trimester
| Psychologial Adaptation
acceptance of pregnancy
"I am pregnant"
not a good time to teach about L&D
188
Second Trimester
| Psychological Adaptation
differentiation
focus shift on baby, perceived as seperate
"I am going to have a baby"
better to teach now
189
Third Trimester
| Psychological Adaptation
nesting
ambivalence returns, anxious
"I am going to be a mom"
really teach about L&D
190
Presumptive Signs of Pregnancy
subjective
N/V, breast changes, fatigue, amenorrhea (no period)
191
Probable Signs of Pregnancy
objective
serum lab test, positive pregnancy test, Chadwick's Sign, Goodell's Sign, Hegar's Sign, fetal outlline by examiner, ballottment
192
Positive Signs of Pregnancy
diagnostic
fetal heart audible, fetal movement palpable, visualization
193
Determining Due Date
add 280 days to 1st day of last period
194
Nagele's Rule
1st day of last period, subtract 3 months, add 7 days
195
Ultrasound to Determine Due Date
crown rump length
biparietal diameter
femer length
196
Crown Rump Length
7-13wks
length of the embryo or fetus from the top of its head to bottom of torso
little biological variability during this time - most accurate
197
Biparietal Diameter
>13 diameter
measures the head
198
Femer Length
>13wks
199
Gravida
number of times someone has been pregnant
200
Nulligravida
never been pregnant
201
Primigravida
first pregnancy
202
Multigravida
2nd or more pregnancies
203
Para
number of deliveries after 20wks
twins/triplets: 1 para
204
Nullipara
no pregnancies at viable time
205
Primipara
first pregnancy to viable term
206
Multipara
two or more pregnancies to viable term
207
Post-Term Birth
after 42wks
208
Preterm Birth
after 20wks and before 37
209
Term
38-42wks
210
Viability of Fetus
22-24wks
500g
211
1st Prenatal Visit
* medical history of family
* past medical history of mother
* gynecological history
* past OB history
* social history
* exposes to infection/teratogens
* nutritional status
* immunization record
* illnesses
* risk factors
212
1st Prenatal Exam
* full physical and pelvic exam
* auscultation of FHR
* Labs for blood type and Rh status, HIV, rubella, syphilis, CBC, Hep B, pap smear, urinalysis, STIs, TB
213
Return Visits
every 4 weeks until 28wk
every 2 weeks until 36wk
every week until delivery
214
Weight Gain and Energy Needs
extra 300cal every day
need lots of energy
215
Weight Gain Chart
Thin >18.5 – 28 -40 lbs
Avg 18.5 – 24.9 – 25-35lbs
Heavy 25-29.9 – 15-25lbs
Obese >30 – 11-20lbs
216
Nutritional Needs
folic acid, iron, vitamin D for bone growth, avoiding listerosis
217
Listerosis
food-borne illness from bacteria
avoiding raw fish, meat, lunch meats, unpasteurized milks, fewer than 200mg of coffee daily
218
Nurse's Role in Prenatal Check-Ups
* knowledge of tests
* meanings of results of test
* how procedure works
* what to prepare for prior to test
* what to do before and after test
* risks/complications
* when tests are performed
* client education
219
Ultrasound
tissue imaging using high frequency sound waves deflected by organs and return as echos
220
First Trimester and Ultrasounds
* determine viability
* estimate gestational age
* determine cause of vaginal bleeding
* help visualize for CVS
221
Second Trimester and Ultrasounds
detect polyhydramnios/oligo (too much amniotic fluid)
help visualize for amniocentesis
222
Third Trimester and Ultrasounds
* determine placental insufficiencies
* determine intrauterine growth restrictions
* detect congenital abnormalities
* part of biophysical profile
223
CVS
diagnose for fetal chromosomal abnormalities
sampling chorionic villi of the placenta around 10-12wks
224
Alpha Fetal Protein Screen
screening for neural tube defects (spina bifida) around 16-18wks
225
Amniocentesis
screens amniotic fluid from sac for genetic analysis and fetal lung maturity at 15-20wks
meaures lecithin and sphingomyelin: surfactants in proper pulmonary function, ratio 2:1 for proper lung maturity
severe diabetes can skew test
226
Non Stress Test
reactive=good
watching for accelerations in response to fetal movement
shows good and intact CNS and good oxygenation
2 or more accelerations in 20 minutes
15 bpm above baseline lasting 15 seconds
227
Non-Reactive Stress Test
not good
fetus may be asleep - eat glucose or use vibrations
may be from hypoxia, asphyxia, drug use, congenital heart abnormalities
228
Contraction Stress Test
see if fetus can tolerate labor
looking for decelerations in fetal heart rate
no decels = negative test
229
Biophysical Profile
used to evaluate the well being of a fetus
uses ultrasounds and FHR monitoring
2 points given to each component
less points = may need c-section
* fetal breathing movements
* gross body movements
* reactive FHR
* qualitative amniotic fluid
