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Maternity > Exam 1 > Flashcards

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

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2
Q

The Basic Unit of Society

A

Family

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3
Q

Types of Families

A

Binuclear (divorsed), nuclear (married), single parent, same sex

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4
Q

Birth Rate

A

number of live births in one year/1000 population

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5
Q

Infant Mortality Rate

A

number of deaths of infants younger than 1 year/1000 live births

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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

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7
Q

Healthy People 2030

A
  1. reduce maternal mortality rate
  2. reduce rate of infant mortality
  3. reduce rate of preterm births
  4. increase proportion of women delivering live births and having a healthy weight prior to pregnancy
  5. increase proportion of women who are screened for postpartum depression ar postpartum checkup
  6. increase proprtion of infants who are breastfed
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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

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9
Q

Scope of Practice

A

range in services and care provided by nurse via state requirements
ex: RN vs NP

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10
Q

Scope of Care

A

promotes consistency and ensures quality nursing care and outcomes
minimum legal acceptance

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11
Q

Evidence-Based Practice

A

based on nursing and research to provide quality, safe client care

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12
Q

State Board of Nursing

A

hospitals have own set of policies for nurses
can limit scope of practice but never expand

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13
Q

Professionsal Negligence/Malpractice

5 Reasons

A
  1. duty
  2. breach of duty
  3. foreseeability
  4. causation
  5. injury or harm
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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

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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

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16
Q

Privacy Rule

A

right of patients to keep personal info from being disclosed

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17
Q

Cultural Competence

A

acknowledging, respecting, and appreciating ethnic, cultural, an linguistic diversity

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18
Q

Encultuation

A

socialization into one’s primary culture as a child

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19
Q

Acculturation

A

culture of minority is gradually displaced by culture of dominant cultural group

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20
Q

Assimulation

A

process by which a person or group’s language or culture resembles those of another group

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21
Q

Ethnocentrism

A

conviction that values and beliefs of ones’ own cultural group are best or only acceptable one

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22
Q

Autonomy

A

respect right to self determination, independent decision making

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23
Q

Fidelity

A

keep promises

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24
Q

Justice

A

fairness

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25
Q

Beneficence

A

positive actions to help

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26
Q

Nonmaleficence

A

avoid causing harm

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27
Q

Veracity

A

truth telling

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28
Q

Paternalism

A

provider makes decisions on diagnosis, therapy, and prognosis

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29
Q

Fundal Massages

A

lower hand underneath in cupped position above pubic synthesis, upper hand at fundus
upper hand rotates while lower hand supports
muscles will contract

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30
Q

Breastfeeding

A

important in 1st hour
removal of colostrum
skin-to-skin and allowing baby to smell milk

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31
Q

Attachment

Breastfeeeding

A

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

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32
Q

Breast Milk

Breastfeeding

A

hand in “C” shape, press back, compress, relax

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33
Q

Calories

Breastfeeding

A

frequent, small feedings
bright yellow stools expected at day 5

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34
Q

C-Section

Breastfeeding

A

placed skin-to-skin in operating room

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35
Q

Small/Early Babies

Breastfeeding

A

below 6lbs or 37 wks
may be sleepy, still offer milk even if it is through hand expression and with a spoon

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36
Q

Shaken Baby Syndrome

A

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

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37
Q

Antepartum

A

pregnant women before onset labor

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38
Q

Intrapartum

A

time of labor and childbirth

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39
Q

Postpartum

A

6-8wk time period after delivery of baby and placenta
reproductive system returns to non-pregnant state

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40
Q

Involution

A

pelvic reproductive organs return to approximate pre-pregnancy size, position, and function
takes about 6wks, fastest on day 3-4
risk of hemorrhage

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41
Q

Quick Involution Factors

A

non-complicated L&D process, breastfeeding, early ambulation, complete expulsion of placenta

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42
Q

Slow Involution Factors

A

multiple gestations, c-section, polyhydraminos, retained placenta, full bladder, multiple pregnancies, prolonged labor

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43
Q

Placental Detachment

A

uterus has rapid contractions to vasoconstrict (pinch off) blood vessels as the site of placental attachment - controls bleeding

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44
Q

Protein Catabolism

A

uterine muscle cells decrease in size (6wks)

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45
Q

Exfoliation

A

placental site healing, sloughing off dead tissue in form of lochia

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46
Q

Uterine Atony

A

boggy uterus 1-2hrs after birth

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47
Q

Normal Descent of Uterus

A

1cm / 1 fingerbreadth per day
nonpalpable by day 10-14

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48
Q

Afterpains

Involution

A

intermittent uterine contractions, more uncomfotable in multiparous women
happens during breastfeeding with release of oxytocin

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49
Q

Lochia

A

postpartum uterine discharge classified according to appearances and contents

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50
Q

Lochia Rubra

A

day 1-3
red with small clots
pad saturation in 50 minutes or less - excessive

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51
Q

Lochia Serosa

A

day 3-10
pale pink/brown

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52
Q

Lochia Alba

A

day 10-14
yellow to white

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53
Q

Cervix

Postpartum

A

flabby, thin, protrudes into vagina
closes in 1 wk

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54
Q

Vaginal Walls

Postpartum

A

smooth and swollen, can be ecchymotic (bruised)

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55
Q

Vagina

Postpartum

A

returns to pre-pregnant state
may have edema and small lacerations

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56
Q

Kegels

A

strengthen perineal muscles

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57
Q

Dyspareunia

A

vaginal dryness in painful intercourse because of decreased estrogen

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58
Q

Menstral Flow Postpartum

A

70% return in 9-12wks
7wks for non-nursing mothers
1st cycle - non-ovulatory because of elevated prolactin

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59
Q

Cardiac Output and Blood Volume

A

increase - hypervolemia
CO returns after 12wks of delivery

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60
Q

Diuresis

A

urinate a lot because of decrease in aldosterone and Na retention

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61
Q

Diaphoresis

A

sweating a lot

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62
Q

Fibrinogen

A

protein responsible for blood clotting - must monitor for blood clots after birth

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63
Q

Walking and Urinating Postpartum

A

critical, bladder tone diminished
decrease UTI susceptibility

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64
Q

Neurological Effects Postpartum

A

lack of feeling in legs
dizziness and headache
disconfort and fatigue
symptoms of carpal tunnel syndrome

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65
Q

Endocine Effects Postpartum

A

sharp decrease in estrogen and progesterone, lactation begins
estrogen = prolactin inhibiting hormone

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66
Q

Musculoskeletal Effects Postpartum

A

relaxin hormone relaxes pelvic ligaments and joints within pregnancy
joints may feel altered
abdomen wall - weakened and maybe separated (diastasis recti)

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67
Q

Gastrointestinal Effects Postpartum

A

very hungry and thirsty
bowel tone - sluggish
go on high fiber diet or use laxatives

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68
Q

Integumentary Effects Postpartum

A

melanocyte decreases
cholasma and linea nigra gradually fades
striae fades to silvery lines
spider nevi and palmar erythema disappear

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69
Q

Immune System Effects Postpartum

A

Rubella, Rhogam, Coombs test

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70
Q

Rh Factors with Rh- mom and Rh+ baby

A

Coombs test - negative = mom is not sensitized to it
300mcg of RhoGam in first 72 hours after delivery

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71
Q

Why it is necessary to give mom RhoGam shot

A

prevent maternal antibody production from Rh+ antigens
if blood mixes = cause problems in future pregnancies

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72
Q

Rubella Vaccine

A

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

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73
Q

Lactation

A

synthesis, release, and ejection of milk through ductal system
inhibitory with high levels of progesterone and estrogen

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74
Q

Colostrum

A

rich in nutrients, protein, antibidies, immune cells

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75
Q

Traditional Milk

A

2-5 days after delivery
rich in fat and protein

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76
Q

Mature Milk

A

10-15 days after delivery

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77
Q

Let Down Reflex

A

milk ejected though ductile system through neurohormonal reflexes
infant sucking = stimulates oxytocin from posterior pituitary
milk ejection = stimulates prolactin from anterior pituitary

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78
Q

Breastfeeding Benefits for Baby

A

antibodies, increases intellecual development

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79
Q

Breastfeeding for Mom

A

involution, decrease hemorrhage, increase expenditure of calories, decrease risk of osteoporosis, breast cancer, ovarian cancer, increse attachement

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80
Q

Common Breastfeeding Positions

A

football, lying down, cradling, across lap

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81
Q

Rubin’s Restorative Phases

A

Taking in
Taking hold
Letting go

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82
Q

Taking In

Rubin’s Restorative Phases

A

dependent, absorbing experiences of labor, need rest, comfort, and nutrition

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83
Q

Taking Hold

Rubin’s Restorative Phases

A

independent, attend to infant’s needs, want to learn about how to care for child

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84
Q

Letting Go

Rubin’s Restorative Phases

A

interdependent, redefine new role

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85
Q

Positive Attachement

A

touching, holding, kissing, cuddling, talking, singing, “en face” position

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86
Q

Malattachment

A

refusing to look at infant, no touch, no holding, no naming, negative comments, refusing to respond to infant cues

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87
Q

Malattachment Interventions

A

rooming in, skin-to-skin in en face position, providing praise and support

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88
Q

Baby Blues

A

3-5 days after delivery
80% of women
changes in hormones can make mom feel sad, irritable, and confused

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89
Q

Postpartum Assessment

A

determine physiological needs: vitals
intrapartum history
need for immunizations
educational/cultural/religious/language/DV

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90
Q

Vital Signs

A

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

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91
Q

Orthostatic Hypotension

A

BP decreases after lying down for long period and standing rapidly

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92
Q

C-Section Assessment

A

stool softeners, early ambulation, incision: REEDA

93
Q

REEDA

C-Section Assessment

A

redness, edema, ecchymosis, discharge, approximation

94
Q

Pulmonary Infections Postpartum

A

use of narcotics and immobility

95
Q

Postpartum Focused Assessment (BUBBLE HEB)

A

breasts, uterus, bladder, bowels, locia/lacerations, episotomy
hemmorhoids, emotions, bonding

96
Q

Intimate Partner Violence

A

pattern of coercive control, imbalance of power
hostile, demanding, answering for patient

97
Q

Types of Abuse

A

emotional/psychological, verbal, physical, sexual, financial, spiritual

98
Q

Violence Against Women Statistics

A

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
Q

Cycles of Violence

A

tension building
explosion
honeymoon

100
Q

Tension Building

Cycle of Violence

A

abuser is critical and bully
victim feels some control, but walking on eggshells

101
Q

Explosion

Cycle of Violence

A

physical or emotional violence
victim feels helpless

102
Q

Honeymoon

Cycles of Violence

A

apologetic abuser, very romantic

103
Q

Batterers

A

90-95% men
personal entitlement, charming, angry, very attentive to victim in hospital

104
Q

Screening for DV

A

private space, non-judgemental
direct and indirect questions

105
Q

Newborns’ and Mothers’ Health Perception Act (NMHPA)

Preparing for Discharge

A

minimum federal standards for health plan coverage and minimum stay
48hrs for uncomplicated vaginal birth
96hrs for uncomplicated C-section

106
Q

Criteria for Discharge - Mother

A
  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
Q

Criteria for Discharge - Newborn

A
  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
Q

SIDS

A

sudden death in 1st year of life
most occur 2-4 months old

109
Q

Triple Risk Model

SIDS

A

vulnerable infant, critical development period, stressors

110
Q

Safe to Sleep

A

firm mattress, no soft objects in crib, no smoking, right temperature, sleeping close but not with, in supine position

111
Q

Ovulation

A

egg is released from ovary and uterus thickens

112
Q

Ovary

A

contains oocytes in a folicle

113
Q

GnRh

A

gonadotropin-releasing hormone
released from hypothalamus to stimulate FSH and LH

114
Q

Anterior Pituirary Hormones

A

FSH and LH

115
Q

Ovarian Hormones

A

estrogen and progesterone

116
Q

FSH and LH in Ovary

A

promote folicle growth and oocyte maturation, estrogen production, primes endothelium to thicken

117
Q

Rise of Estrogen on LH

A

surge of LH secretion, also surges progesterone to increase

118
Q

Rise of LH Effect

A

trigger ovulation and a formation of a corpus luteum

119
Q

Corpus Luteum

A

yellow hormone-secreting body in the female reproductive system
secretes estrogen and progesterone
maintains endothelium if pregnancy occurs

120
Q

Effects of Progesterone and Estrogen on FSH and LH

A

progesterone and estrogen inhibit FSH and LH

121
Q

Uterine Cycle

A

menstural phase
proliferate phase
secretory phase
ischemic phase

122
Q

Menstural Phase

Uterine Cycle

A

3-6 days, starts on first day of flow
uterus sheds
progesterone and estrogen are low

123
Q

Proliferate Phase

Uterine Cycle

A

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
Q

Secretory Phase

Uterine Cycle

A

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
Q

Ischemic Phase

Uterine Cycle

A

blood supply to the endothelium sloughs and blood escapes with tissues and mucus
does not happen if fertilization occurs
estrogen and progesterone decrease

126
Q

Ovarian Phase

A

follicular phase
luteal phase

127
Q

Follicular Phase

Ovarian Cycle

A

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
Q

Luteal Phase

Ovarian Cycle

A

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
Q

Conception

A

union of sperm and ovum
sperm: 48-72hrs
ova: 12-24hrs

130
Q

Fertilization

A

sperm penetrates outer layer of ovum
develops embryo
72hr critical time
occurs in ampulla of fallopian tube

131
Q

3 Factors of Fertilization

A

ability of egg and sperm to mature
ability of sperm to reach ovum
ability of sperm to penetrate ovum

132
Q

Estrogen and Fallopian Tubes

A

increases contractility
have peristalis and cilia

133
Q

Capacitation

A

sperm penetrating ovum
sperm has to stay in genital tract for 4-6 hours to fertilize because of this

134
Q

Ovum Once Penetrated

A

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
Q

Zygote

A

fertilized ovum with unique genetic material
secretes HCG

136
Q

Zygote and Placenta Secrete

A

hCG

137
Q

Function of hCG

A

maintain corpus luteum to secrete progesterone

138
Q

Pre-Embryonic Period

A

begins with fertilization
rapid cell division
zygote implants in upper posterior part of uterus (lining is thickest and best blood supply)
becomes blastocyst

139
Q

Embryonic Period

A

rapid organ formation
susceptible to teratogens
3 germ layers
embryonic membranes: chorion and amnion
umbillical cord and placental development

140
Q

Chorion

A

outermost layer closest to uterine lining

141
Q

Amnion

A

smooth membraine that lines fluid-filled space
fills with amniotic fluid
prevent umbillical cord compression

142
Q

Amniotic Cavity

A

cusion, movement, temperature, protection

143
Q

Umbilical Cord

A

2 arteries with deoxygenated blood from fetus to placenta
1 vein supplying O2 and nutrients
Wharton’s Jelly to insulate and protect

144
Q

Placental Functions

A

transport and exchange: serves as lungs, GI, liver, passive immunity
hormone secretion: hCG, estrogen, progesterone, hPL

145
Q

First Trimester: Fetus

Conception to 12wks

A

face more human
reflexes
spontaneous movement
heartbeat
45g, 3 1/2in
susceptible to teratogens
sex distinguished

146
Q

Second Trimester: Fetus

13wks-26wks

A

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
Q

Third Trimester: Fetus

27wks-Birth

A

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
Q

Estrogen

A

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
Q

Progesterone

A

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
Q

hCG

A

secreted from placental cells
prevents involution of corpus luteum
peak at 9-10wks

151
Q

Relaxin

A

secreted in corpus luteum and small amounts in placenta
decreases uterine contractility
relaxes connective tissues

152
Q

hPL

A

secretes in placenta
makes glucose available for fetus
growth promoting and lactogenic

153
Q

Prolactin

A

secreted in the anterior pituitary
promotes development of breasts and supports lactation
lactation inhibits estrogen

154
Q

Melanocyte Stimulating Hormone

A

secreted in anterior pituitary
produces hyperpigmentation

155
Q

Oxytocin

A

secreted in posterior pituitarty
stimulates uterine contractions
stimulates milk ejection reflex

156
Q

Aldosterone

A

secreted in the adrenals
conserves Na and maintains fluid balance

157
Q

Cortisol

A

secreted in adrenals
active in metabolism of glucose and fats
may help prevent rejection of pregnancy because of anti-inflammatory effect

158
Q

Thyroxine

A

secreted in thyroid
stimulates basal metabolic rate

159
Q

FSH

A

secreted in anterior pituitary
initiates maturation of ovum and suppressed during pregnancy

160
Q

LH

A

secreted in the anterior pituitary
stimulates ovulation of mature ovum in non-pregnant state

161
Q

Prostaglandins

A

secreted in cell membrane
stimulates smooth muscle contractility
influences onset of normal labor with oxytocin
promotes cervical ripening

162
Q

Fundal Height at the 12th, 20th, and 36th Week

A

palpated just above the pubic symphysis
level of umbilicus
at xiphoid process

163
Q

McDonald’s Rule

A

fundal height = gestational age between 22wks and 34wks

164
Q

Heger’s Sign

Uterus Changes

A

softening of lower part of uterus

165
Q

Braxton Hicks Contractions

A

irregular and intermittent contractions about 4mo into pregnancy

166
Q

Goodell’s Sign

A

softening of the cervix

167
Q

Chadwick’s Sign

A

increased vascularituy to cervix and vagina - turns purple

168
Q

Leukorrhea

A

vaginal secretions that are white and thick
ph down to 4/5

169
Q

Breasts in Pregnancy

A

tingling/tenderness
increased vascularity
areola darkens, Montgomery tubercles enlarge

170
Q

Blood Volume in Pregnancy

A

increases 1500mL

171
Q

RBC in Pregnancy

A

increase 20-30% for increased iron

172
Q

Coagulation in Pregnancy

A

increased fibrinogen, clot easier

173
Q

WBC in Pregnancy

A

increase 45-50%

174
Q

BP in 2nd Trimester

A

goes down because of systemic vascular resistance

175
Q

Hemorrhoids in Pregnancy

A

enlargement of uterus puts pressure on pelvic and femoral vessels, interferes with venous blood return

176
Q

Supine Hypotensive Sign

A

lying supine allows fetus to put pressure on vena cava - reduces blood flow to right atrium
feeling of faintness, BP lowers

177
Q

Respiratory System in Pregnancy

A

more need for O2, stable rate
estrogen relaxes ligaments for better chest expansion
may see epitaxis (nosebleeds)

178
Q

GI and Pregnancy

A

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
Q

Renals and Pregnancy

A

ureters: hyperplasia and hypertrophy
urine rate low - leads to UTIs
increased urinary frequency
nocturia

180
Q

Musculoskeletals and Pregnancy

A

cartilage loosens
lordosis
carpal tunnel syndrome: edema in perpheral nerves

181
Q

Endocrines and Pregnancy

A

basal metabolic rate increases
thyroid increases
pancreas increases insulin

182
Q

Skin and Pregnancy

A

warm and flushed from increased circulation
stretch marks: striae gravidarum
hyperpigmentation
melasma/cholasma: on face

183
Q

Hair and Pregnancy

A

hair is in a resting phase
fewer hairs fall out

184
Q

Hyperemesis Gravidarum

A

excessive vomiting
risk of dehydration, electrolyte balance

185
Q

Gestational Diabetes

A

glucose intolerance or not secreting enough insulin

186
Q

Maternal Role Attachment

A

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
Q

First Trimester

Psychologial Adaptation

A

acceptance of pregnancy
“I am pregnant”
not a good time to teach about L&D

188
Q

Second Trimester

Psychological Adaptation

A

differentiation
focus shift on baby, perceived as seperate
“I am going to have a baby”
better to teach now

189
Q

Third Trimester

Psychological Adaptation

A

nesting
ambivalence returns, anxious
“I am going to be a mom”
really teach about L&D

190
Q

Presumptive Signs of Pregnancy

A

subjective
N/V, breast changes, fatigue, amenorrhea (no period)

191
Q

Probable Signs of Pregnancy

A

objective
serum lab test, positive pregnancy test, Chadwick’s Sign, Goodell’s Sign, Hegar’s Sign, fetal outlline by examiner, ballottment

192
Q

Positive Signs of Pregnancy

A

diagnostic
fetal heart audible, fetal movement palpable, visualization

193
Q

Determining Due Date

A

add 280 days to 1st day of last period

194
Q

Nagele’s Rule

A

1st day of last period, subtract 3 months, add 7 days

195
Q

Ultrasound to Determine Due Date

A

crown rump length
biparietal diameter
femer length

196
Q

Crown Rump Length

A

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
Q

Biparietal Diameter

A

> 13 diameter
measures the head

198
Q

Femer Length

A

> 13wks

199
Q

Gravida

A

number of times someone has been pregnant

200
Q

Nulligravida

A

never been pregnant

201
Q

Primigravida

A

first pregnancy

202
Q

Multigravida

A

2nd or more pregnancies

203
Q

Para

A

number of deliveries after 20wks
twins/triplets: 1 para

204
Q

Nullipara

A

no pregnancies at viable time

205
Q

Primipara

A

first pregnancy to viable term

206
Q

Multipara

A

two or more pregnancies to viable term

207
Q

Post-Term Birth

A

after 42wks

208
Q

Preterm Birth

A

after 20wks and before 37

209
Q

Term

A

38-42wks

210
Q

Viability of Fetus

A

22-24wks
500g

211
Q

1st Prenatal Visit

A
  • 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
Q

1st Prenatal Exam

A
  • 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
Q

Return Visits

A

every 4 weeks until 28wk
every 2 weeks until 36wk
every week until delivery

214
Q

Weight Gain and Energy Needs

A

extra 300cal every day
need lots of energy

215
Q

Weight Gain Chart

A

Thin >18.5 – 28 -40 lbs
Avg 18.5 – 24.9 – 25-35lbs
Heavy 25-29.9 – 15-25lbs
Obese >30 – 11-20lbs

216
Q

Nutritional Needs

A

folic acid, iron, vitamin D for bone growth, avoiding listerosis

217
Q

Listerosis

A

food-borne illness from bacteria
avoiding raw fish, meat, lunch meats, unpasteurized milks, fewer than 200mg of coffee daily

218
Q

Nurse’s Role in Prenatal Check-Ups

A
  • 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
Q

Ultrasound

A

tissue imaging using high frequency sound waves deflected by organs and return as echos

220
Q

First Trimester and Ultrasounds

A
  • determine viability
  • estimate gestational age
  • determine cause of vaginal bleeding
  • help visualize for CVS
221
Q

Second Trimester and Ultrasounds

A

detect polyhydramnios/oligo (too much amniotic fluid)
help visualize for amniocentesis

222
Q

Third Trimester and Ultrasounds

A
  • determine placental insufficiencies
  • determine intrauterine growth restrictions
  • detect congenital abnormalities
  • part of biophysical profile
223
Q

CVS

A

diagnose for fetal chromosomal abnormalities
sampling chorionic villi of the placenta around 10-12wks

224
Q

Alpha Fetal Protein Screen

A

screening for neural tube defects (spina bifida) around 16-18wks

225
Q

Amniocentesis

A

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
Q

Non Stress Test

A

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
Q

Non-Reactive Stress Test

A

not good
fetus may be asleep - eat glucose or use vibrations
may be from hypoxia, asphyxia, drug use, congenital heart abnormalities

228
Q

Contraction Stress Test

A

see if fetus can tolerate labor
looking for decelerations in fetal heart rate
no decels = negative test

229
Q

Biophysical Profile

A

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

Maternity (5 decks)

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