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NSG 312 OB > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

what age is considered an old maternal age?

A

over age of 35

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2
Q

what does the baby need to become independent in after birth?

A
  • their respiratory system
  • their circulatory system
  • their ability to thermoregulate
  • their ability to produce a source of glucose
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3
Q

how much fluid is in a newborn’s lungs?

A

about 80-110 mL

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4
Q

why do c-section babies have more fluids in their lungs compared to normal newborns?

A

because they aren’t being squeezed out and the fluid isn’t being ejected

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5
Q

ductus arteriosus location

A

between pulmonary artery and aorta

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6
Q

foramen ovale location

A

between right and left atrium

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7
Q

what is common in a newborn due to their foramen ovale and ductus arteriosus not closing?

A

they might have murmurs for the first 6 months, then should close

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8
Q

normal newborn heart rate

A

100-160 beats/min

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9
Q

how is NB circulation changed?

A

with adequate respiratory function

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10
Q

during sleep, what might be a normal HR?

A

80-100 beats/min

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11
Q

during crying, what might be a normal HR?

A

180 beats/min

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12
Q

how long should apical HR be counted?

A

a full minute

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13
Q

apgar score

A

initial assessment of vital functions; assess HR, RR, muscle tone, reflex irritability and color

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14
Q

when is an apgar score taken?

A

at 1 minute after birth and 5 minutes after birth

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15
Q

normal RR for a newborn

A

30-60 per min

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16
Q

since NB RR are irregular often, what is the best way to check for them?

A

by watching their abdomen since they are nose breathers

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17
Q

what is important to know about a NB’s temperature immediately after birth?

A

it drops rapidly

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18
Q

what is the best way to assess for a NB temperature?

A

axillary; rectal is not advised

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19
Q

normal temp of a NB

A

97.7-100.0

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20
Q

how long does a NB temp take to stabilize?

A

24 hours

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21
Q

what is the best way to keep a NB warm besides using a heater?

A

skin-to-skin (kangaroo care)

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22
Q

what body temperature would be concerning and why?

A

anything under 97.9; below 97.5 is correlated with poor brain growth and increased mortality

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23
Q

explain brown fat

A
  • metabolized for heat production
  • develops at 26-30 weeks
  • depletes by 2-5 weeks of age
  • more rapidly depleted by cold stress (hypothermia)
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24
Q

what are effects of hypothermia?

A
  • resp. distress
  • hypoglycemia
  • loss of weight
  • jaundice
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25
Q

what can the nurse do to keep the baby warm?

A
  • dry and wrap in warm blanket
  • cover head with hat
  • place under radiant heat source or on mom’s abdomen
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26
Q

what can hyperthermia cause?

A

increased metabolic rate and increased need for glucose and oxygen

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27
Q

what is the NB stomach capacity and when do they empty their stomach?

A

5-10 mL at birth (30-90 when stretched) and empties within 2-4 hours

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28
Q

what occurs in the first period of reactivity?

A
  • it is from birth to 30-60 minutes
  • NB is alert, responsive, rapid HR and resp., strong suck
  • best time to feed
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29
Q

what occurs in the period of inactivity?

A
  • lasts 60-100 minutes
  • NB sleeps, recovers from birth
  • bowel sounds audible
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30
Q

what occurs in the 2nd period of reactivity?

A
  • occurs at 4-8 hours of age and lasts 4-6 hours
  • awake/alert, rapid color changes
  • meconium, void, feed
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31
Q

what is common in a NB since their cardiac sphincter is immature?

A

regurgitation of food; must burp in between feedings

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32
Q

how much weight is a NB expected to lose?

A

5-7% of their birth weight

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33
Q

meconium stool

A

black, tarry, no odor; passed within 12-48 hours after birth

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34
Q

what would it mean if the meconium is passed before birth?

A

could be a sign of fetal distress

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35
Q

transitional stool

A

3-4th day; greensih/loose

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36
Q

newborn stool

A

5-6th day; depends on type of feeding

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37
Q

breastfeeding stools

A
  • occurs on 4th day
  • light yellow stools
  • sweet smelling
  • seedy
  • goes 3-4 times a day
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38
Q

bottle-feeding stools

A
  • occurs on 4th day
  • pale yellow to light brown stools
  • more odor than breastfed: sour milk odor
  • 2 stools per day
  • firmer consistency
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39
Q

normal WBC count in NB

A

9,000-30,000/mm (avg. 17,000) ~ higher due to inflammatory process in beginning of life

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40
Q

normal bilirubin count in NB

A

1-4 mg/100mL

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41
Q

normal blood sugar in NB

A

50-60 mg/dl x 3 days
60-70 mg/dl after 3 days
*we worry more about hypoglycemia

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42
Q

why do NBs have leukocytosis when first born?

A

due to stress of labor, not an infectious process

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43
Q

when does urine production begin and what is it used for?

A

it begins in the 12th week of fetal life and is a component of amniotic fluid

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44
Q

when should a NB’s first void be?

A

by 24 hours of life, then 6-10 times/day

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45
Q

how is a NB’s urine?

A

it is very dilute for the first 3 days due to the decreased ability to concentrate urine

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46
Q

what does the NB liver play a role in?

A
  • iron storage (from mom) for RBC production
  • carbohydrate metabolism
  • conjugation of bilirubin
  • coagulation
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47
Q

what is given when a NB is born to help with clotting?

A

vitamin K

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48
Q

where is vitamin K given and what is the maximum a NB can be given?

A

given in the vastus lateralis and 1 mL is the maximum

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49
Q

why is a prophylactic eye ointment given to a NB?

A

to prevent ophthalmia neonatorum caused by gonorrhea or chlamydia

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50
Q

IgG

A

passive immunity from mom

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51
Q

IgM

A

produced by fetus/NB

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52
Q

IgA

A

produced by infant 6-12 weeks after birth

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53
Q

when do antibodies get transferred to fetus?

A

in the 3rd trimester and when breastfeeding

54
Q

is fever a reliable sign of infection?

A

NO; low body temperature is more indicative of a bacterial infection

55
Q

caput succedaneum

A

edema of scalp caused by pressure from cervix; disappears in 3-4 days

56
Q

cephalohematoma

A

blood between skull bone and periosteum; caused by pressure on maternal pelvis or birth trauma; resolves in 3-6 weeks; increases risk of hyperbilirubinemia

57
Q

signs of neurologic integrity

A

NB’s ability to console himself, sleep and wake, and respond to voices

58
Q

what kind of cry is concerning?

A

high pitched cries and weak cries or no cries

59
Q

blink reflex

A

protects eye from an object coming near

60
Q

rooting reflex

A

when the cheek is stroked and the NB will turn their head that direction; works with breast feeding too

61
Q

sucking reflex

A

when lips are touched, NB sucks; disappears in 3-4 months

62
Q

if a baby is not taking fluids by mouth due to feeding tube, what should be offered to them to stimulate the sucking reflex?

A

they should be offered a pacifier

63
Q

moro (startle) reflex

A

NB will raise her arms and cry when startled

64
Q

how does vision work in a NB?

A

can see best at 8-12 inches (why we do cradle hold); sensitive to light; prefer human face

65
Q

how does hearing work in a NB?

A

it is well developed and respond to mother’s voice most often; listen best to a quiet voice

66
Q

how does smell and taste work in a NB?

A

well developed in 6 days

67
Q

how does touch work in a NB?

A

most sensitive at mouth and hands

68
Q

preterm babies

A

born before 37 weeks

69
Q

term babies

A

born between 37-40 weeks

70
Q

post-term babies

A

born after 40 weeks

71
Q

what gestation babies tend to be more prone to hypoglycemia?

A

small and large gestational age babies

72
Q

macrosomia

A

when mom has high BG levels the fetus will receive high glucose levels

73
Q

when does the fetus secrete their own insulin?

A

10-14 weeks

74
Q

acrocyanosis

A

hands and feet are blue; may be due to baby being cold or poor circulation

75
Q

hypospadias

A

urethral openeing under penis

76
Q

epispadias

A

urethral opening on top of penis

77
Q

how long do each trimesters last?

A

1st = from LMP through 13th week
2nd = 14th week - 26th
3rd = 27th week - 40

78
Q

how do you start counting when a pregnancy began?

A

start with the first day of missed menstrual period

79
Q

gravida

A

any pregnancy, regardless of duration

80
Q

nulligravida

A

never been pregnant

81
Q

primigravida

A

pregnant for the first time

82
Q

multigravida

A

second of subsequent pregnancy

83
Q

para

A

counts births after 20 weeks, regardless of outcomes; does not count infants, just births

84
Q

GTPAL

A

Gravida
Term deliveries (37 weeks and up)
Preterm births (between 20 and 36 6/7 weeks)
Abortion
Living children

85
Q

when does ovulation occur?

A

14 days before the first last day of the cycle

86
Q

what do the urine tests test for?

A

human chorionic gonadotropin (hCG) ~ when sperm and egg come together, this is created

87
Q

what might higher than normal levels of hCG be seen with?

A
  • molar pregnancy
  • ectopic pregnancy
  • abnormal gestation (DS)
  • multiple gestation
88
Q

what might a decrease in hCG be seen with?

A

impending miscarriage

89
Q

what does hCG do?

A

preserves function of corpus luteum and ensures a continued supply of estrogen and progesterone

90
Q

where is the uterus in 12-14 weeks of gestation?

A

right above the symphysis pubis

91
Q

where is the uterus 20-24 weeks of gestation?

A

above level of umbilicus

92
Q

where is uterus 36 weeks gestation?

A

touches xyphoid process

93
Q

lightening

A

occurs at about 38-40 weeks gestation; when the pressure in the pelvis lightens

94
Q

operculum

A

mucus plug ~ protects body from pathogens entering in the vagina

95
Q

goodell sign

A

softening of the cervix ~ noticeable during first 3 months

96
Q

chadwick’s sign

A

violet or bluish discoloration of the vaginal mucous membrane and cervix

97
Q

ballottement

A

between 16-18 weeks, can bounce fetus gently and have it rebound

98
Q

during the 2nd and 3rd trimesters what will occur with the breasts?

A

colostrum might be present

99
Q

what might occur with the respiratory system?

A

nasal stuffiness or congestion

100
Q

supine hypotensive syndrome

A
  • enlarged uterus may press on the vena cava and the aorta which reduces blood flow to the right atrium
  • this lowers BP and causes dizziness and will also reduce blood flow to the placenta
  • AVOID LAYING SUPINE!
101
Q

recommended weight gain for women of normal pre-pregnancy weight

A

25-35 pounds

102
Q

recommended weight gain for overweight women

A

15-25 pounds

103
Q

what might occur in a pregnant moms urine?

A

glucosuria: trace amounts may spill into urine due to kidneys inability to filtrate the glucose

104
Q

what are the three signs of pregnancy categorized as?

A
  • presumptive = changes felt by woman
  • probable = changes observed by an examiner
  • positive = those that can be attributed only to the presence of a fetus
105
Q

oxytocics

A

uterine stimulants: stimulate uterine contractions to promote labor

106
Q

tocolytics

A

uterine relaxants: suppression of preterm labor

107
Q

what does it mean for the cervix to be “ripe”?

A

it shortens, softens, and dilates; must be ripe before drugs can be given

108
Q

what drugs promote cervical ripening?

A

prepidil, cervidil, cytotec

109
Q

most widely used agent for cervical ripening and controlling postpartum hemorrhage

A

misoprostol (cytotec)

110
Q

what does pitocin (oxytocin) do during labor?

A

it causes uterine contractions but does NOT ripen the cervix

111
Q

when would we not be able to administer pitocin?

A
  • fetal lungs are not mature
  • cervix is not ripe
  • patient had previous c-section or uterine surgery
  • patient has genital herpes
  • cephalo-pelvic disproportion (CPD)
112
Q

what drug develops the fetal lungs?

A

betamethasone

113
Q

antidote for magnesium sulfate

A

calcium gluconate

114
Q

where does fertilization occur?

A

in the outer third of the fallopian tube

115
Q

how long is an ovum fertile for after ovulation?

A

24 hours after

116
Q

how long can sperm survive?

A

48-72 hours but most are only fertile for 24 hours

117
Q

zygote

A

when sperm and ovum unite: 23 chromosomes from each zygote so the zygote has 46 chromosomes

118
Q

functions of amniotic fluid

A
  • cushions and protects
  • controls embyro temp.
  • allows freedom of movement for the fetus
119
Q

what does the umbilical cord consist of?

A

one large vein that carries oxygenated blood to the baby and two small arteries that carry unoxygenated blood from the baby to the mom

120
Q

explain both sides of the placenta

A
  • maternal side - “A” = “dirty duncan”
  • fetal side - “B” = “shiny shultz”
121
Q

what time during a pregnancy would be most susceptible to teratogens?

A

the embryonic stage (week 3-8)

122
Q

when is the most crucial time period for developmental disorders?

A

during the first 3 months

123
Q

when can mom begin to feel fetal movement?

A

20th week

124
Q

when do fetal lungs mature?

A

usually by the 36th week

125
Q

main advantage of a male condom

A

protects from pregnancy and STI’s

126
Q

what is the permanent way to avoid contraception?

A

tubal ligation or vasectomy

127
Q

disadvantages of oral contraceptives

A
  • need to take pill daily at same time
  • can be cosly
  • not an option for smokers > 35 years
  • not an option for h/o thromboembolic disease
  • does not offer STI protection
128
Q

infertility

A

inability of a couple to achieve conception after a year of unprotected sex (6 months if the woman is over age 35) or the inability to carry a pregnancy to a live birth

129
Q

subfertility

A

reduced fertility in both partners

130
Q

secondary infertility

A

couples have one successful pregnancy and are unable to conceive or sustain a second pregnancy

131
Q

what is the usually the first approach when trying to diagnose infertility?

A
  • semen analysis
  • extensive interview
  • physical exams of both
  • lab tests for both
132
Q

hysterosalpingogram (HSG)

A

shows if tubes are blocked; can cause uterine clamping after since uterus is trying to get dye out

NSG 312 OB (4 decks)

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