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Nursing School > 🤰🏾- Exam 1 > Flashcards

🤰🏾- Exam 1 Flashcards

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0
Q

Para

A

Refers to number of births 20wks or after , regardless of born alive or stillborn

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1
Q

Gravida

A

A pregnant woman

Also refers to a woman’s total number of pregnancies, including the ones in progress

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2
Q

Term

A

37wks- 41wks + 6days

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3
Q

Preterm

A

20wks - 36wks + 6days

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4
Q

Post term

A

Anything after 42wks

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5
Q

GTPAL

A

G- pregnancies

T- term (37+ wks)

P- preterm (20-36.5 wks)

A- abortions

L- current living

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6
Q

Nullipara

A

A woman who has never been pregnant or has not completed a pregnancy of at least 20wks

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7
Q

Nagele’s rule

A

First day of last menstrual period (LMP) , subtract 3 months , add 7 days plus 1 year

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8
Q

Gestational age 5-8 wks

A

Woman misses period

Nausea, fatigue, tingling of breast

Uterus size of a lemon

Positive Chadwick, goodell and hegar signs

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9
Q

Gestational age 9-12 wks

A
  • nausea usually ends by 10 to 12 wks
  • uterus size of an orange
  • fetal heartbeat with Doppler
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10
Q

Gestational age 13-16 wks

A
  • fetal movement at 16wks
  • uterus in abdomen
  • fundus midway between symphysis pubis and umbilicus

**colostrum present

-blood volume increases

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11
Q

Gestational age 17-20wks

A
  • heartbeat heard with fetoscope
  • skin pigmentation increases
  • areolae darken
  • melasma and Linea nigra present
  • Braxton hicks contractions palpable
  • fundus at umbilicus level at 20 wks
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12
Q

Melasma

A

Brownish pigmentation of the face during pregnancy

Aka chloasma and “mask of pregnancy”

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13
Q

Gestational age 21-24 wks

A

-relaxation of smooth muscles of veins and bladder increases the chance of varicose veins and UTI

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14
Q

Gestational age 25-28 wks

A

Period of greatest weight gain and lowest hemoglobin level begins

Lordosis may cause backache

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15
Q

Gestational age 29-32 wks

A
  • heartburn common as uterus presses on diaphragm and displaces stomach
  • Braxton hicks more noticeable
  • lordosis increases
  • waddling gait develops
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16
Q

Gestational age 33-36 wks

A
  • shortness of breath caused by upward pressure on diaphragm
  • difficulty finding comfort during sleep
  • umbilicus protrudes
  • pedal or ankle edema present
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17
Q

Gestational age 37-40wks

A
  • woman is uncomfortable
  • cervix softens , begins to efface
  • mucous plug often lost
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18
Q

Growth changes in uterus during pregnancy

A

Nonpregnant uterus

Weight: 70g/2.5oz
Capacity: 10ml

Term uterus

Weight: 1100-1200g/2.4-2.6lb
Capacity: 5L

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19
Q

Uterine growth occurs as a result of ?

A

Hyperplasia in early pregnancy caused by estrogen and growth factors

Hypertrophy in later pregnancy due to muscle fibers stretch in all directions to accommodate growth

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20
Q

The fundus is normally located at the umbilicus at what gestational age

A

20 weeks

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21
Q

The fundus reaches its highest level when

A

The xiphoid process At 36 weeks gestation

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22
Q

Lightening

A

Descent of the fetal head into the pelvic cavity

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23
Q

Presumptive indications

A

Are subjective changes that are experienced and reported by the woman

These changes are the least reliable indicators of pregnancy because they can be caused by conditions other than pregnancy

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24
Q

Examples of presumptive indications

A 
Amenorrhea 
Nausea and vomiting 
Fatigue 
Urinary frequency 
Breast and skin changes 
Quickening
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25
Q

Quickening

A

The first movements of the fetus felt by the mother

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26
Q

Probable indications

A

Are objective findings that can be documented by an examiner

Primarily related to physical changes in the reproductive organs

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27
Q

Examples of probable indications

A 
Abdominal enlargement 
Goodell sign 
Hegar sign 
Ballottement 
Braxton hicks contractions 
Palpation of fetal outline 
Uterine souffle 
Positive pregnancy test
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28
Q

Goodell sign

A

Softening of the cervix due to pelvic vasocongestion

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29
Q

Hegar sign

A

Softening of the lower uterine segment that allows it to be easily compressed at 6 to 8 weeks of pregnancy

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30
Q

Ballottement

A

When the cervix is tapped, the fetus floats upward in the amniotic fluid. A rebound is felt by the examiner when the fetus falls back

Near mid pregnancy

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31
Q

Uterine soufflé

A

In late pregnancy - a soft, blowing sound may be auscultated over the uterus

This is the sound of blood circulating through the dilated uterine vessels and it corresponds to the maternal pulse

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32
Q

Funic soufflé

A

The soft, whistling sound heard over the umbilical cord and corresponds to the fetal heart rate

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33
Q

Examples Positive indications

A

Only 3 signs accepted as positive confirmation of pregnancy :

Auscultation of fetal heart , fetal movement detected by an examiner and visualization of the embryo or fetus

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34
Q

Chadwick sign

A

Bluish purple discoloration of the cervix, vagina and labia during pregnancy as a result of increased vascular congestion

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35
Q

Supine hypotension syndrome

A

When the pregnant woman is in the supine position, the weight of the uterus partially occludes the vena cava and the aorta.

Laying on your LEFT side corrects it

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36
Q

Progesterone and respiratory changes

A

Relaxes smooth muscle in the respiratory tract

Heightened awareness of the need to breathe

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37
Q

Estrogen and respiratory changes

A

Increased vascularity of mucous membranes

Causes increased nasal congestion and epistaxis

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38
Q

Relaxin and respiratory changes

A

Causes relaxation of the ligaments around the ribs

Relaxes skeletal muscle and cartilage

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39
Q

Ovaries and reproductive system changes

A

Ovulation ceases due to increased levels of estrogen and progesterone inhibiting the release of FSH and LH

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40
Q

Ptyalism

A

Excessive salivation

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41
Q

Progesterone and gi changes

A

Relaxes smooth muscle , which decreases gi motility , which can lead to constipation

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42
Q

Angiomas

A

Tiny red elevations branching in all directions

Look like red moles to me

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43
Q

Diastasis recti

A

Separation of the rectus abdominal muscles

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44
Q

HCG

A

Prevents deterioration of the corpus luteum so that it can continue producing estrogen and progesterone until the placenta is sufficiently developed and takes over

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45
Q

Estrogen

A

GROWTH

stimulates uterine growth
Increased vascularity
Prepares breast for lactation
Hyperpigmentation

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46
Q

Progesterone

A

MAINTENANCE

maintains endometrial lining / prevents menstruation

Relaxes smooth muscle

Increased respiratory sensitivity to CO2 (urge to breathe)

Suppress immune response - prevents rejection of the fetus

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47
Q

HPL

A

Human placental lactogen

Primary function to increase the availability of glucose for the fetus

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48
Q

What is the recommended weight gain during pregnancy

A

11.5 to 16 kg (25-35 lbs)

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49
Q

Pattern of weight gain

A

First trimester: gain 0.5 to 2 kg (1.1-4.4 lb)

0.35 to 0.5 kg (0.8-1lb) per week thereafter

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50
Q

Calorie intake during each trimester

A

First: no additional calories needed

Second: increase by 340 per day

Third: increase by 452 per day

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51
Q

Most common simple carbohydrate

A

Sucrose (table sugar)

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52
Q

Complex carbohydrates

A

Present in starches such as cereal, pasta and potatoes - supply vitamins, minerals and fiber

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53
Q

Fiber

A

Nondigestible product of plant foods , important source of bulk in the diet

Stimulates peristalsis, prevents constipation and slows gastric emptying causing a sensation of fullness

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54
Q

Fats help in the formation of

A

Fetal nerve, brain and visual development and visual function

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55
Q

Examples of Food sources for omega 3 fatty acids

A

Salmon, flaxseeds and oil, soybeans, walnuts

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56
Q

RDA of protein during pregnancy

A

Should be increased to 71 g daily

Compared to 46g for non pregnant females

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57
Q

Examples of sources of protein

A

Fish, egg, beans , peas , nuts, soybeans

Tofu from soybeans is a good source of protein , calcium and iron

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58
Q

Fat soluble vitamins

A

K A D E

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59
Q

Water soluble vitamins

A

B C

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60
Q

Women during child bearing age should consume how much folic acid

A

400 micrograms daily

Once pregnancy occurs should increase to 600 mcg daily

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61
Q

Folic acid

A

Deficiency results in neural tube defects, which can lead to spina bifida or skull/brain malformations

Also cleft lip, cleft palate, some heart defects, premature birth, LBW, abruptio placentae

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62
Q

What is the goal of iron consumption during pregnancy

A

To prevent iron-deficiency anemia

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63
Q

For best results iron should be taken with

A

Water or a source of vitamin c like orange juice

** don’t take with coffee, tea or milk **

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64
Q

Calcium is important in

A

Mineralization of fetal bones and teeth

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65
Q

Calcium is best absorbed when taken with

A

Vitamin d (eggs, cereal) to increase absorption

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66
Q

PICA

A

Eating substances not usually considered part of a normal diet

Ex: ice, clay or dirt and laundry starch

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67
Q

A multifetal pregnancy should gain how much

A

Woman with twins should gain 5.5 to 9kg (12-19lbs) more than a woman with a single fetus

Or

17 to 25kg (37-54lbs)

68
Q

Puerperium

A

The first 6 weeks after the birth of an infant

Aka postpartum

69
Q

Involution

A

The changes the reproductive organs, particularly the uterus, undergo after childbirth to return to their nonpregnant size and condition

70
Q

Descent

A

The fundus descends by approximately 1 cm, or 1 fingerbreadth per day after delivery

By 14th day, it has descended into the pelvic cavity and can’t be palpated abdominally

71
Q

Afterpains

A

Intermittent uterine contractions

72
Q

Are afterpains more uncomfortable for primipara or multipara

A

Multipara , Because of repeated stretching of muscle fibers

Primipara severe afterpains due to twins, large babies or if blood clots are present

73
Q

Lochia rubra

A

Days 1-3 after childbirth

Consists almost entirely of blood, small particles of decidua and mucus

DARK RED OR RED-BROWN COLOR

74
Q

Lochia serosa

A

Days 3-10

Composed of serous exudate, erythrocytes, leukocytes and cervical mucus

PINK/BROWN TINGED COLOR

75
Q

Lochia alba

A

Day 10-14

Composed of leukocytes, decidual cells, epithelial cells, fat, cervical mucus and bacteria

WHITE, CREAM OR LIGHT YELLOW COLOR

76
Q

Scant

A

Less than 2.5cm (1in) stain on peripad

77
Q

Light

A

Less than 10cm (4in) stain

78
Q

Moderate

A

Less than 15cm (6in) stain

79
Q

Heavy

A

Saturated peripad in 1 hour

80
Q

Excessive

A

Saturated peripad in 15 mins

81
Q

Dyspareunia

A

Discomfort during sex

Can occur postpartum due to vaginal dryness

82
Q

Round os vs slit os

A

Nullipara cervix is round

Para cervix is slit

83
Q

Postpartum plasma volume

A

Is decreased .. via diuresis and diaphoresis

84
Q

Changes in postpartum blood values

A

Increased WBC (up to 30,000mm3

Decreased HNH

85
Q

Changes in postpartum coagulation

A

Increased risk of forming blood clots and thrombus formation

86
Q

What 2 substances may be present in the urine for the first few postpartum days

A

Protein - related to uterine involution

Acetone - suggests dehydration

87
Q

Urinary retention and bladder distention may cause what

A

UTI and increased postpartum bleeding

88
Q

Uterine atony

A

Decreased contraction of the uterine muscles

Caused by displacement of the uterus UPWARD and LATERALLY by a full bladder

Primary cause of excessive bleeding

89
Q

Post puncture headache

A

May occur after a subarachnoid (spinal) block due to CSF leakage

Maybe most severe when the woman is in an upright position and are relieved by assuming a supine position

90
Q

How does breastfeeding affect ovulation and menstruation

A

Delays the return of both - resume as early as 12 weeks or as late as 18 months

*most non-nursing mothers resume at 6-8 weeks postpartum

91
Q

Prolactin vs oxytocin

A

Prolactin - after expulsion of the placenta , estrogen and progesterone decline allowing prolactin to initiate milk production within 2 or 3 days postpartum

Oxytocin - necessary for milk ejection or “let-down” causes milk to be expressed from the alveoli into the lactiferous ducts during suckling

92
Q

Approximately how much weight is lost during childbirth

A

4.5 to 5.8kg (10-13lb)

Includes weight of the fetus, placenta and amniotic fluid

Additional 5-8lbs from diuresis and 2-3lbs from involution and lochia are lost by the end of the first week

93
Q

What does BUBBLE-E stand for

A 
Breast 
Uterus/fundus 
Bladder
Bowel 
Lochia 
Episiotomy/perineum
Edema/emotional status
94
Q

What does REEDA stand for ? Used to asses incision sites

A 
Redness 
Edema 
Ecchymosis 
Discharge 
Approximation
95
Q

Homans sign

A

Discomfort in the calf with dorsiflexion of the foot

May indicated deep vein thrombosis

96
Q

Signs of paralytic ileus

A

(Lack of movement in the intestines)

Abdominal distention, absent or decreased bowel sounds and failure to pass flatus or stool

97
Q

RhoGAM

A

Should be administered within 72hrs after childbirth to prevent the development of maternal antibodies that would affect subsequent pregnancies

98
Q

Rubella vaccine

A

The vaccine is a live virus. Advise woman to not become pregnant for at least 28 days after receiving the vaccine

99
Q

What temperature is common for the first 24hrs after birth

A

Up to 38’C (100.4’F)

Maybe caused by dehydration or normal postpartum leukocytosis

100
Q

Breathing is initiated by which factors

A

Chemical, mechanical, thermal and sensory factors that stimulate the respiratory center in the medulla and trigger respirations

101
Q

Chemical factors that trigger respirations

A

A decrease in PO2 , pH and an increase in PCO2 in blood cause impulses from these receptors to stimulate the respiratory center in the medulla

102
Q

Mechanical factors that trigger respirations

A

During vaginal birth the fetal chest is compressed pushing fetal lung fluid out of the lungs

Fluid passes out of mouth or nose or is suctioned as the head emerges from the vagina

103
Q

Thermal factors that trigger respirations

A

The temperature change that occurs with birth stimulates the initiation of respirations

104
Q

Sensory factors that trigger respirations

A

Tactile, visual, auditory and olfactory stimuli occur during and after birth to stimulate sensors

105
Q

Thermoregulation

A

The maintenance of body temperature

106
Q

Characteristics that lead to baby heat loss

A
  • thin skin
  • blood vessels close to surface
  • little subcutaneous fat
  • more water weight
107
Q

Evaporation

A

Air-drying of the skin that results in cooling

Dry baby as quickly as possible to prevent loss of heat - remove wet linens , use dry blankets

108
Q

Conduction

A

Movement of heat away from the body occurs when newborns have direct contact with objects that are cooler than their skin

Prevent by warming objects that will touch the baby or skin to skin with mom

109
Q

Convection

A

Transfer of heat from the infant to cooler surrounding air

Prevent by providing a warm, draft-free environment

110
Q

Radiation

A

Transfer of heat to cooler objects that aren’t in direct contact with the infant

Prevent because incubators have double walls, placing cribs and incubators away from windows and outside walls

111
Q

Providing cord care

A

Falls off within 10-14 days

The cord clamp is removed 24hrs after birth

112
Q

Effects of cold stress

A

Metabolism of brown fat, increased metabolic rate, increased O2 and glucose consumption can lead to metabolic acidosis, hypoglycemia and jaundice

113
Q

Normal range of erythrocytes in a newborn

A

4.8-7.1 million/mcL

114
Q

Normal range of hemoglobin in newborns

A

15-24 g/dL

115
Q

Normal range of hematocrit in newborns

A

44-70%

116
Q

Polycythemia

A

Abnormally high RBC count

117
Q

Polycythemia increases the risk for what

A

Jaundice and injury to the brain and other organs as a result of blood stasis

118
Q

Normal range of leukocytes in the newborn

A

9.1-34 thousand/mm3

119
Q

Breast milk 💩

A

Seedy and the color and consistency of mustard , with a sweet-sour smell

120
Q

Formula fed 💩

A

Pale yellow to light brown-green color, firmer in consistency and stink

121
Q

Glucose levels on day 1 vs after

A

Day 1: 40-60 mg/dL

Thereafter: 50-90 mg/dL

122
Q

Risk factors for neonatal hypoglycemia

A 
Prematurity 
Postmaturity
Late preterm infant 
Intrauterine growth restriction 
Lga/sga 
Asphyxia 
Problems at birth 
Cold stress 
Maternal diabetes 
Maternal intake of terbutaline
123
Q

Conjugation

A

A process in which the liver turns unconjugated bilirubin which is soluble in fat to water- soluble so that it can be excreted from the body

124
Q

Kernicterus

A

Chronic bilirubin encephalopathy that causes permanent neurologic injury

125
Q

Unconjugated bilirubin

A

Unconjugated bilirubin attaches to albumin in the blood and is carried to the liver

126
Q

Factors that lead to increased bilirubin

A
  • Increased bilirubin production
  • increased break down of RBC
  • less albumin
  • liver immaturity
  • blood incompatibility= ^ RBC breakdown
  • delayed feeding = delayed est of normal flora
  • Trauma
  • fatty acids = greater affinity for albumin binding sites
  • family background
127
Q

Physiologic/nonpathologic jaundice (transient)

A

Is considered normal

Occurs AFTER the first 24hrs of life

Intake
Meconium

128
Q

Nonphysiologic/pathologic jaundice (abnormal)

A

Occurs WITHIN the 1st 24hrs of life

Is a result of abnormalities causing excessive RBC destruction - blood incompatible, infection, etc

Treated with phototherapy

129
Q

Immunoglobulin G

A

Only one that crosses the placenta

Passive temporary immunity to bacteria, bacterial toxins and viruses to which the mother has developed immunity

130
Q

Immunoglobulin M

A

Production as a result of exposure to environmental antigens

Active immunity

131
Q

Immunoglobulin A

A

Important in protection of the gastrointestinal and respiratory systems

Active immunity

Present in colostrum and breast milk

132
Q

First period vs second period of reactivity

A

1st period - begins at birth and lasts for 30mins

Sleep

2nd period - lasts 4-6 hrs

133
Q

Normal newborn respiratory rate

A

30 to 60 breaths per min

134
Q

Choanal atresia

A

Blockage or narrowing of one or both nasal passages by bone or tissue

135
Q

Normal ❤️ rate range of newborn for normal activity , crying and sleeping

A

Normal activity: 120-160 beats per min

Crying: elevate to 180 bpm

Sleeping: drop to 100 bpm

136
Q

Normal range for axillary temp on a newborn

A

36.5-37.5’C (97.7-99.5’F)

137
Q

Anterior fontanel

A

Diamond 💎 shaped

Closes by 18 months

Largest

138
Q

Posterior fontanel

A

Triangle 🔺 shaped

Closes by 2 months

Smaller

139
Q

Caput succedaneum

A

An area of localized edema that appears over the vertex of the newborns head as a result of pressure against the mothers cervix during labor

Is present at birth , usually resolves within 12 to 48 hrs after birth

140
Q

Cephalhematoma

A

Bleeding between the periosteum and the skull , is the result of pressure during birth

May not be present at birth , may develop within the first 24 to 48 hrs

May take 2-3 months to resolve

141
Q

The umbilical cord should contain how many vessels

A

2 arteries and 1 vein

*a two vessel cored maybe associated with chromosomal or renal defects

142
Q

Erb’s palsy

A

Paralysis of the shoulder and arm muscles

Maybe caused by injury to the brachial nerve plexus

143
Q

Polydactyly

A

Extra digits

144
Q

Syndactyly

A

Webbing between digits

145
Q

Talipes equinovarus

A

A birth defect in which the foot is twisted out of shape or position ;
Clubfoot

Foot turns inward and can’t be moved a midline position

146
Q

Hip dysplasia

A

Instability of the hip joint occurs and the head of the femur can be moved in and out of the acetabulum

Hear a click= normal
Feel a clunk= not normal

147
Q

Barlow test vs Ortolani test

A

Barlow test - laying supine, ADDUCT the hips

Ortolani test - laying supine, ABDUCT the thighs

148
Q

Normal range of weight , height , head and chest circumference on a term baby 👶🏾

A

Weight: 2500 - 4000g (5.8-8lb 13oz)

Height: 19 - 21 inches (48-53cm)

Head: 13 - 15 inches (32-38cm)

Chest: 12 - 14 inches (30-36cm)

149
Q

Hearing begins to develop when

A

By 23-24 wks gestation

150
Q

Recommend weight gain during pregnancy based on BMI for underweight , normal weight , overweight and obese

A

Underweight: 28-40 lb

Normal weight: 25-35 lb

Overweight: 15-25 lb

Obese: 11-20 lb

151
Q

Strabismus

A

Crossed eyes

152
Q

Causes of tremors or jitteriness

A

Hypoglycemia
Hypocalcemia
Drug withdrawals

153
Q

Moro reflex

A

Let infants head drop back approximately 30 degrees

Responds with sharp extension and abduction of arms

Disappears at 5-6 months

154
Q

Palmar grasp reflex

A

Occurs when the infants palm is touched near the base of the fingers - the hand closes into a tight fist

Disappears at 2-3 months

155
Q

Babinski reflex

A

Stroke lateral sole of foot from the heel to across base of toes - causes toes to flare outward and the big toe to dorsiflex

Disappears at 8-9 months

156
Q

Rooting reflex

A

When the infants cheek is touched near the mouth , the head turns toward the side that has been stroked

Disappears at 3-4 months

157
Q

Stepping reflex

A

When infants are held upright with their feet touching a solid surface - they lift one foot and then other , giving the appearance that they are trying to walk

Disappears at 3-4 months

158
Q

Sucking reflex

A

When the mouth or palate is touched by the nipple or a finger, the baby begins to suck - difficulties maybe related to problems in the babies ability to suck and coordinate sucking with swallowing and breathing

Disappears at 1 year old

159
Q

Tonic neck reflex

A

The baby extends the arm and leg On the side to which the head is turned and flexes the extremities on the other side

Maybe weak at birth , disappears at 4 months

160
Q

Signs of neonatal hypoglycemia

A 
Poor suck
Jittery 
Tachypnea 
Tachycardia 
Grunting 
Low temperature 
Lethargy 
Asymptomatic
161
Q

Cryptorchidism

A

Undescended testes

162
Q

Lanugo

A

Fine, soft hair that covers the fetus during intrauterine life

163
Q

Milia

A

White cysts

Occur on the face over the forehead, nose, cheeks and chin

164
Q

Erythema toxicum

A

Red, blotchy areas with white or yellow popular or vesicles in the center

“Flea bite or newborn rash”

165
Q

Nevus simplex

A

“Salmon patch, stork bite or telangiectatic nevus”

Flat, pink discoloration from dilated capillaries that occurs on the eyelids, just above the bridge of the nose, or at the nape of the neck

166
Q

Nevus flammeus

A

“Port-wine stain”

Permanent, flat, pink to dark reddish-purple mark that varies in size and location and doesn’t blanch with pressure

*lesions located over the forehead and upper eyelid maybe associated with sturge-Weber syndrome , a neuro condition

167
Q

Nevus vasculosus

A

“Strawberry hemangioma”

Dark red and raised with a rough surface , giving a strawberry like appearance

168
Q

Cafe au lait spots

A

Permanent , light-brown areas that may occur anywhere on the body

*6 or more spots or large size associated with neurofibromatosis , a genetic condition of neural tissue

Nursing School (36 decks)

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