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Family Nursing > Exam 2 > Flashcards

Exam 2 Flashcards

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1
Q

is a hemorrhage of blood between the skull and the periosteum (outer layer of bone) of any age human, to rupture of blood vessels crossing the periosteum.

Or

is a traumatic subperiosteal haematoma that occurs underneath the skin, in the periosteum of the infant’s skull bone

A collection of blood between the periosteum of a skull bone and the bone itself

A

Cephalohematoma

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2
Q

One leg longer, extra skin folds on inner thigh , uneven gluteal folds, hip click maneuver

A

Congenital hip dysplasia

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3
Q

Cleft lip- what it is?

Feedings?

Education for parents ?

Safety precautions?

A

Fissure or opening in the upper lip

The result of failure of maxillary and medium nasal processes

Can be fixed with surgery - encourage them to fix it to improve speech, dental , feedings, positive self image

Feedings- by dropper until the wound is completely healed 1-2 weeks . Breast fed milk or formula as soon as clear liquids are tolerated

Safety- auctioning the mouth should be avoided in infants who have a cleft palate repair

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4
Q

What is presumptive pregnancy?

Signs?

A

Definite diagnoses of pregnancy.. can’t be made.. signs could be common during pregnancy but can indicate something else

Deepening pigmentation, urinary frequency, quickening(moving of baby), amenorrhea (late period) Period late, tired , breast are tender, nauseated.

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5
Q

Define primigravida ?

A

Someone who is pregnant for the first time

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6
Q

What is viability of fetus?

A

The gestational age at which a prematurely born fetus/ infant had 50% chance of long term survival outside the womb

24-25 weeks

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7
Q

How often should women make prenatal visits ?

A

Weeks 4-8: 1 prenatal visit a month

Weeks 28-36: 1 prenatal visit every two weeks

Weeks 36-40: 1 prenatal visit every week

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8
Q

Define supine hypotension ?

Signs/symptoms?

What to do/nursing intervention?

A

Feeling of sickness and low bp that Occurs when pregnant women lie on their back

May feel dizzy/weak, low bp, nausea, sweating, pallor (pale), tachycardia

Turn patient to left side to resolve

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9
Q

Teachings for pregnant women traveling far from home ?

A

Take plenty of rest breaks

Drink plenty fluids

Not recommended after third trimester

Check with airlines if they have cut off when pregnant women can fly

Prenatal records

Seatbelt below abdomen

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10
Q

Signs and symptoms of “true labor”?

A

With true labor contractions, they become stronger, closer together and more regular

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11
Q

Normal fetal heart tones ?

When to report?

A

110-160 bpm

Heard through Mother’s abdominal wall

Report anything under or higher heart rate

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12
Q

What is Gravita and Para status ?

A

Gravita - number of pregnancies

Para - number of births after 20 weeks

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13
Q

What makes up a normal umbilical cord?

A

AVA- Artery vein Artery

2 arteries and one vein

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14
Q

Nurses priority during labor and delivery?

Pg 183
Pg 197

A

? Preparing for delivery
Asses for abnormalities
Promote bonding

Fetal assessment/VS/HR
Labor process
Maternal and fetal tolerance to labor 
Pain management 
I and O
Vitals
Communication with MD
Empty bladder 
Promote position changes 
Provide hygiene 
Support and encouragement 
Assist with breathing techniques
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15
Q

Normal location of zygote implantation ?

A

Upper section of the posterior uterine wall

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16
Q

How to figure out Nagels rule ?

A

First day of last normal period
Subtract 3 months
Plus 7 days
Correct the year if necessary

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17
Q

Interventions and education for nausea and vomiting during pregnancy ?

A

Dry carbs like saltine crackers , lemonade over ice , sea bands , small frequent , and non-greasy meals

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18
Q

Normal weight gain during pregnancy and education?

If under weight ?

If overweight ?

A

25-35 pounds

Healthy nutrition, take vitamins, exercise, watch weight

28-40

11-25

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19
Q

Intrauterine growth restriction

Causes

Treatment

A

A condition in which a baby doesn’t grow to normal weight during pregnancy

Problem with placenta (common cause)

or health problems such as diabetes , HTN, heart disease, infections, kidney/lung disease, anemia, malnutrition, smoking , alcohol, drugs , chromosomal defects

Regular dr apts , be aware of body movements, check meds , eat healthy nutrition, plenty of rest, stop smoking

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20
Q

How to measure frequency of normal contractions ?

Labor vs false labor?

A

Frequency: Time from the beginning of one contraction until the beginning of the next (minutes)

Duration: time from the beginning of a contraction until the end of the same contraction (seconds)

Braxton Hicks- false labor where contractions can be regular or irregular, practicing for labor , does not cause a change in cervix

Real labor - regular rhythmic contractions, cervix changes , bloody discharge, water breaks

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21
Q

Nursing interventions for back labor pain?

A

Put woman on hands and knees , lean forward , birthing ball

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22
Q

What is back labor ?

A

Pain or discomfort in lower back, just above tailbone , to a woman during childbirth

23
Q

Progression of labor ?

What is normal and what can cause it to slow?

A

1st :

Latent phase - slow effacement of the cervix , longest phase , 0-3 cm

Active phase- best time for pain meds epidural, 4-8 cm

Transition phase- angry sweaty, 9-10 cm

2nd- pushing / deliver
3rd-delivery of placenta
4th- bonding-put on belly and breast feed

Can slow- Stress, worry, fear , full bladder

24
Q

What is amniotomy ?

What is the reason it’s done ?

A

Breaking amniotic fluid/ water

Done to induce or expedite labor

25
Q

Normal color of amniotic fluid?

What to report immediately?

A

Clear with flecks of white vernix

Green fluid is also normal and means that hey have passed meconium ( their first stool)

Report- cloudy or yellow fluid with a bad odor- it might indicate an infection.

26
Q

Foods high in iron?

A

Fish, green leafy veggies , red meats

27
Q

What is the fundus?

A

The upper part of the uterus

  • which is broad and flat -where Fallopian tubes enter on each side
28
Q

The distance from the pubic bone to the top of the uterus

A

Fundal height

After 20 weeks your fundal height should match the number of weeks you been pregnant in cm

29
Q

Fundal height at each trimester ?

Assessment after delivery?

Possible reasons for abnormalities ?

A

3rd trimester grow 1 cm per week

Asses 1 hour after Delivery to check if fundus is firm and at the level of the umbilicus- massage

Pain/contractions to normal size, bleeding, Check for clots , boggy uterus can be a sign of hemorrhage that needs to be treated STAT

30
Q

Nurses priority on the newborn?

A

?

Examine head for lacerations, abrasions , or bruising

31
Q

Pain assessment after delivery ?

A

Vaginal hematoma

Pelvic or rectal pain

-Cold pack in area , analgesics

32
Q

Security process between mom and newborn?

A

No one but mom can carry baby to and from nursey

Anyone carrying must have badge ID

Any not mom push in crib

33
Q

Normal vitals of new born?

A

BP- 60-80/40-45. (64/41)

Resp- 40-60

Heart rate - 110-160

T-96.8-99.0

34
Q

Assessment findings for post term infant (born after 42 weeks)?

A

Wrinkled skin

LGA (large macromonia) or long and thin

^Hypoglycemia

Meconium staining

Long nails

Peeling skin

35
Q

What complications to look for with forceps delivery?

A

Trauma : laceration , hematoma, bruising

36
Q

Newborn assessment to report?

A

Vs abnormalities

Apgar number

Gestational age

Anomalies or skin conditions or jandauce - report if any STAT

Reflexes

37
Q

What are (pitocin) Oxytocin infusions used for?

When are they stopped ?

Assessment during infusion ?

Possible complications?

A

Oxy- strengthen contractions

To contract the uterus

Stop IV when it induces labor and notify provider - 2-3 min apart

Asses time of contraction and placenta -

Excessive bleeding , abnormal heart rate , HTN, seizures, shallow breathing, muscle cramps

38
Q

Nursing intervention with a stillborn ?

A

Therapeutic communication (silence, sympathy, open ended statements, reflection)

Promote expression of grief by providing privacy, eliminating time restrictions, allow support visits , recognition of cultural norms for grief/loss

39
Q

What is phototherapy used for ?

Nursing actions?

A

Used to treat jaundice - get rid of excess bilirubin

Keep eyes covered
Hydrate 
Frequent feeding
Expose skin as much as possible
Reposition every two hours or more 
Monitor bilirubin levels in blood
Involve parents
40
Q

Swelling during pregnancy - what it indicates?

Education

Primary assessments?

A

Preeclampsia /edema

Teach the symptoms, mag sulfate May cause hot flash, keep room quit and dim to prevent seizure

watch BP, hourly vitals , urine output 30 ml or more , magnesium levels, 24 hour urine sample, CBC , respiration depression, DTR (deep tenden reflexes) , seizures

41
Q

Gestational hypoglycemia-

Signs and symptoms ?

Priority assessment?

A

Linked to women taking insulin or medicine for bs

Shaking and tremors , immature lungs, macrosomnia in baby,

check for glucose and ketones

42
Q

Kick count education?

A

After 28 weeks, it’s ok if no movement in 30 minutes

Needs to be 10 times in 2 hours

43
Q

Difference between reactive and nonreactive stress test?

A

Reactive: Two or more fetal heart accelerations within 20 minute period with or without fetal movement. Baby’s heart rate above baseline 15x

Non reactive : fetal heart rate did not go up (nothing)

44
Q

Enlarged , gnarled veins commonly in the legs and feet

A

Varicose veins

45
Q

Signs and symptoms of varicose veins ?

Nursing education ?

A

Aches and pain , dark purple veins , burning , throbbing, muscle cramping and swelling in lower legs , itching , bleeding, color changes, hardening, inflammation of skin or ulcers near ankle

Avoid standing or sitting for long periods

Walk/ exercise

Rest with legs elevated

Compression stockings

Avoid tight knee highs

Relieve hemorrhoid swelling with warm sits bath, pain ointment

46
Q

Functions of the placenta ?

A

Delivers nutrients to baby, removes CO2 and waste

47
Q

Placenta previa - what is it?

signs and symptoms ?

A

When placenta covers the opening of the mothers cervix

Painless bright red bleeding

48
Q

Abrupt decrease in fetal heart rate and decrease baseline? Can happen with umbilical cord is temporary compressed

A

Variable decelerations

49
Q

Bonding after delivery ?

A

Out baby on mother’s chest

The newborn should breast feed with in the first hours when alert

Postpartum interferes

Immediately - postpone cream

50
Q

Pre-eclampsia/Eclampsia- priority nursing interventions?

A

Preeclampsia- renal involvement leading to proteinuria . HTN , edema , and protein in urine during pregnancy

Eclampsia- CNS involvement causing seizures, liver and coagulation abnormalities dominate the clinical picture

Monitor urine protein (3+ may indicate proteinuria)
Monitor weight ,urine output less than 30 ml ,baseline vital signs , fetal hr , minimal stimulation, edema , fluid intake and output

Calcium gluconate reverses magnesium sulfate
Blood pressure and seizure meds

51
Q

Treatment for perineal lacerations after delivery?

A

?
Assessed for normal healing and signs of complications

Cold packs before first 12 hours to reduce pain, bruising , edema

12-24 hours after- heat packs or sitz baths increase blood circulation for healing

Oral pain meds

52
Q

Developmental milestones

A

Birth -3 months - cooing and interacting

4-6 months- interests in sounds - balance self, sit up , tripid

7-8 months - waving / gestures , sit alone

9months - walk by a year, fear of strangers

53
Q

Probable signs of pregnancy ?

A

Goodelles sign, Chadwick’s sign , hegars sign, McDonald’s , abdominal enlargement , Braxton Hicks , ballotment , straie, positive pregnancy test

54
Q

Positive signs of pregnancy?

A

Audible fetal heartbeat
Fetal movement felt by examiner
Ultrasound visualization of fetus

Family Nursing (5 decks)

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