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Maternity > Exam 2 Tutor > Flashcards

Exam 2 Tutor Flashcards

1
Q

when to feel Braxtonhicks

A

4th month

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2
Q

are Braxton hicks true labor

A

no

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3
Q

lightening time frame

A

38-40 weeks

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4
Q

what is lightning

A

baby drops

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5
Q

lightening is sooner in

A

primip

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6
Q

hegar sign

A

softening of the lower uterine segment

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7
Q

ballotment time

A

16-18 weeks

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8
Q

quickening

A

first regongitoon of fetal movement
- first kick

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9
Q

gooodeell sign

A

softening of the cervix

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10
Q

friability

A

tissue is easily damage

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11
Q

operculum

A

mucus plug

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12
Q

Chadwick sign

A

violet blue color of vaginal mucosa and cervix

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13
Q

striae gradidaram

A

remain after preg
- stretch marks

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14
Q

presumptive

A

subjective, changes experienced by the woman

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15
Q

Presumptive: ex

A

amenorrhea, fatigue, breast changes

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16
Q

probable

A

objective, changes observed/perceived by examiner & strongly suggest pregnancy

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17
Q

probable ex

A

Hegar sign, ballottement, pregnancy tests

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18
Q

positive

A

objective, changes observed/perceived by examiner indicate proof of pregnancy

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19
Q

positive ex

A

fetal heart tones, ultrasound!!!!

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20
Q

Naegele’s rule to calculate EDB

A

Assumes woman has a 28 day cycle and that fertilization occurs on the 14th day

After determining the first day of the LMP, subtract 3 calendar months and add 7 days

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21
Q

Chorioamnionitis
s/s

A

Maternal fever, foul/purulent amniotic odor, tachycardia (mom and fetus), uterine tenderness,

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22
Q

Chorioamnionitis risk for mom

A

sepsis

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23
Q

Chorioamnionitis risk for baby

A

RDS, meningitis, CP, pneumonia, sepsis

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24
Q

Chorioamnionitis risk factor

A

ruptured logner than 18 hr

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25
Q

infant of DM at risk for

A

hypogly
RDS - decreased surfactant production

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26
Q

what crosses the placenta

A

glucose

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27
Q

when to feed baby

A

first hour before drowsy

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28
Q

preeclampsia

A

HTN/proteinuria develops after 20 weeks in normotensive woman
Can also develop for first time in PP
In absence of proteinuria, preeclampsia may be defined as HTN along with:
Thrombocytopenia
Impaired liver function
New onset renal insufficiency
Pulmonary edema
New onset cerebral or visual disturbances

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29
Q

mag antidone

A

calcium gluc

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30
Q

s/s of mag tox

A

loss of DTR
resp depression

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31
Q

normal mag s/s

A

burning at IV
flushed
decrease DTR

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32
Q

preterm mag why given

A

neural and tocolytic

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33
Q

preeclampsia why give mag

A

anti seizure

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34
Q

when can preeclampsia be diagnosed

A

after 20

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35
Q

if a woman has preeclampsia and then seizes that is it

A

eclampsia

36
Q

what is tested in BPP

A

Amniotic fluid volume
Fetal tone
Fetal HR

37
Q

what is a good score for BPP

A

8 is great

38
Q

t/f always report any bleeding in pregnancy as well as decreased fetal movement

A

true

39
Q

placental preva s/s

A

painless
bright red bleeding
soft relaxed contender uterus with normal tone

40
Q

can previa do vag birth or vag exams or internal monitoring

A

no

41
Q

abruption s/s

A

bleeding
pain
uterine tenderness
contractions
board line abdomen

42
Q

how to differentiate previa and abruption

A

type of bleeding
uterine tonicity
presence or absence of pain

43
Q

tx for cervical insuff

A

cerclage

44
Q

cervial insuff

A

cervical change before ready with no contraction

45
Q

cerclage

A

suture is placed around the cervix beneath the mucosa to constrict the internal os of cervix (McDonald technique)

46
Q

DM rx factor

A

Family history of diabetes
Previous pregnancy that resulted in an unexplained stillbirth or the birth of a malformed or macrosomic fetus
Obesity, hypertension, glycosuria, and maternal age >25 years
BUT…more than half of women with GDM have none of these risk factors

47
Q

when is GDM diagnosed

A

2nd half of preg

48
Q

fFN

A

who should not go into labor
- neg: good! No labor soon
- pos: not good, labor soon

49
Q

FFN what type of predictive value

A

negative

50
Q

what do we see with s dystocia

A

turtle sign

51
Q

who has an increase risk for dystocia

A

DM due to macrosomia

52
Q

what do we due to s dystocia

A

suprapubic pressure
mcroberts

53
Q

what to do if cord prolapse

A

position change, take pressure off of cord, prepare for c-section

54
Q

early PPH

A

atony

55
Q

late PPH

A

sub involution

56
Q

induction

A

before

57
Q

augmentation

A

after labor started

58
Q

5 stages of grief

A

Denial
Anger
Bargaining
Depression
Acceptance

59
Q

The nurse is developing a plan of care for a woman who is pregnant with twins. The nurse includes interventions focusing on which of the following because of the woman’s increased risk?

A) Oligohydramnios
B) Preeclampsia
C) Post-term labor
D) Chorioamnionitis

A

preeclam
- Women with multiple gestations are at high risk for preeclampsia, preterm labor, hydramnios, hyperemesis gravidarum, anemia, and antepartal hemorrhage. There is no association between multiple gestations and the development of chorioamnionitis.

60
Q

tobacco

A

growth restriction

61
Q

cocaine/amp

A

placental abruption

62
Q

alcohol

A

cognitive impairment

63
Q

caffine

A

now BW

64
Q

hypospadias

A

ventral

65
Q

epispadias

A

dorsal

66
Q

t/f vernix has benefits for preterm infant skin

A

yes

67
Q

mag

A

Magnesium sulfate- given in severe preeclampsia but not necessarily for BP, instead for neuroprotection (preventing seizures). Can also prolong pregnancy short term
Normal effects- flushed, warm feeling, burning at IV site
Abnormal effects (possible mag toxicity, give calcium gluconate as antidote)- resp depression, hypotension, absence of DTRs.
Calcium gluconate- antidote for mag sulfate- adverse effects include bradycardia, arrhythmias and cardiac arrest

68
Q

labetalol

A

beta blocker to decrease BP

69
Q

hydralazine

A

IV only. vasodilator. Monitor FHT, mom in left lateral position

70
Q

Procardia / nifedipine

A

calcium channel blocker to decrease contractions, also helps hypertension

71
Q

tocolytic

A

drugs that inhibit contractions. May be used in preterm labor

72
Q

tocolytic drugs

A

terbutaline/brethine
mag
Procardia

73
Q

terbutaline/brethine

A

relaxes uterus, given subcutaneously, only used before 37 weeks but usually stopped by 34 weeks due to adverse effects

74
Q

mag tocolytic

A

relaxes muscles including the uterus

75
Q

Procardia toco

A

calcium channel blocker to decrease contractions, also treats hypertension

76
Q

Betamethasone/Dexamethasone-

A

given for baby’s benefit, not moms. If a mom is in preterm labor and delivery is inevitable, the steroid is given to increase the production of surfactant which therefore helps their respiratory system develop before birth.

77
Q

Betamethasone/Dexamethasone- dose

A

12 mg every 24 hours for 2 doses IM

78
Q

Betamethasone/Dexamethasone use up till

A

only if mom is 23/24 weeks and risk for delivery within 7 days use up to 34 days

79
Q

Cervidil/ Dinoprostone

A

prostaglandin, ripens the cervix for labor. Risk for uterine tachysystole (inserted)

80
Q

Cytotec/ Misoprostol,

A

prostaglandin, ripens the cervix for labor. Risk for uterine tachysystole (oral)

81
Q

Oxytocin/ Pitocin

A

induces or augments labor. Side effect is uterine tachysystole, aka over 5 contractions within 10 minutes, averaged over a 30 minute period. Also helps control bleeding postpartum

82
Q

Hemabate/ carboprost

A

useful when hemorrhage is from uterine atony that isn’t resolving from fundal massage and oxytocin. Contraindicated with asthma.

83
Q

Methergine

A

useful for uterine atony and subinvolution. Contraindicated with hypertension

84
Q

meds for PPH

A

cytotec
hemabate
methergine
pit

85
Q

newborn meds

A

Erythromycin- ointment for eyes to prevent ophthalmia neonatorum and prevent blindness. Should be administered within one hour of birth. 1cm of ointment instilled into each lower conjunctival sac, do not wipe away.
Vitamin K- IM in vastus lateralis, prevents hemorrhagic disease due to low vitamin K (sterile GI system). Should be administered within 2 hours.
Hep B- IM in vastus lateralis, delay if baby has a suspected infection (including GBS). Should be administered within 12 hours. If mom is HepB+, baby also gets HBIG
Sucrose- procedural pain, stimulates opioid receptors for pain relief
Narcan- can help with effects of opioids given pre birth, contraindicated if mom is opioid dependent

86
Q

Rhogam

A

Rh neg mother with Rh pos baby, IM injection, includes blood products, protects future pregnancies. + Coombs test means that antibodies are present.

87
Q
A

Maternity (15 decks)

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