Exam 2 Tutor Flashcards
1
Q
when to feel Braxtonhicks
A
4th month
2
Q
are Braxton hicks true labor
A
no
3
Q
lightening time frame
A
38-40 weeks
4
Q
what is lightning
A
baby drops
5
Q
lightening is sooner in
A
primip
6
Q
hegar sign
A
softening of the lower uterine segment
7
Q
ballotment time
A
16-18 weeks
8
Q
quickening
A
first regongitoon of fetal movement
- first kick
9
Q
gooodeell sign
A
softening of the cervix
10
Q
friability
A
tissue is easily damage
11
Q
operculum
A
mucus plug
12
Q
Chadwick sign
A
violet blue color of vaginal mucosa and cervix
13
Q
striae gradidaram
A
remain after preg
- stretch marks
14
Q
presumptive
A
subjective, changes experienced by the woman
15
Q
Presumptive: ex
A
amenorrhea, fatigue, breast changes
16
Q
probable
A
objective, changes observed/perceived by examiner & strongly suggest pregnancy
17
Q
probable ex
A
Hegar sign, ballottement, pregnancy tests
18
Q
positive
A
objective, changes observed/perceived by examiner indicate proof of pregnancy
19
Q
positive ex
A
fetal heart tones, ultrasound!!!!
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
21
Q
Chorioamnionitis
s/s
A
Maternal fever, foul/purulent amniotic odor, tachycardia (mom and fetus), uterine tenderness,
22
Q
Chorioamnionitis risk for mom
A
sepsis
23
Q
Chorioamnionitis risk for baby
A
RDS, meningitis, CP, pneumonia, sepsis
24
Q
Chorioamnionitis risk factor
A
ruptured logner than 18 hr
25
infant of DM at risk for
hypogly
RDS - decreased surfactant production
26
what crosses the placenta
glucose
27
when to feed baby
first hour before drowsy
28
preeclampsia
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
29
mag antidone
calcium gluc
30
s/s of mag tox
loss of DTR
resp depression
31
normal mag s/s
burning at IV
flushed
decrease DTR
32
preterm mag why given
neural and tocolytic
33
preeclampsia why give mag
anti seizure
34
when can preeclampsia be diagnosed
after 20
35
if a woman has preeclampsia and then seizes that is it
eclampsia
36
what is tested in BPP
Amniotic fluid volume
Fetal tone
Fetal HR
37
what is a good score for BPP
8 is great
38
t/f always report any bleeding in pregnancy as well as decreased fetal movement
true
39
placental preva s/s
painless
bright red bleeding
soft relaxed contender uterus with normal tone
40
can previa do vag birth or vag exams or internal monitoring
no
41
abruption s/s
bleeding
pain
uterine tenderness
contractions
board line abdomen
42
how to differentiate previa and abruption
type of bleeding
uterine tonicity
presence or absence of pain
43
tx for cervical insuff
cerclage
44
cervial insuff
cervical change before ready with no contraction
45
cerclage
suture is placed around the cervix beneath the mucosa to constrict the internal os of cervix (McDonald technique)
46
DM rx factor
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
when is GDM diagnosed
2nd half of preg
48
fFN
who should not go into labor
- neg: good! No labor soon
- pos: not good, labor soon
49
FFN what type of predictive value
negative
50
what do we see with s dystocia
turtle sign
51
who has an increase risk for dystocia
DM due to macrosomia
52
what do we due to s dystocia
suprapubic pressure
mcroberts
53
what to do if cord prolapse
position change, take pressure off of cord, prepare for c-section
54
early PPH
atony
55
late PPH
sub involution
56
induction
before
57
augmentation
after labor started
58
5 stages of grief
Denial
Anger
Bargaining
Depression
Acceptance
59
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
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
tobacco
growth restriction
61
cocaine/amp
placental abruption
62
alcohol
cognitive impairment
63
caffine
now BW
64
hypospadias
ventral
65
epispadias
dorsal
66
t/f vernix has benefits for preterm infant skin
yes
67
mag
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
labetalol
beta blocker to decrease BP
69
hydralazine
IV only. vasodilator. Monitor FHT, mom in left lateral position
70
Procardia / nifedipine
calcium channel blocker to decrease contractions, also helps hypertension
71
tocolytic
drugs that inhibit contractions. May be used in preterm labor
72
tocolytic drugs
terbutaline/brethine
mag
Procardia
73
terbutaline/brethine
relaxes uterus, given subcutaneously, only used before 37 weeks but usually stopped by 34 weeks due to adverse effects
74
mag tocolytic
relaxes muscles including the uterus
75
Procardia toco
calcium channel blocker to decrease contractions, also treats hypertension
76
Betamethasone/Dexamethasone-
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
Betamethasone/Dexamethasone- dose
12 mg every 24 hours for 2 doses IM
78
Betamethasone/Dexamethasone use up till
only if mom is 23/24 weeks and risk for delivery within 7 days use up to 34 days
79
Cervidil/ Dinoprostone
prostaglandin, ripens the cervix for labor. Risk for uterine tachysystole (inserted)
80
Cytotec/ Misoprostol,
prostaglandin, ripens the cervix for labor. Risk for uterine tachysystole (oral)
81
Oxytocin/ Pitocin
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
Hemabate/ carboprost
useful when hemorrhage is from uterine atony that isn’t resolving from fundal massage and oxytocin. Contraindicated with asthma.
83
Methergine
useful for uterine atony and subinvolution. Contraindicated with hypertension
84
meds for PPH
cytotec
hemabate
methergine
pit
85
newborn meds
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
Rhogam
Rh neg mother with Rh pos baby, IM injection, includes blood products, protects future pregnancies. + Coombs test means that antibodies are present.
87
