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N201 > Exam 9 > Flashcards

Exam 9 Flashcards

1
Q

Sinciput

A

fetal brow

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2
Q

Vertex

A

area btwn anterior & posterior fontanelles

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3
Q

Occiput

A

area beneath posterior fontanelle occupied by occipital bone

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4
Q

Mentum

A

fetal chin

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5
Q

4 bones of pelvis

A

2 innominate
1 sacrum
1 Coccyx

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6
Q

Supports weight of growing & directs presenting part into true pelvis

A

False Pelvis

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7
Q

Bregma

A

anterior fontanelle

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8
Q

Intersection btwn posterior cranial sutures

A

Posterior Fontanelle

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9
Q

relationship of fetal spine to the maternal spine

A

Lie

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10
Q

Attitude (Fetal orientation)

A

relationship of fetal parts to one another (flexion/extension)

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11
Q

fetal body part entering the pelvis 1st or lying over the inlet

A

Presentation (Fetal orientation)

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12
Q

Cephalic Presentation

A

fetal head first

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13
Q

Breech Presentation

A

fetal buttocks, feet or knees first

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14
Q

3 classifications of Breech Presentation

A

Complete
Frank
Footling

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15
Q

Shoulder Presentation

A

transverse lie

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16
Q

1+ presenting part

A

Compound presentation

Ex: head, hand and arm.

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17
Q

Rapid, slow or irregular FHT

A

Fetal hypoxia

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18
Q

Greenish-Brown amniotic fluid in for a check presentation

A

Fetal distress

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19
Q

Port-wine colored amniotic fluid/bleeding

A

placenta previa

Separation of the placenta; torn maternal tissue; DIC

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20
Q

Unengaged presenting part

A

Disproportion or malpresentation

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21
Q

Failure to progress in dilation

A

Prolonged labor w/ increased danger of perinatal loss

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22
Q

Failure of presenting part to descend after complete cervical dilation

A

Disproportion or Error in estimate dilation

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23
Q

Rising B/P

A

Preeclampsia

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24
Q

Low BP (significance)

A

Shock; postural hypotension; reaction to drugs

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25
Q

Significance of fever

A

Amnioitis; extrauterine infection

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26
Q

Significance of maternal tachycardia

A

Impending shock

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27
Q

Foul or Purulent vaginal discharge

A

Amnioitis (Eventual fetal infection)

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28
Q

Significance-abnormal abdominal pain/tenderness

A

Separation of placenta;
Rupture of uterus;
Abnormal condition not r/t pregnancy

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29
Q

Uterine tetany (significance)

A

Interuterine bleeding D/T premature separation of placenta, possible uterine rupture

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30
Q

Excessive C/O pain (significance)

A

Hysteria;
Undetected abnormality;
Reaction to medication;

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31
Q

Prolapsed cord (significance)

A

W/o instant intervention-perinatal death

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32
Q

Unconsciousness (significance)

A

Eclampsia
Shock
Hysteria
Sedation

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33
Q

Pallor, cool damp skin, air hunger

A

Bleeding; shock

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34
Q

Cyanosis (significance)

A

Aspiration of vomitus
Cardiac failure
Pulmonary embolism

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35
Q

Stage–>onset of labor to complete cervical dilation

A

First stage

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36
Q

Three phases of the first stage of labor

A

Latent
Active
Transition

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37
Q

Labor on set to 3 cm dilation

A

Latent phase (first stage)

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38
Q

4– 7 cm dilation

A

Active phase (first stage)

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39
Q

8–10 cm dilation

A

Transition (first stage)

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40
Q

Complete dilation to birth of baby

A

Second stage of labor

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41
Q

Birth to placental expulsion

A

Third stage

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42
Q

1–4 h after placental expulsion; uterus contracts to control bleeding

A

Fourth stage of labor (recovery)

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43
Q

Single most important factor influencing fetal well being

A

euglycemic status of mother

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44
Q

S&S of impending labor

A

Premonitory Signs

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45
Q

aka as engagement; fetus descends into pelvic inlet

A

Lightening

Subjective sensation

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46
Q

Weeks before delivery Lightening occurs in Primigravida

A

2-4 weeks before delivery

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47
Q

Lightening in Multigravida occurs

A

with onset of labor

48
Q

Support wait a growing uterus and directs presenting part into true promise

A

False pelvis

top of V

49
Q

There any limits of birth canal

A

True pelvis

50
Q

Point where baby interstate true pelvis

A

Inlet

51
Q

Female pelvis
Inlet is rounded
favorable for delivery
50%

A

Gynecoid pelvis

52
Q

Normal female pelvis

Usually OA

A

Gynecoid pelvis

53
Q

Male pelvis

A

Android pelvis

54
Q

Inlet heart-shaped
Head decent into pelvis slow
Arrest of labor frequent -> C/S

A

Android pelvis

55
Q

Android pelvis (head engages)

A

Head usually engages transverse or OP

56
Q

Favorable influence
labor inlet is oval
Abe like pelvis

A

Anthropoid pelvis

57
Q

Anterior fontanelle

A

Bregma

58
Q

Relationship of fetal parts to one another (flexion/extension of fetal head)

A

attitude

59
Q

Cephalic presentation

A

Fetal head first

60
Q

Shoulder presentation

A

Transverse lie

61
Q

You don’t hips are flexed, knees are extended; buttocks present. (Legs by ears)

A

Breech (frank) presentation

62
Q

HTN w/o Proteinuria after 20wks gest.

A

Gestational HTN

63
Q

HTN + Proteinuria post 20wks gest.

A

Preeclampsia

64
Q

0.3g+/24h protein excrete

A

proteinuria

65
Q

Mild pre-eclampsia

A

140/90+ +proteinuria

66
Q

Severe pre-eclampsia

A

160/110+

67
Q

160/110+ >15 MIN =

A

MEDICAL EMERG

68
Q

3+ proteinuria or 5+g/ 24h

A

Severe Preeclampsia

69
Q 
Oliguria <500cc/24h
Cerebral  visual disturbances 
Pulmonary edema/ cyanosis
RUQ/ Epigastric Pain
Impaired Liver Function 
Thrombocytopenia
IUGR
A

s/s of severe preeclampsia

70
Q

New-onset grand mal seizures in woman with pre-eclampsia

A

Eclampsia

71
Q

New onset/ sudden increase of proteinuria in a woman with HTN PRIOR to 20 wks best, sudden increase in HTN or HELLP syndrome

A

Superimposed preeclampsia

72
Q

Antihypertensive of choice in Pregnancy (Chronic HTN)

A

Aldomet

Methyldopa

73
Q

AntiHTN Meds Necessary if BP>

A

150-160/100-110

74
Q

HELLP

A

Hemolysis
Elevated Liver enzymes
Low Platelets

75
Q

Danger Signs

A

Clonus
HA
Vision Changes
RUQ Pain

76
Q

MgSulfate

A

Monitor BP
I&O
RR (CNS depressant)
Deep tendon reflexes

77
Q

MgSulfate Antidote

A

Ca+ Gluconate

Must Keep at Bedside

78
Q

Hour PP Risk for Seizures Continues

A

48h

Diuresis –>Decreased Risk

79
Q

Nursing Considerations Pre-eclampsia

A 
Close to RN Station
Dark, quite, low stimuli
Private
L side lying
Decrease Na+ Increase Protein
80
Q

relative position of fetal presenting part above or below an imaginary line drawn between maternal ischial spines

A

Station

81
Q

largest diameter of presenting part reaches or passes through pelvic inlet

A

Engagement

82
Q

Irregular contractions
Pain in fundus, lower abd, or groin (all up front)
Easily Sedated

A

False Labor

83
Q

Pain felt in back and radiates forward, Contractions become regular, Sedation is not effective

A

True Labor

84
Q

Only Definitive Way to Dx Labor

A

Vag Exam

Reassess 1h after admit

85
Q

During Stage 1 of Labor SBP

A

increases w/ contractions

86
Q

During Stage 2 of Labor (BP)

A

SBP& DBP increase w/ contractions, may stay SLIGHTLY elevated btwn

87
Q

During labor- GI motility, gastric emptying, blood glucose, and insulin requirements

A

decrease–> N/V (esp w/ transition)

88
Q

Increase during labor

A

O2 demand/ consumption –> increased RR; Immune response –> Increased WBC

89
Q

+GBS

A

PCN q4 x 2 doses

90
Q

Pattern and intensity directly effect labor length (wavelike)

A

uterine contractions

91
Q

Amniotic Fluid Characteristics

A

Clear
Alkaline
May have white flakes/ earthy odor

92
Q

Natrazine Test

A

pH
want blue/ purple (alkaline)
MUST be before bag. lube

93
Q

Green Natrazine Test

A

False Reading

94
Q

Negative Natrazine Test

A

Yellow

95
Q

Ferning

A

(ROM)Definitive

Sample placed on slide–> fern pattern

96
Q

Always first intervention after ROM

A

Immediately assess FHR

97
Q

ROM–> Temp

A 
q1-2h
before ROM (q2-4)
98
Q

Hours of labor vs cervical dilation

based on prime vs multi

A

Labor Curve

99
Q

Uterine Contractions MUST BE

A

validated by PALPATION
q15-30
note f,d,I, Tone

100
Q

1 stage assess FHR

A

q15-30 min

Continuous monitoring best

101
Q

2nd Stage Assess FHR

A

q5-15 mins

Continuous monitoring best

102
Q

BP, Pulse, RR

A

q1h (dictated by status/ meds/ induction)

103
Q

Low platelets

A

NO EPIDURAL

104
Q

Contraindications for Activity

A 
ROM w/o engagement
Faulty presentation/ fetal position
Complications of preg
Vaginal Bleeding
Active Labor
Meds
105
Q

Frequent voiding prevents

A

distended bladder–> slows fetal descent & increases discomfort w/ contractions

106
Q

Effleurage

A

counterclockwise
straight back
tactile stimulation/distraction
Helps w/ back ache

107
Q

Breathing to prevent pushing

A

Panting

108
Q

Ritgen’s Maneuver

A

push on rect. area –> lift fetal head (extend)

109
Q

Suction

A

mouth then nose before body delivered

110
Q

bladder fails to close properly during embryonic development –> fistula between the bladder and umbilicus

A

patent urachus

111
Q

Clinical Manifestations of patent urachus

A

Clear odorless fluid draining from base of the cord→ph test

112
Q

Exstrophy of the Bladder:

A

bladder on the o/s
asc. w/ multiple deformities
No tub baths

113
Q

IgG

A

Passive acquired immunity:
Transferred to fetus in utero
Fetus does NOT produce

114
Q

Protection of IgG

A

Active against bacterial toxins

115
Q

Acquisition IgM

A

Active immunity
Fetus is able to produce by 20wks gestation
Stimulated by infectious agents

116
Q

IgA

A

Does NOT cross placenta
Not produced by fetus
Protects respiratory, GI, eyes

117
Q

Passive immunity of the NB is gone by

A

3 mo of age

N201 (21 decks)

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