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Women's Health > Final > Flashcards

Final Flashcards

1
Q

Normal Fetal HR

A

110-160

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2
Q

Teratogens

A

TORCHZ

Toxoplasmosis
Other - glucose, dry cleaning fluid, pesticides
Rubella
Cytomeglovirus
Herpes
Zika

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3
Q

Presumptive Signs of Pregnancy

A

May mean pregnancy

Amenorrhea
Breast Tenderness
Fatigue
Potential spotting 6-10 days after ovulation

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4
Q

Probable Signs of Pregnancy

A

Objectively observed by examiner

Positive urine HCG
Chadwick’s – bluish color of vagina/cervix
Hegar’s Sign – softening of uterine walls/isthmus
Goodell’s Sign – softening of cervix

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5
Q

Positive Signs of Pregnancy

A

Can only mean fetus present

Palpate maternal pulse and then locate second (fetal) pulse

Visualize fetus on US

Palpate fetal movement

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6
Q

Maternal exam: Normal vs Abnormal Skin Findings

A

Normal - pink or tan; linea nigra, cholasma, striae, pruritc urticarial, papules, plaques of pregnancy (PUPS)

Abnormal - red, pale, grey, jaundice; bruising, MRSA,

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7
Q

Maternal Exam: Normal vs Abnormal Face

A

Abnormal - swelling

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8
Q

Maternal exam: Normal vs Abnormal Eyes

A

Normal - white sclera, normal dilation, PERRLA, EOM w/o nystagmus

Abnormal - yellow sclera, overdilation, pupil constriction, EOM w/ nystagmus

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9
Q

Maternal Exam: Normal vs Abnormal Mouth

A

Normal - tonsils 0 1 2, tonsils symmetric, no inflammation

Abnormal - lesions, HSV, HPV, tonsils 3 or 4, asymmetric tonsils, inflammed tonsils, dry mucus membranes

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10
Q

Maternal Exam: Normal vs Abnormal heart

A

Normal: systolic murmur, S3

Abnormal: diastolic murmur, S4

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11
Q

Maternal Exam: Normal vs Abnormal Lungs

A

Normal: 12-20 respirations

Abnormal: wheezes, crackles, stridor, frictionrub, tachypnea, bradypnea, decreased oxygenation

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12
Q

Neonate Exam: Normal vs Abnormal Posture

A

Normal - flexion
Abnormal - extension

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13
Q

Neonate Exam: Normal vs Abnormal Cry

A

Normal - lusty, vigorous
Abnormal - weak or absent

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14
Q

Neonate Exam: Normal vs Abnormal Skin

A

Normal - thick, peeling

Abnormal - clear, translucent, cracked, leathered

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15
Q

Neonate Exam: Normal vs Abnormal Lanugo

A

Normal - mostly or entirely bald

Abnormal - abundant, thinning

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16
Q

Neonate Exam: Skin

A

Normal - vernix, milia, mongolian spots, erythemia toxicum, telangietic nevi

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17
Q

Neonate Exam: Head

A

Normal - caput

Abnormal - cephalhematoma

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18
Q

Neonate Exam: fontanels

A

Normal - open, overriding, molding

Abnormal - fused, bulging (unless crying), depressed, sunken, fused

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19
Q

What are abnormal contraction rates?

A

Less than 3 minutes
Longer than 90 seconds or absent

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20
Q

Abnormal Fetal heart Tones

A

Absent - hypoxia, brain damage

Minimal - 1-5 beats longer than

20 minutes - hypoxia/asphyxia, acidosis, drugs

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21
Q

PROM

A

Spontaneous rupture of amniotic sac and leakage of fluid prior to onset of labor at any gestational age

Oxytocin may be given

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22
Q

APGAR

A

Scored 0 to 10, with 7 to 10 being okay/supportive care

Heart rate >100
Cry - should be vigorous
Tone - should be flexed
Reflex irritability
Color - should be acrocyanosis or pink
Respiratory effort

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23
Q

Why do we use the ballard exam?

A

Estimates gestational age/maturity

Can be used up to 4 days post birth

Assess physical and neuromuscular activity

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24
Q

Neonate Axillary Temp

A

97.8-99.5F

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25
Q

Neonate HR

A

110-160

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26
Q

Neonatal RR

A

30-60

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27
Q

Neonate O2 Sats

A

> = 95

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28
Q

What is the triad of doom? Give specific numbers

A

Respiratory distress (grunting, nasal flaring)
Hypoglycemia <45
Cold stress <97.8

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29
Q

How do we test for Rh incompatibility?

A

Indirect Coombs - detects antibodies in Mom against Rh - fetus

Direct Coombs - detects antibodies against Rh+, performed with PUBS

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30
Q

First Trimester Ultrasound

A

Ask mom to drink 3-4 glasses of water and to not urinate

of fetuses
presence of fetal cardiac movement/rhythm
uterine abnormalities
gestational age

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31
Q

Chorionic Villi Sampling

A

Performed at 10-12 weeks gestation

Evaluates DNA, bleeding, infection or miscarriage risk

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32
Q

Biochemical analysis

A

Tay Sachs

1st Trimester

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33
Q

Rh Incompatibility

A

AKA isoimmunization

When mom is Rh- and baby is Rh+, it has inherited this gene from the Dad, mom will create antibodies against the fetus, typically the first pregnancy is not affected, but antibodies grow with future pregnancies

If not treated, then fetus can become anemic or jaundiced with immature RBC production

No impact if mom is + and baby is -

Complication: Hydrops Fetalis

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34
Q

Non-Stress Test

A

Evaluates fetal oxygenation

Reactive=normal; 2 accels (15x15) in 10-20min

If nonreactive, then will need biophysical profile (in utero) and apgar (out of utero)

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35
Q

Early Decelerations: What are they? Interventions?

A

Before peak of contraction

Associated with head compression resulting in vagus stimulation and slowing of HR

NO interventions, baby is coming

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36
Q

Variable Decelerations: What are they? Interventions?

A

Resemble U, V, W

Associated with cord compression cutting O2 at random times

Nursing Interventions:
- change maternal position
- drink juice
- stop pitocin
- administer O2
- vaginal exam for cord prolapse
- Severe - amniocentesis

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37
Q

What are normal contraction rates?

A

Every 3-5 minutes
Last 45-90 seconds
Uterus is soft and relaxed between contractions

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38
Q

Variable Fetal Heart Tones

A

Normal is 6 to 25 beats
IF <5, fetus may be sleeping

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39
Q

VEAL CHOP

A

Variable Cord Compression
Early Head Compression
Accelerations OK
Late Placenta issue

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40
Q

Abortion: Types, S/Sx

A

Elective or spontaneous
No fetal viability before 20weeks

S/sx:

Uterine Cramping
Vaginal Bleeding - bright red
Pelvic Pressure
Backache

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41
Q

Ecotopic Pregnancy: What it is, S/Sx, Treatment

A

Fertilized ovum outside uterus in fallopian tube

S/Sx:
UNILATERAL, sharp abdominal pain
Normal pregnancy symptoms
positive pregnancy test

If suspected you can perform gentile uterine palpitation

Treatment:
NPO if surgery (sometimes sent home on methotrexate)
VS
Monitor for signs of bleeding, including Cullen Sign
Type and Crossmatch blood

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42
Q

Molar Pregnancy

A

Degenerative placenta, fertilized egg without embryo but incorrect chromosomes

Characterized by grape-like clusters

S/Sx:
Preeclampsia prior to 20 weeks
NO FHT or skeleton
hCG continues to rise when it should decline
Abnormal uterine bleeding
Uterus larger than dates
Anemia from blood loss
Excessive vomiting
Abdominal cramping

Treatment:
- Prep for D&C
- Monitor hCG levels for 1-year: monthly for first 6-months then every 2 months for 6-months
-No pregnancy for 12-months as pregnancy can mask symptoms of chorioncarcinoma
- Possible prophylactic chemo

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43
Q

Gestational Diabetes: What’s happening, risks?

A

Hormonal changes increase maternal insulin resistance to ensure baby has enough glucose

Insulin resistance due to placental hormones (insulinase and cortisol)

Moms are more prone to preeclampsia, hemorrhage, infection, hydroaminos and macofetus

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44
Q

Macroscopic Fetus

A

> 4000g

May cause prolonged 2nd labor stage, head injury or shoulder dystocia

If C-section, then baby may have respiratory distress due to absence of vaginal squeeze

Baby may experience hypoglycemia - if >5000g may last for 1 week

Very large babies need to be vented or receive supplemental O2

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45
Q

Respiratory Distress in GDM

A

Caused by decreased surfactant

Increased risk ventilation or supplemental oxygen

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46
Q

In GDM, what happens in 3rd stage of labor to mom?

A

Insulin requirements drop substantially in first 24-hours, recommended to discontinue long acting insulin before delivery.

Mom recommended to breast feed for better glucose control

Hospital Care:

5% glucose infusion
Monitor ketones
monitor hemorrhage

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47
Q

Neonatal Hyperproliferation of Pancreas

A

Enlarged pancreas due to high maternal glucose which causes increased insulin needs in fetus, but when umbilical cord is cut then no constant source of glucose but pancreas continues to put out high levels of insulin

Resolves in 4hrs, but if baby is >5000g then it can take a week

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48
Q

Fetal Lung Maturity

A

Based on LS - lecithin:sphingomyelin ratio

Accounts for AFV changes

Tested via amniocentesis before induction

Considered mature if ratio >2.2 or if PG (phosphatidyglycerol) is present in surfactant past 36 weeks

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49
Q

Preeclampsia: S/Sx, medication, complications

A

HTN after 20-weeks gestation with no history of HTN

S/Sx: (acronym = pre)

Proteinuria
Rise in BP (>140/90 on 2 occasions) or >160/90 on shorter occasions
Edema
Rapid weight gain >2lbs/week
Decrease UOP
Hyperrefelxia 2+ Clonus

Medication:

Labetaol
Hydrazine hydrochloride

Complications: eclapsia, HELLP syndrome, DIC

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50
Q

Eclampsia: S/Sx, treatment

A

Pregnancy HTN w/ seizures

S/Sx

Persistent headache, blurred vision, epigastric/RUQ pain, AMS, SEIZURE

Medication: MgSO4 before and 24-hours post if no signs of toxicity;

Treatment:
Side- lying position
oxygen

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51
Q

HELLP Syndrome

A

Life threatening complication of preeclampsia

S/Sx (HELLP)

Hemolysis
Elevated Liver enzymes
Low Platelet count
Malaise
epigastric/RUQ pain
N/V
Normotensive w/o proteinuria

Treatment: MgSO4

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52
Q

Signs of DIC

A

bleeding gums or nose
reduced lab values for platelets and prothrombin
Bleeding from IV sites
Ecchymosis

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53
Q

MgSO4 Toxicity

A

Therapeutic Range: 4-7 mg/dL
MgSO4 also hs increase risk of post partum hemorrhage has it relaxes muscles and uterus not able to contract

S/Sx:

ABSENT DTR
Decrease RR
Diaphoresis/flushing
Warmth
EKG Changes
Decreased UOP but increase in mag level

Antidote: calcium gluconate

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54
Q

Fetal Movement

A

Evaluate fetal oxygenation

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55
Q

Fetal Kick Counts

A

Fetal movement evaluates fetal oxygenation

Emergency: No kick counts of <10 in 12 hours

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56
Q

Contraction Stress Test

A

Evaluates fetal oxygenation and ability to tolerate contractions w/o placental insufficiency

negative contraction test is desired
positive indicates late DHR decelerations

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57
Q

Biophysical Profile

A

IN UTERO
Looks for signs of distress

Assessment of fetal well-being based on 5 factors

1) fetal breathing movement
2) Fetal movement
3) fetal tone
4) Reactivity of FHR/ reactive NST
5) AFV

Score of 2 or 0 can be assigned, fetal well-being 8-10 is healthy

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58
Q

Amniocentesis: What is it, when is it performed, what does it determine, complications

A

Performed at 20 weeks

Anatomy or DNA for high-risk moms (>35 or MSAFP elevated or decreased)

Determines:
karotype
biochemical analysis
AFV
Fetal lung maturity
Fetal well-being

Complications: infection, miscarriage, bleeding

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59
Q

Fetal heart Echo

A

Fetal heart sonogram for structural abnormalaties

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60
Q

STI

A

Mom has an infection and we can give antibiotics (bacterial)

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61
Q

STD

A

Mom has an infection and cannot clear it but can manage symptoms (viral)

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62
Q

Stage 1

A

Early/latent 0-5cm
Active 6-10cm with cervical dilation

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63
Q

Stage 2 labor

A

Pushing and birth of neonate
Ends with delivery of baby’s feet

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64
Q

Stage 3 Labor

A

Delivery of placenta
Must not exceed 20 minutes due to dilated uterine veins and increased hemorrhage risk

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65
Q

Stage 4 labor

A

Recovery
Lasts 2 hours after delivery of placenta - q15m for 1 hr, then q30min for 2 hours
Fundus should be firm and midline NOT soft, boggy or displaced

66
Q

Why can the placenta be retained? Interventions?

A

Break or tear in the placenta
Use of oxytocin before delivery of placenta

Treatment:
Inspect placenta for breaks
US
Manual removal – D&C or vaginal

67
Q

What is the position for pushing?

A

Lithotomy

68
Q

Normal Blood Loss: Natural vs C-Section

A

Natural 500mL
C-Section 1000mL

69
Q

Bishop Score: What is it?

A

Assesses cervix induciability
Scores range 0-13

Score > 8 indicates induction likely to be successful, and cervix is soft and anterior, 50% or more effaced, dilated 2cm or more, presenting part engaged

70
Q

Cervical Ripening

A

Prostaglandin Gel (E1 and E2)
Misoprostol/Cytotec
Foley bulb
Hydroscopic dilators - laminara

71
Q

Oxytocin: Use and Risk

A

Use:

  • Induce labor
  • Augment slow labor
  • Used after placenta is delivered to encourage uterus to contract, if given before delivery of placenta it can cause placenta to be retained

Risks -

Hemorrhage - made uterus work harder than it would have

72
Q

Amniotomy

A

Manual rupture of membranes
Used with oxytocin/pitocin to induce labor

Risk of prolapsed chord

73
Q

Operative Assistive Birth: Forceps: Maternal and Baby Risk

A

Maternal Risk: vaginal laceration, risk of pp hemorrhage

Baby Risk: Bruising

74
Q

Operative Assistive Birth: Vacuum Extraction - what is it, baby risk,

A

Used to get baby under pelvic bone

Baby - cephalohematoma or skull fracture, caput succedaneum due to vacuum cup

Can only be used 2 times/2 pop offs

75
Q

Duramorph

A

Used post c-section to manage pain
Long acting morphine (24hrs)
Nurses may forget it is on board and increased risk for respiratory depression

76
Q

C-Section

A

Birth through transabdominal incision

NO VBAC for classical c-section - look at operative report

77
Q

When do you not give tocolytics?

A

DO NOT GIVE if HR >110-130

78
Q

What medication provides cerebral neuroprotection?

A

MgSO4

79
Q

Fetal Fibronectin (fFN)Test

A

Predicts who will NOT go into preterm labor

Women with negative test have less than 1% chance of giving birth within 2-weeks

Tests fFN, a glycoprotein found in plasma during fetal life

80
Q

Preterm Birth: Cervical Length

A

Cervical length >30mm in 2nd and 3rd trimester unlikely to give birth prematurely

81
Q

Risk factors for preterm labor/birth

A

ART
Hx of previous preterm birth
smoking
cocaine
multifetal gestation
uterine anomoly

82
Q

PPROM

A

Membranes rupture BEFORE 37 weeks

Preceeded by infection - chorioamionitis

Tocolytic to stop labor, steroid to enhance fetal lung maturity and antibiotic will be given

83
Q

Chorioamnionitis: What is it? S/Sx? Treatment? Fetal Risks?

A

Bacterial Infection

S/Sx:
- Maternal fever
- Maternal/fetal tachycardia
- Foul odor in amniotic fluid

Treatment: amp/gent

Fetal Risks:

-meningitis
-PNA
-Bacteremia

84
Q

Postmaturity Syndrome

A

Decreased SC fat
Infant lacks lanugo/vernix
Dry, cracked and peeling skin
Meconium stained skin
Baby will have wasted appearance

85
Q

Hypotonic Uterine Dysfunction:

A

Occurs during active phase

Woman makes normal progress into active phase, then contractions are weak and inefficient or stop altogether

86
Q

Hypertonic Uterine Dysfunction

A

Occurs during latent phase of stage 1

Frequent contractions that are ineffective in causing cervical dilation or effacement

Mom needs rest

87
Q

Tocolytic Medications

A

Given to delay birth until transferred to facility where corticosteroids can be given to enhance fetal lung maturity

Magnsium Sulfate
Terbutaline
Nifedipine
Indomethacin

88
Q

Terbutaline Contraindications

A

Do not give if HR >110-130bpm or BP < 90/60

Assess for chest pain, MI, pulmonary edema

89
Q

Precipitous Delivery

A

Labor is less than 3 hours from start of contractions

Associated with increased hemorrhage risk

90
Q

First Degree laceration

A

involves epidermis

91
Q

Second Degree Laceration

A

Involves epidermis, dermis, muscle and fascia

92
Q

Third Degree Laceration

A

Extends into anal sphincter

93
Q

Fourth Degree Laceration

A

Extends up rectal mucosa

94
Q

Episiotomy Interventions

A

<24 hrs ice pack
>24 hours - warm sitz bath, epifoam, tuck

95
Q

Pudendal Block

A

Blocks vaginal pain, perineum pain

useful for vacuum, forceps, vaginal delivery w/ epiotomy

96
Q

Epidural Anesthesia

A

Blocks uterine pain

Usually IV/IM opioids

Contraindications - MRSA, spinal surgery, idiopathic, thrombocytopenia

97
Q

Epidural Interventions: Pre, During, Post

A

Pre - fluids to prevent hypotension

During - positioning, safety, monitoring HR

Post - SAFETY, bladder, bp monitoring, continuous fetal monitoring, perineal care

98
Q

Use of sedatives

A

Anxiety, induce sleep

99
Q

Fentanyl

A

Never give 1hr before delivery due to risk of neonatal respiratory depression, safety, and fetal monitoring

100
Q

Stadol and Nubain

A

NEVER give 1hr prior to delivery due to risk of neonatal respiratory depression, safety and fetal monitoring

101
Q

Primapara Labor and Delivery Length

A

14+ hours

Based on fetal position, size, and contractions

102
Q

Multipara Labor and Delivery

A

8+ hours

Based on fetal position, size, and contractions

103
Q

Placental Abruption: Patho, assessment, intervention

A

Placenta tears away from decidua causing mom to hemorrhage

Asssessment:
- New onset pain, despite epidural
- Bleeding
- Hard, firm abdomen

Intervention: stat c-section

104
Q

Placenta Previa: patho, assessment, intervention

A

Placenta implanted lower

Assessment:
- Vaginal bleeding, bright red
- No pain
- Soft uterus

Intervention: prep for c-section

105
Q

Prolapsed Umbilical Cord: patho, ews, intervention

A

Fetus in negative or high station
Fetus not vertex/cephalic
Membranes ruptured and cord delivers or proplapses and is compressed (no O2 or CO2 exchange)

EWS:
- Fetal heart tone
- Variable decel

Intervention:
- knee/chest
- Trendelenburg
- Stat c-section

106
Q

Shoulder Dystocia: Clinical Sign, Intervention, Maternal Risks, Fetal Risks

A

Turtle Sign - head is born, but anterior shoulder not able to pass under pubic arch

Intervention
- Stool
- McRobert’s posiiton
- Suprapubic pressure

Maternal Risks:
- PP hemorrhage
- Internal bleeding
- 4th degree laceration

Fetal Risks:
- Facial bruising
- broken clavicle
- Brain damage
- brachial plexus injury

107
Q

Amniotic Fluid Embolism: patho, assessment, interventions

A

Patho:

Amniotic fluid crosses into placental circulation then maternal circulation, passes through heart causing major asphyxiation
Assessment

VS
Lung sounds
Decreased LOC
Respiratory changes
Interventions:
- Code
- Start CPR
- Transfer to ICU
- C-Section if not delivered yet

108
Q

Postpartum Hemorrhage: What is it? Clinical Signs, Causes

A

Cumulative blood loss > 1000cc w/ in 24-hours of delivery

OR

Blood loss partnered with signs associated w/ hypovolemia 24hrs of delivery

Clinical Signs
- Soaked peripad in 15 minutes
- VS changes
- WIdening pulse pressure, increase HR, narrowed/decreasing bp, decrease O2 sats, pallor, then gray

Causes:

Tone
Trauma
Tissue
Thrombin

109
Q

Treatment for Uterine Tone/Atony Hemorrhage

A

Fundal massage
Oxytocin, cytotec, methergine, hemobate

110
Q

Treatment for Uterine Tissue Retained

A

Inspect placenta for breaks
US
D&C or vaginal removal

111
Q

S/Sx and Treatment for Uterine Trauma

A

S/Sx
- Inspect for lacerations, rupture, inversion, hematoma

Treatment: repair tissue, evacuate hematoma

112
Q

Who is at risk for PPHemorrhage?

A

Grand Multipara (>5 pregnancies past 20 weeks)

Twins/Triplets

Macrosomia >4000g

Uncontrolled diabetes

Polyhydroaminos

Fibroid uterus

Uterus worked too hard - labor >24 hours, oytocin, precipitous delivery

Sick uterus - HTN, MgSO4, chorioamnionitis

113
Q

Lochia Rubra

A

Dark Red
Should subside by day 5

114
Q

Lochia Serosa

A

Blood with serum
3-4 weeks

115
Q

Lochia Alba

A

White cells shedding with mucus

116
Q

Postpartum Depression: S/Sx, How is it assessed?

A

S/Sx:

withdrawn
appetite changes
anxiety
crying/sadness
fatigued
difficulty concentrating
less responsive
suicidal ideation

Measured with Edinburg scale

117
Q

How much Tylennol can you have in 24-hours?

A

4000 MAX

Anything over 3000 is unsafe

118
Q

Postparum Pain meds

A

Percocet - has Tylenol in it
Ibuprofen
Extra strength Tylenol
Toradol
Narcan

119
Q

Postpartum bowel drugs

A

Bisacodyl
Colace
Percocet
Peri-colace
Simethicone/mylicon

120
Q

Why is simethicone/mylicon given to c-section patients?

A

Eliminates trapped gas

121
Q

Why do we prescribe progesterone only pills post c-section?

A

Estrogen decreases breast milk

Micronor
Depo

122
Q

Why do we want patients to wait 3-weeks before progesterone only pills?

A

Establish max breast milk

Clotting risk returns to normal

123
Q

Rhogham

A

Given if mom is Rh negative and baby is Rh positive

Must be given within 72 hours of delivery

Prevents Rh isoimmunization

124
Q

Rubella Vaccine

A

Given post partum since it is a live vaccine

Avoid pregnancy for 1 month due to teratogenic effect

Protects future pregnancies

125
Q

Dtap

A

whooping cough prevention

126
Q

Neonatal Abstinence Syndrome: What is it? Substances that put baby at risk?

A

Infant born with dependence on alcohol or drugs due to maternal use/abuse

Substances:

Pot, cocaine, crack, heroine, lortab, xanax, percocet, methadone, subutex, ocycodone, alcohol

Systems -

127
Q

Neonatal S/Sx of withdrawal

A

Hyperactivity
Shrill cry
Tremors, seizures
Sneezing, yawning
Disturbed sleep
Drooling, poor sucking
Tachypnea
Poor feeding
nasal congestion
vomitng
diarrhea
sweating
mottling

128
Q

How do we care for babies with NAS?

A

Cluster care - feed, medicate, diaper, console and let them rest

Provide for uninterrupted sleep

129
Q

Ductus Venous

A

Vein to vein
Last to close - benign - creates 2 lobes of the liver

130
Q

Foramen Ovale

A

First to close during first minute of life

131
Q

Ductus arterosis

A

artery to artery
Must close within 24-48 hrs or may cause irreversible heart and lung damage

132
Q

Fetal Circulation in-utero

A

ductus venous
shunt
right atrium
shunt
formamen ovale
shunt
ductus arteriosis
shunt

133
Q

Surfactant Administration

A

Administered via ET tube as adjunt to O2 and vent therapy to prevent and treat RDS in premature infants

134
Q

Prevention of RDS

A

Surfactant provided at birth to infants with clinical manifestations of surfactant deficiency or with birth weight <1250g

135
Q

Treatment of RDS

A

Surfactant administered to infants with confirmed diagnosis of RDS w/ in 8-hours of birth

Monitor for signs of diuresis as this can signal improvement

136
Q

Adverse Effects of Surfactant

A

Respiratory distress immediately administration, bradycardia and O2 desaturation

137
Q

What is conduction?

A

Placed on cold surface

Always put blanket on scale before placing baby

138
Q

What is evaporation?

A

Baby is wet after delivery and water cools baby quickly, dry baby off immediately

139
Q

What is convection?

A

Baby is under ac vent or fan, do not place warmer near fan or ac vent

140
Q

What is radiation?

A

Baby placed near cold surface, baby is warmer than bed so bed will warm and baby will cool

141
Q

Infant ABC

A

Airway - nasal breathers; suction mouth then nose
Breathing
Circulation

142
Q

How many wet diapers?

A

Voids within 4-6 hours of birth, then should use 1 diapers for each day of life until day 6 when they should produce 6-8 wet diapers

Initial voiding may have brick-red dust

143
Q

When do we screen for PKU?

A

24-hours after breast milk or formula ingestion

144
Q

Stool Progression

A

Meconium - black, tarry, sticky

Transitional (yellow-green)

Milk stool - yellow

145
Q

Vit K

A

Prevents hemorrhagic disorder in newborn

NB not born with sterile gut, no enteric bacteria to create vit K

Given IM 1st hour after birth in vastus lateralis

146
Q

Conjugated vs unconjugated bilirubin

A

Unconjugated bilirubin bound to albumin and requires an accelerator to be rid of

Body can excrete conjugated

147
Q

Kernicterus

A

Permanent brain damage from sustained bilirubin > 21mg/dL

Bilirubin moves from blood into brain tissue

148
Q

Normal Serum Glucose Neonate

A

40-80

149
Q

Erythromycin

A

Prevents opthlmalia neonatorum and chlamydia conjunctivitis

Thin layer of ointment along lower lid in conjunctival sac
Only one tube per baby

150
Q

Meconium Aspiration Syndrome

A

Meconium passed into amniotic fluid, hypoxia results and causes chemical pneumonitis if not relieved right away

Risk Factors: IUGR, post-term neonate, fetal distress

Treatment: suction after head delivered, O2 and vent, pulm hygiene, antibiotics, bicarbonate

151
Q

Necrotizing Enterocolitis

A

Vascular ischemia affecting GI mucosa due to perforation
Appears after initial feeding

S/Sx: abdominal distention, pallor, poor feeding, gastric residual 2ml, + guaiac test, increased apnea

Treatment:

NPO w/ NG suction on low, intermittent
Monitor dehydration
abx therapy

Risk Factors:

Asphyxia, RDS, polycthemia, umblical catheter

152
Q

Group B Strep

A

Causes generalized sepsis, septic shock

153
Q

Who is a candidate for estrogen/progesterone therapy?

A

No history of breast cancer b/c estrogen causes most cancers to grow

NO blood clots

NO liver problems

No migratine headaches with auras

No heart disease

Postpartum and within 3 weeks of delivery

No breastfeeding

154
Q

BRAIDED

A

Used for contraception

Benefits
Risks
Alternatives
Inquiries
Decisions
Explanations
Documentation

155
Q

ACHES

A

Warning signs to teach women taking COCs (combined oral contraceptives)

Abdominal pain
Chest Pain
Headaches
Eye problems
Severe leg pain

156
Q

A woman who has a seizure disorder and takes barbiturates and phenytoin sodium daily asks the nurse about the pill as a contraceptive choice. What is the nurses best response?

A

“Your current medications will reduce the effectiveness of the pill.”

157
Q

When does emergency contraception need to be taken to be effective?

A

Within 72 hours of unprotected sex

158
Q

An unmarried young woman describes her sex life as “active” and involving “many” partners. She wants a contraceptive method that is reliable and does not interfere with sex. She requests an intrauterine device (IUD). Which information is most important for the nurse to share?

A

“The risk of pelvic inflammatory disease is higher with the IUDs and multiple partners”

159
Q

A woman will be taking oral contraceptives using a 28-day pack. What advice should the nurse provide to protect this client from an unintended pregnancy?

A

Take one pill at the same time every day.

160
Q

Candidate for oral or injectable progesterone?

A

Almost everyone except patients with breast, cervical or endometrial cancer and liver disease

161
Q

Progesterone IUD

A

Progesterone delivered 24hrs day
Very reliable b/c progesterone is high during luteal phase preventing luteal bed from growing so creates negative feedback when given during follicular phase

Also decreases cervical mucous which decreases sperms ability to travel to fallopian tubes

Contraindications:

Postabortion or partum
gonorrhea
Chlamydia
pelvic TB
unexplained vaginal bleeding

162
Q

Copper T IUD

A

Non hormonal
Prevents endometrial bed from maturing, damages cervical mucus

Women's Health (6 decks)

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