Final Exam Flashcards by Alice Camp

When do we give betamethasone?

between 23-34 weeks

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Review fetal heart rate monitoring- be able to answer questions like you would have on exam one

know the strips -there are 2 with strips, many with verbage..know the lingo
ealy decels mirror-head compression - check cervix
late decels
veal chop
acceleration should be 15x15
uncoil

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What do you think about when a fundal height is above the umbilicus and deviated to the right during the postpartum period?

distended bladder

use the bedpan over cathing

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and what we would do for decreasing hgb/hct levels.

if below 10 give iron

below 7 give transfusion will need an order and a type and cross and a large bore IV

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What are good techniques for breastfeeding mothers?

Lips flanged areola inside
should not be noisy
know the holds
detach properly
observe for feeding cues 2-3 hours
use lanolin, air dry

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Describe risk factors for cesarean sections.

HIV above 1000
platepoid shape
macrosomia
HSV with lesions or prodromal s/s

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What are some nursing interventions related to epidural placement?

platelets over 100,000
fall and safety
give IV fluids before to prevent hypotension
avoid areas of skin infection

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Review the 1 hour and 3 hour gtt.

1 hour - not fasting-50 mg - 140
3 hr -fasting no smoking for 12 hours- 100 mg- 2 high ##s
If there is an elevated A1c you do not have to test glu
leads to CV and CNS baby will need fetal echo
8 or highr on the A1c

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Review maternal/fetal circulation.

maternal arteries to placenta to umbilical vein

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What are interventions for severe vaginal pain post birth?

first assess the area, do what you can do before you call the HCP

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Know the PPH medications and contraindications

oxytocin first line therapy no contraindications
cytotec -
methergine - give for hypertension
heabate -

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What do we know about pre-eclampsia r/t CNS overload?

***use seizure precautions
minimize stimuli
hyperreflexia - clonus

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***What is the difference between hypertonic and hypotonic uterine dysfunction?

give rest - therapeutic rest, can give meds

contractions -describe them -

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Discuss interventions for hypoglycemia in the newborn.

<40
tremors
irritability
rooting reflex

> 40 nurse first then move up the line
reassess the glucose level

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Know about fundal heights, how to measure, what they mean

measure from the pubic synthesis
+/- 1 cm per gestational week until lightening
starts at 36 weeks

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Know normal maternal serum glucose levels during the intrapartum period

90-110
interventions are
too high start an insulin drip
too low give D5

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Consider interventions for fetal demise.

allow mom to see baby if she requests
make a memory box
use therapeutic communication
give them choices
guide them into options
**Hutti  - grief association

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What meds do we give to newborns? Why?

vitamin K

erythromycin to prevent blindness

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What are the symptoms and risk factors for endometritis?

*** painful utters
fever chills
smelly profuse lochia
risk factors ---
C-section
chorioamnionitis from prolong membrane rupture or 
ascending vag infection

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Review the techniques that nurses can use to support maternal/infant bonding.

claiming
enfacement
etc.

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Review the postpartum labsPunnett squares

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When do you consider IV antihypertensive for pre-e?

> =160/110

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What do Bishop Scores mean?

likelihood of an induction to be successful

higher is better

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Review Hutti’s research on Perinatal loss

SATA look at Hutti research

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What is the most common cause of pph? What are the interventions

fundal message

How can nurses care for bereaving families?

What is GBS? What is the treatment?

perinatal infection, abx

Our fave, GTPAL

one question

When do we avoid epidurals

platelets less than 100,000 | HELPP syndrome

What are some ways that we can speed up the second stage of labor?

intercourse, nipple stimulation peanut ball strip membranes ambulation

What are concerns of post dates gestation?

placental calcification meconium aspiration nursing priority - meconium staining -get the NICU shoulder dystocia skeletal structure can be harder, harder delivery not as pliable and flexible

Review diagnostic criteria for postpartum mental health disorders

``` look at slide dx criteria for postpartum lack of sleep loss of joy isolation etc. ```

Discuss weight gain criteria for pregnancy

know wt gain per pre-pregnancy weight | BMI provided

Know normal lab values during labor

platelets nitrates in urine Hct/hgb wbc are normally a little high

Discuss the Lactational Amenorrhea Method

breastfeed q 2-3 hours, up to 6 hours at night | 1-2% failure rate

Premature rupture of membranes – what are important concepts

``` infection risk go to hospital monitor FHR check for cord prolapse localized abd tenderness ```

Discuss the important aspects of magnesium sulfate for preterm labor

neuro protection for the babies brain | therapeutic if contractions slow down contractions

What are the female factors of infertility?

``` PCOS turners syndrome endometriosis anovulation anxiety or depression SATA ```

What is goal of magnesium sulfate in pre-e patient?

prevent seizures

Review NAS- symptoms and interventions

``` cry yawning poor feeding tremors increased muscle tone gi problems breathing problems sweating fever mottling ```

Priority interventions for absent fetal movement.

they must be on continuous fetal monitoring

What are some things that you think about with absent or limited prenatal care.

Considerations with epidural

``` lower extremities weakness hypotension infection at site retained placental fragments baby is sleepy ```

What is the CURE for pre-e? What do you have to consider?

delivery, as close to term as possible without causing more harm

Know normal newborn vital signs

Know normal ranges for newborn glucose

What is the best way to prevent hypothermia in newborn?

kangaroo care

When thinking about infant with meconium-stained fluid, what are some priorities?

Call the NICU - respiratory issues- need deep suction

Methotrexate for ectopic pregnancy – important client education.

needs to be done prior to rupture | they need to be seen if they have sever abd pain could still rupture

Review med math

4 questions

Prevalence of STI in United States

HPV ##1 chlamydia gonorrhea

When is oxytocin indicated?

induction or augmentation of labor

What is considered apnea in a newborn?

not breathing for more than 20 seconds | see this baby first

Male infertility- be able to categorize risk factors again.

look at the slides again count vs quality | there are 2 questions on the exam

What does TORCH stand for? Know about these infections

most dangerous if mom gets iit in first trimester 3 TORCH questions on the exam primary infection during preg is a risk factor to baby both herpes are a risk for baby

Rubella titers- what do they mean? What is normal?

rubella titers are checked for antibodies

What does a corrected age of a neonate mean?

these babies do not meet developmental milestones from birthdate

Know normal bili levels (remember the curve I showed you)

around 48 hours plateaus at 7 is normal

Know about the following tests: GBS, MSAFP, Level 3 ultrasound, 1 hour gtt

matching question, know when they get them

Know the follow up diagnostic tests for abnormal screening tests.

amniocentesis and ultrasound

What are some risks to a baby born to an mom with IDDM?

hypoglycemia at birth, macrosomia, birth defects memorize the slide risk for

What is priority for a pregnant patient having a seizure?

change position of patient, wedge under right side | uncoil

What are objective findings of a woman who is experiencing hemorrhagic shock?

hypotension, tachycardia, decreased urine output less than 30 ml, tachypnea,

Heat loss in newborns- memorize what it is and examples of all four

radiation convection evaporation conduction

What are risk factors for shoulder dystocia? What are interventions that should be done for shoulder dystocia?

flat on back, knee up

Know how to categorize fetal heart rate tracing

1 2 or 3 level

Know positions of the fetus and where you would listen to heart tones.

LOA ROA etc | where would you look for heart rate

What do you know about progesterone levels and ovulation?

elevated days in late cycle

List the risk factors for preterm delivery

``` infection prev hx of prom poly multiples uti amniocenteses previa abruptio trauma cervical insufficiency hx of leep maternal abnormalities reduced platelets ```

What is the process for administrations of Rhogam?

give to Rh negative patients at 28 weeks then again afterbirth before 72 hours

What are risk factors for hyperbilirubinemia?

hematomas

Think about newborns with jaundice who are on a bili blanket, what are some interventions?

Which STD’s require cesarean section? What are some important aspects to know about STD’s and delivery?

HIV over 100,000 | HSV outbreak or prodromal symptoms

What are the risk factors for PPH?

punnet squares

there are two

Know prenatal tests and when they are done

GBS | Fetal Surveillance

know bottle feeding

sholud take about 15 to 30 ml of formula and fed on demand, no longer than 4 hour between feedings, wake to feed for first few weeks