Final Exam Flashcards by Rachel P

Maternity practice- what is this?

Focuses on a high-quality family experience. We’re childbearing is seen as a normal and healthy event

Parents are prepared for the changes that take place during pregnancy, labor, and delivery.

They also prepare for changes in family dynamics after the birth

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Calcium how to obtain in a diet?

Increase by 50% when pregnant

DRI is 1200mg

Supplements should be taken for women who don’t drink milk or are under 25 years old because bone density is not complete

Take separately from iron supplements for better absorption. Take with vit D

Calcium sources: cereals, legumes, nuts, dried fruits, broccoli, green leafy veggies, canned salmon, sardines with bones

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Presumptive, probable, positive

Signs of pregnancy?

Presumptive- amenorrhea (no period), nausea, breast tenderness, deepening pigmentation, urinary frequency, quickening

Probable- goodells sign, chadwicks sign, hegars sign, McDonald’s sign,abdominal enlargement, Braxton’s Hicks contractions, ballottement , striae, positive pregnancy test

Positive - fetal heartbeat, fetal movement felt by examiner, ultrasound visualization of fetus

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Exercise during pregnancy- goal?

Goal should be maintaining fitness not improvement or weight loss

Mild to moderate exercise during pregnancy is beneficial during pregnancy but extreme exercise should be avoided such as hot yoga weight loss, weight lifting, elevated temp

Good for heart, bones, muscles, joints, overall well-being, circulation

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What influences of labor pains

Contractions of the muscles of the uterus

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Prenatal vitamins

Folic acid -.4mg/day 
Protein - 60 g/day
Calcium -1200mg
Iron-16 mg 
Fluids

Preganant teens may need more

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RH negative blood- what is this? Schedule to receive immune globulin ?

During pregnancy problems can occur if you are RH negative and your fetus is Rh positive. It is called Incompatibility

Given to prevent blood cells from attacking positive blood type in baby’s. (Building antibodies)

Given at 38 weeks and with in 72 hours after delivery to protect against future preganacys

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Fetal heart heard at what gestation?

8-12 weeks

7 weeks ultrasound

Hard to hear under 12 weeks with a Doppler

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Define placenta previa ?

Delivery options?

Treatments ?

Painless bright red bleeding, low lying placenta, not contacting with cervix, - can do vaginal birth

partial = covering small amount,

Complete is covering completely -c-section only , treatments ?

Treatment - bed rest ? C section

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What is SIDS?

Prevention?

Sudden infant death syndrome

Back to sleep, place nothing in crib

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What is HPV? Vaccine/prevention ?

Human papillomavirus infection that can cause cancer or genital warts through sexual contact - vaccine is Gardasil vaccine to prevent cancer

Repeat a 7 years??

Prevention - gardasil shots , safe sex?

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Different types of twins ( monozygotic, dizygotic, conjoined and identical)

Mono- one egg- identical

Dizygotic- two eggs-fraternal

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Benefits of breastfeeding?

Calories needed?

Possible complications

and how to know if baby is getting enough?

Benefits- ? Nutrients to baby, save money, reduces allergies, promotes bonding

Calories- ? Same as when pregnant

Breast engorgment , mastitis

Know baby is getting enough of have 6 wet diapers a day

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Gate control Theory during labor?

Explains how pain impulses reach the brain, pain is transmitted through small- diameter nerve fibers .

However the stimulation of large diameter nerve fibers temporarily interferes with the conduction of impulses through small diameter fibers. Techniques to stimulate large diameter favors and close the gate too painful impulses include massage, Palm and fingertip pressure, and heat and cold applications.

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Contractions?

Phases, frequency, duration , Braxton Hicks , false labor , true labor

Relaxation between?

Phases:

Increment: the period of increasing strength

Peak or acme- the period of greatest strength

Decrement - the period of decreasing strength.

Duration is the start of one contraction to the end of the same contraction

Frequency is the beginning of one contraction to the beginning of the next contraction

Braxton Hicks are irregular contractions

False labor is contractions that help prepare the woman’s body and the fetus for true labor

True labor contractions will become progressively more painful and regular, about every 2 to 5 minutes

Relaxation between contractions helps infantsReceive oxygen between periods of rest

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Fetal lungs- when are they fully developed?

Glucocorticoids?

37 weeks

Glucocorticoids- are giving before birth to speed up lung development

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Nursing interventions after delivery?

Fundus- normal vs abnormal?

Fundus should firm, if soft or boggy then massage .

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Mag sulfate and calcium gluconate ?

Uses and nursing interventions ?

Mag sulfate- can help stop preterm labor, Protect the fetus in developing Sarabel palsy, monitor vital signs every hour, respiration rate , lung sounds, signs of fluid overload,Urine output, deep tendon reflexes, bowel sounds

Calcium- To adverse effect in newborn of mag sulfate

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Gestational diabetes - risk factors , expectations to resolve ?

GDM- macrosomnia 
Polyhydration 
Still birth 
Hx of having larger babies 
Hx of having GD in other pregnancies

Expectations to resolve ?

Metformin
Diet/exercise
Insulin

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Infant vaginal discharge and scrotal swelling - causes, normal vs. abnormal?

Psudomenses- puffy labia
Vaginal discharges from a new born girl - can look bloody or white - this is normal from maternal hormones
- check anus for patency/ infection/ by rectal temp

Scrotal swelling is normal - palpate to make sure both testicles have descended into scrotal sac. (Cryptorchidism - abnormal)

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PKU - what is this and when given ?

Test done for PHENYLKETONURIA

A birth defect that causes an amino acid called phenylalanine to build up in the body.

body can’t metabolize phenylalanine due to the absence of the phenylalanine-hydroxylase enzyme.

Screening is done after 24 hours and prior to 96 hours after delivery (1-2 days)

Heel stick

Low protein diet

If the infant has this disorder the formula starts in the first two months of life and can reduce disability and can also prevent severe mental retardation

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Jaundice - causes , risk factors , why/when it likely develops ?

Never should develop before 24 hours

May lead to brain damage

Phototherapy keeps eyes closed and covered

Needs to be reported if it occurs in the first 24 hours of life

Why it happens - breast fed babies or liver isn’t mature enough in preterm babies to get rid of excess bilirubin.

Babies need to poop and pee the excess bilirubin out - yellow substance to replace old RBC

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Infant retinopathy - causes?

Disorder of the developing retina in premature infants that can lead to blindness

Causes - premature babies -immature retinas , increase O2, Retinal detachment is the main cause of visual impairment and blindness in ROP.

is a disease that affects immature vasculature in the eyes of premature babies.

It can be mild with no visual defects, or it may become aggressive with new blood vessel formation (neovascularization) and progress to retinal detachment and blindness

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Mensuration education ?

We are Born with all the eggs that we will have for our life

Eggs will age, that’s my older women have a harder time becoming pregnant or have more pregnancy difficulty

Ages 11 to 15 is when it starts for most girls

Some cycles are irregular in the first six months

Then the cycle will become more normal six months to a year after the first cycle

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Low sperm count - causes ?

High temp
Infections 
Drug/ alcohol
Tight firing clothes 
Hot tubs 
Saunas

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Define oogenesis?

Mitosis in the ovum (development of egg)

Nursing diagnoses r/t labor and delivery

Congenital heart defects ?

Signs and symptoms

Abnormal defect in the heart that develops before birth

S/s- tired , stop eating due to tiredness , size (small for age can be an indicator)

Abnormal heart rhythms, grey/blue tinted skin (cyanosis), SOB, increase respiration’s, swollen body tissue

RSV- S/S

Nursing interventions

common, and very contagious, virus that infects the respiratory tract of most children before their second birthday
chance of severe infection is greatest for: Babies born prematurely.

Fever, severe cough, rapid or difficulty breathing ,bluish color of skin (cyanosis)

NPO If respiration’s are greater than 60,
breathing is the priority may need IV for nutrition
Oxygen to maintain stat (needs order)
Saline nasal drop
Watch for grunting and retraction

PIH- S/S

Pregnancy induced hypertension (preeclampsia)

High bp
Proteinurea, Headaches, visual changes, Edema, nausea and vomiting, sudden weight gain

Usually returns normal six weeks post pregnancy

Preschool - imaginary friends

Normal and is common

School age - friends

Children tend to play side by side rather than interactively

Grade school kids have the same sex friends

Dehydration in infants ?

S/S- earliest symptom?

Tachycardia - earliest sign 
No tears 
Dry mucus membrane 
Depressed fontanel 
Decreased LOC
Hypokalemia 3.5-5 /electrolyte imbalances 
Thirst
Muscle weakness

Replace fluid 20ml

Strep throat- risk factors, possible complications, treatment and follow up?

Contagious 
Take full course antibiotics 
Change toothbrush with in first 24 hours 
Saline gargle 
May lead to rheumatic fever

Cystic fibrosis- what is this? Treatment ?

An inherited life-threatening disorder that damages the lungs and digestive system. Mucus blacks airways

Pancreatic enzyme necessary to help with digestion

Increase fat and salt intake/foods

Breathing difficulty CPT

Can cause infertility

Pneumococcal vaccine ,Sodium chloride
Dietary supplement, Antibiotics, Penicillin antibiotic, and Cough medicine

Sickle cell disease?

Maintenance?

A group of disorders that cause red blood cells to become misshapen and break down.

Immunizations asap

No iron

Encourage fluids to prevent dehydration

Increased volumes of urine, due to kidneys cannot concentrate urine

When a child produces more urine, they also need to increase their fluid intake

Do you hydration can trigger pain crises

Child abuse - s/s

Triggers ,

Trust?

Bruce’s of multiple stages of healing

Stories do not match

Hovering parents

Child has sexual relationships at a young age

Emancipation- what is this?

Rights?

A legal mechanism by which a minor is freed from controlled by their parents or guardians, and the parents or guardians are freed from any legal and all responsibility towards the child

Laws vary by state

A child can sign for medical care for their child and self ?

A child younger than 18 has a baby becomes an emancipated once they have the baby?

Impetigo? What is this? How is this contracted ?

Commonly contagious bacterial infection usually found in the mouth

Keep clean, antibiotics, easily spread to others Staphylococcus aureus carriers, infection is thought to be spread by the person from their nose or other area to the skin

Normal child development ? Self concept ?

View of oneself fluctuates and is molded by the demands of parents, peers, teachers, and others

Risk for low self-esteem if they cannot gain view of self

Cleft lip- post op nursing interventions

Avoid crying after repair, keep clean with dropper, feed would drop her, keep up right with head support

Celiac disease- diet and treatment

An immune reaction to eating gluten, a protein found in wheat, barley, and rye.

Intestinal biopsy, gluten-free diet

Intussusception -signs and symptoms?

A slipping of one part of the intestine into another part just below it, small intestine opens into the ascending colon

Generally occurs in boys between three months and six years

High fever, and infants severe pain in abdomen, loud cries, straining efforts, kicking and drawing of legs towards abdomen, green or greenish yellow vomit, BMs Diminished with little flatus, Blood and mucus with no feces is common – known as jelly stool

Hypokalemia -s/s?

Related to muscular or cardiac function

Weakness or muscle spasms, dysrhythmias – ECG changes, muscle breakdown

Define glomerulonephritis ?

Acute inflammation of the kidneys

Formally called Bright’s disease, is an allergic reaction to a group of streptococcal infection. It may appear after the patient has had scarlet fever or skin infections

Atrial septal defect -what is this? Signs and symptoms?

ASD Involves an abnormal opening between the right and left atria. Blood that already contains oxygen is forest from the left atrium back to the right atrium

Signs and symptoms – most patients do not have symptoms. The defect may be recognize when a murmur is her during a routine health examination

Epistaxis- signs and symptoms ? Treatment ?

Nosebleeds -Leading from the nostril, nasal cavity, or nasal pharynx

Treatment includes direct pressure, do not tell head back, categorization packing

Femur fracture - possible complications?

Can cause growth issues and children

A spiral femur fracture and a young child may indicate child abuse and must be referred to an assessment team immediately

Absence seizures- signs and symptoms?

Temporary loss of awareness that results in lack of succeeding in the learning environment

Symptoms include appearing to stare into space for a few seconds, As if they are not paying attention,lip-smacking, island fluttering, chewing motions

Afton recognized when in an intelligent child is referred for medical evaluation because of unexplained failure to achieve in school

Haemophilus influenza meningitis?

Treatment ?

Inflammation of the brain and spinal cord

Influenza is the most common cognitive agent

Peak incidents for bacterial meningitis is between six and 12 months of age

If a child cannot touch chin to chest usually a sign of meningitis, sensitivity to light, and severe headache

Treated with antibiotics

Reye’s syndrome - signs and symptoms?

A rare but serious condition that causes confusion, swelling in the brain, and liver damage.

Avoid aspirin, Afton comes on after a viral syndrome, persistent vomiting

Pertussis? What is this? Priority nursing diagnosis?

Highly contagious bacterial disease aka whooping cough

Vaccinate - Tdap

Watch airway - aspiration - pneumonia is a big risk for pts

Endometritis- s/s?
Education?
Treatment ?

Tender/ inflammation/enlarged inner lining of the uterus

Severe cramping

Foul smelling lochia

Fever

Tx- IV antibiotics, culture and sensitivity of Uterine cavity

Nursing care –
Teach women progression of lochia because infection often occurs after just charge, followers, Analgesics, observe for absent bowel sounds, abdominal distention, N/V

Newborn skin- 38 weeks vs 40 weeks vs 42 weeks , after birth ?

38-most of the vernix and lanugo protecting the skin is gone

40-

42 weeks - skin dry and peeling

After birth?

Newborn complications ?

S/s?

APGAR score - calculated ?

A score less than seven we need to work on bringing that score up

Scored on a scale of 0-10

A: appearance
0-blue all over
1:blue in arms and legs
2: no blue

P: pulse

0: no pulse
1: less than 100bpm
2: greater than 100 bpm

G: grimace

0: no response
1: cry when stimulated
2: sneezing,coughing, pulling away when stimulated

A: Activity

0: no movement
1: some
2: active

R:respiration’s
0-none
1-weak/slow/irregular
2-strong cry

Vulva hematoma - s/s?

Vulvar tissue is crushed against the pelvic bone plane,

Severe pain, sense of pressure in the Vulva,Penis or wreck dumb, unable to urinate, pulse and respiration increase, blood pressure falls

May develop signs of hypovolemic shock due to blood loss

Define involution ?

Rolling or turning inward

Reduction in the size of the uterus after delivery

Cold stress ? (Newborn)

Nursing interventions

Caused by hypothermia,

increased energy to generate body heat causes increased respiratory rate and oxygen consumption

Nurses should dry the infant, please infant in radiant warmer, please hat on the infants head, wrap infant in warm blanket

Post partum depression

S/s

May last for two weeks or more,

can be hormonal or caused by sleep deprivation

, if it last longer than two weeks then they start to look at if this is depression

Down syndrome - Newborns skin after birth? (Palm)

Single palmer crease ?

Nursing care for child with asthma ?

Inhaled steroids – rinse mouth after use due to yeast

Rescue inhaler carry with at all times

Can be triggered by infections, exercise, allergies, cold air

Pink eye (conjunctivitis)?

Itchy, red, watery eyes

Treated with antibiotic drops

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Final Exam Flashcards

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