Final Exam Flashcards
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
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
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
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
What influences of labor pains
Contractions of the muscles of the uterus
Prenatal vitamins
Folic acid -.4mg/day Protein - 60 g/day Calcium -1200mg Iron-16 mg Fluids
Preganant teens may need more
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
Fetal heart heard at what gestation?
8-12 weeks
7 weeks ultrasound
Hard to hear under 12 weeks with a Doppler
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
What is SIDS?
Prevention?
Sudden infant death syndrome
Back to sleep, place nothing in crib
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?
Different types of twins ( monozygotic, dizygotic, conjoined and identical)
Mono- one egg- identical
Dizygotic- two eggs-fraternal
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
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.
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
Fetal lungs- when are they fully developed?
Glucocorticoids?
37 weeks
Glucocorticoids- are giving before birth to speed up lung development
Nursing interventions after delivery?
Fundus- normal vs abnormal?
Fundus should firm, if soft or boggy then massage .
?
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
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
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)
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
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
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
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
Low sperm count - causes ?
High temp Infections Drug/ alcohol Tight firing clothes Hot tubs Saunas
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
