Final Exam Notes Flashcards
What time period does antepartum consist of?
From the moment you become pregnant to the moment you deliver
EDC/EDD stands for?
Estimated date of delivery
Thyroid issues in pregnancy can cause?
multiple miscarriages
Lordosis means?
spine curvature
cervical os means?
opening of cervix
When are fetal heart tones not present?
in a tubal pregnancy
When is a mildly elevated white count normal?
during pregnancy
What lab value is always lower in pregnancy?
hemoglobin
What should be checked during 2nd trimester?
blood glucose
Goodell’s Sign refers to?
When the vaginal portion of the cervix becomes softer due to vascularization
Chadwick’s Sign refers to?
Bluish appearance to the cervix; probable sign of pregnancy.
Oxytocin is known as?
Labor hormone (contracts uterus), the ‘love’ hormone
Relaxin causes?
relaxation of uterus
Embryonic Stage time period?
is from conception through the end of 8th wk of pregnancy
Fetal Stage time period?
Week 9-Birth
Full Term time period?
38-40 weeks after conception
Naegele’s Rule is calculated how and for what reason?
Last Menstrual Period-3 months + 7 days
Four Types of Pelvis and most common/favorable?
Gynecoid (most common and favorable); Android, Anthropoid, Platypelloid
GTPAL means?
Gravida, Term, Preterm, Abortions, Living Children
Gravida definition?
Total number of pregnancies
Leopold’s Maneuver is what?
Feeling for baby’s head and back to determine the position of the baby.
How is fundal height measured?
By measuring the distance from the pubic symphysis to the highest part of the uterus
What should a pregnant woman take for headaches?
Tylenol Only; not safe over 20 wks.
What is a stable HR in a baby?
110-160
Where are Braxton Hicks felt?
Only in front of the uterus; caused by uterine irritability.
What can a pregnant woman do to decrease urine loss?
Kegel Exercises
What age defines a geriatric mother?
Over 35
What is a normal amount of fetal kicks per hour?
10 or more.
What problem can happen if there is not enough amniotic fluid?
Baby can have kidney problems.
Nuchal cord means?
Umbilical cord wrapped around baby’s neck
Placental circulation is?
The direction of flow is different from that in the normal body
Why is psyche important in a laboring mom?
It is difficult for the uterus to dilate if mom is trying to maintain control and has anxiety.
Fetal Attitude refers to?
Relation of fetal body parts to each other
Fetal Lie means?
Orientation of long axis of fetus to long axis of woman; can be longitudinal or transverse
What positions are best for a baby delivery?
LOA or ROA
How are contractions measured?
From the beginning of one to the beginning of the next
What is the key for a ticket to stay in L&D?
Progressive cervical changes
What are signs of true labor?
Contractions 45 seconds to 1 minute, for greater than one hr and increasing in intensity; symmetrical, regular, predictable contractions and do not stop
Latent Phase of labor consists of?
30-45 second contractions; every 5-20 mins apart
Active Labor consists of?
Dilation from 4 to 7 cm; contractions 45-60 seconds long and 2-5 mins apart, membranes may rupture
Transition phase consists of?
8-10cm dilation, 60-120 second long intense contractions with rest periods of 30-90 seconds; this stage lasts 10-60 minutes
2nd Stage of Labor happens when?
Pushing, fully dilated
3rd Stage of Labor happens when?
Delivery of Placenta; risk of hemorrhage increases as length of 3rd stage increases
What should you do if fetal distress is present?
Turn Pitocin off if being induced; give fluid bolus of Lactated Ringers, change maternal position, FHR
When is APGAR score assessed?
At 1 and 5 minutes
What is the purpose of a fundal massage?
It reduces the risk of hemorrhage in mom
Which infectious agent is the most prevalent and significant in health care settings?
Bacteria
What are some possible reservoirs for infectious agents?
People, animals, soil, food, water, milk, inanimate objects
What is a portal of exit?
A means for a micro-organism to leave its source
What are some common portals of exit?
Respiratory, blood, GI (feces, saliva, vomit) and GU (vaginal secretions, urine) systems, breaks in skin or through tissue.
Incubation Period
Organisms growing and multiplying
Prodromal Stage
Person is most infectious (vague and nonspecific signs of disease)
Full stage of Illness
Signs and symptoms present
Convalescent period
Period of recovery
What are the Stages of Infection?
Incubation period, Prodromal Stage, Full stage of Illness, Convalescent period
What are some cardinal signs of infection?
Redness, heat, swelling, pain, loss of function
What are some lab values indicating infection?
Elevated WBC (normal 5-10k), elevated erythrocyte sedimentation rate, presence of pathogens in urine, blood, cultures or sputum
What are the four major categories of hospital acquired infections?
CAUTI’s (catheter UTI), surgical site infection, central line associated bloodstream infection, ventilator associated pneumonia
Risk factors for VRE
Prolonged hospitalization, long-term use of vancomycin, recent surgery, compromised immune system
What is the body’s defense against infection?
inflammatory response, immune response, normal flora
What is the primary immune response?
Antibodies
What do antibodies do?
Bind with antigens to inactivate an immune response
T/F Immune function declines with aging.
True
Passive immunity (natural) means?
Immunity passed from mom to baby via breastmilk, placenta
Passive immunity (artificial) means?
Antibodies produced in another animal or person and given to at-risk individual to prevent disease after exposure
Active Immunity (natural) means?
exposure to antigen naturally
Active Immunity (artificial) means?
Antigen given in form of vaccine to stimulate antibody production
What is an inactivated vaccine?
A vaccine that is given to stimulate production of antibodies, but the microorganism has been killed
What is a live vaccine?
Microorganism exists in the vaccine in a weakened form
Which live vaccines are contraindicated in pregnancy and immunocompromised patients?
MMR (immunocompromised) & Var (pregnancy and immunocompromised)
What are three distinct roles of the nurse?
Patient advocate, collaborator, coordinator
What are some of the national patient safety goals? (NPSG)
Patient identification, improve staff communication, medication safety, safe use of alarms, infection prevention, identify patient safety risks (mental health assessment), prevent surgical error
What are keys to effective collaboration by the RN?
Inform, empower, assist in goal setting, be patient-centered
What are outcomes of successful collaboration?
Reduced use and cost of resources, improved patient safety.
Covert conflict means?
Avoiding and ignoring
Overt conflict means?
Openly disagreeing and confronting
What is the basic cell of the nervous system?
A neuron
How many pairs of cranial nerves are there?
12
How many pairs of spinal nerves are there?
31
What function do cranial nerves serve?
sensory, motor or mixed
What function do spinal nerves serve?
motor and sensory activities; each with a specific function
What are somatic reflexes?
skeletal muscle contraction
What are autonomic reflexes?
Reflexes that activate cardiac, smooth muscle, and glands
How long does white matter grow steadily?
For the first four decades of life
What is the limbic system responsible for?
The drive for basic needs, melatonin release, circadian rhythm, emotions
Which neurological system is linked to addiction?
The limbic system
What is increased intracranial pressure?
A condition or trauma that causes pressure within the cranial vault
What are consequences of increased intracranial pressure?
Cerebral edema, increased ICP, and decreased cerebral perfusion
What are risk factors for ICR problems in the elderly?
degenerative diseases and/or conditions, falls
What are risk factors for ICR problems in adolescents and young adults?
Trauma, MVA, ATV accidents
What are risk factors for ICR problems in infants and toddlers?
accidents, congenital defects
What is important to know when assessing LOC?
Your patient’s baseline
What is evident in deep brain injuries?
Vital sign changes
Full consciousness definition
A&Ox4
Disorientation definition
Not oriented to person, place, time
Obtundation definition
Lethargic
Stupor definition
Awakes with vigorous or painful stimuli
Semicomatose definition
Painful stimuli may result in stirring
Coma definition
Unarousable; nonpurposeful response
Deep Coma definition
brain-dead
What are the most common nursing assessment findings on those with affected intracranial regulation?
Motor & mental functioning issues
What can increased ICP cause?
Increased ICP restricts blood flow, causing ischemia
What is Caloric testing?
Hot or cold stimuli on face.
What is an abnormal sign in Romberg testing?
ataxia (swaying)
What is a positive (abnormal) Brudzinski sign?
Pain when flexing head to chest (meningitis sign)
What is a positive (abnormal) Kernig sign?
Pain when flexing knees and hips or straightening legs
Which is a worse sign, decorticate or decerebrate posturing?
Decerebrate
What can you do to prevent dysfunction in intracranial regulation?
Have a good diet, exercise regimen, no tobacco, be safe!
What is active transport?
A process in which energy moves substances against the concentration gradient (high to low, low to high); moves things back and forth
What lab values are higher in the blood if you are not well hydrated?
Sodium, Potassium and hematocrit
What is osmosis?
The movement of water across cell membranes from less concentrated solution to more concentrated solutions
What is colloid osmotic pressure?
A form of osmotic pressure that is exerted by proteins (albumin) in a blood’s plasma that pulls water into the circulatory system
What does osmolality mean/refer to?
thickness of solutes
What happens in a hypertonic solution?
It shrinks/squishes a cell
What happens in a hypotonic solution?
It enlarges a cell
Diffusion goes from a ___ concentration to a ___ concentration
high, low
Filtration is the ….
movement of fluid and solutes together across a membrane from one compartment to another; it is like putting coffee through a filter
Sodium lives ____ the cell
outside
Potassium lives ___ the cell
inside
How much fluid intake should a normal individual have per day?
2500 ML/day
How much fluid output should an individual have per day of urine?
1400-1500 ML’s of urine
How can you maintain homeostasis within the body?
Drink water, limit salt, consume potassium
Potassium is responsible for?
Skeletal, cardiac and smooth muscle function
What is calcium responsible for and where is most found?
Regulating muscle contractions (Cardiac), most is found in skeletal system
What is Magnesium responsible for?
Operating the sodium potassium pump, regulating cardiac and neuromuscular function, relaxing muscle contractions
What is Bicarbonate?
A major body buffer that regulates acid-base balance
How are babies different with fluid loss?
Babies lose a lot of fluid when they have diarrhea.
Does stress increase or decrease production of ADH?
Increase
What can beta-blockers help with?
Reducing the response to adrenaline
What are signs of fluid volume excess?
Neuro: Changes in LOC, confusion, headaches, seizures
Respiratory: Pulmonary congestion
Cardiovascular: Bounding pulse, high BP, JVD, S3 heart sounds, tachycardia
GI: Anorexia, nausea
Edema: pitting edema
What should you assess for fluid volume deficits?
Hypotension, weak pulses, perfusion, LOC, muscle strength, electrolytes, CBC, specific gravity–urine
Electrolytes balance the ____ in your body
fluid
Electrolytes balance your __ level
pH
Homeostasis occurs via ____, _____, and ____ _____
diffusion, osmosis and active transport
Fluid overload in the body is held in ______ _____ in an effort to store it until the body can process it.
interstitial spaces
When providing holistic care, whose perspective should we use to look at life?
The patient’s
What are components of the holistic nursing assessment?
The assessment of the entire physical body, the use of our five senses during the exam and the use of caring and being present during assessment.
What is culture shock?
The feelings a person experiences when placed in a different culture
What is world view?
How any person or culture perceives or understands the world of others
How is health viewed in the West?
As an absence of disease, food impacts health in good & bad ways, independence/individualism is valued
How is health viewed in the East?
Health is a state of harmony involving mind, body and spirit; food can heal imbalances, there are cultural healers
What does acculturation mean?
The process of accepting another culture as your own
What are Tanner Stages?
Stages of sexual maturation
What are the five stages of the sexual response cycle?
Desire, Arousal, Plateau, Orgasm, Resolution
STI’s can lead to infertility and PID. T/F
True
STI’s can cause major issues or death in newborns. T/F
True
T/F A person exposed to HIV is two to five times more likely to acquire HIV than a person who does not have an STI.
True
Which STI is the leading cause of infertility?
Chlamydia
What does integrity mean?
Doing the right thing even when no one is looking; admit your mistakes
The Nurse Practice Act is written by _______
legislatures
Who does the Nurse Practice Act protect?
The public
What are the steps of the nursing process in order?
Assessment, diagnosis, planning, implementation, evaluation
What is the Patient Self-Determination Act?
An act mandating health care facilities to inform patient’s of their right to make decisions about their medical care
What are the 5 rights of delegation?
Right task, circumstance, person, direction, supervision
T/F The National Counsel of State Boards of Nursing oversees the state boards, develops licensure exams and deals with national standards for nurses and protects the public instead of the nurse.
True
What can a nurse never delegate?
Assessments, client teaching, evaluations
What main idea is behind the primary level of prevention?
To prevent disease or illness
What main idea is behind the secondary level of prevention?
To detect and treat an illness
What main idea is behind the tertiary level of prevention?
Educate the client to prevent further issues
What are some barriers to access of health care?
Lack of health insurance, lack of a PCP, uneven distribution of services (underserved areas), perceptions to an individual of need
What are signs of skin cancer?
Asymmetry, Uneven border, variety of color, large diameter, any change in mole appearance or size.
Cold increases inflammation T/F
False; cold decreases inflammation.
T/F Heat increases inflammation
True.
Maceration definition
Too wet
What are signs of an infection?
errhythema, necrosis, purulent drainage, smell
Dehiscence definition
Partial or total separation of wound layers
Evisceration definition
Total separation of wound with perfusion
What is the Braden Scale?
A measure used to predict risk for pressure ulcers.
What are the five principles of ethics?
Beneficence, Autonomy, Justice, Fidelity, Veracity
What are the five values from the Code of Ethics?
Altruism, Social Justice, Integrity, Autonomy, Dignity
Nonmaleficence definition
One ought not inflict harm
Beneficence definition
One ought to prevent harm
Veracity definition
Full disclosure
What is a normal pH range of body fluids?
7.35-7.45
What are the three systems that work together to maintain a normal range of pH?
Buffer System, Respiratory System, Renal System
Which system acts first in maintaining a normal pH?
The buffer system; Bicarb 24-28 mEq/L; used up quickly, not effective long-term
Which system acts second in maintaining a normal pH?
Respiratory system; the person blows off acid, which causes respiratory alkalosis; less effective over time
Metabolic acidosis in the Respiratory drive causes..
Increased respiratory rate; must fix the issue via blowing off CO2 or hyperventilate (Kussmal respirations)
The renal system is used to compensate for respiratory imbalances T/F
True
Renal compensation is the slowest compensation T/F
True
Renal compensation is the most powerful method of compensation T/F
True
Renal compensation is effective in patients with renal failure. T/F
False; renal compensation is ineffective in patients with renal failure.
Terbutaline stops contractions by relaxing the uterus. T/F
True
Magnesium sulfate is given with pre-eclampsia and eclampsia to prevent seizures. T/F
True
