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NUR 209 - Maternaty > Final Exam - Powerpoints > Flashcards

Final Exam - Powerpoints Flashcards

1
Q

When is it gestational DM vs just normal DM1 or DM2

A

if it develops after 20 weeks it is gDM

if it develops before 20 weeks its just DM

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2
Q

Gestational DM (gDM) cycle in pregnancy

A

high BG in mom –> extra weight gain in baby (RF macrosomia) –> extra glucose to baby –> 39 week induction

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3
Q

why do gDM babies need to be induced at 39 weeks

what are they at risk for

A

because of their rapid growth rate they are at RF shoulder dystocia and macrosomia

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4
Q

Risk factors for gDM

A 
BMI > 25
Age >25
Hx of gDM, abn glucose tolerance, 
Family Hx of DM
High risk ethnic group
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5
Q

gDM care focuses mainly on …

A

Managing normal BG levels

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6
Q

gDM baby be more likely to have

A

Laboured breathing and hypoglycemia

(NTD, RDS, CHD)?

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7
Q

Glucose challenge test values

A

Fasting: >126
Nonfasting: >200

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8
Q

Oral glucose tolerance test

A

Fasting: >95
1 hr: >180
2 hr: >155
3 hr: >140

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9
Q

? good sources of sugars

A

6 saltine crackers
4-6 oz of juice
3 glucose tablets
1 tbsp of honey or syrup

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10
Q

The need for folic acid … during pregnancy.

A

doubles

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11
Q

folic acid deficiency related to what defect

A

spinal bifida

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12
Q

foods with folic acid

A

leafy greens
vegetables
legumes

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13
Q

Thalassemia common in …

A

Mediterranean and Asian peoples

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14
Q

Thalassemia causes what

A

less hgb and less RBCs

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15
Q

Sickle cell disease (SCD)

A

abn hgb, most common in AA

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16
Q

SCD pts should avoid

A

infection, exertion

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17
Q

SCD pts should stay

A

hydrated, maintain good oxygenation, take prophylactic ATB and take folic acid supplements

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18
Q

Anemia hgb minimum in 1st and 3rd trimester

A

hgb < 11

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19
Q

Anemia hgb minimum in 2nd

A

hgb < 10.5

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20
Q

Fe deficiencies are common in … of pregnancies

A

75%

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21
Q

Classification of gestational HT (gHT)

A

develops after 20 weeks

otherwise is considered chronic HT

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22
Q

Pathophysiology of Preeclampsia

A

increase in peripheral vascular resistance decreasing circulation to all organs resulting in a generalized vasospasms

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23
Q

Preeclampsia prevention

A

early/regular prenatal visits
controlled wt gain
deceased stressors

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24
Q

Risk factors of Preeclampsia

A 
Primigravidia or Multifetal pregnancy
Family Hx
Obesity 
AA
Teen or >35 
Vascular disease, chronic renal disease, diabetes
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25
Q

What would the nurse be monitoring in a pt with preeclampsia

A 
BP
ALT, AST
platelets for DIC
Kidneys for urine output of >30ml/hr
pulse ox
pulmonary edema 
reflexes (2+ normal, 3+ = impending seizure)
HA 
blurred vision
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26
Q

Preeclampsia (preE) usually occurs in what trimester(s)? In which trimester(s) is it most severe?

A

usually in 3rd

severe 2nd

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27
Q

For how long is a pt preE after delivery

A

48 hr and is still at RF seizure

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28
Q

during preE urine would have WHAT in it

A

trace protein

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29
Q

for a preE pt do not palpate what

A

the liver as it is excreting proteins

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30
Q

interventions for pt with severe preE

A

keep pt calm, track I/O and give MgSO4 promptly

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31
Q

severe preE would cause what with the lungs

A

collection of fluids –> pulmonary edema –> respiratory distress (<12 Breaths/min and <95%)

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32
Q

MgSO4 purpose

A

prevents seizures and has a side effect of lowering BP

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33
Q

Therapeutic range of MgSO4

A

4-8 mg/dl

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34
Q

SS of MgSO4 toxicity

A 
<12 Breaths/min 
<95%
absence of DTRs
sweating and flushing
altered LoC
HoT
MgSO4 > 8 mg/dL
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35
Q

antidote for MgSO4

A

1g calcium gluconate at 1 ml/min

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36
Q

Hydralazine

A

HT drug for during pregnancy

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37
Q

Labetalol

A

HT for postpartum

38
Q

HELLP meaning

A 
Hemolysis
Elevated
Liver Enzymes
Low
Platelets
39
Q

assessments of HELLP syndrome

A

bleeding out of IV and all orifices

40
Q

1 Ix for HELLP syndrome during delivery and after

A

keep blood on had and mother would go to ICU after birth

41
Q

Ix for decreasing heart workload

A 
low cholesterol diet
no caffeine
prevent anemia 
low salt 
prevent infection
prophylactic ATB
limit pain
42
Q

Med types for decreasing heart workload

A

diuretics
heparin
Antidysrhythmics

43
Q

how to minimize effects of labor and delivery on CV

A

vaginal birth bc body does all the work then it can be one via assisted delivery

C-S would be worse bc it would increase the RF infection, fluid overolad

44
Q

first 24-48 hrs after PP that increases work on the heart

A

RF decompensation bc sudden wt loss (cough, crackles, pitting edema, chest pain)
cardiac arrest , pallor, exhaustion

45
Q

What changes for pregnant woman for CPR

A

have hands under breast not under umbilicus

46
Q

Are asthma meds safe for breastfeeding

A

yes

47
Q

should pregnant woman have asthma meds at all times even if they havent had any symptoms

A

yes bc being pregnant is different than not being

48
Q

hypothyroidism considerations

A

RF SAB=spont abortion, PT birth, low birth wt, preE,

need to make sure they get their thyroid meds at the right time daily

49
Q

Hep B considerations on baby and mother

A

wash baby before injection
mothers be tested
newborns receive IgG at birth

50
Q

Lupus
rt
and common in

A

Joint pain
SAB, premature birth, fetal demise, preterm rupture of membranes
Pre-eclampsia
African or Hispanic ancestry

51
Q

Key thing to remember regarding pregnant women and substance abuse

A

do not judge or they will stop getting care

52
Q

common stimulants

A

cocaine
nicotine
amphetamines
methamphetamines

53
Q

common depressant

A

etoh

54
Q

common narcotics

A

heroin
methadone
opioids

55
Q

Drug effects on fetus caused by withdrawao

A 
Preterm labor
Preterm birth
Spontaneous abortion
Abruption
IUGR – intrauterine growth restriction
Hypoxia
Fetal Alcohol Syndrome
CNS impairment
Tremors (jitters-like)
56
Q

On how many separate occasions do women need to be asked about abuse

A

7 and make sure they are alone; true abuser will be afraid to leave, make sure they take the kids

57
Q

what is domestic violence

A

It is a pattern of behavior in which one intimate partner uses physical violence, coercion, threats, intimidation, isolation and emotional, sexual or economic abuse to control and change the behavior of the other partner

58
Q

Cycle of violence

A

Tension Building –> Abusive Incident –> Honeymoon Phase

59
Q

ABCDEs of caring for the abused

A 
ALONE
BELIEF
CONFIDENTIALITY
DOCUMENTATION - important to help establish a pattern
EDUCATION
60
Q

Birth control options

A 
IUD
Oral contraceptives
Condoms 
Diaphragm/spermicide
Natural family planning
61
Q

IUD

A

invasive device inserted into uterus to prevent pregnancy, can cause PID

62
Q

Oral contraceptives

A

need to be taken at the same time daily

63
Q

condoms

A

most reliable for preventing STDs (need to be aware of allergies against latex, expiration dates, heat)

64
Q

diaphragm

A

weight fluctuations and must be refitted

65
Q

natural family planning

A

must know ovulation cycle and must have regular menses cylce

66
Q

HIV positive mother tx during pregnancy

A

prenatally and during labor mom will need to take retroviral drugs orally and IV - importance of strict adherence to drugs
– baby maybe protected from HIV but will need them prophylactically

67
Q

HIV mother delivers?

A

by c-s no vaginally bc of bodily fluids

68
Q

can HIV mom breastfeed

A

no

69
Q

HPV causes

A

warts

70
Q

Herpes types cause

A

Simplex 1 = canker sores

simplex 2 = genital warts

71
Q

Herpes treatment

A

Acyclovir or Valtrex

72
Q

delivery options for HPV and herpes with active lesions

A

c-s

vaginal ok if none

73
Q

herpes (HSV) effects on neonate

A

eyes, mouth, skin, encephalitis

74
Q

bacterial STI

A

chlamydia
gonorrhea
syphillis

75
Q

bacterial STI risks in pregnancy

A

premature labor/birth
low birth weight
PROM

76
Q

bacterial STI tx

A

Azithromycin
Ceftriaxone
Penicillin G

both partners need to be treated or will reinfect each other - untreated will lead to PID –> scarring and infert

77
Q

syphilis with no tx

A

long term brain dmg/ death to child

78
Q

Menopause is considered

A

climacteric

change of life

79
Q

age of menopause

A

45-50

80
Q

menopause definition

A

final menstral period for 1 year

combo of endocrine, body, and phys changes occuring at the end of the reproductive cycle

81
Q

menopause causes what damage

A

osteoporosis via estrogen deficit

82
Q

45-50 yo women education

A 
hormone therapy 
increased Ca and vit D
exercise 30 min/day with wt bearing 
kegel exercisese
drink 8 glasses of water
use lubricants
83
Q

Hormone therapy considerations (E/P or EP)

A

women with hx of breast cancer or coagulation disorders; smoking, HT, DM, CV, renal/liver disease are CI for ~

84
Q

Pelvis examinatoin aka

A

pap smear

85
Q

pap smear involves

A

collection of squamous glandular tissue cellsfrom cervix to detect precancerous and cancerous cells shed by the cervex

86
Q

self breast exam frequency

A

done monthly

87
Q

clinical breast exams frequency

A

routinely done every 3 yrs from 20-39

88
Q

mammograms frequency

A

after 40 yearly

89
Q

mammograms should be done with

A

self breast exams

90
Q

warning signs of breast cancer

A

palpable mass
dimpling of tissue
nipple retraction
changes in skin or shape of breast

91
Q

risk factors breast cancer

A 
female 
over 55
family Hx
nulliparity or first pregnancy after 30 
early menarchy or late menopause (1255)
LT hormone replacement after menopause
overwt
physical inactivity

NUR 209 - Maternaty (7 decks)

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