Final Review Flashcards by Kelsey Thomas

Physiologic Anemia

Hct – 32-42

Hgb – 10-14

How well did you know this?

Not at all

Perfectly

True Anemia

Hct < 32

Hgb < 10

How well did you know this?

Not at all

Perfectly

Rubella Titer > 1-8

patient is immune

How well did you know this?

Not at all

Perfectly

Rubella Titer < 1-8

patient needs to be immunized

How well did you know this?

Not at all

Perfectly

Dip stick urine for protein Trace =

spilling sugar

How well did you know this?

Not at all

Perfectly

Dip stick urine for protein > trace

gestational DM

How well did you know this?

Not at all

Perfectly

Overweight BMI

25-29.9

How well did you know this?

Not at all

Perfectly

Obesity BMI

30-39.9

How well did you know this?

Not at all

Perfectly

Recommended weight gain 1st Trimester

2-4lbs total

How well did you know this?

Not at all

Perfectly

Recommended weight gain 2nd and 3rd Trimester

1 lb/week

How well did you know this?

Not at all

Perfectly

Underweight weight gain during pregnancy

20-40 pounds

How well did you know this?

Not at all

Perfectly

Overweight weight gain during pregnancy

15-25 pounds

How well did you know this?

Not at all

Perfectly

Ideal weight - weight gain during pregnancy

25-35 pounds

How well did you know this?

Not at all

Perfectly

Non stress test = client is admitted for a non-stress test – strip shows two accelerations in 20 minutes, what would you advise the client

Reassuring results = good!

How well did you know this?

Not at all

Perfectly

Increased MSAFP indicates

Possible Neural Tube Defect

How well did you know this?

Not at all

Perfectly

Decreased MSAFP indicates

Possible Downs Syndrome (trisomy 21)

How well did you know this?

Not at all

Perfectly

Patient that has a history of previous child with spina bifida or neural tube defect will have what testing?

Amniotic fluid study - amniocentesis = more accurate

How well did you know this?

Not at all

Perfectly

Recognize decelerations indicate

Placental insufficiency

How well did you know this?

Not at all

Perfectly

V
E
A
L

C
H
O
P

Variable
Early decels
Accelerations
Late decels

Cord compression
Head compression
OK
Placental insufficiency

How well did you know this?

Not at all

Perfectly

What is mother at risk for with hyperventilation during labor

Respiratory alkalosis

Sx – numbness, tingling in fingers/hands, dizziness

How well did you know this?

Not at all

Perfectly

Interpreting different fetal heart patterns

FHR 110-160 (norm)

Variability = reliable indicator of fetal well being

How well did you know this?

Not at all

Perfectly

Difference between true and false labor

cervical change

How well did you know this?

Not at all

Perfectly

Fetal heart rate strip that shows decreased variability what would you do for that patient?

Sign of fetal compromise-
Possible c-section
Administer O2

How well did you know this?

Not at all

Perfectly

Labor support – patient going into transition

Continue to encourage voiding every 2 hr.
☐ Continue to monitor and support the client and fetus.
☐Encourage a rapid pant-pant-blow breathing pattern if the client has not
learned a particular breathing pattern prenatally.
☐ Discourage pushing efforts until the cervix is fully dilated.
☐ Listen for client statements expressing the need to have a bowel movement.
This sensation is a sign of complete dilation and fetal descent.
☐ Prepare the client for the birth.

How well did you know this?

Not at all

Perfectly

Signs and symptoms of transition phase

```  Cervix dilates 8-10 cm  Short, but most intense phase  Bloody show increases  Contractions close, lengthy, intense  Strong urge to bear down  Leg tremors, nausea, vomiting common  Behavior – irritable, loss of control, bothered ```

Normal contraction

( Every 2-3 minutes and lasting 60 seconds) and fetal heart pattern Abnormal is hypertonic and hypotonic (irregular frequency)

Rationale for Vitamin K

to prevent clotting problems because liver can’t synthesize

Patient who had c-section with general anesthetic – what would be the biggest concern for MOM

hemorrhage

Rationale for pre-hydration with an epidural

to keep BP up & decrease risk for hypovolemia

Which drug is contraindicated in a Mom with an opiate addiction?

Nubain

Post C-section patient is complaining of dyspnea, diaphoretic and restless - What are these signs of?

Pulmonary Embolism *Assess respirations/lung sounds – presence of or absence of lung sounds

Teaching after Rubella vaccination

Don’t get pregnant for at least 4 weeks

Patient at risk for hemorrhage

uterine atony, overdistention, multipara, induction, Pitocin, long labor

Contraindications with Methergine

HTN – check blood pressure!

Action if fundus is boggy

```  Massage  Determine when last voided  Express clots as needed  Reassess fundus  Inform primary nurse/doctor ```

Highest priority for immediate post op patient

Prevent hemorrhage

Baby’s vitals are normal, but baby is a LARGE baby - Risk for ________

hypoglycemia

Which baby would you assess first

All normal except one is large (LGA)

Calculate percent of weight loss

BW – TW / BW x 100 = %

Moro reflex

startle reflex (arms go up and in front)

Warm stethoscope and hands to prevent heat loss due to ________

Conduction

What is in breast milk that is vital

immunoglobulin’s

Women with anxiety have

decreased milk production

Nurse assesses which physiologic response to hypothermia in newborn

hypoglycemic (metabolic rate increases, they need to consume more O2)

Because a mom is infected with HIV doesn’t mean that

the baby will be infected too

34 week mother has vaginal bleeding

evaluate maternal and fetal oxygenation and circulation

Term Mom (and fetus) with stable VS has large amount of bright red blood - what would you do?

Ultrasound

S/Sx of Mag Sulfate Toxicity - Mom complains of

double vision | blurry vision

Mag therapeutic levels

4-8mg/dl

What causes hydramnios… Why do pregnant women with diabetes have excessive amniotic fluid?

Baby’s responding to sugar by excessively urinating

Diet and insulin requirements

Vary during pregnancy

What is the hormone that creates insulin resistance during pregnancy?

Human placental lactogen (HPL)

Signs/Sx of PTL

Often painless menstrual cramps BACKACHE possible ROM pelvic pressure “feels sick or not right"

Posterior presentation – nursing care

Backache – counter pressure and back rubs

Shoulder dystocia - R/F and Signs/Sx

LGA baby | turtles sign – head retracts back McRobert’s Maneuver

Vacuum extraction indications

prolonged 2nd stage fetal distress maternal exhaustion

Prolapsed cord

Always do vaginal exam 1st!!! Then knee to chest position

R/F for hemorrhage

``` uterine atony – multiparity overdistention obesity c-section exhaustion LGA AMA ```

Hematoma Sx/Tx

Perineal/Rectal pain (CARDINAL Sx), cold compresses to swelling

Signs/Sx of Metritis

supra pubic tenderness subinvolution achy

In order for there to be an ABO incompatibility – mother must be

type O and baby AB

Necrotizing enterocolotis

measure abdominal GIRTH

Babies at risk for hypoglycemia

SGA and LGA

Calcium requirements-

 1200mg/day (11-24 year old)  1000mg/day (24-50 year old and 50-64 year old taking HRT)  1500mg/day (50-64 (not taking HRT))  1500mg/day ( > 65 year old)

Diet recommendations decrease atherosclerosis

whole grains

Stop taking pill when - ACHES

Abdominal pain Chest pain Headaches Eye (visual pain) Severe calf pain

Natural family planning

Basal Body Temperature (+.4-.8 after ovulation due to increased progesterone)

Hysterosalpingogram - when do you perform this test?

Do this in the first half of the cycle so if there is a fetus, it’s not “flushed out”

When using Clomid - always check for

PREGNANCY

R/F developing ovarian cancer

```  Diet high in fatty foods  Nulliparity  Genetics  Age  Hx of other cancers  Infertility ```

Hot flashes are related to

loss of estrogen

ERT is never recommended for patient with

uterus and decreased progesterone

Danasol indications

inhibits estrogen productions – causes endometrial tissue to shrink

HSV

Transmission during prodrome and active lesions, Teaching – air dry lesions, treat before birth

R/F cervical cancer

```  Low SES  Early Sexual Activity  Multiple partners  Smoking  Exposure to DES in utero ```

Rhogam is used with Rh- mother to prevent

Rh+ antibodies from forming  Given to mother at 28 weeks and also after a trauma situation  Given again AFTER delivery if baby is Rh+ to stop formation of Rh+ antibodies

Most accurate way to determine gestational age

Physical Assessment

IV antibiotics are indicated with

+ GBS - Group B Strep

A c/section is indicated if a pt has

Active HSV lesions

Fiber recommendations

25-35 grams/ day – fruits, veggies, whole grains, lean proteins

Characteristics of cervical mucus during fertile period

stretchy | clear

Fibrocystic disease – what age group is likely to develop this

Teens and 20s