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Women and Families > final study guide > Flashcards

final study guide Flashcards

1
Q

post-partum blood loss

A

less than 500mL SVD is normal; less than 1000mL C/s is normal; weigh pads for quantification; saturating pad in 15 min- 1hour is abnormal

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2
Q

puerperal fever

A

any infection of genital canal within 28 days after abortion or birth; 100.4 fever or greater in 2/10 days following birth not including first 24 hours or 101 or greater within first 24 hours

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3
Q

post-partum women lab results

A

H&H, CBC, Rh status

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4
Q

eclampsia

A

occurrence of seizure or coma as result of HTN during pregnancy; treat with Magnesium Sulfate to prevent seizure and antihypertensive meds; fetus should recover when mom is stable

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5
Q

amniocentesis

A

procedure used to determine fetal lung maturity (measures lecithin and sphingomyelin ratio: greater than 2:1 = lung maturity);test for neural tube defects

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6
Q

psychosocial issues post birth

A

postpartum depression and postpartum psychosis

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7
Q

fertility awareness methods

A

temperature method: take temperature every day when get out of bed; cervical mucus: check vaginal discharge every day; calendar method: chart menstrual cycle on calendar; 77-98% effective

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8
Q

estrogen in contraception

A

suppresses ovulation

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9
Q

bacterial vaginosis

A

common bacterial infection d/t disruption in normal vaginal flora; signs/symptoms are fishy vaginal odor, gray/milky discharge; require antibiotic either orally or gel inserted into vagina

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10
Q

preeclampsia

A

blood pressure of 140/90 in pregnant women after 20 weeks gestation with or without presence of proteinuria; need 2 occasions in 4 hours or 1 occasion of 160+ systolic

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11
Q

gravida and para status

A

Gravida- number of times pregnant; Para- number of deliveries to viable babies

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12
Q

FHR

A

monitored via tracing; wanted moderate variability ~15 bpm; normal HR is 110-160

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13
Q

decelerations

A

last few seconds to 2 minutes

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14
Q

cord prolapse

A

obstetric emergency occurs when umbilical cord drops down alongside/in front of presenting part of fetus; circulation of fetus can be reduced causing serious physiological effects; place mom in tredelenberg or knee-chest position or elevate portion of fetus with sterile gloved hand

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15
Q

stages of labor

A

first stage: 0cm-10 full dilation and effacement; second stage: descent and expulsion of fetus (from full dilation to birth); third stage: expulsion of placenta (from birth to placental birth) usually about 5-10 minutes after; fourth stage: immediate postpartum following placental birth for 4 hours

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16
Q

fundus location

A

around umbilicus +/-1 cm and then descends 1cm per day until complete involution has taken place

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17
Q

postpartum lochia

A

rubra 1-3 days bright red bleeding (9 months shedding), serosa 3-10 days pale pink, alba 10-14 up to 6 weeks creamy yellow

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18
Q

back pain in labor

A

sign of impending labor; pain begins in back and spreads to abdomen

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19
Q

narcotic complications in delivery

A

can slow down labor, can cause respiratory depression in mom and fetus, can cause fetal distress

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20
Q

effect of epidurals

A

spinal is anesthesia that blocks sensation from area of admin down; epidural is partial anesthesia to lessen pain

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21
Q

naegels rule

A

last menstrual period - 3 months then add 7 days

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22
Q

1st trimester symptoms

A

decrease in BP in mom; fetus: ~3 inches, all organ systems present, audible HR, large head, ~1-2 oz,

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23
Q

APGAR scores

A

assessed at 1 and 5 minutes; indicative of transition to extrauterine life; 0-3 = severe distress, 4-6 = moderate difficulty with transition, 7-10 = stable status

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24
Q

transverse lie in labor

A

horizontal lying fetus that requires C-section

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25
Q

cervical changes in labor

A

effacement: thinning, dilation: expanding for birth of fetus

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26
Q

rubella issues

A

can infect all 3 germs layers during embryonic period; vaccine is live so do not get pregnant for 4 weeks following

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27
Q

Rh issues

A

Rh is present on surface of RBC; Rh- mother with Rh+ fetus can cause sensitization if RHOGAM not administered; next pregnancy with Rh+ infant can cause hemolysis

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28
Q

betamethasone

A

corticosteroids that promote fetal lung maturity usually following tocolytic to slow preterm birth

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29
Q

direct coombs test

A

used to determine hemolytic disease of newborn due to Rh or ABO incompatibility; positive test result means you have antibodies that are working to destroy own RBC

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30
Q

preeclampsia and the infant

A

HTN can cause uteroplacental spasm and result in IUGR, fetal hypoxia, fetal death

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31
Q

newborn signs of distress

A

grunting/flaring/tachypnea/gray skin/cyanosis/hypoxemia/subcostal retractions/hypoglycemia/hypothermia/hypotonia/tachycardia/apnea

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32
Q

physiologic jaundice

A

jaundice following first 24 hours (usually 2-5 days); increased bilirubin d/t polycythemia and short life spa of fetal RBC, decreased uptake by liver, decreased enzyme activity/ability to conjugate, decreased ability to excrete bilirubin, breast feeding

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33
Q

pathologic jaundice

A

jaundice within first 24 hours, total serum bili levels above 12mg/dL in term neonate or >15mg/dL in preterm, total serum bili level more than 5mg/dL per day, conjugated bili >2mg/dL, jaundice lasting greater than 1wk for term or 2 wk for premature

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34
Q

purulent amniotic fluid

A

can be sign of chorioamnionitis, prolonged rupture of membrane, or STI

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35
Q

DVT in maternal setting

A

occurs most often in lower extremities (foot to iliofemoral region); can lead to pulmonary embolism; presents as hot red edematous region; treat with anticoagulants, then ambulation and anti-embolic socks once symptoms reside

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36
Q

thermoregulation of newborn

A

heat loss causes newborn to compensate; signs/symptoms are increased metabolic rate, decreased surfactant production and hypoxemia, hypoglycemia d/t increased glucose consumption, metabolic acidosis increases risk of jaundice

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37
Q

mastitis

A

infected nipple fissure (usually S. aureus) due to bacteria introduced through cracks/fissure via mom/caregiver; engorgement and stasis of milk precede; need to breast feed, analgesic, bedrest, fluids, antibiotics

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38
Q

1 hour glucose challenge

A

screening for gestational diabetes; at 24-28 weeks mother drink 50g glucose and test after 1 hour; >140mg/dL requires 3 hour glucose test; <140mg/dL is negative and mom can continue routine prenatal care

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39
Q

STD’s (STIs)

A

can be parasitic, bacterial, viral; can cause PID, infertility, cancer, chronic hepatitis

40
Q

true labor

A
  1. presence of regular phasic uterine contractions increasing in frequency and intensity 2. progressive cervical effacement and dilation, discomfort begins in back then radiates to abdomen, sedation does not diminish contraction, show usually present
41
Q

false labor

A

irregular contractions, no regular pattern, discomfort in lower abdomen and groin, show not present, no cervical change, contractions might stop when walking/rest, sedation stops or decreases contractions

42
Q

contraceptives

A

natural family planning, barrier methods, hormonal methods, IUD’s, surgical

43
Q

signs of ovulation

A

increased maternal estrogen levels (d/t LH surge), leukorrhea (increased discharge), pH of vagina becomes more alkaline (more favorable for sperm)

44
Q

ABO blood compatibility

A

most common incompatibility is mother=O and infant type A or B

45
Q

genital herpes

A

painful genital lesions that may be present internally or externally; up to 60% transmission rate from maternal-fetus with those who acquire herpes near time of delivery; less than 2% for those with recurrent herpes; treat with aycyclovir and antirviral therapy; c-section if active outbreak

46
Q

fetal heart rate decelerations

A

indicative of fetal distress; decrease in HR; VEAL CHOP

47
Q

neonatal abstinence syndrome

A

infants from substance abusing mothers; may be irritable (6-8 weeks), jittery, reduce withdrawals, promote adequate respiration/temp./nutrition, swaddle,

48
Q

symptoms of hypoglycemic infant

A

jittery, tachypnea, diaphoresis, hypotonia, lethargy, apnea, temperature instability

49
Q

syphilis in pregnancy

A

chancre or ulcer in mom and can lead to CNS and cause organ damage; can cause preterm birth, physical deformity, neurological complications, still birth, or neonatal death; transplacental transmission; treat with penicillin

50
Q

emergency contraceptives

A

must be taken with 72-120 hours; for one time use by suppressing ovulation; ex levonorgestrel

51
Q

nursing considerations prior to epidural

A

check lab values for bleeding or clotting abnormalities, check platelets; obtain consent; fluid bolus (NS or LR); ensure emergency equipment available; conduct time out; vitals (watch for hypotension)

52
Q

PPH

A

> 500 mL in SVD; >1000 mL in C-section; any bleeding that puts mother in harm

53
Q

positional changes during labor

A

walking,rocking, peanut ball/birthing ball; encourage change every 30 minutes

54
Q

normal percent weight loss after birth (newborn)

A

lose up to 7% of birth weight

55
Q

GBS treatment

A

if mom positive at 35-37 weeks, treat with penicillin or ampicillin to prevent transmission to fetus

56
Q

phototherapy nursing considerations

A

assessments (VS, feeding, bowels), warmth (cold stress, acidosis), phototherapy (cover eyes, genitalia), tactile stim., readjust position q2hours, answer parent question/concerns

57
Q

normal post partum bleeding

A
58
Q

abnormal postpartum bleeding

A

saturating pad within 1 hour; saturating pad within 15 minutes is extreme; rubra after day 4; foul odor;from alba to bright red bleeding

59
Q

contraceptives avoiding during breast-feeding

A

do not use estrogen; it can decrease milk supply

60
Q

Vitamin K

A

intramuscular vaccination given to newborn to prevent hemorrhagic disease

61
Q

natural family planning contraception

A

24% failure rate; need to have proper awareness of own body including temperature (increase in basal metabolic rate) and vaginal discharge (clear egg white like is fertile compared to white secretion)

62
Q

transition phase of labor

A

8-10 cm; short but intense, contractions every 1.5-2 minutes for 60-90 sec; very irritable; may lose control; N/V common

63
Q

epidurals

A

epidural: anesthetic injected into epidural space that allows for mother to walk and decreases pain; spinal: 100% block of sensation and motor function

64
Q

HIV in pregnancy and transition to newborn

A

early antiretroviral and lessen chances of transmission to fetus (less than 2% with treatment); 15-25% chance of maternal-fetal transmission without treatment; treatment is anteviral and c-section; avoid breast-feeding

65
Q

postpartum depression

A

occurs in 10-20% of all postpartum patients; pervasive sadness, mood swings, fear, anger, anxiety, unable to care for self or infant, irritability that may lead to violence, rejection of infant, obsessive thoughts

66
Q

chlamydia

A

usually asymptomatic in women but can cause burning sensation while urinating; presence during birth can cause fetal conjunctivitis or premature birth; treat with oral antibiotics

67
Q

variable decelerations

A

present in between contractions; indicative of cord compression; requires maternal movement or manual manipulation of fetus off of cord

68
Q

CVS

A

used to diagnose fetal chromosomal abnormalities; earlier use then amniocentesis (~10 weeks gestation)

69
Q

risk factors of developing placenta previa

A

from scarring from previous previa, C/C, abortion, multiparity; large placenta/multiple gestation; nonwhite; infertility; low socioeconomic status; impeded endometrial vascularization from >35Y, diabetes, smoking, cocaine

70
Q

placenta previa

A

painless intermittent bleeding confirmed by ultrasound

71
Q

placenta previa risk for fetus

A

prematurity then malpresentation, IUGR, anemia

72
Q

placenta previa maternal risk

A

hemorrhage then lower uterine not responsive to oxytocin (use methergine)

73
Q

placenta abruption

A

premature separation of normally implanted placenta; sudden onset of intense sharp abdominal pain; vaginal bleeding may or may not be present; port-wine stained amniotic fluid

74
Q

risk factors for placental abruption

A

HTN, seizures, blunt trauma, short umbilical cord, previous abruption, cocaine use

75
Q

maternal serum AFP (MSAFP)

A

high level = neural tube defect (spina bifida); low level = might indicate down syndrome

76
Q

APGAR specifics

A

Activity- 0= flaccid, 1 = some flexion, 2 = active flexion; Pulse- 0 = absent, 1 = 60-100, 2 = >100, Grimace- 0 =no response (floppy), 1 = grimace (minimal response), 2 = vigorous cry; Appearance - 0 = cyanotic/pale, 1 = body pink/extremities blue, 2 = pink; Respiration- 0 = apneic, 1 = slow, irregular weak, 2 = lust cry

77
Q

Active phase labor

A

4-7cm; fetal descend; contractions stronger longer closer together, every 2-5 min for 40-60 sec; increased discomfort and anxiety; instinctual behavior

78
Q

early phase labor

A

0-3cm; initially mildly uncomfortable; contractions every 10-30 minutes for 20-40 seconds; then every 3-7 minutes for 30-40 sec; pt is excited and sociable; songs of progressing are longer stronger and closer contractions

79
Q

torch

A

can cause congenital conditions if fetus exposed in utero; toxoplasmosis, other, rubella, cytomegalovirus, herpes

80
Q

parasitic STDs

A

pediculosis, scabies, trichomoniasis

81
Q

bacterial STDs

A

chlamydia, gonorrhea, syphilis, bacterial vaginosis

82
Q

viral STDs

A

HPV, HIV, HSV, Viral Hep A and Hep B

83
Q

GTPAL

A

gravida- number of pregnancies (including current one); term- birth to term infants (37 weeks); preterm- birth to preterm infant (20-36.6 weeks); abortions- miscarriages/abortions; Living- number of living children currently

84
Q

toxoplasmosis

A

caused by parasite; can cause flu-like symptoms but most are asymptomatic; causes chorioretinitis, hydrocephaly, microcephaly, intracranial calcifications

85
Q

other (torch)

A

syphilis, GBS, varicella zoster, HIV, parvovirus B19

86
Q

cytomeglovirus (CMV)

A

can be transmitted by primary infection, reinfection with different strain, or reactivation of previous infection during pregnancy; greatest risk in 3rd trimester; most common non-genetic cause of childhood hearing loss

87
Q

ovulatory phase begins…

A

when estrogen peaks and ends with release of oocyte from mature graafian follicle known as ovulation

88
Q

12-36 hours prior to ovulation

A

LH levels surge, estrogen begins to decrease, progesterone starts to increase

89
Q

graafian follicle matures d/t

A

LH and FSH released from pituitary; mature graafian follicle produces estrogen

90
Q

ovarian cycle

A

follicular phase begins after first day of menstruation and lasts 12-14 days, then ovulation occurs, then luteal phase occurs for 14 days following ovulation

91
Q

luteal phase consists of

A

empty follicle cells morph to corpus luteum to produce high levels of progesterone and low levels of estrogen, if pregnancy occurs then placenta takes over this function; if it does not occur corpus luteum degenerates and decreases progesterone leading to menstruation

92
Q

endometrial cycle

A

has to do with the changing of the endometrium in uterus corresponding to hormones released during ovarian cycle; consists of proliferative phase, secretory phase, menstrual phase;

93
Q

proliferative phase

A

occurs following menstruation and ends with ovulation; endometrium thickens and becomes more vascular in preparation for implantation of zygote; occurs as result of increasing estrogen from graafian cell

94
Q

secretory phase

A

begins after ovulation and ends with menstruation; endometrium continues to thicken d/t release of progesterone secreted from corpus luteum; if pregnancy does not occur then endometrium and corpus luteum begin to degenerate

95
Q

menstrual phase

A

occurs as result of hormonal changes and results in sloughing off of endometrial tissue

Women and Families (4 decks)

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