Goad test 1 deck 2 Flashcards
What can prenatal education teach pregnant mom
abdominal and perineal excercises, tailor sitting, squatting, kegels, pelvic rocking
Gate control pain managemnt techniques
cutaneous stimulation, distraction, anxiety reduction
type of cutaneous stimulation
effleurage -light abdominal or thigh patterns
how do you reduce labor anxiety
telling women what to expect
Whats the diff betw LDR and LDRP
labor delivery recovery vs. labor delivery recovery postpartum
When can you first palpate fundus of uterus. How much does it rise per week?
12-14 weeks, 1 cm
what is diagonal conjugate, what is the minimum
Distance between the anterior surface of sacral prominence & anterior surface of inferior margin of symphysis pubis, 12.5 cm
how do you figure true conjugate
subtract 1.2 to 2 from diagonal conjugate
What distance is needed between ischial tuberosities?
11 cm
What antibody titers would a pregnant woman get? What serological? What vag cultures?
rubella, hep B, syphilis VDRL, chlamydia & gonorrhea,
what is vdrl
venereal disease research lab’s test for syphilis
how to screen mom’s blood for birth defects. WHat does high result mean, what does low mean?
increased alpha-fetoprotein AFP for neural tube defects, decreased with fetal chromosome abnormality
What is the test they give Rh neg women to see if they have Rh antibodies
Coombs test
What week would you do a group B strep test?
35-38
why is oral care a pregnancy issue
gingival hyperplasia
what is leukorrhea
vaginal discharge in pregnancy
Can I still have socks while I am pregnant? What could go wrong?
Yes, but no garters or knee highs. Tight socks could give you varicose veins.
Saunas and hottubs and tanning beds?
Heck no. Increased temp can cause birth defects.
What’s that one knee up sleep position i use?q
Sim’s poition
How many weeks do you get from family Leave Act?
12
WHy get out and walk every 2 hours when pregnant driving?
circulation
nonpharm help for breast tenderness
keep em warm
Why am I nauseous during preganancy?
hormones, smoth muscle relaxation, less gastric motility, low blood glucose, vitamin B6 deficit
Morning sick: when should I drink fluids
betw meals
Why am I so tired if preg
^ metabolism, hormonal change
WHy cant I work on my feet all day if preg and stand around in warm areas
VTE and blood pooling in legs and pelvis-could faint
why do I get musc cramps if preg?
low calcium, high phosphorus, circulation changes, uterus pressure
leg cramp! what now
lie down and dorsiflex foot
Why would I get amphojel?
inclower phosphorus and stop leg cramps
What does uterus flatten in supine hypotension
vena cava
What vitamin can help varicosity?
C
what position relieves hemorrhoid pain?
knee-chest
What way to walk decreases backache
pelvic tilt forward to support fetal weight
preg headache advice
nutritious snack, change position slowly, cold comress on head, tylenol
if preg woman has edema, check for what
HTN and proteiuria
list danger signs of preg
bleeding, persistent vomiting, chills & fever, sudden relase of clear fluid from vag, chest or abd pain, increase or decrease in fetal movement, HTN
Pregnancy Induced HTN signs
HTN, proteinuria, edema, weight gain over 2 lbs/wk second trimester and 1 lb/wk 3rd trimester, flashes of lights or eye spots or blurring, continuous headache, decreased urine output
lead and mercury attack what in fetus
nervous system
tetracycline attacks what in fetus
tooth and bone
disease that attacks the most fetal organs
rubella
how does alcohol hurt fetus
vit b deficiency
how does early preg (4-6 weeks) fever hurt fetus
can affect brain devel, cause seizures, cause hypotonia, cause skeletal deformity
how fast can I gain weight
1 lb per month inf the first three months, then 1 lb per week
How many more calories/day for preg
300
Why not eat low protein in preg
ketoacidosis will happen break down proteins for energy when there is no cho for energy, and that can cause neuro disorders
How many grams protein a day for preg. what is normal
71, usually around 46
What is the most critical fatty acid and where does it come from? Why stress over it?q
linoleic acid, veggies, The body does not make it
How many mgs of calcium a day if preg? what’s normal
1300
Iron rda per day
27g
what are foods high in iron
eggs, organ meat, green leafy vegs, dried fruit, whole grains
best thing to gulp down your iron tablet
OJ
WIC eligibility
pregnant, PP 6 monts w/ bottle and 12 months w/breast , children birth to 5
why would my cholesterol shoot up in pregnancy. What risks are created?
progesterone, gallstones & cardiovascular disease
For underweight preg, why notuse protein drinks and hi cal supplements?
too hard on kidneys, and the ratio of carbs to protein is low and can cause ketoacidosis
what is fetal macrosomia and which mom is most at risk for it
excessive fetal growth and obese women are more at risk
What if the client is lactose intolerant?
Can give her lactase before she drinks milk. Or use substitutes.
Hyperemesis gravidarum may be related to problems with this gland. What bacteria is it associated with? What do labs show? WHat should go in their IV?
thyroid overstimulated. H pylori. elevated ketones, elevated hematocrit (dehydration) low sodium, potassium, chloride: Give her Lactated Ringer’s with vit. B, maybe Zofran or Reglan
What triggers labor?
prostaglandins from uterus stretching, oxytocin from pressure on cervix
primipara lightening when? multipara when
10-14 days in advance. Multiparas can be day of labor or sooner.
What causes nesting?
decreased progesterone increases epinephrine and energy
What is cervical softening called?
Goodells sign
how does primip know its time to go to the hosp? what a bout multip?
5 minutes apart and 45-60 seconds long and increasing intensity. Multip same but 10 minutes apart.
How does true labor feel? what signs?
back to front wave, cerv dilation, bloody show, ROM
What station is engagement?
0
what is caput succedaneum
fetal head edema from pressing on cervix
who gets external version?
mom whose baby is breech
RSA is
Right sacral anterior, a breech presentation where the butt is pointing right and forward (anterior)
What is LOP and why is it a problem?
Left occiput posterior, the back of the head points to mom’s left and her back, meaning labor will be long with a lot of back pain.
List cardinal movements of labor
descent, flexion, internal rotation, extension, external rotation,
when is full descent reached. Where will head be?
at vagina: head in on sacral nerves oh my god i gotta push
internal rotation from what to what
from the head’s anteroposterior diameter being transverse to being occiput anterior
What’s flexion
chin to chest
What’s extension
opposite of flexion, head thrown back
What are the 3 phases of a contraction
increment, acme, decrement
What is the duration and the relaxation interval for very late contractions?
Up to 90 seconds long with 2-3 minutes between.
When does 1st stage labor begin and end?
beginning with true labor contractions & ending when the cervix is fully dilated (10 cm)
When does 2nd stage labor begin and end? What is it called?
from full dilatation until the baby is born. Expulsion stage.
When does 3rd stage labor begin and end?
from the time the baby is born until the placenta is expelled
When does 4th stage labor begin and end
the first 1-4 hours after the delivery of placenta
Which stage of labor has its own stages, and what are they?
1st, latent, active, and transition
Latent phase of 1st stage- begins with ____, ends with ____. How long are the contractions? How long does it last for new moms? Old moms?
begins w reg contractions, ends at effacement and dilation of 0-3cm. Contractions are 20-30 seconds. Lasts 6 hours for new moms and 4.5 in multips.
Active phase of 1st stage- ___cm dilation to ___cm. Contractions last _____ and occur every ______ min. How long is this phase?
4-7cm, lasting 40-60 seconds and happening every 3-5 minutes. Phase lasts 2-3 hours.
Transition phase of 1st stage- __cm dilation to __cm. Contractions last ____ and occur every ___ min. What signals the end of this phase?
8-10cm, lasting 60-90 sec and happening every 2-3 min. Ends at 10 cm and the irresistible urge to push.
How much blood is lost when placenta is delivered, and why is this ok?
300-500ml, pregnancy shoots blood volume up anyway so it’s ok.
How much can SBP increase with a contraction?
15 mm Hg
What happens to WBCs at birth (for mom)
increase to 25,000 to 30,000
How do contractions affect fetal HR?
decrease up to 5 bpm
WHy can the vaginally delivered baby breathe better?
gunk is squeezed out of lungs and labor process increases surfactant.
What color meconium is a danger sign?
green
Why worry if fetus is actively moving in labor?
Usually quiet, hyperactivity cd be hypoxia.
Why test fetal scalp blood? Whatt’s a sign of distress?
fetal acidosis- pH below 7.2
What’s materal BP danger signs?
SBP over 140 or more than 30 over baseline, DBP over 90 or more than 15 over baseline. Or falling BP could show hemorrhage.
What’s maternal (non BP) danger signs?
pulse over 100, fever, inadequate contractions, increasing maternal apprehension
DO NOT do a vaginal exam if there is this. Why?
fresh bleeding, could show placenta previa
How often do you take temp after ROM?
q2h
what is normal FHR
110-160bpm
What’s wrong with late decelerations?
Suggests uteroplacental insufficiency or reduced blood flow through the intervillous spaces of uterus during uterine contractions, May be caused by hypertonia or abnormal uterine tone R/T administration of oxytocin
What are the interventions for late decelerations
If oxytocin is being used—stop it or slow rate
– Turn woman to left lateral side—will send more blood to uterus—take pressure off of vena cava & aorta
– Increase IV rate & O2 administration
– Report any pattern changes—especially prolonged decelerations & persistent patterns
– Prepare for birth—C-section
What’s wrong with variable decelerations?
Cord compression—most common cause
– Oligohydramnios—post term preg or intrauterine growth restriction
What are the interventions for variable decelerations?
Change of position—left lateral or knee chest—to relieve pressure on the cord
– Administer IV fluids & O2 – Aminoinfusion may be prescribed
