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2 Maternal Health > HESI Maternal Health > Flashcards

HESI Maternal Health Flashcards

1
Q

GOODell’s sign

A

cervical softening
“soft cervix is a GOOD sign”

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2
Q

CHADwick’s sign

A

blue/purple birth canal
“CHAD is a bully, he’ll beat you black and blue”
PROBABLE SIGN

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3
Q

Hegar’s sign

A

Softening of the lower uterine segment
H-Head goes
PROBABLE SIGN

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4
Q

Positive sign diagnosis of pregnacy (x3)

A

Fetal heartbeat (Doppler device at 10-12 weeks)
Ultrasound
Fetal movement (palpate or observed by HCP

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5
Q

GTPAL

A

Gravidity
Term Birth
Preterm birth
Abortion
Living children

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6
Q

Safe vaccines during pregnacy

A

T: Tetanus
D: Dophteria
P: Pertussis
Inactivated Influenza (flu shot)
Tdap vaccine 27-36 weeks

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7
Q

Meds to avoid during pregnacy

A

NSAIDS: Naproxen, Salyslic acid, Aspirin, Ibuprofen (indomethacine), Ketorolac
ACE and ARBS: -prils and -sartan
DoxyCYCLINE and TetraCYCLINE
Carbamazepine: seizure drug

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8
Q

Expected weight gain

A

25-35lbs during pregnancy
Gain one pound per week with normal BMI during 2nd and 3rd trimester

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9
Q

Morning sickness interventions

A

Nausea during first trimester (1-13)
High-protein diet upon awakening
Drink fluids between meals
Vit B6

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10
Q

placenta previa Interventions

A

Painless vaginal bleeding
Bright red
Interventions: 2 large-bore IV catheters, draw blood for cross reference
Monitor fetal monitor

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11
Q

Placental abruption

A

Severe pain with dark red bleeding
Uterine Tachysystole

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12
Q

Preeclampsia

A

Protein in urine
Elevated blood pressure
Weight gain of >1lb/ week
Begins after 20 weeks of pregnancy

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13
Q

HELLP Syndrome

A

Hemolysis, Elevated Liver, Low Platelet
Symptoms: Right upper quadrant pain, nausea and vomiting
Treatment: Magnesium Sulfate

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14
Q

Lochia color changes

A

Rubra, Dark red: 3-4 days
Serosa, Pinkish brown: 4-10 days
Alba, Whitish yellow: 10-28 days
Excessive bleeding: 1 pad in 15 minutes

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15
Q

Normal contractions

A

Every 2-3 minutes
Duration, intensity, rest: rule of 60!
Tachysystole: Over 5 contractions in 10 minutes

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16
Q

Fetal Tachycardia causes

A

FHR over 160 for over 10 minutes (early sign of fetal distress)
Causes: Mother broken bone, maternal infection or fever

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17
Q

Fetal Bradycardia causes

A

FHR under 110 for over 10 minutes
Causes: Uteroplacental insufficiency
Interventions: ROADI
Reposition, Oxygen, Alert HCP, Discontinue oxytocin, Increase IV fluids

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18
Q

Sinusoidal FHR

A

No response to contractions: wave-like fluctuations
Causes: abdominal trauma- leading to fetal blood loss or anemia
EMERGENCY C-SECTION

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19
Q

Epidural and spinal block interventions

A

IV fluids to help counteract side effects
Turn mother to left lateral position and increase IV fluid rate

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20
Q

What is the number one cause of neonatal mortality?

A

Preterm labor

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21
Q

DIC pregnancy Intervention

A

PRIORITY: Draw coagulation tests, fibrinogen, and platelet count

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22
Q

Placenta Accreta

A

Placenta attaches to the uterus too firmly

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23
Q

Amniotomy

A

HCP manually induce labor by rupturing the amniotic membrane (breaking the water)

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24
Q

Bishops score

A

Cervical readiness for induction of labor
Over 6-8 score indicated induction will be sucessful

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25
High pitch cry meaning
Signs of hypoglycemia of newborn
26
APGAR score
1 minute after birth, then 5 minutes after birth
27
Newborn vital signs
Every 30 minutes after birth for 2 hours
28
Pain scale (x3)
Cries scale: 0-6months Flacc scale: 2months-2 years Face scale: 3-4 years Numeric scale: 5 years
29
Toilet training age
18-24 months Bowel control first, then bladder control at 24 months
29
Wilms tumor
(Cancer) Nephroblastoma: kidney cells do not fully develop to maturity One side abdominal mass "bulging" DO NOT PALPATE
30
Tetralogy of Fallot
Experience bluish skin w/ crying or feeding 4 types Tet spells: knees to chest
31
Patent ductus arteriosus
Opening that connects aorta to pulmonary artery Machine like murmur "duck machine"
32
PKU: Phenylketonuria
Avoid high protein and iron foods No meats, eggs, dairy products, peanut butter
33
Projectile vomiting
Pyloric stenosis
34
Ribbon like stools
Hirschsprung's disease missing nerve cells in colon
35
Stool blood-streaked and mucus mixed Currant jelly appearance Sausage-shaped abdominal mass
Intussusception
36
Hemophilia A and B
A: clotting factor 8 B: clotting factor 9
37
Whooping cough
Pertussis: dangerous due to inflammation of small airways Single private room Give small amount of fluids frequently
38
No longer contagious with varcella
When lesions crust over within 7 days Cover with band-aid until completely dry, crusted over
39
Separation anxiety
Starts at 6 months
40
Meningitis and Increased ICP
2 years or less Bulging fontanelles at rest: report to HCP Sclera visible above the iris
41
Hydrocephalus Priority assessment
Fontanel assessment
42
Cerebral palsy signs/symptoms
Delayed development with walking, speaking and swallowing "pausing" Infant head that falls back behind the shoulders
43
Key sign of status asthatius
Pulsus paradoxus: drop in systolic blood pressure more than 10mmHg
44
Epiglottitis causes
Missing standard vaccinations (Influenza type B) Trach and endotrach kit ready by bedside Have stridor (squeak)
45
Cryptorchidism
Not a priority descend spontaneously after 6 months after birth
46
Nephrotic vs glomerulonephritis
Key difference: Nephrotic: "nasty protein loss" autoimmune Glom: inflammation and scarring
47
What med to use for dry and cracked nipples
Lanoline
48
After delivery breasts will leak what fluid and begin to fill?
Colostrum
49
Chorioamnionitis what to monitor
Maternal infection that affects the placenta and the membranes that surround the growing baby ASSESSMENT: check FHR FIRST, then fluid and color Monitor: Maternal temp q 2 hours after rupture of membrane FHR above 180 Pt has severe headache, assess TEMPERATURE FIRST
50
SROM assessment
#1 assessment: Fetal heart rate Assess color and consistency to identify meconium aspiration
51
Atraumatic care 6 months and older
EMLA cream 60 minutes before ICE pack on injection site 2 nurses to give multiple immunizations
52
Post partum depression
intense and pervasive sadness with labile mood last >2 weeks
53
Epiglottitis 1st action
Racemic epinephrine (to reduce edema) 2nd action: airway management (intubation, not tracheostomy)
54
Spontaneous abortion care
vaginal rest >2weeks May shower daily Birth control teaching
55
Spontaneous abortion return visit
Fever >38 or 100.4 Chills >2 saturated pads in 2 hours Foul smell vaginal discharge
56
Post term babies
Blood sugar PRIORITY Hair and nails long Dry, peeling skin OXYGEN IS NOT A PRIORITY (lungs are fully developed)
57
Newborn vital signs
HR:120-140 RR:30-50 Systolic: 50-70
58
Bronchiolotis/RSV
Supportive care (VIRUS) SYNAGIS is not a vaccine, children can still get severe RSV disease
59
Lyme Disease Early treatment
Caused by ticks Antibiotics for 2-4 weeks Prevents the spread to joints, nervous system, or heart
60
Lyme Disease Late treatement
Return to MD if bruising goes away with these symptoms: Headache Stiff Neck Arthritis Facial Palsy
61
Physiologic anemia of pregnancy (Hemodilution)
3rd trimester (28-40) if hemoglobin is less than 10.5
62
Iron supplement
Ferrous Sulfate 325mg BID
63
Spastic Cerebral Palsy
TIP TOE WALKING Babinski reflex Hypertonicity with poor control of posture
64
Cleft lip surgical care
Syringe feeding for 7-10 days after procedure
65
Vomiting/Diarrhea
Assess for signs of dehydration CHECK Elevated HR FIRST, blood pressure late sign Sunken fontanels Number of wet diapers Listlessness
66
Which stage can children start giving their own insulin
Industry vs inferiority (6-12)
67
Suspected compartment syndrome: nursing intervention
DO NOT call the provider without all of your assessment completed including 6 P's Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Pressure
68
Breastfeeding Education
Feed on first breast until it softens (ensures baby is receiving hindmilk: Higher fat content)
69
Pelvic Inflammatory Disease PID
Sexually transmitted bacterial spreading to ovaries Treatment: extensive antibiotic therapy to prevent infertility
70
Transposition of the great arteries Assessment/Treatment
No communication between the systemic and pulmonary circulation Assessment findings: severe cyanosis, cardiomegaly Treatment: Keep PDA open until surgery
71
Heart failure: signs/symptoms
Hepatomegaly Cardiomegaly Dyspnea, tachycardia ALSO CHECH BP
72
Cytotec (Misoprostol)
softens cervix Bishop score <4 25-50mcg tablets intravaginally Have patient lay on side after administration >4 hours after last dose: Pitocin administration Have terbutaline 0.25mg on hand
73
Sickle cell crisis: signs/prevention
Signs: extreme pain episodes Prevention: #1-Hydration #2-Oxygen #3-pain medication
74
Biliary atresia
Bile duct narrowing Jaundice Dark urine Diet: medium chained triglyceride (pregestimil)
75
Vitamin K
Activate blood clotting factors Not initially synthesized due to sterile gut (no normal flora in intestine) Cannot be synthesized until food is introduced into the bowel
76
Pediculosis Capitus
Head lice Children should remain home from school and daycare until child is louse and nit free
77
Weeks of trimesters
First: 1-13 weeks Second: 14-27 Third: 28-40
78
Necrotizing enterocolitis #1 intervention
Stop the feeding
79
Quickening
Fetal movement Occurs after 14 weeks Nulliparous patient: after 18 weeks
80
Precipitous labor
Dangerous labor

2 Maternal Health (8 decks)

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