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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
Q

High pitch cry meaning

A

Signs of hypoglycemia of newborn

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26
Q

APGAR score

A

1 minute after birth, then 5 minutes after birth

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27
Q

Newborn vital signs

A

Every 30 minutes after birth for 2 hours

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28
Q

Pain scale (x3)

A

Cries scale: 0-6months
Flacc scale: 2months-2 years
Face scale: 3-4 years
Numeric scale: 5 years

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29
Q

Toilet training age

A

18-24 months
Bowel control first, then bladder control at 24 months

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29
Q

Wilms tumor

A

(Cancer) Nephroblastoma: kidney cells do not fully develop to maturity
One side abdominal mass “bulging”
DO NOT PALPATE

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30
Q

Tetralogy of Fallot

A

Experience bluish skin w/ crying or feeding
4 types
Tet spells: knees to chest

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31
Q

Patent ductus arteriosus

A

Opening that connects aorta to pulmonary artery
Machine like murmur
“duck machine”

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32
Q

PKU: Phenylketonuria

A

Avoid high protein and iron foods
No meats, eggs, dairy products, peanut butter

33
Q

Projectile vomiting

A

Pyloric stenosis

34
Q

Ribbon like stools

A

Hirschsprung’s disease
missing nerve cells in colon

35
Q

Stool blood-streaked and mucus mixed
Currant jelly appearance
Sausage-shaped abdominal mass

A

Intussusception

36
Q

Hemophilia A and B

A

A: clotting factor 8
B: clotting factor 9

37
Q

Whooping cough

A

Pertussis: dangerous due to inflammation of small airways
Single private room
Give small amount of fluids frequently

38
Q

No longer contagious with varcella

A

When lesions crust over within 7 days
Cover with band-aid until completely dry, crusted over

39
Q

Separation anxiety

A

Starts at 6 months

40
Q

Meningitis and Increased ICP

A

2 years or less
Bulging fontanelles at rest: report to HCP
Sclera visible above the iris

41
Q

Hydrocephalus Priority assessment

A

Fontanel assessment

42
Q

Cerebral palsy signs/symptoms

A

Delayed development with walking, speaking and swallowing
“pausing”
Infant head that falls back behind the shoulders

43
Q

Key sign of status asthatius

A

Pulsus paradoxus: drop in systolic blood pressure more than 10mmHg

44
Q

Epiglottitis causes

A

Missing standard vaccinations (Influenza type B)
Trach and endotrach kit ready by bedside
Have stridor (squeak)

45
Q

Cryptorchidism

A

Not a priority descend spontaneously after 6 months after birth

46
Q

Nephrotic vs glomerulonephritis

A

Key difference:
Nephrotic: “nasty protein loss” autoimmune
Glom: inflammation and scarring

47
Q

What med to use for dry and cracked nipples

A

Lanoline

48
Q

After delivery breasts will leak what fluid and begin to fill?

A

Colostrum

49
Q

Chorioamnionitis what to monitor

A

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
Q

SROM assessment

A

1 assessment: Fetal heart rate

Assess color and consistency to identify meconium aspiration

51
Q

Atraumatic care 6 months and older

A

EMLA cream 60 minutes before
ICE pack on injection site
2 nurses to give multiple immunizations

52
Q

Post partum depression

A

intense and pervasive sadness with labile mood
last >2 weeks

53
Q

Epiglottitis 1st action

A

Racemic epinephrine (to reduce edema)
2nd action: airway management (intubation, not tracheostomy)

54
Q

Spontaneous abortion care

A

vaginal rest >2weeks
May shower daily
Birth control teaching

55
Q

Spontaneous abortion return visit

A

Fever >38 or 100.4
Chills
>2 saturated pads in 2 hours
Foul smell vaginal discharge

56
Q

Post term babies

A

Blood sugar PRIORITY
Hair and nails long
Dry, peeling skin
OXYGEN IS NOT A PRIORITY (lungs are fully developed)

57
Q

Newborn vital signs

A

HR:120-140
RR:30-50
Systolic: 50-70

58
Q

Bronchiolotis/RSV

A

Supportive care (VIRUS)
SYNAGIS is not a vaccine, children can still get severe RSV disease

59
Q

Lyme Disease Early treatment

A

Caused by ticks
Antibiotics for 2-4 weeks
Prevents the spread to joints, nervous system, or heart

60
Q

Lyme Disease Late treatement

A

Return to MD if bruising goes away with these symptoms:
Headache
Stiff Neck
Arthritis
Facial Palsy

61
Q

Physiologic anemia of pregnancy (Hemodilution)

A

3rd trimester (28-40) if hemoglobin is less than 10.5

62
Q

Iron supplement

A

Ferrous Sulfate 325mg BID

63
Q

Spastic Cerebral Palsy

A

TIP TOE WALKING
Babinski reflex
Hypertonicity with poor control of posture

64
Q

Cleft lip surgical care

A

Syringe feeding for 7-10 days after procedure

65
Q

Vomiting/Diarrhea

A

Assess for signs of dehydration
CHECK Elevated HR FIRST, blood pressure late sign
Sunken fontanels
Number of wet diapers
Listlessness

66
Q

Which stage can children start giving their own insulin

A

Industry vs inferiority (6-12)

67
Q

Suspected compartment syndrome: nursing intervention

A

DO NOT call the provider without all of your assessment completed including 6 P’s
Pain, Pallor, Pulselessness, Paresthesia, Paralysis, Pressure

68
Q

Breastfeeding Education

A

Feed on first breast until it softens (ensures baby is receiving hindmilk: Higher fat content)

69
Q

Pelvic Inflammatory Disease PID

A

Sexually transmitted bacterial spreading to ovaries
Treatment: extensive antibiotic therapy to prevent infertility

70
Q

Transposition of the great arteries
Assessment/Treatment

A

No communication between the systemic and pulmonary circulation
Assessment findings: severe cyanosis, cardiomegaly
Treatment: Keep PDA open until surgery

71
Q

Heart failure: signs/symptoms

A

Hepatomegaly
Cardiomegaly
Dyspnea, tachycardia
ALSO CHECH BP

72
Q

Cytotec (Misoprostol)

A

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
Q

Sickle cell crisis: signs/prevention

A

Signs: extreme pain episodes
Prevention:
#1-Hydration
#2-Oxygen
#3-pain medication

74
Q

Biliary atresia

A

Bile duct narrowing
Jaundice
Dark urine
Diet: medium chained triglyceride (pregestimil)

75
Q

Vitamin K

A

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
Q

Pediculosis Capitus

A

Head lice
Children should remain home from school and daycare until child is louse and nit free

77
Q

Weeks of trimesters

A

First: 1-13 weeks
Second: 14-27
Third: 28-40

78
Q

Necrotizing enterocolitis #1 intervention

A

Stop the feeding

79
Q

Quickening

A

Fetal movement
Occurs after 14 weeks
Nulliparous patient: after 18 weeks

80
Q

Precipitous labor

A

Dangerous labor

2 Maternal Health (8 decks)

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