HESI Maternity Flashcards
When is terbutaline used and what are the main side effects?
- in preterm labor, to stop contractions
- tachycardia, increased CO, restlessness, headache, and a feeling of nervousness
What disease can cause infection in babies and can be prevented by an ophthalmic ointment after birth?
- gonorrhea
What does a decrease in tenderness in the breast indicate in the first trimester?
- hormone levels have declined and that a miscarriage is imminent
What are discharge instructions for a circumcision on an infant?
- wash with warm water at each diaper change to remove any urine or feces
- petroleum ointment to prevent diaper from sticking to the site
- do NOT remove yellow exudate
- if bleeding occurs, apply gentle pressure to the site with sterile gauze squares and call HCP
erythema toxicum
small red patches on the cheeks and trunk; normal finding
milia
small white papillose present on the nose and chin; disappear w/n a few weeks
acrocyanosis
blue color of the hands and feet; common finding in newborns
V C
E H
A O
L P
- variable decelerations = cord compression
- early decelerations = head compression
- accelerations = oxygen
- Late decelerations = placental insufficiency
When will a nulliparous woman feel fetal movements
18 weeks
Discharge teaching for someone with mild preeclampsia (of when to report to the HCP)
- inc in BP
- protein in the urine
- weight gain greater than 1 pound per week
- edema
- 3 or fewer fetal movements in an hour
Signs of Magnesium Sulfate toxicity
- THINK CNS depression
- respiratory depression
- loss of DTR
- sudden decrease in FHR and/or maternal HR
- sudden drop in BP
Methylergonovine (methergine)
prescribed for PPH
- the nurse must assess BP administering it because it causes arterial vasoconstriction
naegele’s rule
- how to determine estimated date of delivery
- first day of LMP - 3 months + 7 days + 1 year
What is the most favorable pelvis for successful labor and birth?
gynecoid pelvis
ductus venousus
connects the umbilical VEIN to the inferior VENA CAVA
ductus arteriosus
connects the AORTA to the pulmonary ARTERY
When can the gender of the baby be determined?
Week 12- with the appearance of the external genitalia
What is the first thing that you should do with someone that is 38 weeks pregnant has a FHR of 174 bpm
notify HCP
normal FHR in the first trimester
160-170bpm
normal FHR
110-160bpm
G/P
gravida = number of pregs para = number of pregnancies that have reached 20 weeks regardless of viability
GTPAL
G= gravida T= term =>37 weeks P= preterm 20-37 weeks A= abortion = doesn't make it to 20 weeks L= living
Prenatal Visits (for low-risk pregs)
- q 4weeks until 28th week
- q 2weeks 28-36th week
- q 1 week 36 weeks and beyond
High Hematocrit levels may indicate what?
gestational HTN
Foods high in iron
- fish and red meats
- cereal and yellow veggies
- green leafy veggies
- citrus fruits
- egg yolks
- dried fruit
Healthy weight gain during pregnancy
- 2-4 lbs in the first trimester
- 1 lb per week after
- total weight gain should be btw 25-35 pounds
fundal height
- at week 18 the funds should be the same length in cm as the gestational weeks
When do nausea, fatigue, and urinary freq usually subside?
after 13 weeks
exercise in preg
as long as the woman is ale to easily hold a conversation when exercising
S/s of preeclampsia/ eclampsia
- visual disturbances
- swelling of face, fingers, or sacrum
- severe, continuous headache
- persistent vomiting
- epigastric pain
Bladder for amniocentesis
in early preg…the bladder must be full to help support the uterus and to help push the uterus up in the abdomen for easy access
in late pre….. it must be empty so it will not be punctured
hegar’s sign
compressibility and softening of the lower uterine segment
chadwich’s sign
violet coloration of the mucous membranes of the cervix, vagina, and vulva
ballottement
rebounding of the fetus against the examiner’s fingers on palpation
when will the nulliparous woman experience quickening?
18th week
nonstress test
- assess placental function and oxygenation (fetal well being)
- reactive NST is normal, negative (a good sign)
contraction stress test
- negatve, normal means there are no late decals
what labs are affected by pica
decreased hemoglobin
What should you teach a pregnant woman to do when she has leg cramps?
- extend the knee and dorsiflex the foot
Pt teaching with rubella vaccine
-
Pt teaching with rubella vaccine
- effective birth control: cannot become preg 1-3 months after vaccine
- avoid contact with immunosuppressed individuals
- admin subcutaneously
- no egg allergy
Fetal Kick Count (when to notify her provider)
fewer than 10 kicks over two, 2-hour intervals or as instructed by HCP
how to provide relief from hemorrhoids
ice packs
how to provide relief from hemorrhoids
ice packs
When should you suspect ectopic pregnancy?
in a childbearing age who presents at an ER with unilateral or bilateral abdominal pain
Nursing Interventions ofr Abruptio Placentae
- admin O2 by face mask
- monitor for bleeding at IV sites and gums d/t inc risk for DIC
- prepare for emerergency c/s
- NO abdominal or vaginal manipulation
toxoplasmosis
related to exposure to cats, gardening, or eating raw meat
=> stillbirth, microcephaly, hydrocephalus, blindness, deafness
aclovir
not recommended during preg
What is the desired effect of pitocin?
- contractions every 2 to 3 mins, with duration of contractions no longer than 90 seconds
What medication is given to prevent seizures in a preeclamptic pt to prevent seizures AND prevent preterm labor?
magnesium sulfate
magnesium sulfate
- CNS depressant
- hold if rest
s/s of magnesium sulfate toxicity
- absent DTRs
- 8 mg/dL
What blood thinner can be safely taken during pregnancy
only heparin because it cannot cross the placenta
What are the cardinal signs of preeclampsia?
- HTN
- generalized edema
- proteinuria
Trimesters
1st trimester: 1-13 weeks
2nd trimester: 14-26 weeks
3rd trimester: 27-40 weeks
Prematurity Categories
Very Premature:
Normal Birthweight
2500-3999 grams
When is respiratory apnea concerning in a newborn
> 20 seconds
Fetal BG
40-60
Fetal RR
30-60
Fetal O2 sat
> 95%
Fetal temp
97.7 - 99
What is the goal of labor augmentation
contractions 12-3 mins with a duration of 60-70 seconds without Fetal distress
what is theophylline
used for asthma, infant apnea, and COPD
normal is 10-20 mg/dl
how to calculate caloric need in children
caloric need is 108 kcal/kg/day
For every 1 degree over normal temp, give 10% extra of the total calories that they are supposed to receive for that day
What meds do you give to someone to stop contractions when they are in pre-term labor
Think: Not my time!
Nifedipine
Mag Sulfate
Terbutamine
+ corticosteriods (for fetal lung development
What do you need to do prior to giving epidural?
- IV
- Fluid Bolus (500 mL)
- empty bladder
- lab ((platelets - do not give if low)
When can you give an epidural?
when 4 cm dilated
If a women is coomb’s negative what do we do?
- give rhogham (2nd injection) w/n 72 hours
4 Ds of Epiglottis
- drooling
- dysphagia
- dysphonia
- distressed inspiratory air movement (stridor)
craniosynotosis
premature
triad for RSV
- wheezing
- retractions
- cough
TOF
- VSD
- R vent hypertrophy
- pulmonic stenosis
- overriding aorta
What meds do you give to someone to stop contractions when they are in pre-term labor
Think: Not my time!
Nifedipine
Mag Sulfate
Terbutamine
+ corticosteroids (for fetal lung development
