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school > Introduction Part 1 maternity & mental health > Flashcards

Introduction Part 1 maternity & mental health Flashcards

1
Q

electronic fetal monitoring identifies what

A

non reassuring fetal heart rate tracings

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2
Q

what is the amplitude of external contraction monitoring effected by?

A

belt tightness, amount of adipose tissue, amount of amniotic fluid, position of mom and fetus and contraction strength

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3
Q

internal monitoring can be used only if…

A

after the rupture of membrane and cervical dilation

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4
Q

internal contraction monitoring accurately measures what

A

frequency, duration, intensity, resting tone, fetus’s favorite color

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5
Q

what is the normal fetal heart rate baseline

A

110-160 bpm

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6
Q

the frequency of a contraction is measured on the strip from what to what

A

beginning of one contraction to the beginning of the next contraction

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7
Q

the resting phase of a contraction pattern is wen the fetus gets what

A

re-oxygenated

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8
Q

when can you start listening to the fetal heart rate

A

8-12 weeks

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9
Q

abnormal findings in heart rate mean what

A

a compromised fetal state

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10
Q

what are reasons that a fetal heart rate can not be auscultated

A 
too early in pregnancy
fetal death
maternal obesity
polyhydramnios 
fetal position
peak of contraction
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11
Q

polyhydramnios

A

too much amniotic fluid

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12
Q

why was fetal monitoring first done

A

so cerebral palsy can be detected

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13
Q

doppler

A

ultrasound device, detects heart rate, used for low risk labor

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14
Q

electronic fetal monitoring

A

ongoing assessment of fetal oxygenation, looking for changes, device is placed over the fetal back and transmits to the monitor

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15
Q

the electronic fetal monitoring measures what

A

rate and pattern of fetal heart tones

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16
Q

uterine monitoring

A

placed on maternal fundus (top portion of uterus, gets tightest during contractions), measures in mmHg

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17
Q

uterine monitoring measures what

A

frequency, duration, intensity and resting tone

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18
Q

where is the fetal internal monitoring placed

A

electrode is clipped to baby’s skin (scalp)

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19
Q

does external monitoring show intensity of a contraction?

A

no, intensity is done by palpation

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20
Q

why is internal monitoring used

A

more accurately detects fetal heart rate and changes in FHR, and is not impeded by obesity, position or fluid

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21
Q

internal uterine monitoring is done because

A

shows pressure changes in uterus, more exact (objective) measurement of uterine activity (frequency, duration, resting tone and intensity)

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22
Q

what are the components of the internal/external monitoring paper

A

upper portion = fetal heart rate
lower portion = uterine activity
small block 10 seconds
large block 1 minute

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23
Q

average fetal HR observed during a 10 minute window, increases and decreases will not be counted

A

baseline

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24
Q

interplay between the sympathetic and parasympathetic nervous systems

A

baseline variability

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25
Q

absent baseline variability

A

amplitude is undetectable

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26
Q

minimal baseline variability

A

1-5 bpm (peak to trough)

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27
Q

moderate baseline variability

A

6-25 bpm (peak to trough)

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28
Q

marked baseline variability

A

more than 25 bpm (peak to trough)

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29
Q

where do we want the baseline variability to be?

A

moderate

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30
Q

what is the most sensitive indicator of fetal well being, and most important aspect of the strip

A

baseline variability

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31
Q

baseline of less than 110 bpm

A

bradycardia

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32
Q

what can unresolved bradycardia lead to

A

hypoxia

*intervention is needed

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33
Q

baseline of greater than 160 bpm

A

tachycardia

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34
Q

baseline of greater than 180 bpm

A

severe tachycardia

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35
Q

visual abrupt, temporary increase in FHR above baseline

A

accelerations

increase of 15 bpm, that 15 seconds of baseline from beginning to end

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36
Q

are accelerations normal? why or why not

A

yes, indicate fetal well being and an intact nervous system (seen with fetal movement)

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37
Q

decrease of FHR baseline, occurs with blood supply change to fetus

A

decelerations

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38
Q

Early Deceleration

A

gradual decrease of FHR below baseline, ALWAYS occurs with the contraction
*mirrors contraction

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39
Q

cause of early deceleration

A

fetal head compression

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40
Q

fetal head compression causes what

A

increase of ICP = decrease cerebral blood flow = vagal nerve stimulation = decrease of FHR

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41
Q

variable deceleration

A

abrupt decrease of FHR & abrupt recovery

Shape of V, W, U

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42
Q

are variable decelerations common

A

yes

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43
Q

what is the cause of a variable deceleration

A

cord compression

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44
Q

late deceleration

A

gradual decrease in FHR, occurs after contraction and with every contraction
**NOT GOOD

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45
Q

when does an early deceleration happen

A

mirrors contractions

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46
Q

when does a variable deceleration happen

A

varies

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47
Q

when does a late deceleration happen

A

after every contraction and with every contraction

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48
Q

cause of late deceleration

A

utero-placental insufficiency

*decrease in available O2 to fetus

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49
Q

fetal heart rate patterns that are abnormal may indicate what

A

fetal distress

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50
Q

what are S & Sx of fetal distress

A

bradycardia, tachycardia, decrease baseline variability (decrease of fetal movement), periodic changes

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51
Q

POPI

A

POSITION-relieve cord compression & fetal weight on moms vena cava (Left lateral position)
OXYGEN-non re-breather 10 lpm
Stop PITOCIN-stop Rx, which will stop contractions
IV Bolus- increase blood flow to fetus, increase intravascular volume

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52
Q

what can be done if there is fetal distress

A

POPI, internal monitor, call MD, administer tocolytic

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53
Q

Tocolytic

A

soften uterus (stop contractions)

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54
Q

who dictates the definition of “mental illness”

A

society

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55
Q

the inability of the general population to understand the motivation behind a behavior.

A

incomprehensibility

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56
Q

behavior is categorized as “normal or abnormal” according to ones cultural or societal norms

A

cultural relativity

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57
Q

the walking wounded

A

Severely mentally ill
this population is neglected, the people who need the most care are the ones who are not getting the help bc are poor or no insurance

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58
Q

worried well

A

majority of people in therapy, see therapist bc they have the money or insurance to pay for it

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59
Q

homelessness

A

70% are linked to drug/alcohol use

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60
Q

pre-enlightenment

A

Assistance- least restrictive approach, provided food and money to help keep family intact
Banishment-wandering bands of lunatics
Confinement-most restrictive, often chained, placed on display

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61
Q

period of enlightenment

A

1790 asylums, Dorothea Dix had first asylum in US

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62
Q

period of scientific study

A

1870 shift from sanctuary to Tx
sigmound freud
classification of mental disorders

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63
Q

period of psychotropic drugs

A

1950
Thorazine: antipsychotic
Lithium: antimanic
Tofranil: antidepressant

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64
Q

period of community health

A

1960
least constrictive movement
federal funds
commitment laws

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65
Q

decade of the brain

A

1990s
brain research
1st diagnostic manual
1st introduced into RN books

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66
Q

Axis I

A

the mental disorder

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67
Q

Axis II

A

disorders related to personality & mental retardation

68
Q

Axis III

A

Current medical problems

69
Q

Axis IV

A

Psychosocial/Environmental Problems

-loss of job, homelessness, prison etc

70
Q

Axis V

A

Global Assessment of Functioning (GAF)

scale of 0-100

71
Q

what 3 things are needed in the psychotherapeutic management

A

nurse patient relationship-use of self
psychopharmacology-use of Rx
milieu-use of environment

72
Q

what is the major intervention is the nurse patient relationship

A

communication

73
Q

rapport

A

development of trust, getting acquainted

74
Q

empathy

A

hear what you are saying and ask how YOU are feeling

75
Q

sympathy

A

feeling sorry for someone and relating how it has effected them

76
Q

what are circumstances that blur boundaries

A

over helping, controlling, narcissism, transference, counter-transference

77
Q

transference

A

pt relates caregiver as someone they know

78
Q

counter-transference

A

caregiver relates pt as someone they know

79
Q

narcissism

A

all about me not the pt

80
Q

milieu

A

therapeutic community or environment

81
Q

active listening allows for the RN to do what

A

watch pts non-verbals

82
Q

using silence allows for the client to do what

A

gives client the opportunity to collect and organize thoughts

83
Q

paraphrasing

A

restating in different words

84
Q

restating

A

repeating the main idea and using the same key words

85
Q

reflecting

A

questions and feeling are referred back to client

86
Q

nursing process

A

assessment, verify data, nursing Dx, outcomes, planning, implementation, evaluation

87
Q

S & Sx for postpartum infection of uterus

A

uterine tenderness, pain, foul smelling lochia, temp elevation, tachycardia, N/V, chills

88
Q

S & Sx for postpartum infection of episiotomy

A

tenderness, firmness, edema, redness, loss of approximation, may or may not have temp

89
Q

S & Sx for postpartum infection of UTI

A

LQ pain, dysuria, frequent voids, incomplete emptying of bladder, bladder distention, temp increase

90
Q

S & Sx for postpartum infection of phlebitis

A

pain, warmth, tenderness, color changes, low grade temp, Homan’s sign may or may not be present

91
Q

BUBBLE-HE

A 
breast
uterus
bladder
bowel function
lochia
episiotomy/perineum
Homans sign
emotional stress
92
Q

what is the #1 Dx for pregnancy pt

A

risk for bleeding

93
Q

why is risk for bleeding the #1 Nursing Dx for any OB pt

A

overstretched uterus, weak tired muscles, obstruction, trauma

94
Q

lochia Rubra

A

red 3-4 days

95
Q

lochia serosa

A

pink 4-10 days

96
Q

lochia alba

A

white 10 days- 2 weeks

97
Q

fundal

A

top of fundus (uterus)

98
Q

fundal height and firmness day of delivery

A

at umbilicus

99
Q

fundal height and firmness 1 day after deliver

A

1 finger breath below umbilicus

100
Q

involution

A

decreasing of size of uterus after birth

101
Q

amenorrhea

A

absence of menstruation

102
Q

quickening

A

first movements of fetus felt by the mother (16-18 weeks)

103
Q

funic souffle

A

hissing sound synchronous with fetal heart beat and produced by the umbilical cord

104
Q

uterine souffle

A

heard when auscultating abdomen over the uterus

105
Q

bloody show

A

discharge of blood tinged mucous from cervix as labor begins

106
Q

effacement

A

thinning measurement of the cervix

107
Q

protracted

A

slow rate of progress

108
Q

prolonged

A

long span of time for progress to occur

109
Q

arrested

A

progress stops

110
Q

gestation

A

number of weeks since first day of last menstrual period

111
Q

abortion

A

birth that occurs before end of 20 weeks gestation

112
Q

fetal demise

A

fetal death

113
Q

term

A

normal duration of pregnancy (37-42 weeks)

114
Q

antepartum

A

time between conception and the onset of labor; prenatal

115
Q

intrapartum

A

time from onset of true labor until birth of infant and placenta

116
Q

postpartum

A

time from birth until woman’s body returns to pregnant condition

117
Q

premature labor

A

labor that occurs between 20 and 36 and 6/7 weeks

118
Q

still birth

A

infant born dead after 20 weeks

119
Q

gravida

A

any pregnancy, including present

120
Q

nulligravida

A

never been pregnant

121
Q

primigravida

A

pregnant for the 1st time

122
Q

multigravida

A

multiple pregnancies

123
Q

para-

A

birth after 20 weeks gestation

124
Q

nullipara

A

no births after 20 weeks gestation

125
Q

primipara

A

one birth after 20 weeks gestation

126
Q

multipara

A

two or more births after 20 weeks

127
Q

GTPAL

A 
G- # times pregnant
T- # of term births
P- # of premature babies
A- # of pregnancies ending in abortion
L- # of living children
128
Q

AGA

A

appropriate for gestational age

129
Q

AMA

A

advanced maternal age

130
Q

AROM

A

artificial rupture of membranes

131
Q

C/S

A

c section

132
Q

CNM

A

certified nurse midwife

133
Q

CPD

A

cephalopelvic disproportion

134
Q

Ctx

A

contractions

135
Q

EDC

A

est date of confinement

136
Q

EDB

A

est date of birth

137
Q

EDD

A

est date of delivery

138
Q

FHT

A

fetal heart tones

139
Q

FHS

A

fetal heart sounds

140
Q

FOB

A

father of baby

141
Q

GBS

A

group b strep

142
Q

IUFD

A

intrauterine fetal demise

143
Q

LGA

A

large for gestational age

144
Q

LMP

A

last menstrual period

145
Q

MLE

A

midline episiotomy

146
Q

NB

A

neborn

147
Q

NST

A

non stress test

148
Q

NSVD

A

normal spontaneous vaginal delivery

149
Q

PN

A

prenatal

150
Q

PROM

A

premature rupture of membranes

151
Q

SGA

A

small for gestational age

152
Q

SVD

A

spontaneous vaginal delivery

153
Q

VBAC

A

vaginal birth after C section

154
Q

VE

A

vaginal exam

155
Q

Vtx

A

vertex

156
Q

storage of breast milk

A

5 hours on counter
5 days in fridge
5 month in freezer

157
Q

no pacifiers until when

A

4-6 weeks

158
Q

are babies born hungry

A

no

159
Q

sore nipples result from what

A

poor positioning, shallow latch

160
Q

where is the baby placed after delivery

A

skin to skin

promotes oxytocin release-decrease bleeding

161
Q

how many feedings in 24 hours

A

6-8

162
Q

1st 24 hours the baby should pee and poop

A

1 pee 1 poop, increases by one each day

163
Q

maternal benefits for breast feeding

A

burns calories, contracts uterus, lower cost

164
Q

benefits for newborn for breast feeding

A

forms barrier in intestines, decrease risk of respiratory , obesity and cancer, increase brain growth, prevents allergies

165
Q

American academy of pediatrics recommend breast milk for how long

A

6 months

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