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Nursing research > Maternal Child > Flashcards

Maternal Child Flashcards

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1
Q

Female life expectancy

A

82 years old

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2
Q

Male life expectancy

A

79 years old

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3
Q

what % of Canadians live in families

A

84%

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4
Q

what % of Canadians are lone parents

A

15.5%

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5
Q

Teenage birth rates have what

A

decreased and are now 15/1000 women

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6
Q

Canadian health care system is what

A

publicly administrated
comprehensive
universal/portable
accessible

Additional: eye wear, dental, physio

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7
Q

infant mortality

A

the rate of deaths per live births that occur within the first 12 months of life

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8
Q

Maternal mortality

A

the rates of maternal deaths from child births and complications of pregnancy, child birth and puerperium (first 42 days after the end of pregnancy)

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9
Q

Puerperium

A

post partum where mother goes back into pre pregant state. approximatly 6 weeks

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10
Q

leading cause of infant morbidity

A

prematurity
low birth weights
congenital illnesses

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11
Q

leading cause of maternal morality

A

pulmonary embolism
gestational hypertension

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12
Q

diagnosis associated with maternal mortality

A

disease of circulatory system
indirect causes
postpartum hemorrhages
hypertension

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13
Q

Infant and maternal mortality rates are an index of what

A

an index of the general health of a country

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14
Q

family-centered maternity and new born care national guide (FCMNC)

A

is based on 17 principals

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15
Q

childhood health issues

A

obesity
type 2 diabetes
childhood injuries
mental health
substance abuse

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16
Q

leading cause of infant morbidity

A

respiratory illness

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17
Q

atraumatic care

A

providing therapeutic care that minimizes distress and is essential in avoiding harm

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18
Q

the Calgary family assessment model

A

a framework used by nurses to asses and understand family dynamics

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19
Q

Family genograms

A

visual family tree

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20
Q

ecomaps

A

patient condition and relationship with others

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21
Q

implantation (duration and what is it)

A

between 6-10 days, when the embryo moves down the fallopian tubes and enters the uterine cavity then burrows un the lining of the uterus

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22
Q

Embryo

A

fertilized egg

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23
Q

placenta

A

supply’s rich blood and oxygen to the fetus

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24
Q

viability

A

capability to survive outside the uterus
must have a functioning nervous system and lungs
500grams or 21 weeks

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25
Q

surfactant

A

reduces surface tension on baby’s lungs in order to survive

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26
Q

Fetal circulation

A

amniotic fluid goes into the lungs and into the heart.

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27
Q

amniotic fluid

A

serves as a cushion and exchanges nutrients for the fetus

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28
Q

dizygotic twins

A

two implantations and two fertilizations

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29
Q

monozygotic twins

A

one fertilizations and the blastomeres separate

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30
Q

gravida/gravidity

A

a woman who is pregnant

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31
Q

nulligravida

A

never been pregnant

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32
Q

primigravida

A

pregnant for the first time

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33
Q

multigravida

A

a woman who has had two or more pregnancies (20 weeks gestation or more)

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34
Q

parity

A

number of pregnancies that have reached viability, weather fetus was born or not.

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35
Q

nullipara

A

zero pregnancies beyond viability

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36
Q

primipara

A

one pregnancy that reached viability

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37
Q

multipara

A

two or more pregnancies that have reached viability

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38
Q

post date/post term

A

pregnancy beyond 41 weeks

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39
Q

pre term

A

between 20 and 36 weeks

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40
Q

term

A

start of week 37 to end of week 40, plus 6 day gestation

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41
Q

pregnancy is how long

A

9 calendar months
10 lunar months of 28 days (280 days), 40 weeks

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42
Q

When does a positive pregnancy test show

A

4 to 12 weeks

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43
Q

Negele’s rule

A

subtract 3 months, add 7 days to the last menstrual period

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44
Q

first trimester

A

weeks 1 - 13

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45
Q

second trimester

A

weeks 14 - 26

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46
Q

third trimester

A

weeks 27 - term

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47
Q

human chronic gonadotropin (hCG)

A

is a hormone produced by the placenta during pregnancy. Its main role is to support the development of the embryo and maintain the pregnancy by stimulating the ovaries to produce progesterone. It’s also the hormone detected in pregnancy tests.

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48
Q

why is the β-hCG is important

A

because it is the portion detected in blood and urine pregnancy tests and for confirming pregnancy.

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49
Q

Braxton hicks contractions

A

16-28 weeks, they are irregular and infrequent and often go away with changing positions. It is the way your body gets prepared

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50
Q

quickening

A

16-20 weeks, when women starts to feel baby move

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51
Q

vernix

A

waxy substance that coats and protects babies skin after birth and in the womb

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52
Q

lanugo

A

soft and unpigmented hair

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53
Q

maternal adaptations cardiovascular

A

blood volumes increased by 40-60% and RBC increased by 20-30%

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54
Q

major causes of maternal deaths

A

hypertension disorders
infection
hemorrhage
ages over 35 or under 20
partner violence
maternal health

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55
Q

high risk pregnancy

A

heath of the mother or fetus is jeopardized. mother could extend all the way to 6 weeks post birth.

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56
Q

gestational hypertension

A

is a condition characterized by high blood pressure (hypertension) that develops during pregnancy, usually after the 20th week, in women who did not have high blood pressure before pregnancy. Unlike preeclampsia, gestational hypertension does not involve protein in the urine or other signs of organ damage.

140/90 mm Hg or higher on two separate occasions

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57
Q

factors that go into gestational hypertension

A

first time pregnancy
family history
history of diabetes
renal disease
age
obesity

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58
Q

intervention for gestational hypertension

A

delivery is the only definitive treatment

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59
Q

HELLP

A

potentially life-threatening complication of pregnancy, often considered a variant of preeclampsia. It typically occurs in the third trimester but can also develop after childbirth.

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60
Q

what does HELLP stand for

A

hemolysis (break town of RBC)
elevated liver enzymes (Liver damage)
low platelets (effect blood clotting)

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61
Q

Complications of HELLP syndrome

A

Liver rupture or failure
Kidney failure
Placental abruption (early detachment of the placenta)
Disseminated intravascular coagulation (DIC), which can lead to excessive bleeding
Increased risk of preterm birth for the baby

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62
Q

treatment of HELLP syndrome

A

The only definitive treatment for HELLP syndrome is delivery of the baby, even if preterm. Management may involve medications to stabilize blood pressure, corticosteroids to improve fetal lung maturity (if premature)

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63
Q

Non-severe preeclampsia (MILD)

A

characterized by elevated blood pressure and some signs of organ dysfunction, but without severe symptoms or complications. It typically develops after the 20th week of pregnancy

blood pressure: 140.90 not exceeding 160/110
MAP: 105 mmHg
proteinuria: >0.3 g in 24 hour

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64
Q

severe pre-eclampsia

A

dangerous form of preeclampsia, a pregnancy complication characterized by high blood pressure and damage to organs, most often the liver and kidneys. It typically occurs after 20 weeks of pregnancy but can also develop postpartum

blood pressure: 160/110
MAP: 110 mmHg
proteinuria
cerebral disturbances
seizures
/coma

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65
Q

treatment for pre-eclampsia

A

Antihypertensive drugs to lower blood pressure, magnesium sulfate to prevent seizures, and corticosteroids to help mature the baby’s lungs if early delivery is planned

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66
Q

gestational diabetes mellitus

A

type of diabetes that develops during pregnancy in women who did not previously have diabetes. It usually occurs in the second or third trimester when the body becomes less sensitive to insulin, a hormone that regulates blood sugar levels.

While GDM typically goes away after childbirth, it can increase the risk of complications for both mother and baby

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67
Q

risk factors for gestational diabetes

A

35 or older
obesity
use of corticosteroids
family history of type 2 diabetes
previous GDM
polycystic ovary syndrome

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68
Q

hyperemesis gravidarum

A

is a severe form of nausea and vomiting during pregnancy that goes beyond typical morning sickness. It can lead to dehydration, weight loss, and nutritional deficiencies, requiring medical treatment. Unlike normal pregnancy nausea, which typically subsides after the first trimester, hyperemesis gravidarum can persist throughout the pregnancy.

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69
Q

controlling hyperemesis gravidarum

A

vitamin B6
antiemetics (zofran)
no gravol until birth

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70
Q

hemorrhagic disorder

A

50% of bleeding in the third trimester is placenta previa or placental abruption

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71
Q

abortion

A

loss of pregnancy before the fetus is viable, under 20 weeks or 500 grams. spontaneous or induced

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72
Q

manifestations of an abortion

A

spotting, uterine, cramping, back pain, pelvic pressure

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73
Q

threatened abortion

A

vaginal bleeding occurs

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74
Q

inevitable abortions

A

membranes rupture, cervic dilates, heavy bleeding

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75
Q

incomplete abortions

A

not all products are expelled. requires oxytocin

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76
Q

complete abortions

A

all is expelled, cervix closes

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77
Q

missed abortions

A

fetus dies and half of the pregnancy is retained in the uterus, requiring dilation and cuttage.

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78
Q

medications for spontaneous abortions

A

misoprostol

79
Q

what should you eat after an abortion

A

food high in iron and protein

80
Q

ectopic pregnancy

A

occurs when a fertilized egg implants and grows outside the main cavity of the uterus, most commonly in one of the fallopian tubes. Since the fallopian tubes are not designed to hold a growing embryo, the pregnancy cannot proceed normally and can lead to life-threatening complications if untreated.

81
Q

manifestations of ectopic pregnancy

A

missed periods, abdominal pain. pelvic pain, vaginal spotting

82
Q

interventions for ectopic pregnancy

A

methotrexate (inhibits cell production)
surgical is required if ruptured salpingostomy

83
Q

placenta previa

A

complication where the placenta partially or completely covers the cervix, the opening of the uterus. This condition can lead to severe bleeding during pregnancy and delivery.

84
Q

placenta previa diagnosis

A

by a transabdominal ultrasound or transvaginal ultrasound

85
Q

placenta previa management

A

caesarean birth, doubble set up procedure

86
Q

placenta previa risk factors

A

no vaginal exams or oxytocin
age
previous c-section or surgical abortion
multiple gestations

87
Q

manifestations of placenta previa

A

sudden onset of painless bleeding, bleeding is caused by placenta villli being torn. delay birth administer corticosteroids for maturation of fetal lungs

88
Q

marginal:

A

the placenta is next to the cervix but does not cover the opening

88
Q

partial:

A

the placenta is covering part of the cervix opening

89
Q

complete

A

the placenta covers the whole cervical opening

90
Q

placental abruption

A

serious pregnancy complication in which the placenta detaches from the inner wall of the uterus before childbirth, either partially or completely. This separation can deprive the baby of oxygen and nutrients, and it can cause heavy bleeding in the mother

91
Q

partial abruption

A

concealed bleeding, you cant see and it only detaches partially

92
Q

marginal abruption

A

external bleeding, may escape through cervix, does not significantly impact baby if it is managed

93
Q

complete abruption

A

severe or heavy bleeding, lack of oxygen and nutrients. high risk if completely detaches

94
Q

HIV and AIDS

A

perinatal transmission and obstetrical complications. strict adherence to medications and does not accelerate conditions

95
Q

HIV and AIDS after birth

A

No vaginal delivery no breast feeding, new born must be cleared of all fluids and stuff must adhere to infectious control

96
Q

substance use from mother to baby

A

can easily be passed through placenta when cutting the cord, the fetus is automatically cut off and may go through with drawls.

97
Q

health risks to baby when mother is using substances

A

miscarriage
still born
prematurity/low birth weights
sudden infant death

98
Q

what should you treat the mother with who is using substances

A

Methadone

99
Q

Rh incompatibility

A

woman has Rh-negative blood and the fetus has Rh-positive blood, inherited from the father. This difference can lead to the mother’s immune system producing antibodies against the Rh factor, treating the baby’s Rh-positive red blood cells as foreign invaders. If these antibodies cross the placenta, they can attack the fetal red blood cells, causing probelms

100
Q

RohGam

A

a medication used to prevent Rh incompatibility in Rh-negative individuals, especially during pregnancy. It works by preventing the immune system from forming antibodies that could target Rh-positive red blood cells.

101
Q

cervical ripening and induction

A

medical interventions used to initiate the labor process when it does not start naturally or there are health concerns for the mother or fetus.

indwelling catheter
prostaglandins (prostin)
Oxytocin
artifical rupture

102
Q

when is premature labor

A

true labor before 37 weeks, 7.6% in Canada

103
Q

cord prolapse

A

obstetric emergency that occurs when the umbilical cord descends into the birth canal ahead of or alongside the presenting part of the fetus (usually the head). This can lead to compression of the cord, restricting blood flow and oxygen to the baby, which may cause fetal distress or even death if not managed promptly.

104
Q

cesarean section

A

surgical procedure used to deliver a baby through incisions made in the mother’s abdomen and uterus. It is performed when vaginal delivery would pose a risk to the mother or baby

105
Q

cesarean section incision

A

classical, low cervical vertical, low transverse

106
Q

monitoring signs of labor

A

cervical changes
lightening (fetus will drop)
increased energy level
bloody show spotting
braxton hicks contractions
spontaneous rupture of membranes

107
Q

process of labor

A

moving fetus and placenta and membranes out of uterus and through birthing canal

108
Q

mechanism of labor

A

Cardinal movements, is when the fetus undergoes several position changes

109
Q

true labor

A

contractions are 5 minutes apart lasting 30-60 seconds, becomes stronger there is pressure felt

110
Q

1st stage of labor

A

0-10 cm dilation
-latent phase
-active phase
-transition phase

111
Q

latent phase

A

0-3 cm, contractions every 5-10 minutes, for 30-45 seconds

112
Q

active phase

A

4-7 cm, contractions every 2-5 minutes, for 45-60 seconds

113
Q

transition phase

A

8-10 cm, contractions every 1-2 minutes, for 60-90 seconds

114
Q

2nd stage of labor

A

10 cm to birth (1hour)
- pelvic phase
- perineal phase

115
Q

pelvic phase

A

period of fetal descendance

116
Q

perineal phase

A

crowning, babys exsit

117
Q

3rd stage

A

separation and delivery of placenta
- placenta separation phase
- placenta expulsion phase

118
Q

placenta separation phase

A

detach from uterine wall

119
Q

placenta expulsion phase

A

placenta coming out

120
Q

4th stage of labor

A

1 to 4 hours after birth

121
Q

5 P’s that effect labor

A

-Passenger (fetus and placenta)
- Passageway (birth canal)
- Powers (contractions)
- Position of mother
- Psychological response

122
Q

Passenger

A

size of head
fetal presentation
fetal position
amniotic membrane
placenta and cord

123
Q

fetal head

A

5 bones that are not fused together, sutures and fontanels provide landmark to determine position

124
Q

leopards maneuver

A

determine the position, presentation, and engagement of the fetus in the uterus.

125
Q

station

A

to the position of the presenting part of the fetus (usually the head) in relation to the mother’s pelvis during labor. It measures how far the baby has descended into the birth canal and is an important factor in assessing the progress of labor. (you want + 1, 2, 3, never negative)

126
Q

passageway is composed of

A

bony tissue
cervix soft tissue
pelvic floor
vagina
introitus (external opening of vagina)

127
Q

gynecoid

A

circle shape pelvis, classic female in 50% of women

128
Q

android

A

heart shape pelvis, resembling the male pelvis shape

129
Q

anthropoid

A

oval shape

130
Q

platypelloid

A

flat pelvis, least common

131
Q

Powers (contractions)

A

primary powers
- contraction (pushing)
- dilation (opening)
- effacement (thinning of cervix)
Secondary powers
- maternal pushing efforts

132
Q

Ritgen maneuver

A

help reduce tearing of the pernium, by controlling the speed of delivery by pressure with hand on babys head

133
Q

delivery of placenta

A
  1. separation and expulsion
  2. cord and blood collection
  3. maternal physical status
  4. umbilical cord blood banking
134
Q

visceral pain

A

lower position of abdomen, in fallopian tubes, ovaries and ligaments

135
Q

referred pain

A

abdomen wall, illiac crest, gluteal area

136
Q

somatic pain

A

intense, sharp, burning sensation

137
Q

after birth in the 4th stage of labor what happens

A

uterus returns to normal size and shape, vaginal discharge, bladder beings to function normally, perineal tissue heals, hormones adjust for milk production

138
Q

uterus returns to normal size and shape is called what

A

involution

139
Q

vaginal discharge is called what

A

lochia

140
Q

how often are post partum vital signs taken

A

Q15 minutes for the first hour then as needed

141
Q

Blood loss expectancy

A

500ml for vaginal and 1000ml for c-section

142
Q

Cause of bleeding 4 T’s

A

tone
tissue
trauma
thrombin

143
Q

amount of blood loss (compensation, mild, moderate, severe)

A
  • compensation (500-1000ml, 10-15%)
    no changes
  • mild (1000-1500ml, 15-25%)
    slight BP fall
  • moderate (1500-2000ml, 25-35%)
    Fall in BP
  • severe (2000-3000ml, 35-45%)
    perfomed fall
144
Q

post anesthesia recovery

A

1-2 hours, must recover before discharge

145
Q

laparotomy

A

incision in abdominal wall

146
Q

hysterotomy

A

incision in uterus

147
Q

pfannenstiel incision

A

that allows access into abdomen

148
Q

Post partum assessment

A

BUBBLLEE
breast
uterine
bladder
bowel
lochia
legs
epistomy
emotional

149
Q

Post partum assessment - breast

A

firmness and nipples and lactation

150
Q

Post partum assessment - uterine

A

fundus and location, decreases by 1-2 cm every 24 hours returns to normal size after 6 weeks, edges are firm. 2 weeks after uterus should lye in true pelvis

151
Q

subinvolution

A

failure to return to non pregnant state

152
Q

Post partum assessment - bladder

A

amount and freqauncy

153
Q

Post partum assessment - bowels

A

passing gas and bowel movements

154
Q

Post partum assessment - lochia

A

lochia ruba - red
lochia serosa - pink
lochia alba - white

155
Q

Post partum assessment - legs

A

peripheral edema

156
Q

Post partum assessment - epistomy /laceration

A

first degree - involving only the vaginal mucosa (the lining of the vagina
second degree - involves both the vaginal mucosa and the perineal muscles, which help support the pelvic floor
third degree - ear involves the vaginal mucosa, perineal muscles, and extends into the anal sphincter
fourth degree - the vaginal mucosa, perineal muscles, anal sphincter, and into the rectal mucosa

157
Q

Post partum assessment - emotional status

A

energy level, interactions, posture,
comfort level, sleep and rest patterns

158
Q

lochia ruba

A

red, 1-3 days post partum, blood fragments

159
Q

lochia serosa

A

pink, 3-10 days, blood mucus and invading leucocytes

160
Q

lochia alba

A

white, 10-14 days, mucus, leucocyte count is high

161
Q

scant

A

2 inch stain

162
Q

small

A

4 inch stain

163
Q

moderate

A

6 inch stain

164
Q

large

A

more than 6 inch stain

165
Q

assess of perineum REEDA

A

redness
ecchymosis
edema
drainage
approximation

166
Q

early forms of contact with mother and baby

A

skin to skin
nursing baby

167
Q

postnatal depression screening

A

should be done and then reassess if needed, 80% of women experience mild depression “baby blues”. 10-15% experience serious depression.

168
Q

post partum depression

A

low mood or lack of interest in activities, treatment - antidepressants, anxiety medications

169
Q

post partum psychosis

A

depression, hallucinations, delusions and thoughts to harm baby or self could be a psychiatric emergency treatment is with antipsychotics and mood stabilizers like lithium

170
Q

Assessing complications in the 4th stage - pulse

A

may decrease due to labor, it might be due to post partum hemorrhages

171
Q

Assessing complications in the 4th stage - blood pressure

A

mild rise, could be due to eclampsia or gestational hypertension

172
Q

Assessing complications in the 4th stage - lochia

A

moderate rube, more than 2 pads saturated in one hour, post partum hemorrhages or by laceration

173
Q

Assessing complications in the 4th stage - bladder

A

should not be palpated, distention may be due to urinary retention

174
Q

Assessing complications in the 4th stage - perineum

A

pink, no bruising or edema, bruised edema may be due to hematoma or trauma from delivery

175
Q

post partum infection

A

infection in genital canal within 28 days after abortion or delivery may cause endometris, wound infection and uti and mastitis. usually from streptococcal or anaerobic

176
Q

post partum hemorrhages

A

tone, tissue trauma, thrombin. determined by blood work, vital signs q4h and RPN. administer hemabate

177
Q

Criteria for discharge

A

women and baby are stable
no complications for 24 hours
must complete (vitals, bubble and lab tests)
lab tests: hemoglobin and hematocrit

178
Q

Rubella vaccination

A

Rubella vaccination is crucial for pregnant women, due to the severe risks rubella poses to the fetus. Rubella infection during pregnancy, especially in the first trimester, can lead to congenital rubella syndrome (CRS)
- birth defects
- developmental delays
- Still born/ miscarage

179
Q

Rh immunoglobin

A

RhoGAM is administered at specific times during and after pregnancy to prevent sensitization

If the baby is Rh-positive, the mother will receive another dose of RhoGAM within 72 hours after delivery to prevent her body from forming antibodies against the baby’s Rh-positive blood. This ensures future pregnancies are not at risk.

180
Q

perinatal bereavement

A

loss of what was hoped for, dreamed about or planned. loss during child birth, child complications, neonatal

181
Q

what is oxytocin used for

A

augment of labor by strengthening and regulating contractions

182
Q

what drug is used if you notice the newborns central nervous system is depressant.

A

Narcan (Naloxone)

183
Q

TPAL stands for what

A

term births
pre term births
abortions
living children

184
Q

what foods should you avoid if your pregnant

A

sushi- toxoplasma (harms the fetus)
hot dogs- complications may cause still born
tuna fish - affects babys nervous system
deli meat - complications still born
alcoholic beverages - FADS birth defects or delays

185
Q

when is a vaginal exam done

A

no only at final weeks of gestation because it may simulate contractions or cause infection

186
Q

what does infertile mean

A

inability to conceive after 1 year of unprotected intercourse

187
Q

Primary vs secondary infertility

A

primary couples who have never conceived
Secondary who have before and now cant

188
Q

how often should you go see the doctor when you being pregnant

A

o Up to 28 weeks: Every 4 weeks.
o 28-36 weeks: Every 2 weeks.
o 36 weeks to delivery: Weekly.

189
Q

family centered trends

A

technology
consumer and professional participation
health care restructuring
evidence based practice
diversity in canadian population

190
Q

Hegar sign

A

compressibility and softening of the cervical isthmus. In the 4 to 6th week of pregnancy

191
Q

Chadwick’s sign

A

Estrogen causes the cervix to become congested with blood, resulting in the characteristic bluish purple color that extends to include the vagina and labia.

192
Q

Goodell’s sign

A

Collagen fibers in the connective tissue of the cervix decrease, causing the cervix
to soften.

Nursing research (2 decks)

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