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Pharmacology > Maternal/Child Exam 2 > Flashcards

Maternal/Child Exam 2 Flashcards

1
Q

What age group of children are most at risk for accidental poisoning?

A

2-3 years

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2
Q

True or false: NG and OG tubes always need an MD order.

A

True

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3
Q

What does sorbitol and activated charcoal do?

A

Binds to toxins and causes diarrhea, which helps eliminate the poison from the body fast.

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4
Q

Which of the following are a risk for containing lead? Select all that apply.
A. Certain foods
B. Old paint chips
C. Homemade canned goods
D. Home-glazed pottery

A

A, B and D

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5
Q

What is the maximum acceptable level of lead a child should have in their body?

A

<5g/dL

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6
Q

How many breaths of water does it take for someone to start drowning?

A

Three

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7
Q

What neurologic response is triggered when the face is immersed in cold water and what does it include?

A

The Mammalian Diving Reflex, and it includes apnea and bradycardia. The purpose is to shunt blood from the periphery to vital organs

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8
Q

What are the characteristics of hypotonic labor?

A

Coordinated but weak contractions, over-distension of the uterus (thinner muscle), low uterine resting tone, easily indented abdomen

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9
Q

What are the characteristics of hypertonic labor?

A

Uncoordinated and irregular contractions, painful but ineffective contractions, overly high uterine tone

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10
Q

What is the main risk associated with overly high uterine tone?

A

It restricts blood flow to the uterus which decreases the fetal oxygen supply

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11
Q

Would administering oxytocin be be indicated for hypotonic labor or hypertonic labor?

A

Hypotonic

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12
Q

When should maternal vital signs be taken during labor and why?

A

Between contractions, because BP will be higher and HR will be lower during a contraction due to blood flow to the placenta being slowed. Pain will also be greater during a contraction.

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13
Q

What are the ways the fetus adapts to reduced blood flow in the umbilical cord during contractions?

A

More RBCs are produced, and there is a baseline “reserve” of blood in the uterine circulation to compensate

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14
Q

What are the 4 P’s of labor?

A

Power, passage, passenger, and psyche

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15
Q

What happens during the 1st phase of labor and when does it occur?

A

Occurs from the onset of labor until complete dilation. Involuntary uterine contractions push the fetus down through the pelvis

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16
Q

What happens during the 2nd phase of labor and when does it occur?

A

Occurs from complete dilation until birth. The birth parent takes over with voluntary pushing

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17
Q

What is relaxin and what role does it play?

A

It is a hormone that softens the cartilage in the pelvic bones to make the passage of the baby’s head easier

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18
Q

What is the ideal fetal position for birth?

A

Occiput Anterior = fetus is facing the parent’s back and the top of the head reaches the cervix first)

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19
Q

What are Braxton Hicks contractions?

A

“Practice” or false contractions

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20
Q

Where are labor contractions felt in the uterus (as opposed to false contractions)?

A

In the back of the uterus

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21
Q

What are some signs that a contraction is false?

A

They’re usually felt in the front of the uterus, they go away after sitting or movement, they do not get stronger or closer together

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22
Q

What are the three phases of Stage 1 of labor?

A

Latent phase, active phase, and transition phase

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23
Q

Fractured clavicals and damage to the brachial plexus (of the fetus) are two major risks of what birthing complication?

A

Shoulder dystocia

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24
Q

What is precipitate labor?

A

Birth that occurs within 3 hours of the onset of labor

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25
What is the purpose of the peanut ball?
It helps open the pelvic floor
26
What sensation is sometimes an indicator that the baby is coming in someone who has had an epidural?
The need to poop
27
Fetal heart rate of >160 BPM for more than 10 minutes can be an indication of what?
Intrauterine infection
28
What are some benefits of skin to skin contact during "Golden Hour" (or Golden Time)?
It helps regulate the baby's temperature, HR, breathing, and blood glucose and helps birth parent stop bleeding due to oxytocin release
29
How long should you wait before giving the newborn baby a bath and why?
12-24 hours. If given too soon it can cause a dangerous spike in blood sugar.
30
What is the main concern for newborns whose birth parent has diabetes?
Hypoglycemia (due to large amount of circulating insulin in response to the parent having high blood sugar)
31
When would oxytocin be administered and why?
During the third stage of labor to help prevent postpartum hemorrhage
32
What postpartum complication involves signs of blood loss (tachycardia, drop in BP), a firm fundus, and lochia within normal limits?
Hematoma
33
What are two early signs of hypovolemic shock?
Cold extremities and tachycardia
34
When inducing labor, prostaglandin E should be used cautiously in people who have which conditions?
Glaucoma, asthma, ischemic heart disease, renal disease, pulmonary disease, or hepatic disease
35
How does the cervical ripening balloon work?
It puts pressure above and below the cervix to help mechanically induce dilation
36
What is the purpose of prostaglandins?
To help ripen the cervix
37
What is the purpose of oxytocin?
It induces contractions
38
What is the result of oxytocin oversaturation during induced labor?
Oxytocin receptors become flooded and all the receptor spots get "taken up" which prevents the uterus from being able to relax so that it can contract again properly
39
What is the purpose of making sure the pregnant patient is voiding regularly?
To reduce bladder trauma during birth. A full bladder can also obstruct the path of the fetus
40
What is the major physiologic difference between the eustachian tubes of children under 3 and adults?
The tubes are horizontal in children under 3
41
What is the significance of children under 3 having horizontal eustachian tubes and why?
It makes them more susceptible to ear infections because fluid doesn't drain as easily
42
Are children under 3 years more susceptible to viral or bacterial tonsil infections?
Viral
43
In what type of tonsil infection would you expect to see redness, swelling, and white spots in the back of the throat?
Bacterial
44
Is the size of a child's tonsils an accurate indication of infection?
No. Tonsil size varies from child to child.
45
What are the s/s of adenoiditis? Select all that apply. A. Bad breath B. Mouth breathing C. Sleep apnea D. Nasal-sounding speech E. Difficulty hearing F. All of the above
F. All of the above
46
What is the most common cause of adenoiditis?
Strep
47
What makes a child eligible for a tonsilectomy and/or adenoidectomy?
They must be older than 3 years and have had tonsilitis every year for more than 3 years
48
How long does a patient need to be symptom-free before a tonsilectomy/adenoidectomy can be done?
7 days
49
What is a late sign of infection in children?
Hypotension
50
What is the earliest sign of infection in children?
Tachycardia
51
What are the risks for long-term otitis media?
Meningitis and and mastoiditis
52
Why are children more at susceptible to laryngeal spasms (multiple coughs)?
The larynx is narrower and more flexible than an adult larynx
53
Do asthma and bronchiolitis generally produce wheezing or stridor?
Wheezing
54
Is stridor heard on inspiration or expiration?
Inspiration
55
What are four degrees of airway management?
Positioning, corticosteroids, racemic epinephrine (inhalation via mask), and intubation
56
Patients requiring more than ___% oxygen will be automatically moved to the ICU?
50%
57
Which type of croup would you expect to see treated at home?
Spasmodic croup aka acute spasmodic laryngitis
58
What type of croup is always a medical emergency?
Acute epiglotitis
59
What is usually the cause of acute epiglotitis?
Hib (Influenza B)
60
What 4 signs/symptoms would you expect to see in acute epiglotitis
The 4 D's: dysphagia, drooling, dysphonia, distress
61
What does administering racemic epinephrine do?
It relaxes the larynx and pharynx to help reopen the airway
62
What is insensible fluid loss?
Fluid loss that isn't measurable, such as from sweating or high respiratory rate
63
What is sensible fluid loss?
Fluid loss that is measurable, such as from vomiting, urination, diarrhea, bleeding, or large burns
64
What does a gray/pink tympanic membrane indicate?
Gray/pink is the color of a healthy tympanic membrane
65
What is the function of ECF?
To transport nutrients and waste products to and from the cells
66
What is the formula for pediatric daily fluid maintenance?
100mL/kg for first 10kg + 50mL/kg for second 10kg + 20 mL/kg for remainder of weight Divide total by 24 to figure out mL/hr
67
When is it appropriate to give a fluid bolus to a child?
Never
68
What is a NST and what does it indicate?
Non-stress test. It detects acceleration in the fetal heart rate, which indicates healthy neural pathways and adequate oxygenation
69
What is a BPP and what does it indicate?
Biophysical profile. It's an NST with added ultrasound and measures fetal breathing patterns, amniotic fluid index, FHR reactivity, fetal tone, and gross body movements
70
What is late deceleration of the FHR and what does it indicate?
Late deceleration is the slowing of the FHR following a contraction, and it indicates uteroplacental insufficiency
71
What is early deceleration of the FHR and what does it indicate?
Early deceleration is the slowing of the FHR due to the head being compressed by contractions, and it is a normal sign
72
What is the ICF primarily responsible for?
Organ function
73
What type of dehydration would you expect to cause seizures?
Hyponatremic dehydration
74
What type of dehydration needs slow fluid replacement and why?
Hypernatremic dehydration, because you don't want to drop the sodium levels too much too fast
75
What are the most common causes of hyponatremic dehydration?
Renal dysfunction, severe burns, and severe vomiting/diarrhea
76
What is the most important thing to make sure is happening before administering K+?
Make sure the child has had at least one void before administering
77
Does extensive vomiting cause metabolic acidosis or alkalosis?
Alkalosis (because of the loss of stomach acid)
78
Does extensive diarrhea cause metabolic acidosis or alkalosis?
Acidosis (because bicarbonate gets flushed out with the feces)
79
Why does metabolic acidosis need to be corrected as fast as possible?
Metabolic acidosis increases the respiratory rate (because the body is trying to rid itself of excess bicarbonate), which contributes to insensible fluid loss aka more dehydration
80
What parasite causes nocturnal anal itching and how do you test for it?
Helminths, and you can test with a piece of tape over the anus overnight
81
What is the baseline safe volume for a pediatric fluid bolus?
10-20mL/kg
82
What are five physical assessment findings for esophageal fistula?
1. Apnea 2. 3 C's: cyanosis, coughing, choking 3. Respiratory distress 4. Abdominal distension 5. Excessive salivation/drooling
83
What are the signs and symptoms of pyloric stenosis?
Visible peristaltic wave, projectile nonbilious vomiting, palpable mass in RUQ (stenosed pyloric valve), signs of dehydration, hunger, weight loss
84
What must be confirmed prior to restarting feeding for a post-op patient?
Bowel sounds
85
What medical emergency has "currant jelly stool" as a symptom?
Intusussception
86
Where do distocias and dysfunctional labor occur?
Anywhere within the 4 P's (powers, passenger, passage, psyche)
87

Pharmacology (6 decks)

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