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maternal child health RN > Maternal health test 1 > Flashcards

Maternal health test 1 Flashcards

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1
Q

Cheap torches - congenital and perinatal infections

Can cause congenital conditions (present at birth) at birth if fetus is exposed to them in the uterus

A

Chicken, shingles

Hepatitis B, C, D, E

Enteroviruses, polio

Aids

Parvovirus B19

Toxoplasmosis

Other infections such as group b streptococcus, listeria, candida

Rubella

Cytomegalovirus

Everything else such as gonorrhea and chlamydia

Syphilis

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2
Q

Torch is the acronym of the 5 infections covered in the screening for infections at birth.

What is the screening called?

A

Toxoplasmosis

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3
Q

When and how to go about Abuse screening in pregnancy

what is it called?

Who to screen?

What to ask?

What to do if she says yes?

A

IPV screening

Ask patient in private, make it a safe process, nonjudgmental, have a safety plan in place

Screen all women and new patients, during new problems, annually, when pregnant in each trimester, GTT/PP visit

Keep it simple. Have you been injured by a partner in the last year?

Is there anyone that made you have axe against your will?

Is there anyone that made you feel unsafe? If yes? By whom? Number of times?

If yes.. inform that people are here to help she is not alone

Offer options but do not tell her what to do

Believe her and listen to her emphatically

Make a plan and offer resources

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4
Q

The practice of controlling the number of children in a family between births

A

Family planning

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5
Q

No drugs, devices, or surgical procedures are used to avoid pregnancy.

May be used by rhythm method(don’t have sexy during ovulation), calendar method, basal body temp/avoiding sex during fertile periods of the month based on body temperatures, hormone free, identifying fertile period, abstinence

A

Natural family planning

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6
Q

Different contraceptives?

A

Oral

Transdermal -estrogen and progrestone

Rings vaginal -

Implants subdermally -elective for 3 years

IUD device 3-5 years

Depo shot- every 3 months

Permanent - tubal ligation- snip Fallopian tubes (high risk for ectopic pregnancy) and vasectomy- vas deferens

Termination- has to be before 20-24 weeks

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7
Q

Drug use during pregnancy risk is higher when?

A

If homeless, poverty, partner uses drugs, preconception use

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8
Q

What does using drugs during pregnancy do to the fetus

A

Causes adverse catastrophic effects to fetus

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9
Q

What does using opioids during pregnancy do to the fetus

A

Risk of fetal growth restriction, abruptio placentae, fetal death, PTL, intrauterine passage meconium

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10
Q

What does using meth during pregnancy do to the fetus

What to do?

A

Small fetus for age

Low birth weight

Neurodevelopmental abnormalties

-encourage treatment stat

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11
Q

What does smoking during pregnancy do to the fetus

A

Premature labor

Premature rupture of membranes

Placenta previa

Fetus small for age

Resp issues in baby

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12
Q

Healthy people 2020 pregnant goals

A

Reduce HPV and cervical cancer by nurses educating patient with safer sex or abstinence and self examinations

Reduce breast cancer

Safety of LGBT people

Decrease teen sexual activity

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13
Q

What is involved in fetal circulation

A

Blood travels through the umbilical vein from the placenta to the fetus

Some blood circulated through the liver but most bypasses it through the ductus venosus and enters the inferior vena cava

It then enters the right atrium, passes through the foremen ovals, through the right ventricle , and into the aorta and suppling to upper and lower extremities and head

Then blood from head enters to the right atrium through the the right ventricle and into the the pulmonary artery. Most bypasses the lungs through the ductus arteriosus. Then to the pulmonary circulation, back to the right atrium, right ventricle, and aorta.

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14
Q

The umbilical cord contains how many vesicles?

Blood flows through what?

A

3 vessels: two arteries and one vein

Blood flows through the vein from placenta to the fetus

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15
Q

How blood flows through the vein and arteries to/from fetus

A

The umbilical vein carries oxygenated, nutrient-rich blood from the placenta to the fetus,

The umbilical arteries carry deoxygenated, nutrient-depleted blood from the fetus to the placenta

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16
Q

Reasoning for fundal measurements ?

A

To evaluate the gestational age of fetus

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17
Q

When to measure fundal height?

A

At first visit and every visit after 12 weeks

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18
Q

How should the fundal height measure?

A

The height should match the women’s gestational age.

Example- 12 weeks= 12 cm

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19
Q

Fundus to be where at 12 weeks?

16 weeks?

20 weeks?

22 weeks?

36 weeks?

40 weeks?

A

Just above pubis

16- between pubis and belly button

20- belly button

22- right above belly button

36-xiohoid process- pressure on lungs and GI

40-drop slightly into pelvis 4cm

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20
Q

Where should fundus be after birth?

1 hour-

1 day-

2 days-

7 days-

14 days-

Non-pregnant state is when?

A

1hour- at belly button (if slightly above have her urinate)

1 day- 1cm below belly button (umbilicus)

2 days- 2cm below belly

7 days- pubis

14- impalpable - onside pelvic cavity

6 weeks- non pregnant state uterus

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21
Q

GTPAL

A

Gravida

Term pregnancies

Preterm

Abortions

Living children

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22
Q

Gravida means?

A

The number of times a woman has been pregnant including abortions miscarriages pregnancy etc.

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23
Q

Term pregnancies

A

Born at 37 weeks or after

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24
Q

Preterm delivery’s ?

A

Born at 20-37 weeks (includes stillborn or alive)

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25
Q

Abortions/miscarriages

A

Both spontaneous and induced

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26
Q

Living children

A

Includes twins/triplets add two or three

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27
Q

Used to calculate the child’s Expected date of birth or EDD (expected date of delivery)

A

Nagels rule

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28
Q

How to calculate nagels rule

A

Based on the first day of last period
Add 7 days
Subtract 3 months
Plus one year?

Or 
LMP
Add 7 days
Add 9 months
Plus a year
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29
Q

Dietary recommendations for pregnancy

How many calories a day

A

No alcohol

Supplements

Foods high in vitamins and minerals
(vitamin C, iron, folic acid, protein, increase water, calcium, vitaminD and omega 3)

Need more iron after 12 weeks

300 more calories a day

1 year to 6 months before pregnancy should intake folic acid (b9) to reduce chances of neural tube defects

(Calcium and folic acid - dark leafy greens)

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30
Q

Weight gain during pregnancy?

A

Weight gain of 35 pounds is acceptable depending on weight

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31
Q

Folic acid reduces the chance of deformities how ?

A

Helps regulate RBC development and Oxygen carrying - capacity in the blood

Procedures DNA and RNA to help maintain normal brain function and stabilize mental health

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32
Q

Purpose of preconception care?

A

Encourage healthy lifestyles for families that desire pregnancy

Identify and reduce risks during pregnancy or before

(Taking folic acid, exercising, at regulation, no drugs or alcohol, maintaining healthy weight)

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33
Q

Absence of mentsturation most often due to pregnancy,

but can be due to cycle issues or hormonal reasons

A

Amenorrhea

34
Q

Painful mensuration that interferes with daily activities

One of the most OBGYN complaints

A

Dysmenorrhea

35
Q

What helps treat Dysmenorrhea

What causes it?

A

Relaxation, using heat to increase blood flow, exercise or rest, NSAIDs/analgesics/diuretic Myron, Motrin

Heating pad, diet changes, increase activity, I limit alcohol and chocolate

Causes it - prostaglandins in menstural blood

36
Q

Emergency contraceptives

What to know

A

Plan b - take before 72 hours after sex

Will not work if already pregnant

Does not cause miscarriage or abortion

37
Q

Self breast exams

How often?

When to do? Why?

What to educate ?

A

Monthly

(In the shower, 7-10 days after period ends because you want progesterone out of your system because it causes breast to become lumpy)

Educate if you feel a lump see doctor immediately. The sooner it’s treated the better survival rate you have.

38
Q

Contraception- both non hormonal

A 
Abstinence 
Condoms 
Contraceptive sponge 
Copper IUD
Tube tying
39
Q

Hormonal contraceptives

A

Oral (synthetic estrogen)

Transdermal patch

Vaginal ring

IUD

Depo shot

Sub-dermal Implant

40
Q

HPV treatment

A

Warts- topical agents , green tea extract

  • cryotherapy (freezing),
  • CO2 laser surgery
  • electrotherapy
  • surgical removal

Depending on severity and resistance to tx

Gardicil prevents HPV-age 11-12 yo

Can have cancerous strand

41
Q

Presumptive s/s of pregnancy

A 
Nausea and vomiting 
No period 
Breast tenderness
Tired
Quickening 
Weight gain
Polyuria 
Ptyalism (increase saliva)
Fatigue 
Nasal congestion 
Backache 
Leukorrhea- (thick white yellow vag discharge) 
Increased urination-polyuria 
Dyspepsia (indigestion)
Gas 
Constipation 
Hemorrhoids 
Dental problems 
Leg cramps
42
Q

Probable s/s of pregnancy

A

Hegars sign- softening of cervix-between uterus and vaginal portion of cervix

Chadwick’s sign- bluish vagina and cervix

Goodells sign- softening of cervix

Ballottement- easy flexion or uterus when the examiners fingers pushes against the uterus and detects the presence of the fetus by return impact

Positive pregnancy test- rising Hcg levels prompts a positive pregnancy test

McDonald’s sign-indicates uterine enlargement

Uterine enlargement-occurs as the fetus grows

Mask of pregnancy- rash appears on the face due to hormonal influences

43
Q
  • softening of cervix-between uterus and vaginal portion of cervix
  • bluish vagina and cervix

softening of cervix

  • easy flexion or uterus when the examiners fingers pushes against the uterus and detects the presence of the fetus by return impact
  • rising Hcg levels prompts a positive pregnancy test

indicates uterine enlargement

-occurs as the fetus grows

rash appears on the face due to hormonal influences

A

Hegars sign- softening of cervix-between uterus and vaginal portion of cervix

Chadwick’s sign- bluish vagina and cervix

Goodells sign- softening of cervix

Ballottement- easy flexion or uterus when the examiners fingers pushes against the uterus and detects the presence of the fetus by return impact

Positive pregnancy test- rising Hcg levels prompts a positive pregnancy test

McDonald’s sign-indicates uterine enlargement

Uterine enlargement-occurs as the fetus grows

Mask of pregnancy- rash appears on the face due to hormonal influences

44
Q

Positive signs of pregnancy

A

Fetal heart tones

Leopolds maneuver (manual external palpation of the fetal outline)

Ultrasound of the fetal outline

45
Q

When can you hear a fetus with a Doppler?

A

12 weeks

46
Q

Purpose of amniotic fluid?

A

For growth and development

It cushions the fetus and protects against mechanical injury , helps fetus maintain normal body temp and helps musculoskeletal development and lung development

47
Q

Decreased amniotic fluid

A

Oligohydraminos

48
Q

Increased amniotic fluid

A

Increased amniotic fluid

49
Q

What is the umbilical cord used for ?

A

Used for blood flow to and from baby

50
Q

Common and systemic way to determine the position of the fetus inside the uterus

Determines presentation, lye, and fetal weight

A

Leopold’s

51
Q

Swab testing of vagina and rectum of mother

Used to detect the risk that they will
Pass this bacteria to their newborns during birth, possibly causing a serious infection- GBS

When is it checked?

A

Group B strep screening

At 32-36 weeks

52
Q

When to give rhogam ?

and At how many weeks ?

A

Give to Rh(D) negative women-

Check for Rh antibodies and if negative, rhogam is prescribed at 28-32 weeks pregnant

53
Q

A problem of extreme nausea and vomiting causing electrolyte imbalance, severe dehydration and weight loss

Nursing intervention

When it usually occurs?

A

Hyperemesis gravidarium
——————-

IV therapy

Small more frequent meals

Antiemetic for n/v
———————
During the first trimester

54
Q

What is one at risk for if they don’t gain enough weight during pregnancy?

A

Risk for preterm labor.

Increase calories by 300 every day for the 2nd and 3rd trimester

55
Q

Week 1 in fetal growth and development

A

Fertilization occurs and the cyst is implanted by the end of the week

56
Q

Weeks 2 in fetal growth and development

A

Yolk sac develops and amniotic cavity appears. Implantation is complete

57
Q

Week 3 in fetal growth and development

A

Characteristics by the appearance of a primitive streak, skin teeth, mouth glands, nervous system, GU Tract, respiratory, digestive tract

58
Q

Week 4 in fetal growth and development

A

Central nervous system, Brian and spinal cord

59
Q

Week 8 in fetal growth and development

A

Upper and lower limbs

Genitals

Main organ systems

60
Q

Week 9-12 in fetal growth and development

A

The fetal head is half the length of the crown

Face

Intestines

Genitalia is distinguished

61
Q

Week 13-16 in fetal growth and development

A

Skeleton and bones

62
Q

Weeks 17-20 in fetal growth and development

A

Quickening

Vernix

Eyebrows and head

Lanugo

Testies and ovaries

63
Q

Week 21-25 in fetal growth and development

A

Gains majority of weight

Lungs

Fingernails

Eye movement

64
Q

Week 26-29 in fetal growth and development

A

Can breath air

Eyelids

Toenails

Spleen

Bone marrow

65
Q

Week 30-34 in fetal growth and development

A

Pupillary light reflex is present

66
Q

Week 35-40 in fetal growth and development

A

The fetus has a strong hand grasp and orientation to light

67
Q

Antepartum assessment

A

Testing involves use of EFM (electric fetal monitoring) or ultrasound to assess fetal well being or fetal heart rate and other characteristics during during this period from conception to labor

68
Q

Leopolds maneuver position

A

Place her in supine position and stand behind her

69
Q

Leopolds maneuvers 4 steps

A
  1. Presentation (which body part is on top or bottom) head is smooth and round
  2. Position (kicking, heart sounds, beat heard, hard and smooth head)
  3. Presentation -move hands down abdomen and grasp lower uterine

4- attitude- head flexed and engaged in pelvis

70
Q

Impairment in carbohydrate metabolism that first manifests during pregnancy

A

Gestational diabetes

71
Q

Gestational diabetes - women that are at risk

A

Older than 25

Obese

Polycystic ovaries

Hx of GD

Ethnicity

Family hx of type 2

Stillbirth or miscarriage

72
Q

GD infant at risk for ?

A

Large body size

Congenital abnormalities

Low bs

Resp distress

Jaundice

Heart issues

Low calcium

73
Q

GD mother at risk for?

A

C-section

Preeclampsia

Preterm birth

Maternal
Organ damage

Altered ABGs

74
Q

When insulin is given in pregnancy-?

A

Watch fetus carefully with a a non-stress test

Dont want baby to delivery early due to being so big

Check for lung maturity with l/s ratio

Watch blood sugar for baby post delivery (low bs)

75
Q

What is placenta perfusion ?

A

Any time blood flow
Is comprised to the fetus:

Preeclampsia 
Placenta previa 
Infarction 
Placenta hematoma 
Tumors 
Umbilical cord abnormalties 
Septal cysts 
Certain positions
76
Q

Pregnancy issues of concern

A

Bleeding is not normal-painful/painless

Placenta previa (placenta is lying over cervix) -ultrasound but not vaginal

Placenta abruption

77
Q

(placenta is lying over cervix) -painless bleeding

Interventions

A

Placenta previa

Bedrest,ultrasound but not vagina/c-section

78
Q

placenta tears away from the uterus which causes this

S/s?

What may cause?

A

Placenta abruption

Painful bleeding , distended rigid and hard abdomen

Car accident, cocaine or HTN crisis

79
Q

Consist of healthcare services that include:

check-ups

Patient counseling

Screening to prevent illness, disease and other health related problems

A

Preventative care

80
Q

Consists of applying specific measures with the aids of increasing oxygen delivery to the placenta and umbilical flow

To reverse hypoxia (low oxygen) and acidosis

A

Intrauterine resuscitation

81
Q

What to do for placental perfusion heart

A

Position upward lay lateral to

Left side

maternal child health RN (15 decks)

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