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NCLEX: Mark Klimek Lectures > Maternal & Newborn > Flashcards

Maternal & Newborn Flashcards

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1
Q

how do you calculate due date?

A

1st day of LMP + 7 days - 3 months

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2
Q

how long is the 1st trimester?

A

1-13 weeks

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3
Q

how long is the 2nd trimester?

A

14-27 weeks

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4
Q

how long is the 3rd trimester

A

28-42 weeks

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5
Q

what is the total weight gain a person should gain during pregnancy

A

28 lbs plus or minus 3 lbs

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6
Q

how much weight is gained in the 1st trimester

A
  • 1lb/month x3 = 3lbs
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7
Q

how much weight is gained in the 2nd trimester

A

1 lb/week

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8
Q

how much weight is gained in the 3rd trimester

A

1 lb/week

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9
Q

what is a general rule to determine how much weight a person person should have gained at a certain gestation week?

A

week of gestation - 9

ex. if 24 weeks gestation, should have gained 15 lbs

(if off by 1-2 lbs, okay. off by 3lbs, assess. off by 4lbs, trouble)

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10
Q

at what point is the fundus palpable?

A

12 weeks (end of first trimester)

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11
Q

at what point is the fundus at U

A
  • 20-22 weeks gestation
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12
Q

what is the date of viability

A

22-24 weeks

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13
Q

what can identifying fundal height help do?

A
  • help determine trimester
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14
Q

at what point is the fundus above U?

A
  • 3rd trimester
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15
Q

at what point is the fundus at or below U

A
  • 2nd trimester
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16
Q

what are positive signs of pregnancy

A
  • fetal skeleton on xray
  • fetal presence on US
  • auscultation of FHR
  • examiner palpates fetal mvmt
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17
Q

when is the FHR heard

A

8-12 weeks

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18
Q

what are probable/presumptive signs of pregnancy

A
  • urine & blood tests
  • chadwicks
  • cervical softening
  • uterine softening
  • symptoms: nausea, urinary freq etc.
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19
Q

at what point does quickening (feeling kicks) happen?

A

16-20 weeks

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20
Q

what is the pattern of office visits (prenatal visits)

A
  • 1x month until week 28 (6 months)
  • q2 weeks from 28-36 weeks (4 times)
  • every week until delivery or week 42
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21
Q

normal hgb in pregnancy

A

…

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22
Q

when does morning sickness occur in pregnancy

A

1st trimester

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23
Q

what is the treatment for morning sickness

A
  • dried carbohydrate before they get out of bed
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24
Q

when does urinary incontinence occur in pregnancy

A
  • 1st and 3rd trimester
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25
Q

what is included in care for urinary incontinence in pregnancy

A
  • void q2hours
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26
Q

when does difficult breathing occur in pregnancy

A
  • 2nd and 3rd trimester
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27
Q

what is included in care for difficulty breathing in pregnancy

A
  • tripod position
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28
Q

when does back pain occur in pregnancy?

A

2nd and 3rd trimester

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29
Q

what is included in care for back pain in pregnancy

A

pelvic tilt exercises (tilt forward)

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30
Q

what is the truest sign of labour

A
  • contractions that are regular and progressive
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31
Q

what is dilation

A
  • opening of the cervix, 0-10 cm
32
Q

what is effacement

A
  • thinning of cervix, 0-100%
33
Q

what is station

A
  • relationship between fetal presenting part to mom’s ischial spines
34
Q

what does -, +, and 0 station mean

A
  • = above
    + = below
    0 = engagement
35
Q

what is lie

A
  • relationship between spine of mother and spine of baby
36
Q

what does transverse lie mean?

A
  • perpendicular
37
Q

what is presentation

A
  • part of baby entering birth canal first
38
Q

what are 4 stages of labour

A

1) labour
2) delivery
3) placenta
4) recovery (2 hours after placenta)

39
Q

what is the purpose of cnxns in the 1st stage of labour

A
  • dilate and effacement
40
Q

what is the purpose of cnxns in the 2nd stage of labour

A
  • push baby out
41
Q

what is the purpose of cnxns in the 3rd stage of labour

A
  • push placenta out
42
Q

what is the purpose of contractions in the 4th stage of labour

A
  • control bleeding
43
Q

what are the 3 phases of the 1st stage of labour

A

1) latent
2) active
3) transition

44
Q

what is the dilation, cnxn frequency, duration, and intensity in the 1st phase of labour

A
  • 0-4cm
  • cnxns q5-30 minutes
  • cnxn duration: 15-30 sec
  • intensity: mild
45
Q

what is the dilation, cnxn frequency, duration, and intensity in the 2nd phase of labour

A
  • 5-7cm
  • q3-5 minutes
  • duration: 30-60 sec
  • moderate intensity
46
Q

what is the dilation, cnxn frequency, duration, and intensity in the 3rd phase of labour

A
  • 8-10 cm
  • q2 min
  • 60-90 sec duration
  • strong intensity
47
Q

contractions should not be…

A
  • > 90 sec
  • closer than q2min
48
Q

what is contraction frequency?

A
  • beginning of cnxn to the beginning of the next
49
Q

what is contraction duration

A
  • beginning to end of 1 contraction
50
Q

painful back labour can indicate..

A
  • OP baby
51
Q

what do you do with painful back labour?

A
  • position off back (hands and knees)
  • then push (sacral pressure)
52
Q

what is the priority of cord prolapse

A
  • emergency! high priority
53
Q

what do you do if there is cord prolapse

A
  • push (head back up so it’s off cord)
  • and reposition (hands and knees)
54
Q

what are general interventions for all other labour complications

A

Left side
Increase IV fluids
Oxygenate
Notify physician

55
Q

in an OB crisis, what should you do first

A
  • stop synto
56
Q

when should you not (reconsider giving) give pain meds to a pt in labour?

A
  • if the baby is likely to be born during its peak (so if IV, in 15-30 min)
57
Q

what is normal FHr

A

110-160

58
Q

what is the priority of low FHR (<100)? what do you do?

A
  • bad

Left side
Increase IV
O2
Notify physician

59
Q

what is the priority of high FHR (>160)? what do you do?

A
  • nothing major
  • take mom’s temp
60
Q

what do you do if there is low baseline variability

A

LION & stop synto

61
Q

is high variability good or bad

A
  • good
62
Q

what is a late decel? what do you do?

A
  • decrease in HR at end or after contraction
  • LION, bad
63
Q

what is an early decel? what’s its priority

A
  • decrease in HR that mirrors the cnxn
  • normal
64
Q

what is a variable decel? what is its priority

A
  • icicle
  • very bad
65
Q

a variable decel may mean?

A
  • cord compression/prolapse
66
Q

an early decel means?

A
  • head compression
67
Q

a late decel means?

A
  • uteroplacental insufficiency
68
Q

what do you do after the delivery of the placenta

A
  • make sure it’s all there
  • look for 3 vessels (2 artery, 1 vein)
69
Q

what is the assessments & their freq done in the 4th stage of labour

A
  • VS q15min x4
  • fundal check q15 minx4
  • assess bleeding, S&S of shock
70
Q

what assessments are done post partum? frequency?

A

q4-8h

Breasts
Uterine fundus**
Bladder
Bowel
Lochia
Episiotomy
Extremities

+ hgb, hct, affect, discomfort

71
Q

is a cephalohematoma normal in newborns? what is it?

A

yes
- bleeding or hemorrhage under the scalp

72
Q

is caput succedenam normal in newborns? what is it?

A
  • yes
  • swelling or edema of the scalp that crosses sutures
73
Q

when is hyperbilirubinemia normal in newborns

A
  • if occurs after 24 hrs
74
Q

what are tocolytics? what is an example

A
  • meds that stop labour

ex. mag sulfate, turbutaline

75
Q

administering too much mag sulfate can cause?

A

too much Mg = decreased HR, decreased BP, decreased reflexes, decreased RR, decreased LOC, etc.

76
Q

what is the use of betamethasone in pregnancy?

A
  • for fetal lung maturity
77
Q
A

NCLEX: Mark Klimek Lectures (20 decks)

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