Maternal & Newborn Flashcards
how do you calculate due date?
1st day of LMP + 7 days - 3 months
how long is the 1st trimester?
1-13 weeks
how long is the 2nd trimester?
14-27 weeks
how long is the 3rd trimester
28-42 weeks
what is the total weight gain a person should gain during pregnancy
28 lbs plus or minus 3 lbs
how much weight is gained in the 1st trimester
- 1lb/month x3 = 3lbs
how much weight is gained in the 2nd trimester
1 lb/week
how much weight is gained in the 3rd trimester
1 lb/week
what is a general rule to determine how much weight a person person should have gained at a certain gestation week?
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)
at what point is the fundus palpable?
12 weeks (end of first trimester)
at what point is the fundus at U
- 20-22 weeks gestation
what is the date of viability
22-24 weeks
what can identifying fundal height help do?
- help determine trimester
at what point is the fundus above U?
- 3rd trimester
at what point is the fundus at or below U
- 2nd trimester
what are positive signs of pregnancy
- fetal skeleton on xray
- fetal presence on US
- auscultation of FHR
- examiner palpates fetal mvmt
when is the FHR heard
8-12 weeks
what are probable/presumptive signs of pregnancy
- urine & blood tests
- chadwicks
- cervical softening
- uterine softening
- symptoms: nausea, urinary freq etc.
at what point does quickening (feeling kicks) happen?
16-20 weeks
what is the pattern of office visits (prenatal visits)
- 1x month until week 28 (6 months)
- q2 weeks from 28-36 weeks (4 times)
- every week until delivery or week 42
normal hgb in pregnancy
…
when does morning sickness occur in pregnancy
1st trimester
what is the treatment for morning sickness
- dried carbohydrate before they get out of bed
when does urinary incontinence occur in pregnancy
- 1st and 3rd trimester
what is included in care for urinary incontinence in pregnancy
- void q2hours
when does difficult breathing occur in pregnancy
- 2nd and 3rd trimester
what is included in care for difficulty breathing in pregnancy
- tripod position
when does back pain occur in pregnancy?
2nd and 3rd trimester
what is included in care for back pain in pregnancy
pelvic tilt exercises (tilt forward)
what is the truest sign of labour
- contractions that are regular and progressive
what is dilation
- opening of the cervix, 0-10 cm
what is effacement
- thinning of cervix, 0-100%
what is station
- relationship between fetal presenting part to mom’s ischial spines
what does -, +, and 0 station mean
- = above
+ = below
0 = engagement
what is lie
- relationship between spine of mother and spine of baby
what does transverse lie mean?
- perpendicular
what is presentation
- part of baby entering birth canal first
what are 4 stages of labour
1) labour
2) delivery
3) placenta
4) recovery (2 hours after placenta)
what is the purpose of cnxns in the 1st stage of labour
- dilate and effacement
what is the purpose of cnxns in the 2nd stage of labour
- push baby out
what is the purpose of cnxns in the 3rd stage of labour
- push placenta out
what is the purpose of contractions in the 4th stage of labour
- control bleeding
what are the 3 phases of the 1st stage of labour
1) latent
2) active
3) transition
what is the dilation, cnxn frequency, duration, and intensity in the 1st phase of labour
- 0-4cm
- cnxns q5-30 minutes
- cnxn duration: 15-30 sec
- intensity: mild
what is the dilation, cnxn frequency, duration, and intensity in the 2nd phase of labour
- 5-7cm
- q3-5 minutes
- duration: 30-60 sec
- moderate intensity
what is the dilation, cnxn frequency, duration, and intensity in the 3rd phase of labour
- 8-10 cm
- q2 min
- 60-90 sec duration
- strong intensity
contractions should not be…
- > 90 sec
- closer than q2min
what is contraction frequency?
- beginning of cnxn to the beginning of the next
what is contraction duration
- beginning to end of 1 contraction
painful back labour can indicate..
- OP baby
what do you do with painful back labour?
- position off back (hands and knees)
- then push (sacral pressure)
what is the priority of cord prolapse
- emergency! high priority
what do you do if there is cord prolapse
- push (head back up so it’s off cord)
- and reposition (hands and knees)
what are general interventions for all other labour complications
Left side
Increase IV fluids
Oxygenate
Notify physician
in an OB crisis, what should you do first
- stop synto
when should you not (reconsider giving) give pain meds to a pt in labour?
- if the baby is likely to be born during its peak (so if IV, in 15-30 min)
what is normal FHr
110-160
what is the priority of low FHR (<100)? what do you do?
- bad
Left side
Increase IV
O2
Notify physician
what is the priority of high FHR (>160)? what do you do?
- nothing major
- take mom’s temp
what do you do if there is low baseline variability
LION & stop synto
is high variability good or bad
- good
what is a late decel? what do you do?
- decrease in HR at end or after contraction
- LION, bad
what is an early decel? what’s its priority
- decrease in HR that mirrors the cnxn
- normal
what is a variable decel? what is its priority
- icicle
- very bad
a variable decel may mean?
- cord compression/prolapse
an early decel means?
- head compression
a late decel means?
- uteroplacental insufficiency
what do you do after the delivery of the placenta
- make sure it’s all there
- look for 3 vessels (2 artery, 1 vein)
what is the assessments & their freq done in the 4th stage of labour
- VS q15min x4
- fundal check q15 minx4
- assess bleeding, S&S of shock
what assessments are done post partum? frequency?
q4-8h
Breasts
Uterine fundus**
Bladder
Bowel
Lochia
Episiotomy
Extremities
+ hgb, hct, affect, discomfort
is a cephalohematoma normal in newborns? what is it?
yes
- bleeding or hemorrhage under the scalp
is caput succedenam normal in newborns? what is it?
- yes
- swelling or edema of the scalp that crosses sutures
when is hyperbilirubinemia normal in newborns
- if occurs after 24 hrs
what are tocolytics? what is an example
- meds that stop labour
ex. mag sulfate, turbutaline
administering too much mag sulfate can cause?
too much Mg = decreased HR, decreased BP, decreased reflexes, decreased RR, decreased LOC, etc.
what is the use of betamethasone in pregnancy?
- for fetal lung maturity
