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Nursing School Pt 2 > Maternal/ Newborn Exam 2 > Flashcards

Maternal/ Newborn Exam 2 Flashcards

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1
Q

Risks for preterm labor

A
  • infection
  • gestational diabetes
  • uterine fibroids
  • medications
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1
Q

What should you do in the even of fetal distress?

A

prep client for emergency c-section

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1
Q

Who would be an indication for induction?

A

someon at 39 weeks and not progressing

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2
Q

What is a premature rupture of membranes>

A

ruptured earlier than the end of 37th week. Greater risk if before 34th week.

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2
Q

Characteristics of placenta previa

A
  • painless
  • brigh red vaginal bleeding
  • uterus is soft/relaxed/nontender
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2
Q

Cold stress causes oxygen consumption and energy to be diverted from maintaining normal brain cell function and cardiac functinon, what is the result?

A
  • metabolic and physiologic
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2
Q

Describe lactogenesis II

A
  • 2-3 days after birth
  • transitional milk
  • immunoglobins and protein decrease
  • lactose, fat increase
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3
Q

What is the fibronectin test?

A

positive means onset of labor in 1 to 3 weeks

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4
Q

What is a normal contraction frequency?

A

no more frequen than 1-1/2 min

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5
Q

What is the first line of defense for an obstetric emergency

A

cardiopulmonary resuscitation

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6
Q

Circumcision Care

A
  • Vitamin K prior
  • feeding witheld 2-4 hrs
  • bulb syringe ready
  • Petroleum jelly over the site to prevent diaper from sticking
  • diaper attached loosely
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6
Q

What part do you suction first mouth or nose?

A

mouth

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7
Q

What actions should you take if the membranes have ruptured

A
  • assess the FHR b/c of risk of collapsed umbiical cord
  • asses the color of the amniotic fluid b/c meconium stained fluid can indicate fetal stress.
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8
Q

Particles that cannot pass through the placenta?

A

bacteria

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9
Q

What can happen with oligohydramnios

A
  • ruptured membranes
  • placental insufficiency
  • SGA
  • limited oxygen
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9
Q

Describe Colostrum

A
  • high in protein, low in carbs/fat
  • rich in IgA- protects GI
  • helps normal flora
  • speeds passage of meconium (laxative effect)
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10
Q

What is a precipitous labor/birth

A

labor and delivery after an unusually short amount of time

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11
Q

What is the fern test

A

determines the presence of amniotic fluid leakage. Produces a fernlike pattern b/c of salts

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12
Q

What can substance abuse do to the fetus

A

risk for fetal growth restriction, abruptio placentae, and fetal bradycardia

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13
Q

Nursing interventions for tachysystole?

A
  • reduce oxytocin
  • increase infusion
  • lateral position
  • give oxygen
  • notify physican
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15
Q

What could be indications for bradycardia?

A
  • fetal head compression
  • umbilical cord compression
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16
Q

What candidate would not be good for a VBAC

A

if she had a vertical incision

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17
Q

Why does a newbor recieve erythromycin?

A

Opthalmia Neotorium

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18
Q

Post date concerns > 42 weeks

A
  • LGA
  • oligohydramnios- umbilical cord compression
  • green meconium staining
    • less reserve to tolerate contractions
  • Respiratory distress
  • exhaust stores of glycogen
  • Injury
  • hemorrhage
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18
Q

Proper communication for a woman experiencing grief and loss

A

be specific with care, don’t ask why, or “is everything okay”

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19
Q

How long is too long for a newborn to have apnea?

A

10-15 seconds

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20
Q

What is a normal contraction duration

A

no longer than 90-120 sec

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21
Q

Name 4 reasosn why a newborn receives vitamin K

A
  1. hemorrhagic disease
  2. stroke
  3. clotting
  4. gut is still sterile
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22
Q

What is an example of a conductive heat loss?

A

cold hands, stethoscope, wipes, cool surface

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23
Q

Causes for cord prolapse

A
  • premature rupture of membranes
  • high station
  • blugin bag of water
  • unengageed presenting part
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24
Q

Most important assessment when baby is born?

A

breath

cardiopulmonary changes need to occur

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26
Q

When does it qualify as taochycardia or brady cardia

A

consisstent over 10min period

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26
Q

Whats a good measure of fetal heart rate in relation to mother?

A

its about twice the mothers

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26
Q

5 type of obstetric emergencies?

A
  • hypovolemia
  • PPH
  • Amniotic fluid embolism
  • prolase cord
  • shoulder dystocia
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26
Q

What side of the heart can an amniotic embolism effect?

A

left side

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27
Q

Risks for preterm infants

A
  • inadequate brown fat stores
  • 80 % risk for jaundice
  • immature conjucation abilities
  • diminished reflexes (sucking)
  • flaccid or rigid extremities
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28
Q

What does labor dystocia mean?

A

abnormally low progress of labor, inadequate pelvis shape, multifetal, PROM, bladder distention.

could be caused by infection

29
Q

What should you do if you see a positive nitrizine/ferning test?

A

check temp an FHR (amniotic fluid is present)

31
Q

What can cause uterine rupture

A
  • pitocine due to intense contractions
  • precipitate labor
  • if bleeding is excessive and uterus is still firm
  • tachysystole
  • VBAC
  • chest pain in shoulder
31
Q

What is a nitrazine test?

A

used to detect the presence of amniotic fluid in the vaginal secretions

Amniotic fluid has a pH of 7.0 - 7.5

31
Q

When should pitocin be discontinued?

A
  • frequency is less than 2 minutes
  • duration longer than 90 sec
  • fetal distress
33
Q

Correlations to precipitous birth

A
  • abruptio placentae, fetal meconium, pph, low apgar score, cocaine, nerve damage, ROM, risk for sepsis, chorioamnionitis
34
Q

What could be indications for tachycardia

A
  • maternal severe anemia
  • maternal hyperthydroidism
  • drugs (bronchodilators, decongestants)
35
Q

What drugs are used for preterm labor

A

tocolytics, corticosteroids.

35
Q

What is an example of evaporative heat loss?

A

if the baby is wet or not well wrapped

36
Q

When is betamethasone contraindicated?

A
  • chorioamnionitis
  • diabetes
  • pulmonary edema
  • sodium and fluid retention
38
Q

What can happen if fetal fibronectin appears too early

A

labor may begin early (fFN test)

could be caused by infection

39
Q

Why is Betamethazone used in pre term labor?

A

acceleration of fetal lung maturity, can reduce intraventricular hemorrhage

40
Q

When are vaginal exams contraindicated?

A

if the client is supsected of having a placenta previa

41
Q

What can increase risk for RDS?

A
  • fetal hyperinsulinemia retards cortisol production
  • RBC breakdown
  • Fewer albumin binding sites
43
Q

What do you need to asses after an amniotomy

A

temperature every 2 hours

45
Q

Criteria for an amniotomy

A
  • presenting part should be cephalic
  • reassuring fetal heart rate
  • commitment to delivery
46
Q

What is the intervention of a baby is having respiratory distress syndrome?

A

prep surfactant replacement therapy (endotracheal tube)

47
Q

When should you hold trebutiline?

A

if woman is tachycardic

48
Q

What are risk associated with amniotomy

A
  • prolapsed cord
  • infection
  • apruptio placentae
49
Q

manifestations of shoulder dystocia

A
  • turtle head
  • failure to complete external rotation
  • cord gets compressed
  • clavical crepitus, deformity or bruising
  • nerve injury to brachial plexus
51
Q

Characteristics of abruptio placentae

A
  • dark red blood
  • uterine pain/tenderness
  • uterine rigidity
53
Q

How much amniotic fluid does the mother have by the end of pregnancy?

A

800-1200 mL

54
Q

Describe Lactogenesis III

A
  • mature milk.
  • 20 kcal/oz
  • antibacterial components
55
Q

Babies at risk for hyperbilirubemia?

A
  • LGA/SGA
  • RBC’s not getting excreted
  • ABO incombatibility
  • bruising/hematoma
57
Q

What could be causes of premature rupture of membranes

A
  • infections
  • neisseria gonorrhea
  • chorioamnioitis associated with GBS
  • maternal stress
  • recent vaginal intercourse
58
Q

Name 5 symptoms of respiratory distress

A
  1. tachypea
  2. nasal flaring
  3. grunting
  4. retractins
  5. decreased breath sounds
59
Q

What is acreda/percreda

A

placenta attaches to an organ, risk for PPH

60
Q

Complications with oxytocin administration

A
  • abpruptio placentaie
  • impaired uterine blood flow
  • uterine rupture
  • FHR variability
  • late decelerations.
62
Q

What is shoulder dystocia

A

shoulder becomes lodged under the mother’s symphysis pubis during birth

64
Q

Medication used to induce labor

A
  • pitocin
  • prostaglandins
    • caution if woman has asthma, glaucoma
  • seaweed (laminaria tents)
  • transcervical catheter
66
Q

Manifestation of abruptio placentae?

A
  • ab/low back pain
  • high uterine resting tone
  • vaginal bleeding
  • non reassuring FHR
  • concealed hemorrhage
67
Q

What are the nursing interventions for shoulder dystocia?

A
  • McRobert’s maneuver
  • Suprapubic pressure, kneed
  • NO fundal pressure
  • episiotomy
68
Q

Causes of bleeding postpartum

A
  • retained placenta
  • lacerations
  • hemorrhage
69
Q

What are your nursing interventions for a precitous labor x4

A
  • tocolytics
  • oxgenation
  • sidelying to enhance placenta blood flow
  • non additive iv fluids
71
Q

Management of premature rupture of membrane

A
  • labor induction
  • cesarean brth
  • accurate gestational age evaluation
  • fetal lung maturity
71
Q

Causes of bleeding intrapartum

A
  • uterine rupture
  • placenta previa
  • abruptio
73
Q

What are Kubler Ross’s 5 stages of Grief?

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
73
Q

Induction Risks

A
  • Tachysystole
  • water intoxication
  • pulmonary edema
  • CHF
  • Variable/Late decelerations
75
Q

Interventions for RDS?

A
  • ABG’s
  • schedule eye exam for retinal damage
  • suction every 2 hrs
  • position on side or back
  • provide nutrition
76
Q

What is an example of radiative heat loss?

A

if they ar near cold objects and outside walls

77
Q

Particles that CAN pass through the placenta?

A

nutrients, drugs, alcohol, anitbodies, and viruses

77
Q

Interventions for variable decelerations?

A
  • change position of the mother
  • administer oxygen
  • discontinue pitocin
  • assess vital signs
  • notify HCP
  • Assist amnioinfusion (warm saline
79
Q

What is the critical fetal assessment prior to any procedure?

A

FHR

80
Q

Causes of bleeding antepartum

A
  • previa
  • abruption
  • uterine rupture
  • miscarriage
81
Q

What is the antidoe for induction?

A

Trebutiline (tocolytic).

82
Q

What does marked variability mean?

A

fetal heart rate fluctuations are greater than 25 beats/minute

83
Q

What should interventions for late decelerations include?

A

improving placental blood flow and fetal oxygenation

84
Q

What is example of convection heat loss?

A

near a window or draft

85
Q

What is placenta previa

A
  • placenta moves and may be covering the cervix
  • may mean you will need to a C-section or induction of labor
  • umbilical cord can prolapse
86
Q

What is the nursing intervention for cord prolapse

A
  • hips higher than head to shift fetus
  • tendelendburg
  • tocolytics
  • vaginal elevation
87
Q

Is jaundice the first day of life pathologic?

A

yes

88
Q

What is a uterine rupture

A

a tear in the uterine wall because the uterus cannot withstand the pressure against it

89
Q

What does abruptio placentae mean?

A
  • Placenta separation before the fetus is born
  • can occur with hematoma
  • hypovolemic shock, clotting abnormalities
  • greater risk if greater amount of amniotic fluid
90
Q

If fetal bradycardia or tachycardia occur, what is your action?

A
  • change the position of mother
  • administer oxygen
  • assess the mother’s vital signs
  • notify the healtcare provider
91
Q

Nursing interventions for post date

A
  • induction of labor
  • accurate gestational age assessment
  • biophysical profile

Nursing School Pt 2 (13 decks)

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