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

Maternal/ Newborn Exam 2 Flashcards

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
Proper communication for a woman experiencing grief and loss
be specific with care, don't ask why, or "is everything okay"
19
How long is too long for a newborn to have apnea?
10-15 seconds
20
What is a normal contraction duration
no longer than 90-120 sec
21
Name 4 reasosn why a newborn receives vitamin K
1. hemorrhagic disease 2. stroke 3. clotting 4. gut is still sterile
22
What is an example of a conductive heat loss?
cold hands, stethoscope, wipes, cool surface
23
Causes for cord prolapse
* premature rupture of membranes * high station * blugin bag of water * unengageed presenting part
24
Most important assessment when baby is born?
breath cardiopulmonary changes need to occur
26
When does it qualify as taochycardia or brady cardia
consisstent over 10min period
26
Whats a good measure of fetal heart rate in relation to mother?
its about twice the mothers
26
5 type of obstetric emergencies?
* hypovolemia * PPH * Amniotic fluid embolism * prolase cord * shoulder dystocia
26
What side of the heart can an amniotic embolism effect?
left side
27
Risks for preterm infants
* inadequate brown fat stores * 80 % risk for jaundice * immature conjucation abilities * diminished reflexes (sucking) * flaccid or rigid extremities
28
What does labor dystocia mean?
abnormally low progress of labor, inadequate pelvis shape, multifetal, PROM, bladder distention. ## Footnote *could be caused by infection*
29
What should you do if you see a positive nitrizine/ferning test?
check temp an FHR (amniotic fluid is present)
31
What can cause uterine rupture
* pitocine due to intense contractions * precipitate labor * if bleeding is excessive and uterus is still firm * **tachysystole** * VBAC * chest pain in shoulder
31
What is a nitrazine test?
used to detect the presence of amniotic fluid in the vaginal secretions Amniotic fluid has a pH of 7.0 - 7.5
31
When should pitocin be discontinued?
* frequency is less than 2 minutes * duration longer than 90 sec * fetal distress
33
Correlations to precipitous birth
* **abruptio placentae,** fetal meconium, pph, low apgar score, **cocaine**, nerve damage, ROM, risk for sepsis, chorioamnionitis
34
What could be indications for tachycardia
* maternal severe anemia * maternal hyperthydroidism * drugs (bronchodilators, decongestants)
35
What drugs are used for preterm labor
tocolytics, corticosteroids.
35
What is an example of evaporative heat loss?
if the baby is wet or not well wrapped
36
When is betamethasone contraindicated?
* chorioamnionitis * diabetes * pulmonary edema * sodium and fluid retention
38
What can happen if fetal fibronectin appears too early
labor may begin early (fFN test) ## Footnote *could be caused by infection*
39
Why is Betamethazone used in pre term labor?
acceleration of fetal lung maturity, can reduce intraventricular hemorrhage
40
When are vaginal exams contraindicated?
if the client is supsected of having a placenta previa
41
What can increase risk for RDS?
* fetal hyperinsulinemia retards cortisol production * RBC breakdown * Fewer albumin binding sites
43
What do you need to asses after an amniotomy
temperature every 2 hours
45
Criteria for an amniotomy
* presenting part should be cephalic * reassuring fetal heart rate * commitment to delivery
46
What is the intervention of a baby is having respiratory distress syndrome?
prep surfactant replacement therapy (endotracheal tube)
47
When should you hold trebutiline?
if woman is tachycardic
48
What are risk associated with amniotomy
* prolapsed cord * infection * apruptio placentae
49
manifestations of shoulder dystocia
* turtle head * failure to complete external rotation * cord gets compressed * clavical crepitus, deformity or bruising * nerve injury to brachial plexus
51
Characteristics of abruptio placentae
* dark red blood * uterine pain/tenderness * uterine rigidity
53
How much amniotic fluid does the mother have by the end of pregnancy?
800-1200 mL
54
Describe Lactogenesis III
* mature milk. * 20 kcal/oz * antibacterial components
55
Babies at risk for hyperbilirubemia?
* LGA/SGA * RBC's not getting excreted * ABO incombatibility * bruising/hematoma
57
What could be causes of premature rupture of membranes
* infections * neisseria gonorrhea * chorioamnioitis associated with GBS * maternal stress * recent vaginal intercourse
58
Name 5 symptoms of respiratory distress
1. tachypea 2. nasal flaring 3. grunting 4. retractins 5. decreased breath sounds
59
What is acreda/percreda
placenta attaches to an organ, risk for PPH
60
Complications with oxytocin administration
* abpruptio placentaie * impaired uterine blood flow * uterine rupture * FHR variability * late decelerations.
62
What is shoulder dystocia
shoulder becomes lodged under the mother's symphysis pubis during birth
64
Medication used to induce labor
* pitocin * prostaglandins * caution if woman has asthma, glaucoma * seaweed (laminaria tents) * transcervical catheter
66
Manifestation of abruptio placentae?
* ab/low back pain * high uterine resting tone * vaginal bleeding * non reassuring FHR * concealed hemorrhage
67
What are the nursing interventions for shoulder dystocia?
* McRobert's maneuver * Suprapubic pressure, kneed * NO fundal pressure * episiotomy
68
Causes of bleeding postpartum
* retained placenta * lacerations * hemorrhage
69
What are your nursing interventions for a precitous labor x4
* tocolytics * oxgenation * sidelying to enhance placenta blood flow * non additive iv fluids
71
Management of premature rupture of membrane
* labor induction * cesarean brth * accurate gestational age evaluation * fetal lung maturity
71
Causes of bleeding intrapartum
* uterine rupture * placenta previa * abruptio
73
What are Kubler Ross's 5 stages of Grief?
1. Denial 2. Anger 3. Bargaining 4. Depression 5. Acceptance
73
Induction Risks
* Tachysystole * water intoxication * pulmonary edema * CHF * Variable/Late decelerations
75
Interventions for RDS?
* ABG's * schedule eye exam for retinal damage * suction every 2 hrs * position on side or back * provide nutrition
76
What is an example of radiative heat loss?
if they ar near cold objects and outside walls
77
Particles that CAN pass through the placenta?
nutrients, drugs, alcohol, anitbodies, and viruses
77
Interventions for variable decelerations?
* change position of the mother * administer oxygen * discontinue pitocin * assess vital signs * notify HCP * Assist amnioinfusion (warm saline
79
What is the critical fetal assessment prior to any procedure?
FHR
80
Causes of bleeding antepartum
* previa * abruption * uterine rupture * miscarriage
81
What is the antidoe for induction?
Trebutiline (tocolytic).
82
What does marked variability mean?
fetal heart rate fluctuations are greater than 25 beats/minute
83
What should interventions for late decelerations include?
improving placental blood flow and fetal oxygenation
84
What is example of convection heat loss?
near a window or draft
85
What is placenta previa
* 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
What is the nursing intervention for cord prolapse
* hips higher than head to shift fetus * tendelendburg * tocolytics * vaginal elevation
87
Is jaundice the first day of life pathologic?
yes
88
What is a uterine rupture
a tear in the uterine wall because the uterus cannot withstand the pressure against it
89
What does abruptio placentae mean?
* Placenta separation before the fetus is born * can occur with hematoma * hypovolemic shock, clotting abnormalities * greater risk if greater amount of amniotic fluid
90
If fetal bradycardia or tachycardia occur, what is your action?
* change the position of mother * administer oxygen * assess the mother's vital signs * notify the healtcare provider
91
Nursing interventions for post date
* induction of labor * accurate gestational age assessment * biophysical profile

Nursing School Pt 2 (13 decks)

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