Maternal Newborn - Week 4 Tips Flashcards
Severe Pre-eclampsia HELLP Syndrome (HEL)
Hemolysis
Elevated Liver enzymes
Low platelet count
Logan Bow
stainless steel wire w/ tape that protects newly repaired cleft lip
Dystocia
prolonged/difficult labor
“TORCH” infections
Toxoplasmosis Other (Hep B, Syphilis, B Beta Strep) Rubella Cytomegalovirus Herpes Simplex Virus
“TORCH” infections causes
raw/undercooked meat or handling cat poo Congenital anomalies Mothers/children with rashes Droplet infection Direct contact lesions
Intrauterine Device (IUD) complications (PAINS)
Period Abdominal pain Infection Not feeling well, fever/chills String missing
Newborne Assessment Components (APGAR)
Appearance Pulse Grimace Activity Respiratory Effort
APGAR is taken @ which 2 times?
1 and 5 minutes post-birth
APGAR Scoring
Each section is 1 - 2 out of 10
0 - 3 = severe distress
4 - 6 = moderate difficulty
7 - 10 = adapting
APGAR Activity 0 - 2
Flexion
0 = flaccid
1 = some flexion
2 = well flexed
APGAR Grimace 0 - 2
Rule soles
0 = no response
1 = grimace
2 = cry
APGAR Pulse 0 - 2
Pulse of ♥ @ Apex w/ neonatal stethoscope
0 = absent
1 = ↓ 100 bpm
2 = ↑ 100 bpm
APGAR Respiratory Effort 0 - 2
Observe cry
0 = no respiratory effort
1 = weak cry
2 = good cry
APGAR Appearance 0 - 2
Observe color
0 = pale/blue
1 = pink bod/blue extremities (acrocyanosis) OK!
2 = completely pink
Maternity History (GTPAL)
Gravida Term Births (↑ 38 weeks) Preterm Births (Viability to 37 weeks) Abortions/Miscarriages Living Children
Oral Contraceptive Potential problems (ACHES) and meanings.
Abdominal pain (liver/gallbladder) Chest pain/SoB (pulmonary emobolus) Headache (HTN, brain attack) Eye problems (HTN, vascular accident) Severe leg pain (thromboembolic proccess)
Preterm Infant Anticipates Problems (TRIES)
Temperature regulation Resistance to infections Immature liver Elimination problems Sensory-perceptual issues
Fetal Heart Rate (FHR) - VEAL CHOP
Variable Decels - cord compression, move mom
Early Decels - head compression
Accelerations - O2, good!
Late Decels - Placental utero infufficiency, BAD!!!
Admitting Pregnant Ladies (FETUS) Assessment
F - Fetal ♥ Tones, document qshirt E - Emotional Support T - Temperature mom U - Uterine Activity S - Sensations in fetal movement qshirt
Fetal Tone assessment at 20 vs 24 weeks.
Doppler
20 - symphysis pubis
24 - towards umbilicus
Unusual fetal movement r/in lower back pain?
Softly palpate lower abdomen for ↑ 2 minutes… if +pain with ▲ uterine tone, contractions are expected.
Initiate continuous fetal monitoring!
Admitting Post-partum ladies (BLPC) Assessment
B - Boobs
L - Lochia
P - Perineal Care
C - Cesarean Section
BLPC Boob milk timings
first 24 hours = colostrum
first 72 hours = breastmilk
BLPC Lochia timings
immediately - red/heavy, needs pad ▲ q1-2hrs
7 days post - lighter, needs pad ▲ q4hrs
IF heavy, smells bad, and w/ pain REPORT
BLPC Perineal Care
first 2 weeks post-delivery
water rinse post urination w/ warm water and sitz baths
BLPC Cesarean Section
Staples removed 5 days post delivery
REPORT redness, warmth, discharge
Placenta Previa (%)
low implantation of placenta (0.005%)
Abruptio Placenta
premature separation of placenta (10%)
Causes Placenta Previa (5)
High parity OLD Hx C-sections Hx curettage Multiple gestation
Causes Abruptio Placenta (7)
High parity OLD Short umbilical cord HTN Trauma Vasoconstriction r/t cig use Thrombic conditions
Placenta Previa vs. Abruptio Placenta Bleeding?
ALWAYS w/ Previa
Sometimes w/ Placenta
Placenta Previa vs. Abruptio Placenta Blood Color?
Bright red Previa
Dark red Placenta
Placenta Previa vs. Abruptio Placenta Pain?
Painless previa
SHARP STABBING PAIN AAAH PLACENTA
Placenta Previa Management (3)
Bed rest, side-lying
Weigh perineal pads
NEVER exam pelvis/rectum
Abruptio Placenta Management (6)
Fluid replacement O2 via mask Monitor FHR Lateral position NEVER exam pelvis TERMINATE PREGNANCY
Thyroid Hormone Medications are…?
Synthetic THYROxine (T4) which ↑ metabolic rate
Thyroid Medications examples (4)
LevoTHYROxine (Synthroid, Levothyroid)
LioTHUROnien (Cytomel)
Liotrix (THYROlar)
THYROid (Thyroid USP)
AntiThyroid Medications function…?
block conversion of T4 and T3, which treats Grave’s Disease and Thyrotoxicosis
Grave’s Disease
When autoimmune antibodies r/in hyper secretion of thyroid hormones
AntiThyroid Medication examples (4)
Proplythiouracil (PTU)
Methimazole (Tazapole)
Thyroid Radioactive Iodine
Thyroid NonRadioactive Iodine
Thyroid Radioative vs. NonRadioactive Iodine
Radioactive - destroys thyroid cells (good for thyroid cancer)
Non - iodine inhibits hormone production
Thyroid Iodine, how’s it taste?
LIKE SHIT
Drink through a straw to prevent staining of teeth.
No radioactivity precautions necessary for this medication.
Oral Hypoglycemic Agents function…?
Promote insulin release in DM-2 patients
Oral Hypoglycemic Agent examples (3)
Glipizide (GLUCOtrol)
Chlorpropamide (DIABines)
Glyburide (DIABinese, Micronase)
MetformincHC1 (GLUCOphage)
Insulin Overdose antidose
Glucose (GLUCAgon)
Anterior Pituitary (Growth) Hormones function…?
WATCH OUT for when taking?
Stimulate growth for patients w/ growth deficiencies.
DM, as they ↑ r/o hyperglycemia
Growth Hormone examples (2)
Somatropin
Somatrem (Protropin)
Posterior Pituitary (Antidiuretic) Hormones function…?
promotes reabsorption of water in kidneys and causes vasoconstriction
Antidiuretic Hormones examples (2)
Desmopressin (DDAVP, Stimate)
Vasopressin (Petressin Synthetic)
Anticonvulants function…? how?
treat epileptic seizures by suppressing rapid firing neurons in brains that start them.
Anticonvulsant medications (Caphe Valet, misour!) (4)
CA-rbamazepine
PHE-nytoin/PHE-nobarbital
VAL-proic Acid
ET-hosuximide
CAPHE vs. VALET anticonvulsants
VALET’s are only for petit mal seizures
Petit Mal Seizures
aka Absence Seizures…
involve brief lapses of attention
“PHENytoin” Adverse Effects
All seizure medications have these.
P -interactions H -irsutism E -nlarged gums N -ystagmus Y -ellow browning skin T -eratogenicity O -steomalacia I -nterferences w/ B metabolism N -europathies
Hirsutism
Unwanted hair growth where men get it
Nystagmus
Repetitive uncontrolled eye movements
Osteomalacia
Softening of bones
Neuropathy - Ataxia
Loss of full control of body movements
Neuropathy - Vertigo
Sensation of spinning/dizziness
Antiparkinson/sonian medications treat…? How…?
Parkinson’s disease.
↑ dopamine activity to reduce ACh in brain, halting progression but NOT providing relief
Beta-Adrenergic Blocking Agents treat? how?
Open-angle glaucoma by blocking beta-1 and beta-2 receptors
Beta-Adrenergic Blocking medication examples (4)
BETAxolos (Betoptic)
LevoBETAxolol (Betaxon)
Levobunolol (BETAgan)
Timolol (BETimol)
Prostaglandin Analogs treat? how?
glaucoma (w/ fever sfx than B-Adrenergic Blockers) by relaxing ciliary muscle, r/in aqueous humor outflow
Prostaglandin Analog medication examples (2)
LatanoPROST
TravoPROST
Alpha2-Adrenergic Agonists treat? how?
Increased ocular pressure by ↓ aqueous humor production.
ALSO protects retinal neurons from death
Alpha2-Adrenergic medication examples (2)
BrimonIDINE (Alphagan)
ApracionIDINE (Iop Idine)
Direct Acting Cholinergic Agonists/Muscarinic Agonist function?
1 example?
constricts pupil and ciliary muscle, this widens trabecular meshwork, r/in ↑ outflow aqueous humor
Pilocarpine
Cyloplegic medication function
paralyze ciliary muscle
Mydriatic medication function
dilate pupil
Oculus Dexter, Sinister, Uterque
Dexter - R eye
Sinister - L eye
Uterque - Both eyes
Side effects to Opthalmic Medicatiosn (BAD POCC)
Blurred vission Angle closure glaucoma Dry eyes Photophobia Ocular Pressure Can cause systemic effets Ciliary muscle constriction