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Nursing School Pt 2 > Maternal/Newborna Exam 3 > Flashcards

Maternal/Newborna Exam 3 Flashcards

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1
Q

What is Methotrexate used for

A
  • carcinomas
  • it interferes with folic acid metabolism
  • Inhibits DNA synthesis.

used for ectopic pregnancy

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2
Q

Hyperemesis Gravidarum is a different type of morning sickness

A

sick during pregnancy, could cause electrolyte imbalance

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3
Q

What causes hyperemesis Gravidarum

A

Vitamin B6 deficiency (give 3x a day) NOT hCG levels

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4
Q

Phenergan

A
  • increases narcotics
  • slows down metabolism of the narcotic
  • anti-emetic, good for if woman is dizzy
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5
Q

Reglan

A

Antiemetic during chemotherpy

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6
Q

Zofran

A

anti-emetic for chemotherapy

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7
Q

Preeclampsia

A

hypertension after 20 weeks gestation w/ proteinuria (>1+) (140/90+)

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8
Q

Eclampsia

A

when preeclampsi turns into a seizure

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9
Q

chronic htn

A

before 20 weeks, trace proteinura. Persists > 42 days following childrbirth

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10
Q

What is too much protein

A

1+ or 2+ is greater than “trace”

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11
Q

What type of vessels do preeclampsia women have

A

flaccid

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12
Q

Preeclampsia do they have vasoconstriction or vasodilated

A

vasoconstricted, calcified. (dec leveled of vasdilating prostglandins)

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13
Q

What hormone do preeclampsia have a decreased resistance to?

A

angiotensin II (make cells more flaccid)

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14
Q

When assessing woman for preeclampsia what location is the liver

A

RUQ

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15
Q

Signs/Sx of Preeclampsia

A
  • Headache/Blurred Vision
  • Facial Edema
  • pulmonary edema, no crackles
  • BP- increased
  • Liver distended/painful
  • AST/ALT elevated
  • lacking albumin, 3rd spacing
  • reflexes, hyperreflexia
  • clonus,
  • oliguria
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16
Q

normal response during pregnancy H/H

A

decreased due to increased plasma

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17
Q

preeclampsia will have what type of h/h

A

falsely high

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18
Q

Mild Preeclampsia

A

Hypertension and proteinuria

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19
Q

Severe preeclampsia

A

>160 mm organ failure

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20
Q

Treatment for preeclamps

A
  • Magnesium sulfate, NOT anti-hypertensive
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21
Q

Magenesium Sulfate

A
  • acts like a calcium channel blocker, but not antihypertensive
  • prevents seizure
  • check q 15min
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22
Q

Why do we give corticosteroids for preeclampsia

A

for baby

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23
Q

Hydralazine

A

used to lower blood pressure

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24
Q

HELLP syndrome

A
  • hemolysis
  • elevated liver enzymes
  • low platelet count (thrombocytopenia)
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25
Q

What is thrombocytpenia

A

< 150,000

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26
Q

Clinical Manifestation of HELLP

A
  • RUQ pain
  • jaundice
  • liver rupture
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27
Q

Only cure for preeclampsia

A

delivery of the placenta

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28
Q

How should a preeclamptic woman deliver?

A

vaginally, scary bc of water intoxification

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29
Q

Rhogam within how many hours after delivery

A

72 hours

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30
Q

What does coombs test for?

A

antibodies

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31
Q

Pathological Jaundice

A
  • ABO incompatibility
  • O blood type, type A or B fetus
  • can’t give rhogam
  • hyperbilirubemia, anemia
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32
Q

When do we test GBS

A

36 weeks

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33
Q

What should we give for GPS positive

A

penicillin G q4 hours. birthing process puts baby at risk.

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34
Q

Magnesium sulfate classification

A

CNS depressant

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35
Q

What is the dose for magnesium sulfate

A

4-6 grams, A LOT.

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36
Q

What is the antidote for magensium sulfate

A

calcium gluconate

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37
Q

Side Effects of Magnesium Sulfate (Maternal)

A
  • depressed respiration
  • depressed DTRs
  • hypotension
  • extreme muscle weakness
  • flushing
  • decreased u. output
  • pulmonary edema
  • > 9 mg/dl serum mag
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38
Q

DTR clonus for magnesium sulfate

A

hyporreflexia

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39
Q

What is the major vital sign we need for magnesium sulfate?

A

pulse oximeter

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40
Q
A
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41
Q

How is magnesium sulfate excreted?

A

through the urine

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42
Q

What type of drug is Mag Sulfate

A
  • CNS depressant
  • tocolytic
  • neuro protection for mom/fetus
  • treat/prevent eclampsia
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43
Q

Who would be an indication for induction?

A

someon at 39 weeks and not progressing

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44
Q

What should you do in the even of fetal distress?

A

prep client for emergency c-section

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45
Q

Risks for preterm labor

A
  • infection
  • gestational diabetes
  • uterine fibroids
  • medications
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46
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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47
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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48
Q

Characteristics of placenta previa

A
  • painless
  • brigh red vaginal bleeding
  • uterus is soft/relaxed/nontender
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49
Q

What is the fibronectin test?

A

positive means onset of labor in 1 to 3 weeks

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50
Q

What is a normal contraction frequency?

A

no more frequen than 1-1/2 min

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51
Q

What is the first line of defense for an obstetric emergency

A

cardiopulmonary resuscitation

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52
Q

What part do you suction first mouth or nose?

A

mouth

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53
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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54
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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55
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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56
Q

What can happen with oligohydramnios

A
  • ruptured membranes
  • placental insufficiency
  • SGA
  • limited oxygen
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57
Q

What is a precipitous labor/birth

A

labor and delivery after an unusually short amount of time

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58
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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59
Q

What can substance abuse do to the fetus

A

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

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60
Q

Nursing interventions for tachysystole?

A
  • reduce oxytocin
  • increase infusion
  • lateral position
  • give oxygen
  • notify physican
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61
Q

What could be indications for bradycardia?

A
  • fetal head compression
  • umbilical cord compression
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62
Q

What candidate would not be good for a VBAC

A

if she had a vertical incision

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63
Q

Why does a newbor recieve erythromycin?

A

Opthalmia Neotorium

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64
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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65
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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66
Q

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

A

10-15 seconds

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67
Q

What is a normal contraction duration

A

no longer than 90-120 sec

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68
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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69
Q

What is an example of a conductive heat loss?

A

cold hands, stethoscope, wipes, cool surface

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70
Q

Causes for cord prolapse

A
  • premature rupture of membranes
  • high station
  • blugin bag of water
  • unengageed presenting part
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71
Q

Most important assessment when baby is born?

A

breath

cardiopulmonary changes need to occur

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72
Q

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

A

its about twice the mothers

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73
Q

5 type of obstetric emergencies?

A
  • hypovolemia
  • PPH
  • Amniotic fluid embolism
  • prolase cord
  • shoulder dystocia
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74
Q

What side of the heart can an amniotic embolism effect?

A

left side

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75
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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76
Q

What does labor dystocia mean?

A

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

could be caused by infection

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77
Q

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

A

check temp an FHR (amniotic fluid is present)

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78
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

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79
Q

When should pitocin be discontinued?

A
  • frequency is less than 2 minutes
  • duration longer than 90 sec
  • fetal distress
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80
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
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81
Q

Correlations to precipitous birth

A
  • abruptio placentae, fetal meconium, pph, low apgar score, cocaine, nerve damage, ROM, risk for sepsis, chorioamnionitis
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82
Q

What could be indications for tachycardia

A
  • maternal severe anemia
  • maternal hyperthydroidism
  • drugs (bronchodilators, decongestants)
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83
Q

What drugs are used for preterm labor

A

tocolytics, corticosteroids.

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84
Q

What is an example of evaporative heat loss?

A

if the baby is wet or not well wrapped

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85
Q

When is betamethasone contraindicated?

A
  • chorioamnionitis
  • diabetes
  • pulmonary edema
  • sodium and fluid retention
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86
Q

What can happen if fetal fibronectin appears too early

A

labor may begin early (fFN test)

could be caused by infection

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87
Q

Why is Betamethazone used in pre term labor?

A

acceleration of fetal lung maturity, can reduce intraventricular hemorrhage

88
Q

When are vaginal exams contraindicated?

A

if the client is supsected of having a placenta previa

89
Q

What can increase risk for RDS?

A
  • fetal hyperinsulinemia retards cortisol production
  • RBC breakdown
  • Fewer albumin binding sites
90
Q

What do you need to asses after an amniotomy

A

temperature every 2 hours

91
Q

Criteria for an amniotomy

A
  • presenting part should be cephalic
  • reassuring fetal heart rate
  • commitment to delivery
92
Q

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

A

prep surfactant replacement therapy (endotracheal tube)

93
Q

When should you hold trebutiline?

A

if woman is tachycardic

94
Q

What are risk associated with amniotomy

A
  • prolapsed cord
  • infection
  • apruptio placentae
95
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
96
Q

Characteristics of abruptio placentae

A
  • dark red blood
  • uterine pain/tenderness
  • uterine rigidity
97
Q

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

A

800-1200 mL

98
Q

Describe Lactogenesis III

A
  • mature milk.
  • 20 kcal/oz
  • antibacterial components
99
Q

Babies at risk for hyperbilirubemia?

A
  • LGA/SGA
  • RBC’s not getting excreted
  • ABO incombatibility
  • bruising/hematoma
100
Q

What could be causes of premature rupture of membranes

A
  • infections
  • neisseria gonorrhea
  • chorioamnioitis associated with GBS
  • maternal stress
  • recent vaginal intercourse
101
Q

Name 5 symptoms of respiratory distress

A
  1. tachypea
  2. nasal flaring
  3. grunting
  4. retractins
  5. decreased breath sounds
102
Q

What is acreda/percreda

A

placenta attaches to an organ, risk for PPH

103
Q

Complications with oxytocin administration

A
  • abpruptio placentaie
  • impaired uterine blood flow
  • uterine rupture
  • FHR variability
  • late decelerations.
104
Q

What is shoulder dystocia

A

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

105
Q

Medication used to induce labor

A
  • pitocin
  • prostaglandins
    • caution if woman has asthma, glaucoma
  • seaweed (laminaria tents)
  • transcervical catheter
106
Q

Manifestation of abruptio placentae?

A
  • ab/low back pain
  • high uterine resting tone
  • vaginal bleeding
  • non reassuring FHR
  • concealed hemorrhage
107
Q

What are the nursing interventions for shoulder dystocia?

A
  • McRobert’s maneuver
  • Suprapubic pressure, kneed
  • NO fundal pressure
  • episiotomy
108
Q

Causes of bleeding postpartum

A
  • retained placenta
  • lacerations
  • hemorrhage
109
Q

What are your nursing interventions for a precitous labor x4

A
  • tocolytics
  • oxgenation
  • sidelying to enhance placenta blood flow
  • non additive iv fluids
110
Q

Causes of bleeding intrapartum

A
  • uterine rupture
  • placenta previa
  • abruptio
111
Q

Management of premature rupture of membrane

A
  • labor induction
  • cesarean brth
  • accurate gestational age evaluation
  • fetal lung maturity
112
Q

What are Kubler Ross’s 5 stages of Grief?

A
  1. Denial
  2. Anger
  3. Bargaining
  4. Depression
  5. Acceptance
113
Q

Induction Risks

A
  • Tachysystole
  • water intoxication
  • pulmonary edema
  • CHF
  • Variable/Late decelerations
114
Q

Interventions for RDS?

A
  • ABG’s
  • schedule eye exam for retinal damage
  • suction every 2 hrs
  • position on side or back
  • provide nutrition
115
Q

What is an example of radiative heat loss?

A

if they ar near cold objects and outside walls

116
Q

Interventions for variable decelerations?

A
  • change position of the mother
  • administer oxygen
  • discontinue pitocin
  • assess vital signs
  • notify HCP
  • Assist amnioinfusion (warm saline
117
Q

Particles that CAN pass through the placenta?

A

nutrients, drugs, alcohol, anitbodies, and viruses

118
Q

What is the critical fetal assessment prior to any procedure?

A

FHR

119
Q

Causes of bleeding antepartum

A
  • previa
  • abruption
  • uterine rupture
  • miscarriage
120
Q

What is the antidoe for induction?

A

Trebutiline (tocolytic).

121
Q

What does marked variability mean?

A

fetal heart rate fluctuations are greater than 25 beats/minute

122
Q

What should interventions for late decelerations include?

A

improving placental blood flow and fetal oxygenation

123
Q

What is example of convection heat loss?

A

near a window or draft

124
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
125
Q

What is the nursing intervention for cord prolapse

A
  • hips higher than head to shift fetus
  • tendelendburg
  • tocolytics
  • vaginal elevation
126
Q

Is jaundice the first day of life pathologic?

A

yes

127
Q

What is a uterine rupture

A

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

128
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
129
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
130
Q

Nursing interventions for post date

A
  • induction of labor
  • accurate gestational age assessment
  • biophysical profile
131
Q
A
  • Transverse Lie shoulder presentation
132
Q

A positive Triple/Quad Screen is what?

A
  • Estriole low
  • hCG is high

further testing necessary

133
Q

Women are hypercoagulable during pregnancy, why?

A

protective for inevitable blood loss

134
Q

What does Estrogen do? x6

A
  1. stimulates contractions
  2. increased elasticity of ligaments
  3. melanin
  4. decrease GI motility
  5. Alter’s F & E’s
  6. Breast Development
135
Q

HEAD to TOE assesssment postpartum

A
  • Breasts
  • Uterus
  • Bowel
  • Bladder
  • Lochia (pad an hr too much)
  • Episiotomy (laceration)
  • Homans/hemorrhoids/hematoma
  • Emotions
136
Q

What happens to peripheral vascular resistance during pregnancy?

A

It decreases

137
Q

What are danger signs of preeclampsia? x4

A
  • severe headache
  • abdominal pain
  • visual disturbance
  • swelling
138
Q

Interventions for Late Decelerations x6

A
  1. IV bolus of LR
  2. Discontinue oxytocin
  3. tocolytic drug
  4. oxygen 10L/min
  5. reposition
  6. Amnioinfusion
139
Q

This is failure to decend due to placenta retention

A

sub involution

140
Q

Should not be used if patient has asthma

A

hemobate

141
Q

Etiology for early decelerations

A

fetal head compression

142
Q

5 P’s of Labor

A
  1. Passage- type of pelvis
  2. Passenger- size of fetus, presentation
  3. Powers- contraction/relax uterus, voluntary efforts
  4. Psyche- maternal emotional status
  5. partners-relationship of passenger/passage
143
Q

Why is there a UTI risk during pregnancy?

A

dilation of renal pevlis and ureters due to progesterone

144
Q

What causes pseudo anemia

A

more plasma than rbc’s, but both increase

145
Q

What is a full term pregnancy?

A

37-42 weeks

146
Q

This is a block of sympathetic fibers, contraindicated for a women with hypovolemia?

A

spinal block

147
Q

Meds used for bleeding

A
  • oxytocin
  • cytocec
  • hemobate
  • methergen
148
Q

Meds used to induce labor x5

A
  • prostaglandins (rippening)
  • stripping cervix
  • rupturing membranes
  • catheter w/ balloon
  • pitocin (oxytocin)
149
Q
A

Longitudinal Lie Vertex Presentation

150
Q

What does progesterone do?

A
  • gallbladder prolonged emptying
  • prevents bile salts from being released
  • softening of joints and ligaments
151
Q

Assessment for Episiotomy

A
  • Redness
  • Edema
  • Ecchymosis (bruising)
  • Discharge
  • Approximation
152
Q

Disadvantages of epidural block

A

hypotension

153
Q

Why does blood volume increase during pregnancy?

A

to reserve blood loss at birth

154
Q

What does a non stress test show?

A
  • 2 fetal heart accelerations within 20 minutes
  • Intact CNS
155
Q

Etiology for variable deceleration

A

cord compression

156
Q

Where is false labor felt

A

in the abdomen or groin

157
Q

Types of Lochia

A

Rubra, Serosa, Alba

158
Q

What position allows greater perfusion to the fetus?

A

Wedged to the left

159
Q

What does hCG do?

A

maintains corpus luteum until placenta is functioning (21weeks)

160
Q

Para measures…

A

how many were living greater than 20 weeks

161
Q

Pre term

A

20-36.6 weeks

162
Q

Biophysical Profile Assess 5 Parameters

A
  1. NST
  2. Fetal breathing
  3. fetal movements
  4. fetal tone
  5. amniotic fluid volume
163
Q

What does relaxin do? x5

A
  • opening/softening of the cervix
  • prevents premature contractions
  • regulates CV and Renal system
  • relax vessels
  • excreted by placenta
164
Q

Why do you give IV fluids when administering epidural?

A

to keep BP stabilized

165
Q

What are the 7 cardinal movement of labor

A
  1. Descent
  2. Engagement
  3. Flexion
  4. Internal Rotation
  5. Extension
  6. Restitution
  7. External Rotation
  8. Expulsion
166
Q

Signs of malpresentation?

A
  • you can feel bony prominence of the head pushing on sacral nerves
  • back pain
167
Q

What are abnormal concentrations of Alphafetoproein associated with

A

fetal anomalies

168
Q

Advantages of using epidural block?

A

blocks pain and patient is fully awake

169
Q

Why do hematocrit and hemoglobin levels drop during 1st and 2nd trimester?

A

because of blood volume expansion

170
Q

How do you wake a baby up if sleeping?

A

Vibroacoustic Monitor

171
Q

What does amniotic fluid tell you?

A

good organ development, placental function

172
Q

What happens to heart rate during pregnancy

A

it increase 15-20 bpm

173
Q

How many arteries/veins does a fetus have

A
  • 2 arteries (deox to placenta)
  • 1 vein (oxgenated away)
174
Q

Should not be used if patient has preeclampsia

A

methergine

175
Q

Causes for late decelerations x4

A
  • uteroplacental insufficiency
  • impaired xchange of waste products
  • hypo/hypertension
  • excessive uterine stimuli
176
Q

What is the name of the pelvis type that is most favorable for successful labor and birth

A

gynecoid

177
Q

Maternal insulin needs during the first trimester?

A

decrease

178
Q

Maternal insulin needs during the 2nd and 3rd trimester?

A

increases, placental hormones cause insuline-resistant state

179
Q

This is a condition in which the clotting cascade is activated, resulting in the formation of clots in the microcirculation

A

Disseminated Intravascular Coagulation (DIC)

180
Q

What does the rapid and extensive formation of clots that occur in DIC do to platelets

A

depletes platelets and clotting factors.

results in bleeding and vascular occlusion of organs from thromboembolus formation

181
Q

What should all clients be assessed for during during the postpartum period

A

depression

182
Q

What is a normal temp during the first 24 hours postpartum

A

100.4 F due to dehydration, greater indicates infection

183
Q

A patient is taking magnesium sulfate and has respirations of 10, what should you do?

A

call the HCP

184
Q

How should you administer magnesium sulfate

A

IV infusion via an infusion monitoring device

185
Q
  1. Uti Treatment
  2. Super infection
  3. Gram Negative Drugs
  4. Gram Positive Drugs
A
  1. Bactrim, Amoxicillin, Fluroquinolones, Macrodantoin, Pyridium
  2. Broad Spectrum, infection on top of earlier infection, THRUSH, Vag YEAST
  3. Aminoglycoside
  4. Antitubercular, penicillin
186
Q
  1. Bacteriostatic
  2. Bacteriocidal
  3. Drugs that contain -static and -cidal
  4. ototoxcity drugs
A
  1. inhibits growth, lower dose
  2. kills, higher dose
  3. penicillin, macrolides, lincosamides
  4. amphoteracin, vaomycin, gentamycin
187
Q
  1. -vir
  2. -mine
  3. -zine
  4. -mycin
  5. exception to mycin
A
  1. antivirals
  2. 1st generation antihistamine
  3. 2nd generation antihistamine
  4. lincosamide
  5. aminoglycoside, know gentamycin
188
Q
  1. Liver Toxicity
  2. Renal Toxicity
  3. Creatnine BUN
A
  1. Ketoconazole, RTI, Protease, INH, Tetracycline, Macrodantin (LIVER)
  2. Amphoteracin HIGH, Gentamycin, Acyclovir, Tetra, Vanomycin(NEPHR)
  3. Peptides, acycloir, gentamycin BUN
189
Q
  1. GI upset
  2. Peripharl Neruopathy
  3. This is not an antibiotic
  4. Narrow Spectrum drug
A
  1. Ampicillin, Fluroquinolones, MAcrodantoin, Erythromycin
  2. INH
  3. Pyridium
  4. Aminoglycoside
190
Q
  1. Take with food
  2. Empty stomache
  3. Food or no food
A
  1. erythromycin, flagyl, macrodantoin
  2. penicillin, INH, Tetra
  3. ampicillin- watch CITRUS
191
Q
  1. First generation antihistamine
  2. 2nd generation antihistamine
  3. SE of Oral antihistamine
  4. Most effective antiasthma drug
A
  1. Sedating
  2. Non-sedating
  3. anticholinergic- dry mouth, constipation, urinary retention
  4. glucocorticoids
192
Q
  1. Long term, prophylaxis Asthma prevention
  2. Side effects of glucocorticoid inhaler
  3. Why do you rinse your mouth with glucocorticoid inhaler?
  4. Used with glucocorticoid inhaler?
  5. Cromolyn
A
  1. Glucocorticoid inhaler, Long Acting inhaled Beta 2 agonist, Comolyn
  2. throat, dry mouth, cough
  3. oral fungal infections
  4. Long acting Beta 2 Agonist
  5. Mast cell wall stabilixer, prevents mediators
193
Q
  1. Acute Asthma treatment
  2. SE of oral glucocorticoids
  3. How can you take Selective Beta 2 Receptor?
  4. Categories for Beta 2 Agonist/Bronchodilator Agents
A
  1. Oral glucocorticoids, Selective Beta 2 Receptor, Short Acting inhaled Beta 2
  2. peptic ulcer, T.E., must taper
  3. nebulizer, inhaler, systemic effects w/ oral
  4. methyxanthines, anticholinergics
194
Q
  1. What part does asthma effect?
  2. Types of antiinfammatory agents
  3. What does cromolyn do?
  4. What is a leukotriene
  5. Singulair
A
  1. Lower respiratory tract
  2. Glucocorticoids, cromolyn, leukotriene modifiers, IgE antagonist
  3. Stabilize Mast Cell Wall
  4. chemical mediator for inflammatory response
  5. Leukotriene antagonist, bronchodilation
195
Q
  1. Asthma.Methylxanthin derivative agents
  2. Methylxanthin agents cause…
  3. Theophylline
  4. Theophylline action
  5. How do you give it?
A
  1. Aminophylline, Theophyline, Caffeine
  2. bronchodilation, CNS excitation, Vasodilation, Cardiac stimulus, diuresis
  3. Too many SE, narrow window,
  4. relaxes smooth muscle of bronchi
  5. IV or oral
196
Q
  1. Aminophyline
  2. Anticholinergic for Asthma (COPD off Label)
  3. Action
  4. SE of Ephedrine
  5. SE of Pseudoephedrine
A
  1. Salt Theophylline, give slow–>hypotension/death. incompatible
  2. Atrovent(inhaled), Tiotropium
  3. Bronchodilator, block pns
  4. HTN, Dysrrythmias, MI, Stroke, Seizure, hyperglycemia, OFF MARKET
  5. Cardiovasscular collapse, HTN, Seizure
197
Q
  1. Antitussive, Upper Respiratory Tract, cough
  2. Dextromethorphan
  3. Diphenydramine
  4. Non drowsy, antihistamine for hay fever
A
  1. Relief of non productive cough, medulla, drowsiness
  2. Non-narcotic, OTC, cold remedy
  3. also a antihistamine, help to sleep, allergy, cold, cough
  4. Fexofenadine/Allegra
198
Q

Allergic Rhinitis, MAST CELL

  1. Histamines
  2. Leukotrines
  3. Prostaglandins
A
  1. vasodilate, itching, mucus, inc cap perm, bronchoconstrict
  2. asthma, bronchoconstrict, mucus, airway, edema
  3. vasodilate, fever, PAIN, inc cap permeability
199
Q
  1. Glucocorticoids and allergies
  2. First line thearpy for allergic rhinitis
  3. What else cane you use to treat allergy?
  4. Antihistamine prophylaxxis allergy treatment
A
  1. dec inflam, inhibit prostaglandin relese, INTRANASAL MOST effective
  2. intransal glucs, oran/intranasal antihis
  3. sympathomimetics
  4. Histamine 1, common, sneeze, rhinorrhea, itchy nose. DOESN NOT REDUCE NASAL CONGEST
200
Q
  1. Decongestants stimulate which recptor?
  2. Action
  3. Phenylphine, Oxymetazoline, Sudafed Usage, Sympathomimetics
  4. Respiratory and Obstructive Complications
A
  1. Alpha 1 Receptor
  2. HTN, vasoconstriction capillaries in the nuse
  3. use for 5 days only, rebound congestions
  4. beta 2 adrenergic agonist
201
Q
  1. How C/S test can decrease resistance
  2. misues of antibiotics what percent?
  3. Vanomycin
  4. Side effects of Vanomycin
  5. Prevention for antibiotic use
A
  1. Actual microbe specific to antibiotic
  2. 50% use in hospital that don’t need them
  3. Effective against MRSA (avoid use), GLYCOPEPTIDE
  4. redman syndrome, slow iv or pump
  5. vaccines, limit catheters, c/s before, handwashing
202
Q
  1. Gen Broad spectrum antibiotics
  2. Penicillin
  3. Most common type of penicillin
  4. Allergy alternative to Penicillin
  5. Macrolide
A
  1. Thromycin
  2. Beta lactam, interfere with cell wall, LYSE
  3. Amoxicillin, low resp infection, skin infection,
  4. Erythromyciin, Macoline
  5. supress protein synthesis, bacteriostatic
203
Q
  1. Antibacterial Categories
  2. How do you treat allergic reactions?
  3. Gram+
  4. Gram -
  5. Mycostatin
A
  1. Penicillins, cephlosporins, macrolides, lincosamides, sulfonamides, glycopeptides, aminoglycoside, tetra, fluroquinolones, antTB, antifungal
  2. antihistamins, bronchoDILATORS, ephinephrine
  3. thick wall, purple (cocci)
  4. thin wall, violet, neisseria
  5. antifungal, candidiasis, leakage membrane
204
Q
  1. Lincosamides,
  2. Resemblence to Penicillin
  3. Penicillin resistance
  4. Penicillin patient education
  5. Cephalosporin
A
  1. inhibit protein synthesis, SE colitis, rash, antiacne
  2. cephalosporin
  3. Staph, MRSA, Methicillin (NOMARKET)
  4. reduce contraceptive, take entirety, stomatitis, vaginits, c/s before
  5. most common, less side effects, broad spectrum
205
Q
  1. Tetracycline uses
  2. Adverse effects
  3. Why vitamin b6 and inh
  4. Flagyl action
  5. Alcoholic effects of flagyl
A
  1. Chlamydia, anthrax, cholera, lyme, ulcer, acne, pneumonia, rm spotted fever
  2. photo, discolr teeth, NO
  3. decrease peripheral neuropathy
  4. Impairs DNA function of bacteria, antibiotica, antiprotozoal
  5. causes disulifiram, for alcoholics
206
Q
  1. Flagyl Use
  2. Colorectal surgery
  3. Adverse effects
  4. Gentamycin what will you watch for?
  5. Administer Gentamycin how
A
  1. GI, GI, CNS, C.DIFF
  2. flagyl, prophylaxis
  3. dark urine,
  4. narrow window, urin output, balance, hearing
  5. IM IV
207
Q
  1. Potent antibiotic
  2. Adverse effects
  3. Decrease risk of crystalluria
  4. What is fluroquinolones good for?
A
  1. Fluroquinolones, not 1st line treatment
  2. photo, gi, crystalluria
  3. increse fluid intake
  4. tissue penetration, respiratory tract infection, inhibit DNA synthesis.
208
Q
  1. Antiseptic, antiinfective
  2. Baceter…
  3. Adverse Effect
  4. Pyridium and urine
A
  1. UTI’s, Macrodantin
  2. cidal, static
  3. peripheral neruopathy,dizzy, drowsy RUSTY URINE
  4. analgesic w/ antibiotic discolors urine. NOT ANTIMICROBIAL, take when symptoms are gone
209
Q
  1. Sulfanomides
  2. What do sulfanomides treat
  3. Silvadene
  4. Action of sulf
A
  1. Bactrim, Septra, bronchitis too
  2. UTI-E.coli, otitis media, newborn eye prophylaxis
  3. Topical, for burns
  4. interefers with folic acid synthesis, -static
210
Q
  1. Amphotericin B category
  2. administration
  3. Action of amph B
  4. Drug of choice for ringworm, alternative to ampho
  5. why have fungal infections increased?
A
  1. polyene, antifungal, RENAL, severe (mening in HIV patients)
  2. IV only
  3. binds to membrane allow leakage
  4. ketoconazole
  5. invasive procedures, immunosuppresants, broadspectrum antibiotics
211
Q
  1. This is an antiretroviral agent used to treat HIV
  2. HAART
  3. Cocktail for HAART
  4. How long for use
  5. Adverse Effects
A
  1. AZT
  2. Highly Active Antiretrioviral Therapy
  3. 2 Rti’s with Protease inhibitor
  4. lifetime
  5. drug interaction, anemia neutropenia, anorexia,liver, lactic acidosis
212
Q

HAART

  1. Action
  2. Safety
  3. Assess
A
  1. undetectable viral lode, improves CD4 count
  2. does not prevent trasnmission, need refular follow up exams
  3. hypersenstivity
213
Q

Neurominidase inhibitors

  1. What does it treat
  2. when should you take it
  3. How does it treat?
A
  1. release of virus from infected cells
  2. within 48 hours of flu symptoms
  3. Inhibits the enzyme, may alter virus Particle
214
Q
  1. Antiviral, Antiherpes
  2. Route
  3. action
  4. Treats
  5. Adverse effects
A
  1. acyclovir,
  2. Topical, oral IV (oral prevents recurrence)
  3. varicella zoster, EBV, herpes
  4. gingival hyperplasia, encourage fluids, renal BUN
215
Q
  1. AntiTB bacteria
  2. How is it transmitted
  3. Cell wall
  4. How long for treatment
  5. Approach
A
  1. Acid Fast Bacillus (rods)
  2. droplet
  3. Thick, resitat to penetration by antiinfectives
  4. 6-24 months
  5. Use combo drugs
216
Q
  1. What is Isoniazide
  2. Action
  3. Route
  4. Labs
  5. SE
A
  1. prophylaxis antiTB
  2. inhibts mycobacterial cell wall synthesis and intereferes with metabolism
  3. First oral drug affective against TB
  4. Liver enzymes, Sputum samples morning
  5. Peripheral neuropathy b6
217
Q

1. Expectorants drugs

  1. Define Expectorant
  2. Has both Adrenergic and Corticosteroid
A
  1. Robitussin,
  2. Liquefy secretions, increases respiratory tract fluid
  3. Symbicort, Advair

Nursing School Pt 2 (13 decks)

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