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NCLEX > maternity > Flashcards

maternity Flashcards

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1
Q

when can you palpate the fundus at the umbilicus

A
  • 10-12 weeks
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2
Q

when can the fetal HR be heard with doppler

A
  • 10-12 weeks
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3
Q

when can you feel fetal movement with palpation

A
  • after 18 weekds
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4
Q

when does ballotment occur

A
  • 4-5 months
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5
Q

how to calculate due date

A
  • first day of the LMP + 7 days - 3 months
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6
Q

average weight gain

A
  • 28 pounds plus or minus 3
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7
Q

1st trimester weight gain

A
  • 1 lb each month (3 lb for 3 months)
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8
Q

2nd trimester weight gain

A
  • 1 lb per week
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9
Q

3rd trimester weight gain

A
  • 1 lb per week
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10
Q

trick for figuring out how much they should have gained

A
  • take the gestation and - 9
  • if more than 3 lbs, you need to assess, something could be wrong
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11
Q

fundal height

A
  • not palpable until week 12 (not in the 1st trimester)
  • @ belly button 20-22 weeks (2nd trimester)
  • above belly button: 3rd trimester
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12
Q

1st trimester

A
  • 0-12 WEEKS
  • 1/lb/month of weight gain (3 total)
  • fundus is not palpable
  • mother is the priority in an emergency
  • if you can palpate the fundus or she gains 10 lbs, she might have a hydatiform mole, or not really in the 1st trimester
  • you can plpate the fundu at the end of the 1st trimester
  • visit once a month
  • frequent urination
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13
Q

2nd trimester

A
  • 13-27 weeks
  • 1lb/week weight gain
  • mother is priority
  • at 20 -22 weeks the fundus is at the umbilicus
  • quickening: 16-20 weeks
  • visit once a month
  • difficulty breathing, back pain
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14
Q

3rd trimester

A
  • 28-40 weeks
  • 1 lb/week weight gain
  • fundus above the umbilicus
  • baby is the priority
  • week 28: once every 2 weeks until week 35
  • week 36 come every week until delivery until week 42
  • frequent urination, back pain, difficulty breathing
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15
Q

when does the heart beat begin to beat

A
  • 5 weeks
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16
Q

when can you hear the heart beat by doppler

A
  • 8-12 weeks (also when the dr can palpate movement)
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17
Q

if its a first question

A
  • pick earliest part of range
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18
Q

if its a most likely question

A
  • pick middle part of range
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19
Q

if its a should question

A
  • pick end of the range
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20
Q

positive signs of pregnancy

A
  1. fetal skeleton on x ray
  2. fetal presence on ultrasound
  3. auscultation of FHR
  4. examiner palpates fetal movement
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21
Q

probable signs of pregnancy

A
  1. positive prego test
  2. chadwhick
  3. godells
  4. hegar
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22
Q

chadwick

A
  • cervical color change due to cyanosi
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23
Q

goodells

A
  • cervical softening (good when you cervix softens (2 months)
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24
Q

hegar

A
  • utterine softening (6 months)
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25
Q

pt teaching when first pregnant

A
  • frequent urination: void Q 2 hours (1st and 3rd)
  • diffculty breathing: tripod position (2nd and 3rd)
  • back pain: pelvic tilt excercise (2nd and 3rd)
  • hemoglobin will fall- can fall to 10 and still be normal (11 in 1st, 10.5 in 2nd, 10 in 3rd=normal)
  • treat morning sickness with dry carb before you get out of bed
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26
Q

valid sign of labor

A
  • onset of regular progressive contractions
27
Q

station

A
  • relationship between fetal presenting part and the ischial spines
  • negative station: negative (above the tight squeeze)
  • positive: good (below the tight squeeze)
    *if in - for too long of time, cant be born vaginally
  • 0 = crowning
28
Q

lie

A
  • relationship between the spine of the mom and spine of the baby
  • vertex: longitudinal. compatible for birth: mom and babies spine are parallel
  • transverse: shoulder presentation. trouble
29
Q

presentation

A
  • part of the baby that enters the birth canal first
  • most common: ROA or LOA
30
Q

stage one of labor

A
  • uterine contractions dilate and efface the cervix
  • 3 phases
31
Q

phase one

A
  • latent
  • 0-4 cm
  • 5-30 minutes apart
  • last for 15-30 seconds
  • mild intensity
32
Q

phase 2

A
  • ative
  • 5-7 cm
  • 3-5 minutes apart
  • 30-60 seconds long
  • moderate inensity
33
Q

phase 3

A
  • transition
  • 8-10 cm
  • 2-3 minuted apart
  • 60-90 seconds long
  • strong intensity
34
Q

stage two

A
  • delivery of the baby
    1. deliver the head
    2. suction the nose
    3. check for nuchal cord
    4. deliver the shoulders the the body
    5. baby must have ID band on before leaving the delivery area
35
Q

stage three

A
  • delivery of the placenta
    1. make sure it is all there
    2. check for 3 vessels- 2 arteries, 1 vein (AVA)
36
Q

stage four

A
  • recovery
  • contract the uterus to stop the bleeding
  • PP begins 2 hours after the placenta comes out
37
Q

4 things you do 4 times (Q 15 MIN) an hour int he 4th stage

A
  1. vital signs: look for S/S of shock (BP down, HR up, cold and clammy)
  2. fundus check: if boggy= massage, if displaced=void
  3. pads: check pad saturation. if bleeding excessively she will saturate a whole pad (100%) in 15 minutes or less. do not soak a pad in one hour or less due to risk of hemorrhage
  4. roll her over checl for bleedeing underneath her
38
Q

uterine tetany

A
  • contractions lasting longer than 90 seconds and closer than every 2 minutes = stop pitocin
39
Q

how to time contractions

A
  1. frequency: begining of one to the begging of another
  2. duration: beggining of one to the end
  3. intensity: how strong they are: palpate with one hand over the fundus with the pads of the fingers
40
Q

pain management

A
  • do not administer pain med to a woman if the baby is likely to be born when the med peaks
  • IV: 15-30 minutes
  • IM: 30-60 minutes
41
Q

painful back labor

A
  • op
42
Q

position then push when painful back labor

A
  • knee chest (face down, ass up), then push (take a fist and push into sacrum = counter pressure
43
Q

prolapsed cord

A
  • EMERGENCY
  • cord is presenting part
  • push then positon (push the head back in then position knee chest)
44
Q

LION

A
  • interventions for all complications of birth
  • if pitocin is running stop pitocin then do lion
  • Left side
  • Increase IV
  • 02
  • Notify provider
45
Q

what is bubble Head

A
  • post partum assessment
  • 4-8 hours
  • Breasts
  • Uterus
  • Bowel
  • Bladder
  • lochia
  • episiotomy
  • Hemoglobin and hematocrit
  • extremity check
  • affect (emotion)
  • discomforts
46
Q

Uterus- bubble

A
  • want firm and midline
  • if boggy: massage
  • if displaced: catheterize
  • fundal height = day postpartum
47
Q

lochia

A
  • rubra= red
  • serosa= rosey pink
  • alba= white
  • 4-6 inches on a pad in one hour is okay
48
Q

extremity check

A
  • look for thrombophlebitis via bilateral calf measurements
49
Q

VEAL CHOP

A
  • variable decels = cord compression
  • early decel = head compression
  • acceleration = okay
  • late decel = placental insufficiency
50
Q

what to do if low fetal HR (under 110)

A
  • stop pit
  • lion
51
Q

high fetal HR ( over 160)

A
  • normal (document)
  • take moms temp
52
Q

low baseline variability

A
  • FHR stays the same and does not fluctuate
  • bad
  • lion
53
Q

high baseline variability

A
  • FHR always changing
  • good
  • document
54
Q

late decels

A
  • babys heart slows after contraction
  • bad
  • lion
55
Q

early decels

A
  • babys heart slows before or at contraction
  • good
56
Q

variable decels

A
  • very bad
  • prolapsed cord
57
Q

Caput Succedaneum

A
  • Crosses Sutures
58
Q

cephalohematoma

A
  • doesnt cross sutures and asymmetrical
59
Q

pathological jaundice

A
  • normal
  • present at birth
60
Q

physiological jaundice

A
  • 24 hours after birth
61
Q

tocolytics

A
  • stop labor
  • good for women who are threatening pre mature
  • Terbutaline: can cause maternal tachy
  • Mag sulfate: can cause low magnesium- making uterine contractions, HR, BP, reflexes, RR, LOC go down
  • as long as respirations are above 12 and reflexes are 2+ its okay
  • refelxes: + 1 titrate down, +3 titrate up
62
Q

oxytoxics

A
  • stimulate and strengthen labor
  • pitocin: causes uterine hyper stimulation (longer than 90 seconds closer than Q 2 minutes titrate down)
  • methergine: causes high BP
63
Q

fetal lung maturing meds

A
  • Betamethasone (steroid): mom gets it IM given before the baby is born
  • servanta (surfactant): given to the neonate trans-tracheal (blown into the trachea) after the baby is born
64
Q

what is the only antipsychotic pregnant woman can get

A
  • haldol

NCLEX (15 decks)

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