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NCLEX > Maternity > Flashcards

Maternity Flashcards

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1
Q

Pre-eclampsia vs Eclampsia: diastolic BP

A

Mild - >90 but 110

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2
Q

Pre-eclampsia vs Eclampsia: proteinuria

A

Mild >o.3 but 5g in 24 HR specimen >3 on random dipstick

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3
Q

Pre-eclampsia vs Eclampsia: serum creatinine

A

Mild: normal
Severe: elevated

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4
Q

Pre-eclampsia vs Eclampsia: platelets

A

Mild : normal

Severe : elevated - more than 1.2 mg/do

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5
Q

Pre-eclampsia vs Eclampsia: liver enzymes (ALT AST)

A

Mild normal or minimal increase

Severe elevated levels

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6
Q

Pre-eclampsia vs Eclampsia: urine output

A

Mild normal

Severe : oliguria common decreased 500ml

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7
Q

Pre-eclampsia vs Eclampsia: severe unrelenting headache not attributable to another cause

A

Mild absent

Severe often present

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8
Q

Pre-eclampsia vs Eclampsia: persistent RUQ or epigastric pain or pain penetrating to the lower back; nausea and vomiting

A

Mild absent

Severe - maybe present and often precedes seizure

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9
Q

Pre-eclampsia vs Eclampsia: visual disturbances

A

Mild absent to minimal

Severe common

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10
Q

Pre-eclampsia vs Eclampsia: pulmonary edema, heart failure, cyanosis

A

Mild absent

Severe may be present

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11
Q

Pre-eclampsia vs Eclampsia: fetal growth restriction

A

Mild - normal growth

Severe - growth restriction , reduced amniotic fluid volume

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12
Q

What are signs of magnesium toxicity

A

Flushing
Sweating
Hypotension
Depressed deep tendon reflexes and CNS depression including respiratory depression

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13
Q

What is the antidote for magnesium?

A

Calcium gluconate

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14
Q

Signs of true labour

A

Contractions occur regularly, become stronger last longer and occur closer together
Cervical dilation and effacement is progressive
The fetus usually becomes engaged in the pelvis and begins to descend

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15
Q

Signs of false labour

A

Does not produce dilation effacement or descent
Contractions are irregular without progression
Activity such as walking often relieves false labour

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16
Q

Name the different breathing techniques

A 
Cleansing breathing 
Slow paced breathing
Modified paced breathing
Pattern paced breathing 
Breathing to prevent pushing 
Second stage breathing - several variations
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17
Q

Where is the epidural placed for a subarachnoid block

A

Spinal subarachnoid space at L3-L5
Administered just before birth
May cause maternal hypotension
Must lie flat for 8-12 hrs post injection

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18
Q

Describe a total placenta PREVIA

A

Internal cervical os is covered entirely by the placenta when the cervix is dilated fully

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19
Q

Describe partial placenta PREVIA

A

The lower border of the placenta is within 3 cm of the internal so but does not fully cover it

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20
Q

What is a marginal placenta PREVIA

A

Placenta is implanted in the lower uterus but it’s lower border is more than 3 cm from the cervical is

21
Q

Placenta PREVIA assessment

A

Sudden onset
Painless bright vaginal bleeding in the last half of the pregnancy

Uterus is soft relaxed and nontender

Fundal height may be more than expected for gestational age

22
Q

What should be avoided with placenta PREVIA

A

Any sort of vaginal manipulation or vaginal examination

23
Q

Treatment of placenta PREVIA

A

IV fluids
Blood products
Tocolytic medications
Rhogam may be prescribed

If heavy bleeding c-section may be performed

24
Q

What is abruptly placentae

A

Premature separation of the placenta from the uterine wall

After the twentieth week and before the fetus is delivered

25
Q

Abruptio placentae assessment

A

Dark red vaginal bleeding - if bleeding is high in the uterus there can be an absence of visual blood
Uterine pain or tenderness or both
Uterine rigidity
Severe abdominal pain
Signs of fetal distress
Signs of maternal shock if bleeding is excessive

26
Q

Positions for abruptio placentae

A

Trendelenburgs position if indicated to decrease the pressure of the fetus on the placenta

Lateral position with head of the bed flat if hypovolemic Shock occurs

27
Q

In the postpartum period of a client with abruptio placentae what should you monitor for

A

Disseminated intravascular coagulation

28
Q

Pre-eclampsia vs Eclampsia - systolic blood pressure

A

Mild - >140 160 based on two readings 6 hours apart

29
Q

What are the causes of a vaginal hematoma

A

Operative delivery
Forceps
Injury to a blood vessel

Can be life threatening

30
Q

What is the assessment of a postpartum hematoma

A

Abnormal severe pain
Pressure in the perineal area
Sensitive bulging mass in the perineal area with discoloured skin
Inability to void
Decreased hemoglobin and hematocrit levels
Monitor for signs of shock

31
Q

What are the signs of shock due to hematoma

A

Pallor
Tachycardia
Hypotension if significant blood loss has occurred

32
Q

What is the description of wilms tumour

A

Most common intraabdominal and kidney tumour of childhood

Unilaterally and localized or bilaterally

Sometimes metastasizes

Peak is 3 years

33
Q

Assessment of a child with wilms tumour

A

Swelling or mass within the abdomen - firm nontender confined to one side and deep within the flank

Urinary retention or hematuria or both 
Anemia 
Pallor anorexia and lethargy - anemia 
Hypertension 
Weight loss and fever 
Symptoms of lung involvement - dyspnea shortness of breath and pain in the chest if metastasis has occurred

DO NOT PALPATE THE ABDOMEN

34
Q

What is Reye’s syndrome

A

Acute encephalopathye
Follows a VIRAL illness
Characterized - cerebral edema and fatty changes in the liver

35
Q

How is a diagnosis made for Reye’s syndrome

A

Liver biopsy

36
Q

Cause of Reye’s syndrome

A

Unknown

Most commonly follows an illness - influenza or varicella

37
Q

What should be avoided in Reye’s syndrome

A

Administration of aspirin and aspirin containing products

38
Q

What can be prescribed for Reye’s syndrome

A

Ibuprofen Motrin iB

39
Q

What is the goal of Reye’s syndrome

A

Early diagnosis
Early treatment - aggressive
Maintain effective cerebral perfusion and control increasing ICP

40
Q

Assessment of Reye’s syndrome

A

History of systemic viral illness 4-7 days before the onset of symptoms
Fever
Nausea and vomiting
Signs of altered hepatic function such as lethargy
Progressive Neurological deterioration
Increased blood ammonia levels

41
Q

What is kwasaki disease

A

Acute systemic inflammatory disease

42
Q

Cause of kwasaki disease

A

Unknown may be associated with an infection from an organism or a toxin

Cardiac complication is the most serious - as aneurisms can develop

43
Q

Acute phase symptoms of Kawasaki disease

A

Fever
Conjunctival hyperemia
Red throat
Swollen hands rash and en,argument of cervical lymph nodes

44
Q

Subacute stage of Kawasaki disease symptoms

A 
Cracking lips and fissures
Desquamination of the skin on the tips of the fingers and toes 
Joint pain 
Clinical manifestations 
Thrombocytosis
45
Q

Symptoms of convalescent stage of Kawasaki disease

A

Child appears normal but signs of inflammation may be present

46
Q

Medications to give those with Kawasaki disease

A

Aspirin for its antipyretic and anti platelet effects

Immunoglobulin IV to reduce the duration of the fever and the incidence of coronary artery lesions and aneurysms - IV Immunoglobulin is a blood product so blood precautions when given

47
Q

Description of fifths disease

  • agent
  • incubation
  • communicable period
  • source
  • transmission
A
  • agent: human parovirus
  • incubation - 4 to 14 days; maybe 20 days
  • communicable period: uncertain but before the onset of symptoms in most persons
  • source: infected persons
  • transmission unknown possibly respiratory secretions and blood
48
Q

Assessment of fifths disease

A

Before rash: asymptomatic or mild fever, malaise, headache, runny nose

Stage of rash
Erythema of the face slapped check appearance devlops and dissapears by 1-4 days
1 day after the rash on the face - maculopapular red spots appear symmetrically on the extremities; rash progresses from proximal to distal surfaces and may last a week or more

Rash subsides but may reappear if the skin becomes irritated by the sun heat cold exercise or friction

NCLEX (10 decks)

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