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NCLEX > Maternity > Flashcards

Maternity Flashcards

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1
Q

Nagele’s rule

A

(to estimate due date

  • Requires that woman has 28-day menstrual cycle
  • Subtract 3 mths and add 7 days to the first day of the last period; then add 1 year
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2
Q

Nulligravida

A

never been pregnant

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3
Q

Primigravida

A

first time

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4
Q

Multigravida

A

at least second pregnancy

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5
Q

Parity

A

Number of births carried past 20 weeks gestation (regardless of whether alive or not when born)

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6
Q

Nullipara

A

has not had birth at more then 20 weeks

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7
Q

Primipara

A

one birth after 20 weeks

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8
Q

Multipara

A

two or more pregnancies to stage of viability

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9
Q

GTPAL

A 
*used to assess pregnancy outcomes
G = gravidity, number of pregnancies
T = term births, number born at term (longer than 37 weeks)
P = preterm births, before 37 weeks
A = abortions/miscarriages
L = number of living children
Example: female 26 weeks pregnant. Miscarriage at 10 weeks. 3 yr old born at 39 weeks.
G=3, T=1, P=0, A=1, L=1
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10
Q

difference between presumptive, probably, and positive signs of pregnancys

A

presumptive - signs & symptoms experience by woman
probable - signs from examiner
positive - scientific confirmation of pregnancy

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11
Q

Hegar’s sign

A

probable sign of pregnancy

■ Compressibility and softening of lower uterine segment (approx. week 6)

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12
Q

Goodell’s sign

A

probable sign of pregnancy

■ Softening of cervix (beginning of 2nd mth)

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13
Q

Chadwick’s sign

A

probable sign of pregnancy

■ Violet colouration of the mucous membranes of cervix, vagina, vulva (approx. week 4)

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14
Q

Ballottement

A

probable sign of pregnancy

■ Rebounding of fetus against examiners fingers on palpation

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15
Q

why should women take folic acid during pregnancy?

A

Prevents neural tube defects and orofacial clefts

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16
Q

what is abruptio placentae?

A

the premature separation of the placenta from the uterus

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17
Q

how many stages of labour are there?

A

4

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18
Q

describe latent phase (stage, frequencyduration of contractions, dilation, intensity of contractions)

A

stage 1, 15-30 min, 15-30 sec, 1-4 cm, mild

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19
Q

describe active phase (stage, frequencyduration of contractions, dilation, intensity of contractions)

A

stage 1, 3-5 min, 30-60 sec, 4-7 cm, moderate

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20
Q

describe transition phase (stage, frequencyduration of contractions, dilation, intensity of contractions)

A

stage 1, 2-3 min, 45-90 sec, 8-10 cm, strong

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21
Q

describe stage 2 of labour

A

complete dilation, progress measured by station, contractions q2-3 min, 60-75 sec, strong, urge to bear down, neonate born in 2nd stage

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22
Q

describe stage 3 labour

A

placental separation & expulsion 5-30 min after birth

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23
Q

describe stage 4 of labour

A

Period 1-4 hours after delivery

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24
Q

in induction, what is the desired labour pattern during infusion of Pitocin?

A

Frequency q2-3 minutes, duration 60 seconds

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25
Q

at what point should Pitocin be discontinued when infusing for induction?

A

if uterine contraction frequency is less than 2 minutes or duration longer than 90 seconds, or if fetal distress noted

26
Q

what is placenta previa?

A

Improperly implanted placenta in lower uterine segment near or over the internal cervical os

27
Q

characteristics of placenta previa

A

Sudden onset painless, bright red bleeding in last half of the pregnancy
Uterus soft, relaxed, nontender
Fundal height may be more than expected for gestational age

28
Q

characteristics of abruptio placentae

A 
Dark red vaginal bleeding (but could be absence of visible blood)
Uterine pain tenderness or both
Uterine rigidity
Severe abdominal pain
Signs of fetal distress
29
Q

what is placenta accreta?

A

Abnormally adherent placenta

30
Q

what is placenta increta?

A

Placenta penetrates into uterine muscle itself

31
Q

what is placenta percreta?

A

Goes all the way through the uterus

32
Q

what is the main concern with placental abnormalities?

A

hemorrhage and therefore shock

33
Q

signs of fetal distress

A 
FHR <110 bpm or >160 bpm
Meconium-stained amniotic fluid
Fetal hyperactivity
Progressive decrease in baseline variability
Severe variable decelerations
Late decelerations
34
Q

what is a potential serious complication of intrauterine death?

A

DIC

35
Q

signs of postpartum hematoma

A

severe pain
pressure
bulging mass perineal area, discoloured skin
inability to void

36
Q

when should a woman worry about her elevated temperature?

A

temp of 38 is normal within first 24 hours d/t dehydration, a temp of 100.4/38 or greater after 24 hours postpartum indicated infection

37
Q

is it ok for a woman with mastitis to continue breastfeeding?

A

Yes

38
Q

what is the postpartum period?

A

immediately after birth to 6 weeks post delivery

39
Q

what is involution?

A

Rapid decrease in size of uterus as it returns to nonpregnant state

40
Q

what should a non-breastfeeding mother do about engorgement?

A

should not express milk

cool compressess, supportive bra, ibuprofen

41
Q

what do newborn stools look like?

A

light yellow, seedy, watery, and frequent

42
Q

in what order to you suction a newborn?

A

mouth first then nares

43
Q

what are the indicators that make up the APGAR score?

A 
Heart rate
Respiratory rate/effort
Muscle tone
Reflex irritability
Skin colour
44
Q

what is the intervention for apgar score of 4-7?

A

Stimulate; rub newborn’s back; admin oxygen; rescore at specific intervals

45
Q

what is the intervention for apgar score of 0-3?

A

Requires full resuscitation; rescore at specific intervals

46
Q

what is the normal interval for apgar scoring?

A

at 1 minute, at 5 minutes, (and at 10 if needed)

47
Q

normal newborn HR

A

resting 120-160 beats / min
Sleeping 80-100
Up to 180 if crying

48
Q

normal newborn respirations

A

30-60 per minute, assess for full minute

49
Q

normal newborn head circumference

A

33-35 cm

50
Q

number and type of vessels that should be found in umbilical cord

A

2 arteries, 1 vein

51
Q

when does pathological jaundice happen ad what does it mean?

A

within first 24 hours

hemolysis of RBCs

52
Q

care for circumcision

A

petroleum jelly gauze, removed after first voiding post-circumcision

53
Q

meconium

A

greenish black with a thick, sticky, tarlike consistency, usually passed within first 24 hours of life

54
Q

what does meconium staining put the newborn at risk for?

A

meconium aspiration syndrome

55
Q

what does HELLP syndrome stand for?

A

Hemolysis, Elevated Liver enzymes, Low Platelet count|

*severe form of preeclamspia

56
Q

what is the clinical presentation of HELLP syndrome?

A

RUQ pain, Nausea, vomiting, malaise

57
Q

when can fetal sex be determined?

A

usually by end of 12th week by visualizing external genitalia on ultrasound`

58
Q

what is the cause of late decelerations?

A

uteroplacental insufficiency

59
Q

what is the cause of variable decelerations?

A

cord compression

60
Q

what is the significance of TORCH infections?

A

cause fetal abnormalities

61
Q

what are the TORCH infections?

A

Toxoplasmosis, Other [parvo-B19/varicella zoster], Rubella, Cytomegalovirus, Herpes simplex virus

62
Q

signs of ICP infants

A 
bulging fontanels
irritability
high-pitched cry
increased head circumference
setting sun eyes (eyes appear t be looking down and prominent sclera over iris)

NCLEX (8 decks)

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