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NCLEX > Maternity > Flashcards

Maternity Flashcards

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1
Q

what are the 4 presumptive signs of pregnancy

A

ammenorrhea
N/V
Urinary frequency
breast tenderness (excess tenderness)

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2
Q

what homrone causes ammenorrhea

A

progesterone

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3
Q

what are pregnancy tests based on

A

presence of hCG levels

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4
Q

can other conditions cause increased hCG levels?

A

yes; hydatidiform mole; drugs

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5
Q

What is Goodell’s sign and when does it happen

A

softening of cervix

second month

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6
Q

What is Chadwick’s sign and when does it occur

A

bluish color of vaginal mucosa and cervix

week 4

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7
Q

What is Hegar’s sign and when does it happen

A

softening of the lower uterine segment

2nd/3rd month

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8
Q

what are braxton hick’s contractions

A

occur throughout pregnancy; move blood through the placenta

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9
Q

what is linea nigra

A

dark line down center of abdomen during pregnancy

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10
Q

what is facial chloasama

A

pregnancy mask

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11
Q

do the nipples darken during pregnancy

A

yes

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12
Q

at what point can the fetal heartbeat be heard with a doppler

A

fetal 10-12 weeks

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13
Q

when can a fetoscope be used

A

17-20 weeks - can hear the baby heartbeat

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14
Q

what does gravidity mean

A

of times women has been pregnant

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15
Q

what is parity

A

of pregnancies where the baby reached 20 weeks

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16
Q

what is viability and how many weeks

A

at 24 weeks the infant has the ability to live outside the uterus

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17
Q

Is a 20 week old baby considered viable

A

no

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18
Q

what is TPAL

A 
acronym that gives further information on parity
T - term
P - preterm
A - abortion
L - living children
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19
Q

what is NAegele’s rule for the due date estimation and how accurate is it

A

add 7 days and 9 months

accurate to +/- 2 weeks

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20
Q

what is the daily caloric intake increase for moms after their first trimester? what about pregnant adolescents? how much protein?

A

100
500
60 g protein a day

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21
Q

what is the expected weigh gain in the first trimester

A

4 lbs

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22
Q

why do women not like taking iron during pregnancy

A

causes constipation and GI upset

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23
Q

what should iron be taken with to enhance absorption

A

vitamin C

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24
Q

what does taking folic acid prevent

A

neural tube defects such as spina bifida

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25
Q

how much folic acid should be taken per day

A

400 mcg/day

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26
Q

waht are the best exercises for pregnant women

A

swimming and walking

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27
Q

true or false; high impact exercise is necessary during pregnancy

A

false

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28
Q

should hot tubs and heating blankets be used during pregnancy? why or why not?

A

no, increases body temp and can lead to birth defects

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29
Q

what is the exercise rule for pregnancy

A

dont let your hear rate get above 140

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30
Q

what happens if your HR goes over 140 in pregnancy

A

CO and uterine perfusion will drop

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31
Q

What are 8 danger signs during pregnancy

A 
sudden gush of vaginal fluid
bleeding
persisten vomiting
severe HA
abdominal pain
increased temp
edema
no fetal movement
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32
Q

what should you tell the pregnant person about taking medicatons

A

don’t take unless approved by dr

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33
Q

how often should a pregnant client visit the primary HCP during the first 28 weeks

A

once a month

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34
Q

how often should a pregnant client visit the primary HCP during the first 28-36 weeks

A

twice a month

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35
Q

how often should a pregnant client visit the primary HCP after 36 weeks

A

once a week till delivery

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36
Q

what should a pregnant person do prior to an U/S

A

drink water to distend the bladder

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37
Q

why do you want to distend bladder prior to U/S

A

pushes uterus to abdominal surface

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38
Q

what should a pregnant person do about an U/S prior to a procedure

A

void

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39
Q

what is the second trimester

A

weeks 14-26

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40
Q

how much weight gain is expected per week druing the second trimester

A

1 pound a week 4 pounds a month

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41
Q

in the second trimester is N/V still occuring

A

no

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42
Q

does a pregnatn woman still have breast tenderness in the second semester

A

yes

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43
Q

is there urinary frequency in the secondary trimester? why?

A

no, uterus is low in first trimester but rises and enlarges in 2nd

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44
Q

what is quciening and when does it start

A

fetal movement 2nd trimester

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45
Q

what should the fetal heart rate be during the second trimester

A

120-160

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46
Q

what is normal fetal heart rate, when are we worried and watching and when are we panicing

A

120-160 normal
110-120 worried and watching
< 110 panic

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47
Q

when is a pregnancy considered term

A

37-40 weeks

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48
Q

what is considered third trimester

A

27-40

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49
Q

what is the expected weight gain in the third trimester

A

pound a week

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50
Q

when are we worried about pregnancy induced HTN

A

third trimester

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51
Q

what are leopold manuevuers

A

used to determine fetal position and presentation

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52
Q

what nursing intervention should be done prior to leopold manuevuers

A

put in foley

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53
Q

where is the best place to hear the babys HR

A

over the babys back

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54
Q

what are the 3 signs of labor

A

lightening
engagement
fetal stations

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55
Q

what is lightening

A

first stage of labor - usually occurs two weeks before term

head descends into pelvis

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56
Q

how will the pergnant person feel during lightening

A

less congested and breathe easier but urinary frequency is a problem again

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57
Q

what is engagement

A

second stage of labor - largest presenting part is in the pelvic inlet (hopefully the head)

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58
Q

what are fetal stations

A

stage of labor

measured in cm; measures the relationship of the presenting part of the fetus to the ischial spines of the mother

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59
Q

what are braxton hick’s contractions

A

true labor more frequent and stronger

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60
Q

what is ripening

A

softening of cervix

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61
Q

what is bloody show

A

mucousy blood in labor

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62
Q

what is the sudden burst of energy called in labor

A

nesting

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63
Q

is diarrhea a sign of labor

A

yes

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64
Q

when should a client go to the hospital

A

when contractison are 5 mins apart or hwne ht emembranes ruptuer

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65
Q

what are we worried about when membranes rupture

A

prolapsed cord

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66
Q

what is the non-stress test

A

what to see two or more accelerations of 15 beats/minute or more with fetal movement
each increase should last for at least 51s and be recorded for 20 minutes

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67
Q

what is acceleration

A

when the fetal heart rate has an abrupt increase from the baseline
an increase of greater than 15 beats/minute above the baseline that lasts at least 15s but should return to bseline within 2 minutes

68
Q

do you want the non stress test to be reactive or non reactive

A

reactive

69
Q

what is the biophysical profile test BPP?

A 
measures
HR
muscle tone
movmement
breathing 
amniotic fluid
70
Q

when is the BPP test done

A

last trimester but can be done at 32-34 weeks in a high risk pregnancy

71
Q

how often will a high risk pregnancy have the BPP done

A

every week or twice a week in 3rd trimester

72
Q

in the BPP what is done regarding hr

A

nonstress test want it reactive i.e. it increases when baby moves

73
Q

in the bpp what is looked at to assess msucle tone

A

does baby have at least 1 flexion-extension movement in 30 mins

74
Q

what is observed for regarding breathing in the BPP

A

does the baby have breathing movements at lesat 3x in 30 mins

75
Q

what is obserrved for regarding movement in the biophysical profile test

A

does the baby move at least 3 times in 30 minutes

76
Q

what is the observation time for BPP

A

30 minutes

77
Q

what are good worrisome and ominous results in the BPP

A

10 good
6 worrisome
4 omnious

78
Q

what is the contraction stress test: oxytocin challenge test

A

determines if a baby can handle a contraction since contractions decrease blood flow to the uterus and placenta

79
Q

when is contraction stress test or oxytocin challente test done

A

if the NST is non-reavtive and it is a high risk pregnancy

80
Q

what will be seen if the fetus becomes hypoxic during the contraction stress test or oxytocin challenge

A

fetal heart reate will decrese from the baseline HR (deceleration)

81
Q

What do you not want to see in the contraction stress test

A

late decelerations –> means urteroplacental insufficienty

82
Q

do you want a positive or negaitve contraction stress test

A

negative –> means no decelerations were seen

83
Q

the contraction stress test is rarely seen befeore how many weeks

A

28

84
Q

what are the 3 types of decelerations

A 
early - benign not bad - casued by phsyiological hypoxia from fetal head compressionl
late decelerations (bad) - caused by uteroplacental insufficenty (UPI)
what is variable decelerations (bad) - caused by umbilical cord compressin
85
Q

in true labor are contractions regular or irregular

A

regualr

86
Q

do contractions increase or decrease in true labor

A

increase

87
Q

where does discomfort in back radiate to in true labor

A

back

88
Q

does pain decrease with change in activity in true labor

A

no; increases

89
Q

what do contractions do in false labor

A

irregular

90
Q

where is discomfort in false labor

A

just in abdomen

91
Q

what happens to pain in false labor when you cahnge activities

A

it decrease or goes away

92
Q

when is epidural anesthesia done for a pregnant lady6

A

stage 1 of labor at 3-4 cm dilation

93
Q

what is a major complication for epidural anesthesia

A

hypotension

94
Q

what should be done to combat hypotension forepidural anesthesia

A

bolus 1000mL NS or LR

95
Q

what posistion should a pregger lady be put in for epidural anesthesia to prevent hypotension

A

semi-fowler on side to prevet vena cav compression

96
Q

how often should a pregger lady alternate position from side to side when getting an epidural

A

hourly

97
Q

what are the 3 complicatiosn we are worried about for a pt receiving oxytocin

A

hypertonic labor
fetal distress
uterine rupture

98
Q

what is uterine rupture

A

can be partial or complete –>uterus rips open

complete = through the uterine wall into the peritoneal cavity

99
Q

what are S & S of complete uterine rupture

A

sudden sharp shooting pain
“feels liek something gave way”
pain relieved

100
Q

what is partial or incomplete uterine rupture

A

through the uterine wall but doesn’t tear the peritoneum peritoneal cavity is still intact

101
Q

what are the signbs and symptoms of incomplete uterine rupture

A

internal bleeding
pain may or may not be present
client may vomit

102
Q

what is ideal contraction rate

A

1 every 2-3 minutes, with each lasting 60 seconds

103
Q

when should ixytocin be discontinued

A

if contractions are too often or too long

if there is fetal distress

104
Q

do you ever straight line oxytocin

A

no piggy back so when you discontinue oxy be sure to discontinue fluid

105
Q

what posistion should the pt receiving oxytocin be in

A

any posistion but on her back

106
Q

what posistion do we put a preggers lady if there are any unreassuring heart tones

A

left side to enhance uterine perfusion

107
Q

what should be done with the oxytocin infusion if late decelerations are seen

A

turn it off

108
Q

should a client push btwn contractions

A

hellz no

109
Q

what cna a pt. do to decrease the urge to push

A

pant or blow

110
Q

what can be done to prevent the baby from coming out to fast

A

push on head

111
Q

following birth what temperature might the babys temp increase to during the first 4 horus

A

38 degrees celsius

112
Q

what heart rate for a baby is common during the first 6-10 days following birth

A

50-70 bpm

113
Q

when you see tachycardia in a postpartum women what should you immediately think

A

hemorrhage

114
Q

how long are breasts soft before they engorge following birth

A

2-3 days

115
Q

what is diastasis recti

A

abdominal muscles separate–> dent down abdome

116
Q

where is the fundus found immediately following birth

A

midline 2-3 finger breadths below umbilicus

117
Q

whwere should the fundus be a few hours after birth

A

rises to level of umbilicus or one FB above

118
Q

what is the first thing you do if the fundus is boggy

A

massage the fundus until its firm and then check for bladder distension

119
Q

when is bladder distension suspected

A

when the uterus is above the suspected level or is not in the midline

120
Q

what problem does a distended bladder cause following brith

A

not allow the uterus to contract normally which increases the chance of hemorrhage

121
Q

how much should fundal heigh decend per day following birth

A

one finger breadth/day

122
Q

what is the proper term used when the fundus descends and the uterus returns to its pre-pregnancy size

A

involution

123
Q

how long are afterpains common following birth? whta will cause them to continue to be common

A

2-3 days

breastfeed

124
Q

what color should the lochia be the first 3-4 days following birth

A

rubra - dark red

125
Q

what color should the lochia be the first 4-10 days following birth

A

serosa - pinkish brown

126
Q

what color should the lochia be the first 10-28 (as long as 6 weeks) days following birth

A

alba - whitish yellow

127
Q

are clots ok to pass following birht?

A

yes; as long as they are no larger than a nickel

128
Q

what happens to UO in the first 24 hours following brith? what are we worried about

A

diurese

dehydration

129
Q

why should the legs be closely inspected following birth

A

DVT

130
Q

how long should ice packs be used for perineal edema following birth

A

6-12 hours

131
Q

what are 3 things important in perineal care post-partum for patients who have an an epiosotmy, laceration or hemorrhoisd

A

warm water rinses
sitz baths 2-4 times a day
anaestheic sprays

132
Q

what is the peripad rule following birth

A

do not want the client to saturate more than 1 peripad an hour

133
Q

what is bonding also called? how often should it be done

A

kangaroo care; skin to skin

baby should be held for 1 hour at least 4 times a week

134
Q

how should breastfeeding mothers cleanse their breasts

A

with warm water after each feeding and let air dry

135
Q

what should be done for sore breasts in breastfeeding mothers

A

ointment or express some colostrum and let it airdry

136
Q

how soon should breastfeeding be initated following birth

A

ASAP

137
Q

what can be done if breastfeeding is interrupted

A

can pump

138
Q

how much should caloric intake be increased by when breastfeeding

A

500 calories

139
Q

how mcuh fluid/milk should a mother intake that is breastfeeding

A

8-10 8oz glasses a day

140
Q

what breast care should be done for non-breastfeeding mothers

A

ice packs
breast binders
chilled cabbage leaves
no stimulation of brest

141
Q

why do chilled cabbage leaves help for breast care in non breast feeding mothers

A

decreases inflammation and decrease engorgement

142
Q

what are 3 complications postpartum

A

infection
hemorrhage
mastitis

143
Q

how many days post birth are we worried about postpartum infection

A

10 days

144
Q

what are the two things you must have to define early postpartum hemorrhage

A

more than 500 cc blood lost in the first 24 hours and 10% drop from admission hematocrit

145
Q

when does late postpartum haemorrhage occur

A

after 24 hours up to 6 weeks

146
Q

when does mastitis usually occur following birth

A

2-4 weeks

147
Q

what causes mastitis

A

breasts not emptying properly

148
Q

if mom is going to continue to breastfeed after a mastitis infection what does she need to do

A

initate breastfeeding frequently or pump

149
Q

is penicillin ok with breastfeeding

A

yes

150
Q

can a baby be fed during mastitis? should you use the affected breast

A

yes baby should be fed frequently

affected breast should be used first –> empties breast milk

151
Q

what 3 things should be done immediately for newborn care

A

suction
clamp and cut cord
maintain body temperateure

152
Q

when should apgar be done following birth

A

1 and 5 minutes

153
Q

waht does apgar look at? what score do we want

A

looks at HR, R, muscle tone, refelc irritability, color

want at least 8-10

154
Q

what is given for eye prophylaxix for babies? what else does it kill

A

erythromycin —> kills clamidyia too

155
Q

what should be given to promote formation of clotting factors in new babies

A

IM vitamin K given IV vastus lateralis

156
Q

how long does it take for a babies umbilical cord to dry and fall off

A

10-14 days

157
Q

what should the cord be cleansed with and when should it always be cleasened

A

alcohol or NS and with each diaper changing

158
Q

how should a diaper be folded when the umbilical cord has not yet fallen off

A

fold diaper below cord

159
Q

why do some babies experience hypogycemia following birth

A

because they are not getting glucose from mo

160
Q

what risks put a baby more at risk for hypoglycemia

A

large or small babies
preterm babies
babies of diabetic moms

161
Q

when does pathological jaundice occur in newborns? why does this occur

A

1st 24 hours

Rh/ABO incompatibiulity

162
Q

when does physiological jaundice occur in newborns? why

A

after 24 hours

due to normal hemolysis of excess RBCs releasing bilirubin or liver immaturity

163
Q

how is Rh incompatibility diagnosed

A

indirect coombs - measures # of ab in MOMs blood

direct coombs - measures if there are any ab stuck to RBCs for baby

164
Q

what are the 2 things done if you have a Rh+ fetus and a sensitized mother

A 
frequent U/S to watch baby growth
early birth (when baby stops growing)
165
Q

when is Rho(D) given

A

w/in 72 hours following birth

166
Q

true or false Rho(d) is given with any bleeding episode

A

true - prophylaxis

167
Q

how does rhogam work

A

destroys fetal cells that got into mothers blood so mom does not make anitbiods

NCLEX (10 decks)

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