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SET 2 > Maternity > Flashcards

Maternity Flashcards

1
Q

Hormone that induces amenorrhea?

A

Progesterone

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2
Q

Presumptive signs

A

Ammenorrhea
n/v
urinary frequency
breast tenderness

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3
Q

Probable signs

A

Postive hcg - because benign neoplasm vesicles which can become malignant later requiring DNC
Goodell - softening cervix 2nd month
Chadwick - bluish 4th week
Hegar sign - softening lower urine 2/3rd month
Uterine enlargement
Braxton Hicks throughout the pregnancy
Changes in skin - linea, striae, dark areola

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4
Q

Positive sign of pregnancy

A

Fetal heart rate doppler - 10 - 12 weeks
Fetoscope 17-20 weeks
Fetal movement by hcp
Ultrasound

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5
Q

Pregnancy terms

A

Gravida - number of times someone has been pregnant
Parity pregnancy that live till 20 weeks
Viability pregnancy 24 weeks and beyond
20 week parity not viable

TPAL

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6
Q

Miscarriages indications

A

occur before 20 weeks hcG drop levels

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7
Q

Naegles rule for EDD

A

First day of last period, add 7 days, substract 3 months, add one year accuracy is 1-2 weeks minus

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8
Q

1st trimester teaching

A

Balanced diet, eat 60 g of protein, consider culture

Weight gain 1-4 lbs first tri.

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9
Q

1st trimester supplements

A

Iron - leads to constipation and GI upset, take with vitamin C
Folic acid will decrease neurtal tube defects like spinal bifida
daily dose is 400 mcg/day

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10
Q

Foods rich in iron

A

I like to eat FORTIFIED CEREAL in the morning, for lunch ill have LENTILS AND SPINACH. As a snack ill eat DARK CHOCOLATE, RAISINS, DRIED FRUIT.

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11
Q

Exercise routine in pregnancy

A

no high impact, just walking and swimming no hr above 140 because it decreases CO, decreased uterine perfusion. No hot tubs, heating blankets can lead to birth defects.

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12
Q

Smoking and meds

A

No smoking and no meds unless php says so, if they smoke smoke outside

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13
Q

Php visits

A

first 28 weeks - 1 a month
28-36 weeks - Every 2 weeks
36 weeks: weekly
High-risk client will have more visits.

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14
Q

Ultrasound

A

Drink a lot of water to distend bladder and push uterus up, not required for transvaginal
procedures amniocentesis need pts to void.

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15
Q

Second trimester 14-26 weeks recommendations

A

increase to 300 calories of adolescent increase to 500 cal.

Weight gain should be 1lb per week
No Urinary freq. Just Breast Tenderness.
Quickening occurs

Kegel Exercises to help stop flow of urine and keep uterus from falling out.

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16
Q

When should Quickening be felt?

A

16-28 weeks

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17
Q

What should be FHR in second tri?

A

110 - 160

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18
Q

Third Tri 27-40 WEEKS

A

Called term if it advances to 37-40

Weight gain is no more than a pound per week. Monitor BP

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19
Q

What is pre-eclampsia?

A

Develops after 20 weeks gestation.

s/s
increased bp
proteinuria and edema

gain in two or more pounds gained worry about preeclampsia leading to SEIZURE

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20
Q

What is drug of choice with pre-eclampsia

A

mag sulfate

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21
Q

Mag sulfate effects

A

act as an anticonvulsant
sedates
vasodilates

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22
Q

Eclampsia vs. Preclampsia

A

Eclampsia is they have a seizure.

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23
Q

FHR in third tri and position

A

110-160, Leopold to determine position and tell them to void and done between contractions

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24
Q

Client teaching Lightening and engagement Signs of labour

A

occurs 2 weeks before term
presenting part into the pelvis
client will be able to breathe easily
urinary frequency again

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25
Engagment
presenting park is in pelvic inlet
26
Fetal Stations
in cm measure the relationship to presenting part to ischial spine
27
When client reports ruptured membrane
Always worry about prolapsed cord.
28
Other signs in labour third trimester
Braxton hicks frequent | cervix softened, bloody show, sudden burst of energy - nesting, diarrhea rupture of membrane
29
When should they go to the hospital?
contractions are 5 min apart or membrane rupture - prolapsed cord
30
What is a nonstress test
two or more acceleration of 15 beats/min w/o fetal movement. Acceleration is when the fetal hr is abrupt increase greater tha 15 atleast 15 sec but come back to base at 2 minutes each 15 sec last for 20 minutes should be reactive
31
Biophysical test
Done in last tri at 28 weeks in high risk and BPP every week or even twice a week in 3rd tri measurements obtained by ultrasound two points. parameters are hr, muscle tone movement, breathing, and amount of amniotic fluid observation time is 30 minutes 8-10 good, 6 worry, repeat 24hrs, 4 consider delivery
32
Contraction stress test oxytocin
For high risk pregnancies, diabetics preeclampsia, to determine if stress can be handled with uterine contraction
33
OXY challenge
if blood flow decreases to cause hypoxia fhr will decrease from base leading to decelerations meaning uteroplacental insufficiency this should be negative performed at 28 weeks results are good for 1 week.
34
Types of decelerations
early decel - not bad, benigh caused by head compression hypoxia late decel -bad - uterplacental insufficiency varciable decel - bad - umbilical cord compression
35
True labor
regular contractions and increase, with discomfort to back and abdomen
36
False labour
irregular contractions discomfort in abdomen and pain decreases with activity
37
Premature or preterm
Contractions occur with dilation between 20-37 weeks goal stop labour treat infection by hydrating the mom bedrest
38
Meds for preterm premat
``` mag sul betamethsone terbutaline indomethacin nifedipine ```
39
Epidural Anaesthesia
position on left side legs flexed, stage 1 3-4 cm dilated no headache complication headache iv bolus ns / lr to fight hypotension position in semi fowlers to preven vena cava compression (if done is wil decrease CO and BP) alternate side to side hourly check urine output
40
Client receiving oxytocin
high risk one to one Contraction rate 1q 2-3 min lasting 60 seconds d/c if contractions are too often, too long, fetal distress
41
Complications w/ oxytocin
Hypertonic labour detal destress / late dec - STOP oxy Uterine rupture - may becaused by previous csection, vbac, uterine surgery, trauma, difficult forcep delivery.
42
Emergency Delivery
Prince william will tell kate to blow and pant to prevent urge to push wash his hands elevate HOB , place a clean cloth underneath and dont touch vaginal area , as head crowns tear amniotic sac and then place hand on fetal head apply gentle pressure , when head is out check for cord around neck and ease the shoulder keep head baby down , dry baby , cover baby and place on abdomen. wait for placenta. Inspect placenta and tie the tip , 4 inches near baby and the second 8 inches from baby navel.
43
Postpartum assessment
Temperature on the first four hours is ELEVATED may be 38, bp will be stable, HR may be low 50-70 after delivery, high could indicate hemorrhage. Breasts are usually soft for 2-3 days and then the abdomen is soft and lose, uterus fundus midline is 2-3 fingers below umbilicus and will rise to level or one above a few after after birth. The fundus needs to be firm. if it is boggy massage it until firm and then check for bladder distention. Fundus should descend one finger a day and returns to prepregnancy side known as involution if it doesn't think hemorrhage. after pains are common.
44
Bladder distention is suspected when
uterus is above the expected level and to the right increasing chances for hemorrhage
45
Lochia Postpartum
Rubra - dark red - 3-4 days Serosa - pink brown - 4-10 Alba 10-28 (6-weeks) White yellow No clots bigger than a nickel
46
Urine output PP
Diurese as possible to prevent DVT via dehydration
47
Txt Perineal care
Icepacks 24 hrs warm water sitz bath 2-4 times anesthetic spray to ease pain and hygiene promoting healing especially with an episiotomy and hemmorhage Change the pads frequently. No more than 1 per hr. Teach to report foul smell lochia.
48
Skin to skin benefits
Allow bonding, stabilizes HR, improves O2, regulates temp, conserves calories
49
Breast Care
Warm water, air dry, support bra, ointment for soreness or colostrum and let it dry. breast pads to absorb moisture breastfeeding should be initiated immediately increase calories by 500 per day and milk intake should be 8-10 ounce of fluid a day
50
Non breastfeeding mothers
Breast binder, chilled cabbage to decrease inflammation
51
Complications of pp infection
10 days after birth such as ecoli / beta hemolytic strep, teach proper hygiene abx.
52
Pp hemorrherage for early
Early 500 mls of blood in first 24 hrs, with 10% drop of hematocrit meaning both have to be present
53
PP Late hemorrhage
24-6 weeks caused by uterine atony - tone loss and full bladder lacerations retained frags
54
Meds use to stop pp hemorrhage
oxytocin methylergonovine carboprost misoprostol
55
Mastitis
Staph bacteria | occurs 2-4 weeks
56
S/s , treatment of mastitis
rapid onset of fever and chills, swollen breast and malaise treatment bed rest support bra binding and chilled cabbage to relieve engorgement , breastfeed or pumping is acceptable and Penicillin, pain meds hot showers, feed baby frequently and always affected breast first
57
New born care
Maintain temp, apgar 1 and 5 minutes HR, resp, muscle tone, reflex irraitability and color score should be 8-10 Erythromycin to kills nisseria and chlamydia and Vit K to promote clotting
58
Cord care Post Partum
Dries fall off 10-14 days , clean with alcohol or N/S fold diaper below cord and do not immerse the baby as it will cause infection
59
New born complications
Hypoglycemia because not getting glucose from mom, high risk are those with large ges age, small ges age and babies with diabetic moms
60
Pathologic Jaundice and Physiologic
Patho = First 24 hrs Usually means rh/abo incompatibility Physio = After 24 hrs Due to normal hemolysis of excess RBC releasing bilirubin and immaturity of liver
61
RH positive blood comes in contact with moms neg rh
Occurs when placenta sep at birth either miscarriage , amniocentesis or trauma and mother attacks it as foreign
62
Neg effects of RH- and Rh positive mom coming into contact with future baby
Hemolysis, babys rbc tries to compensate by releasing a lot of RBC. (erythroblastosis fetalis)
63
indirect coombs and direct coombs
done with mother to measure antibodies in the blood Direct coomb done with baby to tell if antibodies are stuck via cord
64
Trxt for RH and prevention
Ultrasound Rhogam give once 28 weeks, and again within 72 hrs after birth, and with bleeding episode it works by destroying positive fetal blood cells into mothers negative before antibodies are formed.

SET 2 (16 decks)

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