Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ABSN > Maternity Exam IV > Flashcards

Maternity Exam IV Flashcards

1
Q

What is dystocia?

A

abnormal/difficult labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are risk factors for dystocia?

A 
epidural
multiple gestation
poor pushing/contractions
occipital posterior position
big fat bb
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the causes of dystocia?

A

4 P’s

powers, passageway, passenger, psyche

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What position makes a shoulder dystocia more likely?

A

occiput posterior position (OP)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the nursing role for a shoulder dystocia?

A

give a back massage? (suprapubic pressure may worsen the dystocia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is hypotonic uterine dysfunction?

A

contractions slowing or stopping

“powers” of the 4 p’s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is induction vs augmentation?

A

induction - stimulating contractions BEFORE the onset of natural labor

augmentation - enhancing ineffectual active contractions AFTER natural labor has begun

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What drugs INDUCE labor?

A

prostaglandins: dinoprostone, dinoprostol, misoprostol

oxytocin (Pit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What drugs AUGMENT labor?

A

oxytocin (Pit)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the side effects of Pitocin ?

A

N/V
H/A
HYPOtension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the concentration/dilution of Pitocin that is administered ?

A

10 U in 1000mL LR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the indication for using Cytotec (misoprostol)?

A

labor INDUCTION

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a side effect of Cytotec (misoprostol)?

A

hyperstimulation of the uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How is uterine hyperstimulation defined?

A

more than 5 contractions in 10 minutes

leads to bradycardia, late decelerations and hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How you you manage uterine hyperstmiulation?

A 
STOP the pit
side lying
increase fluids
give O2
notify HCP

Give terbutaline 0.25mg SQ

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What defines the neonatal period?

A

the first 28 days of life

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the normal vital signs for a newborn?

A

HR - 110-160
BP - 60/40
RR - 30-60
T - 97.9-99.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the weird part of newborn respiration that is still normal?

A

30-60 bpm with short periods of apnea <15s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Adaptation to extrauterine life; cardiac -

A

ductus arteriosus closes
foramen ovale closes
HgB declines (physiologic anemia)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Adaptation to extrauterine life; respiratory -

A

surfactant reduces surface tension of the lungs and prevents alveolar collapse after first breath

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Adaptation to extrauterine life; hepatic -

A

physiologic jaundice

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Adaptation to extrauterine life; GI -

A

bacteria colonize the gut

immature cardiac sphincter results in regurgitation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Adaptation to extrauterine life; immune -

A

IgG crosses the placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When does surfactant begin to be produced? When is it complete?

A

24-28 weeks

complete by 35 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

How does a newborn regulate their temperature?

A

by burning “brown fat”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Expected number of diaper changes:

A

6-8/day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

normal weight loss for newborns

A

5-10% of their birth weight

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

S&S of cold stress:

A

hypotension
lethargy
weakness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are Mongolian spots?

A

normal discoloration of a newborn that looks like bruising

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is lanugo?

A

downy, soft hair

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is vernix caseosa?

A

cottage cheesy stuff on a newborn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

When do you take an APGAR

A

1 and 5 minutes after birth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What does the APGAR acronym stand for?

A

activity
0 - absent
1 - arms and legs flexed
2 - active movement

pulse
0 - absent
1 - < 100
2- > 100

grimace
0 - flaccid
1 - some flexion of extremities
2 - active motion

Appearance (skin color)
0 - blue/pale
1 - pink body, blue extremities
2 - pink

Respiration
0 - absent
1 - slow and irregular
2 - vigorous crying

Scoring:
0-3 severely depressed
4-6 moderately depressed
7-10 excellent condition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the average head circumference?

A

32-38 cm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Caput succedaneum vs cephalohematoma:

A

Caput Succedaneum - serous fluid that crosses the suture line below the skin

Cephalohematoma - blood b/w the periosteum and skull (swelling of the skin, not below it)

Both are normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What condition increases the risk for jaundice?

A

cephalohematoma b/c the blood breaks down and releases bilirubin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

what are some considerations for the PKU heel stick?

A
  • infant should be supine
  • do NOT use posterior pole of heal or calcaneus
  • DO use outer edge to minimize pain
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

When is a circumcision usually done? How long does it take to heal?

A

2-3 days after birth

7-10 days to heal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Circumcision care

A

wash with warm soapy water and try to keep it away from stool

over the tip of the penis with petroleum jelly coated gauze to prevent it from sticking to the diaper

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What are the characteristics of thrush?

A

white plaques in the mouth that can NOT be wiped away

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Why do we give infants vitamin K?

A

it helps the liver produce prothrombin, which helps the baby clot - preventing vitamin K deficiency bleeding (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

How do we care for the umbilical cord stump?

A

keep it clean and dry

it will change color from yellow to brown to black

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Describe the (5) infant reflexes:

A 
Tonic Neck (fencer) - until 3/4 mo
Palmar Grasp - until 3/4 mo
Moro (oh no) - until 3/6 mo
Rooting (piggy) - until 4/6 mo
Babinski (toes should FAN OUT) - until 12 mo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Bathing recommendations for a newborn:

A

3X/week is enough

don’t get the stump wet ~10days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the main complication of providing oxygen therapy to the newborn?

A

ROP - retinopathy of prematurity

major cause of blindness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What are the resuscitation guidelines for newborns?

A

A - airway - suction mouth, nose then trachea if HR <100

B - breathing - use PPV for apnea or HR <100 and ventilate at 40-60 bpm

C - circulation - start compressions if HR <60 after 30 seconds of PPV (3 compressions to 1 breathe Q2sec)

D - drugs - give epic if HR is <60 after 30 seconds CPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Definition for a SGA infant

A

< 2500 g or 5lbs 8oz
or
below 10th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Definition for a LGA infant

A

> 4000 g or 8lbs 13oz
or
above 90th percentile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Typical characteristics of a SGA infant:

A

large head
loose skin
scaphoid abdomen
thin umbilical cord

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Typical characteristics for a LGA infant:

A 
large body 
fat face
proportional body size 
poor motor skills 
behavioral px
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Common problems for a SGA infant vs a LGA infant

A 
SGA: 
HYPOglycemia and polycythemia
asphyxia
thermoregulation px
meconium aspiration 
LGA:
HYPOglycemia and polycythemia 
both trauma
ARDS
HYPERbilirubinemia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Symmetric vs Asymmetric IUGR characteristics

A

Symmetric:
< 28 weeks
infant never catches up in size
head, bones, and abdomen are all proportionally decreased in size

Asymmetric:
> 28 weeks
able to catch up in size
normal head and bones size but decreased abdomen size

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Why do we use Gavage feeding?

A

for prelim babies, so they don’t use up their O2 demands eating

54
Q

What does the Silverman Anderson Index score interpret?

A

Respiratory distress syndrome

the higher the score, the worse the respiratory distress

55
Q

What is RDS?

A

respiratory distress syndrome

  • lungs are immature and are lacking surfactant
  • RR > 60
  • Silverman Anderson Score > 7
56
Q

Where and how would we assess a baby for jaundice?

A

press a finger over a bony part of the baby

- nose, forehead and STERNUM are best

57
Q

How do we grade infant jaundice?

A 
0 - none
1 - face and neck only
2 - chest and back 
3 - abdomen below the umbilicus to the knees
4 - arms and legs below knees
5 - hands and feet
58
Q

How do we define hyperbilirubinemia?

A

bilirubin > 5 mg/dL

59
Q

Physiologic vs pathologic hyperbilirubinemia; when it appears:

A

physiologic: 3rd-4th day of life
(can be late onset on day 14 - still not pathologic)
pathologic: 1st day of life

60
Q

Physiologic vs pathologic hyperbilirubinemia; how high the bilirubin goes:

A

physiologic: 10 mg/dL then declines rapidly
pathologic: 17 mg/dL

61
Q

What is the indication for phototherapy in newborns? Considerations?

A

indicated for hyperbilirubinemia

cover the newborn’s genitals and eyes to protect them from the light

62
Q

What is kernicterus?

A

chronic bilirubin encephalopathy

leads to severe neurotoxicity

preventable

63
Q

Define preterm and postterm newborn:

A

preterm - before 37 weeks

postterm - after 42 weeks

64
Q

What are common characteristics of a PREterm newborn?

A 
scrawny 
undescended testes
lots of lanugo
lots of vernix caseosa 
fused eyelids
65
Q

What are common characteristics of a POSTterm newborn?

A 
dry, cracked skin
long nails
creases over entire soles of feet
wide eyed and alert 
thin umbilical cord 
NOT MUCH vernix and lanugo
66
Q

What are the main characteristics for neonatal abstinence syndrome?

A

WITHDRAWAL

Wakefulness 
Irritability
Temp variation, Tremors, Tachycardia 
Hyperactivity, Hyperreflexia, Hypertonia 
Disturbed sleep, Diarrhea, Disorganized suck
Respiratory distress, Rhinorrhea
Apneic attacks
Weight loss
Alkalosis (respiratory)
Lacrimation
67
Q

Major complications of newborns exposed to tobacco, alcohol and drugs:

A
  • IUGR
  • cognitive restriction
  • microcephaly
68
Q

What is HYPOglycemia defined as in a newborn?

A

BG < 40

69
Q

What is the best maintenance for newborn HYPOglycemia?

A

frequent early feedings

temperature maintenance

70
Q

Why would a mother use antiretroviral treatment during pregnancy?

A

to prevent mother to baby HIV transmission

71
Q

How can HIV be acquired from mother to baby?

A

vertical transmission

breastfeeding and through the placenta

72
Q

When should pregnant HIV (+) women begin medication?

A

14 weeks gestation

73
Q

What are the insulin needs for gestational diabetes by trimester?

A

1 - decreased need

2&3 - increased need

74
Q

What are the hPL levels for gestational diabetes by trimester?

A

1 - low hPL

2&3 - high hPL

75
Q

What are the glucose levels for gestational diabetes by trimester?

A

increased glucose use and storage during the 2nd and 3rd trimester

76
Q

What are the postpartum needs for insulin for gestational diabetes?

A

abrupt decrease in need for insulin

77
Q

When are labs drawn for pregnancy screening?

A

on the first visit and again at 24-28 weeks

78
Q

What are insulin needs for breastfeeding vs nonbreastfeeding mothers?

A

Breastfeeding DECREASES the need for insulin b/c it helps stabilize glucose levels for mother and baby

79
Q

What drugs are not recommended during pregnancy?

A

oral HYPOglycemics - teratogenic

80
Q

Can mothers have insulin during pregnancy?

A

Yes - it doesn’t cross the placenta

81
Q

What hormone regulates insulin? How does it work?

A

hPL and GH

they both increase as the placenta grows and resists insulin

insulin rises to counteract the rise in hPL and GH levels

this is not a px for non diabetic women, but women with diabetes can not cope with the rising insulin and get HYPERglycemia

82
Q

What is the main cause of postpartum hemorrhage?

A

uterine atony

83
Q

What is the main cause of LATE/EXCESSIVE postpartum hemorrhage?

A

uterine sub involution

84
Q

What are the 5 T’s of postpartum hemorrhage?

A 
tone
tissue 
trauma
thrombin
traction
85
Q

What are the 3 abnormal placental insertions?

A

accreta - partially in the myometrium
increta - most in the myometrium
percreta - in the perimetrium or past it

86
Q

What nursing actions would you take for a patient with uterine atony?

A 
fundal massage 
Pitocin to contract the uterus 
maintain IV fluids 
Methergine
Hemabate
87
Q

Expected findings for postpartum hemorrhage r/t hematoma and lacerations

A

firm uterus
bright red bleeding
bruising

88
Q

side effect of Pitocin

A

hyperstimulation of the uterus

89
Q

contraindications for Pitocin

A

do NOT give undiluted as a bolus injection

90
Q

Methergine side effects

A

HTN

seizures

91
Q

Methergine contraindications

A

HTN

hx of seizure

92
Q

Hemabate side effects

A

bronchospasm

93
Q

Hemabate contraindications

A

asthma

94
Q

What characterizes postpartum psychosis

A

depression
delusions
thoughts of harming infant or self

95
Q

S&S of postpartum infection

A

fever over 38 or 100.4 after 24 hours

96
Q

What is the most common cause of postpartum infection?

A

endometritis

97
Q

What can women do to prevent uterine prolapse?

A

kegals
passaries
surgery

98
Q

What are the hallmark S&S of gestational trophoblastic disease?

A

high fundal height

expulsion of grape like cysts

99
Q

Which is likely malignant; molar or non-molar GTD?

A

non-molar (molar is usually benign)

100
Q

What happens to HCG levels during gestational trophoblastic disease?

A

they’re high

101
Q

What do we do to manage gestational trophoblastic disease?

A

chemo for invasive moles and surgical evacuation

102
Q

What does the followup care for gestational trophoblastic disease include?

A

hCG level tase at 6 months

103
Q

pregnancy recommendations for gestational trophoblastic disease?

A

wait 6 months after evacuation AND have a normal hCG level, then pregnancy is ok

104
Q

What is the medical definition of abortion?

A

expulsion of an embryo or fetus before viability (before 20 weeks)

105
Q

What is the difference between primary and secondary infertility?

A

primary - can’t conceive after 1 year

secondary - can’t conceive after previous pregnancy

106
Q

What are the % of infertility causes by sex?

A

female - 40%
male - 40%
both - 20%

107
Q

Average blood loss for menstruation?

A

35mL

108
Q

Average menstrual period length

A

4-7 days

109
Q

90% of blood loss is complete during the menstrual cycle by day ______.

A

3

110
Q

How much chronic blood loss during menstrual periods leads to anemia?

A

> 80mL/cycle

111
Q

Meno-

A

menstrual related

112
Q

Metro-

A

time

113
Q

Oligo-

A

few

114
Q

A-

A

without

115
Q

Rhagia-

A

excess/abnormal

116
Q

Dys-

A

not or pain

117
Q

-rhea

A

flow

118
Q

What is AUB? How is it different from DUB?

A

AUB: abnormal uterine bleeding
DUB: dysfunctional uterine bleeding - no organic pathology, r/t hormone px

119
Q

What is dysmenorrhea?

A

weird periods

120
Q

What is the difference between primary and secondary dysmenorrhea?

A

primary - increased prostaglandin production

secondary - pelvic/uterine pathology (#1 cause is endometriosis)

121
Q

What is TSS? Management?

A

bacterial infection that can lead to death

tx - hospitalization, antibiotics, potential dialysis

122
Q

Effects on newborn: Chlamydia

A

eye infections
pneumonia
low birth weight/prematurity

123
Q

Effects on newborn: Gonnorhea

A

inflammation

124
Q

Effects on newborn: Herpes

A

intellectual disability
blindness
seizure

125
Q

Effects on newborn: Syphilis

A

skin px
jaundice
anemia

126
Q

Effects on newborn: Trichomoniasis

A

Premature rupture of membranes

127
Q

Effects on newborn: Genital Warts

A

throat warts

128
Q

What is HPV? Tx?

A

most common viral infection in the US (“genital warts”)

tx - Gardasil, Cervarix

129
Q

What is PID? S&S?

A

bacterial infection of the upper reproductive tract

S&S - fever, elevated WBC, abnormal vaginal discharge

130
Q

What is an ectopic pregnancy? S&S? Tx?

A

ovum implantation outside the uterus

S&S - abdominal pain with spotting 6-8 weeks after a missed period

Tx - education of the S&S of rupture, pain management

ABSN (18 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions