Maternity/Infant Health (Exam Three) Flashcards
Regarding the fetus, what substance(s) can be screened for toxins after birth?
- Umbilical cord
- Urine
- Meconium
Which fetal substance is tested to allow health care providers to view fetal nutrition and toxins for the entire nine month span of pregnancy?
Umbilical cord
Communities should have health services that are what?
- Available
- Accessible
- Acceptable
- Affordable
When does prenatal care begin?
Prior to conception
What should the nurse ensure before a woman becomes pregnant?
- Healthy diet
- Folic acid intake
- Iron supplement intake
Why is it important for a woman to have a well-balanced diet before conception?
To ensure fetal development
What questions should be included on the nutrition assessment prior to conception?
- Eating disorder
- Specific diet followed
- Overweight/underweight
- Daily folic acid supplementation
Give examples of eating disorders the nurse would want to know about?
- Anorexia
- Bulimia
Give examples of specific diets the nurse would want to know about?
- Low carb
- Keto
- Vegetarian
- Vegan
How much folic acid should any woman of childbearing capabilities intake?
0.4 mg daily
What role does folic acid play in fetal development?
Prevents neural tube defects
List food sources of folic acid.
- Green leafy vegetables
- Chicken
- Liver
- Turkey
What will aid in decreasing the risk for mother and baby?
Gaining a desirable amount of weight
What can happen if the mother has an inadequate weight gain?
- Risk for pre-term labor
- Intrauterine growth restriction (IUGR)
What is intrauterine growth restriction (IUGR)?
- Fetus does not have adequate room to develop
- Fetus is not receiving adequate nutrition intake
What is the desired weight gain during pregnancy?
25 to 35 pounds
The desired weight gained by the mother includes what factors?
- Weight of fetus
- Weight of amniotic fluid
- Weight of uterus
The weight gained by the mother during pregnancy is not strictly _____.
Fat or muscle
How much should the mother increase her calorie intake during pregnancy?
Increase by 300 calories per day
What type of foods should the mother intake during pregnancy?
-Wide variety of food (i.e. protein, dairy, vegetables, fruits, etc.)
What food group is specifically important for fetal development?
Complex carbohydrates
Besides folic acid, what is also recommended for the pregnant woman to intake daily?
Multivitamin or prenatal vitamin
What should the nurse recommend if any supplement causes the pregnant woman to become nauseous?
Take the vitamin at night
How many milligrams of calcium should a prenatal vitamin contain?
At least 1300 mg
Calcium is important for the development of what fetal structure?
Fetal skeletal development
List the fat soluble vitamins.
HINT: BAKED - B
Vitamin A
Vitamin D
Vitamin K
Vitamin E
List the water soluble vitamins.
Vitamin C
Vitamin D
Vitamin B
Folic Acid
Too much Vitamin A can result in what?
Fetal anomalies
Excessive amounts of which vitamin can negatively impact the fetus?
Vitamin A
Vitamin B12 is important for the formation of what?
Red blood cells
List food sources of Vitamin B12?
- Eggs
- Dairy
How much folic acid should a woman intake during pregnancy?
0.6 mg daily
What is pica? What might pica indicate?
- Non-food cravings
- Nutritional deficiency or sign of anemia
Severe nausea and vomiting during pregnancy is known as what?
Hyperemesis gravidarum
What would the nurse recommend to a pregnant woman to offset the nauseous feeling?
Sweet or salty food items
What medication is prescribed for nausea and vomiting during pregnancy?
Zofran
What side effects of Zofran should the nurse educate the patient on?
- Headaches
- Constipation
What medication is considered safer, when compared to Zofran, to use during pregnancy?
Diclegis
Diclegis is made up of what? What form of tablet is Diclegis?
- Vitamin B6
- Unisalm
- Extended relief tablet
List non-pharmacological interventions for nausea and vomiting during pregnancy.
- Ginger
- Pressure bands
What is anemia?
Iron deficiency
What will be prescribed if the pregnant patient is anemic?
Iron supplement
What should the patient monitor while taking an iron supplement?
- Constipation
- Monitor stools for color
- Monitor stools for consistency
What vitamin aids in iron absorption?
Vitamin C (i.e. supplement tablet or orange juice)
What nursing management should be provided to a pregnant patient suffering from constipation?
- Increased fluid intake
- High fiber diet
What is pyrosis?
Heartburn
What nursing management should be provided to a pregnant patient with pyrosis?
- Encourage small frequent meals
- Remain in upright position for 30 minutes after meal consumption
What are nutritional concerns regarding adolescent pregnancy?
- Well balanced diet
- Gaining appropriate amount of weight
What is the recommended amount of water consumption during pregnancy?
3L daily
What is the recommended amount of protein consumption during pregnancy?
70 grams daily
Are more calories needed during lactation or during pregnancy?
Lactation
How much should the mother increase her calorie intake during lactation?
Increase by 500 more calories per day
Calories make ______.
Breastmilk
What is postpartum?
Interval from childbirth to the return of the uterus to a non-pregnant state
After childbirth, the uterus should do what?
- Shrink in size
- Move down to non-palpable state inside of pelvic area (below the umbilicus)
What is involution?
Shrinking of the uterus
Does the uterus ever return to its original size before pregnancy? What do we call this state?
- No
- Non-pregnant state
List factors that promote involution?
- Early and frequent ambulation
- Uterine contractions (i.e. fundal rubbing)
- Breastfeeding
How long will the mother experience contractions after delivery?
2 to 3 days postpartum
Explain how breastfeeding promotes involution.
1) Any time the newborn is put to breast or the nipple is stimulated, the body will release oxytocin
2) Oxytocin causes the uterus to contract
3) Uterine contraction will compress blood vessels and minimize blood loss
What is the synthetic form of oxytocin?
Pitocin
Exposed blood vessels in the uterus are a result of what?
The placenta detaching from the uterus
How is the uterus location measured? What landmarks are used?
- Measured by abdomen
- Above or below the umbilicus
After delivery, how many centimeters should the uterus move below the umbilicus?
1 to 2 cm per day
How many hours after delivery will the uterus remain above the umbilicus?
12 hours
How long does it take after delivery before the uterus is unable to be externally palpated?
2 weeks
What is subinvolution?
Failure of the uterus to return to a non-pregnant state
Subinvolution may also be referred to as what?
Uterine atony (no tone)
How will the nurse describe a contracted uterus?
Firm uterus
How will the nurse describe a uterus that is not contracted or soft?
Boggy uterus
What causes postpartum hemorrhage?
Failure of the uterus to contract
What is the normal estimated blood loss (EBL) during a vaginal delivery?
500 mL
What is the normal estimated blood loss (EBL) during a cesarean delivery?
1000 mL
List factors of subinvolution or factors that slow involution.
- Full bladder
- Previous births
- Prolonged labor (18+ hours)
- Anesthesia
- Infection
- Retained placental fragments
What is a nursing intervention that aids in uterine contraction and prevents postpartum hemorrhage?
Fundal rubbing
If the bladder is full, the uterus will be deviated to which side of the body?
Left
What should be assessed before a fundal rub is performed?
- Whether or not the patients bladder is full
- Last time the patient voided
Colostrum is sufficient to nourish the newborn for how many hours?
72 to 96 hours
What is engorgement?
Distended, firm, tender, and fullness of the breasts due to an influx of breastmilk
Colostrum is high in what? Colostrum is low in what?
- High in antibodies and protein
- Low in fat
When will the vagina return to a non-pregnant size following childbirth?
6 to 10 weeks postpartum
Describe the cervix following childbirth.
- Edematous
- Thin
Lactation will delay the production of what? This is in direct relation to what?
- Cervical mucosa
- Directly related to hormones because cervical mucus is dependent on hormones
How long does the postpartum period last?
6 weeks
What is lochia? What is it the result of?
- Vaginal discharge
- Result of involution and the regeneration of the endometrium
What makes up lochia?
- Blood from the site of placental attachment
- Dead cells from the placenta
What is lochia rubra?
- First lochia present after childbirth
- Occurs 3 to 4 days
- Bright, red discharge
What is lochia serosa?
- Pinkish brown discharge
- Lasts 22 to 27 days
What is lochia alba?
- Whitish discharge
- May last up to 6 weeks postpartum
Regarding lochia, what three characteristics should the nurse assess?
- Color
- Amount
- Odor
Regarding lochia, what is the distinct sign of infection?
Smell
List the three different amounts of lochia.
- Heavy
- Moderate
- Scant