maternity test 2 Flashcards
what should temp be postpartumly
norm to 100.4 first 24 hours ok then norm
What should desperations be
norm 12-20
What should blood pressure be ?
same has throughout pregnancy
What would high blood pressure indicate
pre clampsia
Is it normal to have heart rate between 40-60
yes bradycardia first 2 weeks
Why is bradycardia happen
increased blood flow to heart causing increased stroke volume
What does a decreased blood pressure indicate
infection or hemorrhage
What does tachycardia indicate
Bad hypovelmia dehyrdation hemorrhage
uterus returing to pre pregnant state
involution
Why does the fundus moe up first
to prevent bleeding clamps down
Where is the fundus right after delivery
midway between symphsis pubis and umbilicus
where is fundus 6-12 hrs after birth
at unblilcus
How much does fundus drop a day
1cm
What does a uterus displaced to the right mean
bladder full … void before assessment
What does urinary relation cause
urine atony
is exsessive enuris norm
yes getting ride of intravenous fluid anti direct effect .. decrease aldostrone
What are the orders lochia presents in
rubra
serosa
alba
what is lochia
vaginal discharge after birth
deep red 3-4 days after delivery
lochia rubra
pinkish brown… 3-10 days
lochia serosa
white creamy… 10-14 days pp
lochia alba
what does smell y lochia indicate
infection… bad
what if lochia turns back to bright red
to activate … slow down
what causes afterpains
unterus contracting back to normal
Why does breastfeeding trigger afterpains
the realease of oxytocin
Does amount of kids increase or decrease afterpains
increase .. uterus more distended
what changes sensation of elimination
epidural cath feels weird stretched altered sensation
Can you eat and drink after delivery
yes very due to so much energy used
What can you do for constipation
stool softner fiber hydration ambulation sits bath
why constipated
decreased perastalisis .. sluggish bowel.. not eaten..fears..dehyrdation
what does laceration mean
tear
what does episotomy mean
cutting
hemorrhoid care
not always visible .. blood in stool.. might need rectal exam
what does an episotomy look like
slight bruised no red discharge or edema..
large swollen bluish area
hematomas
purulent drainage of episotomy
infection
how much blood do you loose at delivery ?
500 vag 1000 c-sec
What happens to your WBC clount postpartum
elevated slightly
what is lactation
secretion of milk
What happens after delivery of placenta
estrogen and progesterone decrease
what stimulates growth of milk collection
estrogen
what triggers milk production
prolaction
what hormone triggers the let down … or ejection
oxytocin
what is engorgment
sweeping of breast… first 3-5 days
what are ways to decrease pain of engorment if breastfeeding
hot/cold .cabage leaf. message. milk expression. between feedings cold compresses
ways to decrease breast pain if not breastfeeding
tight bra. ice. no sexual stimulation. no hot water on them .
what is the first fluid available to the newborn
chlostrum
how long until breastmilk is available
3-4 days
Should you bring baby to you
yes bring baby to breast
what are some good latch signs
nose and check pressed tightly
swallowing ears wiggle
suck on hold dark part areola
what causes engorgment
pressure from increased congestion of veins and lymphatics
what is stria
white silvery linded skin .. stretch marks
does stria ever go away?
no thin silver line
what is diastasis recti
splitting of abdominal muscles
how much weight do you lose in first 2 days
17 pounds …lose of baby placenta and fluid
what is different with c-section delivery
more help.. football hold.. less bleeding… infection at wound site
what is cervix shape after delivery
pointy fish mouth shape .. softer to never goes back
how soon do you menstrate
6-10 weeks if not breastfeeding
what comes first ovulation or menstration
ovulation
if excessive breastfeeding how long mestrution delayed
3 months
what form of contraception should they be on
any safe IED best
What are reva rubin 3 phases
taking in
taking hold
letting go
what happens in the taking in phase
first 24 hours… others to meet her needs .. passive role.. identify baby features
what happens in taking hold phase
independence
care of baby
health concerned .
2nd-3rd day
what happens in letting go phase
routine .. new normal
after 3rd day
what are the father attachment phases
expectations
reality
mastery
what happens during expectation phase
thinks everything has to be perfect . eye opening
what happens during reality
overwhelemed …sad ambivalence frustation
what happens during mastery
excepatance.. occurs to new role..
how often do you do post partum assment
15 min first hour
30 min second hour
4hrs first 24hrs
8hrs after 24 hours
what do you access
BUBBLE EEE breast uterus bladder bowels lochia epsiotmy epidural emotional extremeties
whats a sign of a boggy or relaxed uterus
sign of uterine atony
what is a peribottle
squeeze bottle filled with warm water spray over perinumem
what is a sitz bath
basin sits on toilet bag filled warm water cleans
How long no urine before cath
4-6hrs
what is postpartum blues
transient emotional distrubances 1st week.. crying anxious insomnia
what is to much blood loss for a vaginal birth
more than 500 ml
what is to much blood loss for c section
1000 ml
diaphoresis
increased cap refill
cool extremities
maternal anxiety
mild shock.. less than 20% blood loss
tachycardia postual hypotension
oligoria
moderate shock.. 20-40% blood loss
hyptension
agitation/confusion
hemodynamic instability
severe shock… greater than 40% blood loss
failure of uterus to contact
utirne atony
failure of uterus to return to its norm size after birth
subinvolution
what are causes of PP hemorrhage
subinvolution utirne atony episotomy/laerations unterine inversion couagulation disorders hematoms
prolapse of cervix. uterus inside out
uterine inversion
your uterus should stay what
firm
what causes uterine atony
distended bladder
fibroids
pieces of placenta left in
tone tissue trauma thrombin traction
5 T for causes of hemorrage
uterine atony, distended bladder
tone
retatined placenta and clots
tissue
vaginal or cervical or uterine injury
trauma
cougluation prob
thrombin
uterine lacerations
traction
Ways to manage hemorrage
massage,oxytocin,breastfeeding, underlying cause, antibodies, pain med, remove fragments from placenta, monitor for shock
during PP nursing assent of hemmorage look at
risk factors uterine tone and vaginal bleeding
whats the uterus feel like if uterine atony occurs
soft and boggy
DVT causes
pain sweeling heat
calf pain, edema , venous distention
DVT can dislodge and cause what
pulmonary embolism
How do you prevent DVT
prevention .. adequate circulation . education ..stockings.. heparin
infection of endometrium, decidua, and adjacent myometrium
metritis
inflammation of the breast
mastitis
what things help with mastitis
empty breast. control infection.. hydration
what is REEDA used for and what stand for
redness edema ecchymosis discharge approximation
used for perineal healing assessment
what does smelly lochia indicate
metritis
can you continue breastfeeding if blood in breastmilk
yes
what are signs of baby blues
anxiety irratable mood swings senstive overwhelmed tired peaks day 3-4 PP gone by day 10
what are signs of postpartum depression
restless worthless quilty hopeless moddy sad los of joy crying no sex NEEDS TREATMENT gets progressively worst evident within first 6 weeks PP
signs of postpartum psychosis
mood labilaty delusions hallucinations disorganized thinking bad don't leave alone with baby will be hospitalized evident within first 3 months
What are the signs of hemmorage
drop blood pressure. increasing pulse, decreasing urinary output
inflammation of blood vessel lining caused by a thrombosis
thromboplhebitis
Chlymadia during pregnancy
effected during delivery..
opthamlmic neaturom.. LBW, PROM
gonorrhea
effected during delivery
opthamic neatomarum, miscarriage, preterm, PROM
Herpes type 2
can be effected during delivery
retartation. preterm,LBW deat
want c section
Syhpilis
all women get tested for during pregnancy
can be passed in utero.. crosses placenta
effects baby organs.. infant or fetal death
Trichomonias
effected in utero.. LBW PROM preterm death
HIV
doesn’t cross placenta. blood exchange needed
baby not treated can die of AIDS
pelvic inflammatory disorder
extopic pregnacy
improperly implanted placenta in to lower uterine segment. with painless bright red bleeding
placenta previa
premature separation of normally implanted placenta from uterine wall.. possible no bleeding
abruption placenta
bleeding that builds up behind placenta. fundal height goes up . very painful . uterus turns blue
couvelaire uterus
chronic villi attach directly to myometrium of uterus
acreta
myometrium invaded
increta
myopmetruim penetrated
percerta
artifical rupture of membranes .
amniotomy
bolus of amniotic fluid enters maternal circulation and then in the lungs
fluid embolism
technique of introducing warmed sterile saline into the uterus through IUPC
amniofusion
softens breakdown of collagen fibrils and effaces
cervical ripening
what are ways of cerival ripening
prostaglandin . cervidil. mechanial methods. surgical methods
score used to evaluate cervical reediness for labor
bishop score
irregular contractions low amplitude. ..protracted labor
hyptonic labor
uterus never relaxes between contractions
hypertonic labor
Preciputous labor
to fast. dilation greater than 5cm per hour
post term pregnancy
after 42 weeks
cessation of mess for a year or more. greater than 40
meopause
if before year mark or around menopause
perimenopause
what changes in brain during menopause
hot flashes sleep mode memory
what changes in heart during menopause
lower levels HDl, increased risk of CVD
what change in bone after menopause
bone density loss , increased risk for osteoporosis
what changes to breast after menopause
duct and gland tissue replaced by fat… less dense better for mamogram
what changes in GU after menopuase
vaginal dryness, stress, inconctinence
GI changes after menopause
less CA absorbed , increased fractures
Skin changes after menopuase
dry, thin, collagen decreases
what causes all these effects on the body system
decrease in estrogen
absence of menses during reproductive years
amenorrhea
absence by age 14 with no sex characteristics… or by age 16 with sexual characteristics
primary amenorrhea
absence of mess of 3 cycles or 6 months in women who have previously menstrated
secondary amenorrhea
painful menstration
dysmenorrhea
what causes primary dysmenorrhea
increased prostaglandin production
what causes secondary dysmenorrhea
pelvic or uterine pathology
irregular abnormal bleeding occurs with no other anatomic pathology
dysfunctional uterine bleeding
inaiblity to conceive a child after 1 year regular sexual activity
infertility
what does male infertility assessment consit of
semen anaylais
female infertility assessment consit of
ovarian function, pelvic organs
what is sign of endometriosis
pelvic pain
bits of functioning endometrial tissue are located outside of normal cite
endometriosis
risk factors for endometrious
high age, history, long flow, short period, fat diet, young start of period, no prego
decrease constellation of recurrent symptoms that occur during lethal phase
PMS or more sever PMDD
home ovulation kit
change in LH
clomphine citrate
FSH
hysterosalpinogram
dye in tubes
laparoscopy
incision in abdominal wall
refers to abnormal descent or herniation of pelvic organs
Pelvic organ prolapse
when rectum sags and pushes against or into posterior vaginal wall
rectocele
small intestine bulges through posterior vaginal wall
enterocele
posterior bladder wall protrudes downward through anterior vaginal wall
cystocele
uterus descends through pelvic floor and into vaginal wall
uterine prolapse
Symptoms of prolapse
feeling of dragging lump in vagina something coming down
synthetic dévide inserted in vagina for support and bladder
pessaries
Management of prolapse
kegel, diet, pessaries, surgery
what fixes cystocele and rectocele
colporrhapy
what fixes uterine prolapse
vaginal hysterectomy
involuntary loss of urine that represents a hygienic or social problem
urinary incontinence
what are common causes of UI
urge, stress and mixed
what is urge UI
detrusor or muscle contractions
stress UI
inadequate sphincter
with UI asses what
onset frequency severity .. nuero rectal exam uranaylsis culture
Management for Urge UI
bladder training, legal, pessary, anticholengerics, surgery
management for stress UI
weight loss, smoking cessation, avoid constipation, Kegel , pessaries, vaginal cones, dulxetine, estrogen
small usually benign growth frequently caused by infection
polyp
where is most common spot for polyp
cervix and uterus
Management of polyps
remvoal via forceps, hysterectomy, laser vaporatzation
what color are endocervical polups
cherry red
what color are cervical polyps
grayish white
symptoms of polyps
abnormal vaginal bleeding or discharge
how do you diagnosis polyps
when visualized through speculum
benign tumors composed of smooth muscle and fibrous connective tissue in uterus
Fibroids
classifications of fibroids
suberosal; underneath perotineal layer
intramural; within wall uterus
surgical treatments for fibroids
myomectomy; fibroid removed
laser surgery; destroying small fibroids
hysterectomy; removal of uterus
abnormal opening between GU tract and another organ such as urinary or GI tract
Genetial Fistula
vesisovaginal
bladder to GI
urethrovaginal
urethra to vagina
rectovaginal
rectum to vagina
swollen guild filled sac like structure that results when 1 of the ducts become blocked
Bartholins cyst
how do you diagnosis bartholins cyst
when mass is located
Fluid filled sac that forms on the ovary
ovarian cyst
types of ovarian cysts
follicular; failure of the ovarian folic to rupture at ovulation
corpus letum; when corpus letup becomes cystic or hemorragic fails to degenerate
theca lutein; increased HCG
involves the presence of multiple inactive follicle cysts within the ovary that interfere with ovarian function
polycystic ovary syndrome
signs and symptoms of POS
hirsutism,alpoceia, infertility , ovesity, insulin restiatnt, cancer risks
typically not diagnosed . no adequate screening test
ovarian cancer
symptoms of ovarian cancer
bloating, fatigue, vague abdominal pain, urinary frequency, constipation, diarrhea,
symptoms of endometrial cancer
unexpected bleeding after menopause. change in size and shape of uterus
changes in cellular lining at squamous columnar junction
cervical cancer
procedure used to obtain cells from the cervix for cytology screening
PAP test… cervical cancer
symptom of cervical cancer
abnormal vaginal bleeding after sexual intercourse
signs of vaginal cancer
painless vaginal bleeding, abnormal discharge, dysuria, constipation
abnormal growth on external female genetial
vulvar cancer
symptoms of vulvar cancer
persistant itching, burning, edema, raised fleshy lesion
management of vulvar cancer
no tight garments, examine self, condoms, no smoking
painless sores. only one that crosses placenta .. treat with penicillin
syphilis
treat with doxycoline
chlymadia
itching. vaginal dishrage
trichomoniasis
if live HPV outbreak at delivery
infant can get
most common bacterial STI
chylamydia
neonatal conjuctivitis
gonorhea and chylamdia
reccurnt lifelong viral infectin
herpes
treat with penicillin
syphilis
inflammatory state of upper female GU tract involves uterine lining tubes
PID pelvic inflammatory disorder
symptoms of PID
lower stomach tenderness, adnexal tenderness
most common viral infection
HPV
