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Maternal Child Nursing > Midterm Exam (Ch.17, 18, 19, 21, 22, 25, 31, 32, 33, 34, 35, 36, 37, 40) > Flashcards

Midterm Exam (Ch.17, 18, 19, 21, 22, 25, 31, 32, 33, 34, 35, 36, 37, 40) Flashcards

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1
Q

Lochia Rubra

A

bright red & consists of blood; lasts 3-4 days

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2
Q

Lochia Serosa

A

pink/brown; lasts 10-14 days

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3
Q

Lochia Alba

A

yellow to white; continues 4-8 weeks after birth

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4
Q

When should you report to the healthcare provider if sloughing of eschar over placental site does not subside?

A

1-2 hours

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5
Q

What is one indication of lochia serosa?

A

con’t flow of lochia serosa after 3-4 weeks

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6
Q

In nonlactating women, when do estrogen levels increase?

A

within 2 weeks

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7
Q

After birth when is hCG detectable?

A

3-4 weeks after birth

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8
Q

Fluid loss PP

A

postpartal diuresis is caused by decreased estrogen

  • profuse diaphoresis occurs
  • w/in 12 hours women begin to diurese
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9
Q

Blood Volume PP

A
  • blood loss is tolerated due to pregnancy-induced hypervolemia
  • by 3rd PP day, plasma volume replenished
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10
Q

Cardiac Output

A

increased in PP by 60-80%

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11
Q

Vital Signs

A
  • increased BP >140/90 when measured at least twice indicates preeclampsia
  • temp. increase to 100.4 in 1st 10 days indicates infection
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12
Q

What kind of bradycardia is common PP?

A

Puerperal

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13
Q

Cardiac Output affects the blood components

A
  • Hct & Hbg return to normal
  • coagulation factors return to normal
  • varicosities regress rapidly/totally
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14
Q

PP period

A

interval between birth & return of reproductive organs to normal

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15
Q

Uterus Involution

A

The process is return of uterus to nonpregnant state

  • timeframe of 6 weeks
  • fundus descends 1-2 cm/24 hrs
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16
Q

Subinvolution

A

Failure of the uterus to return to normal

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17
Q

Lochia

A

Postbirth uterine discharge

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18
Q

Placental hormones- metabolic changes

A

decrease in chorionic somatomammotropin, estrogens, placental enzyme insulinase

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19
Q

When does ovulation return in nonlactating women?

A

As early as 27 days after birth; pituitary hormones are responsible for this

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20
Q

3 Crucial Points for OB nurses

A
  • understand normal birth
  • prevent & detect deviations
  • Implement nursing measures
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21
Q

What are the main interventions for labor & birth?

A
  • suppression of uterine activity
  • promotion of fetal lung maturity
  • fetal & early natal loss
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22
Q

How are spontaneous labors predicted?

A

Risk factors; Cervical Length; Fetal Fibronectin test

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23
Q

PROM

A

Premature Rupture of Membranes
-rupture of the amniotic sac
Labor will be AUGMENTED

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24
Q

PPROM

A 
Preterm premature rupture of membranes
-pathologic weakening of membranes
-membranes rupture before 37 weeks
Managed conservatively
Usually hospitalized
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25
Q

What is a MAJOR risk factor for PPROM/PROM?

A

INFECTION

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26
Q

Chorioaminonitis

A

bacterial infection of the uterine cavity
-cause of complications
Maternal fever and fetal tachycardia are two key findings; foul odor of fluid

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27
Q

How many weeks are considered to be post-term?

A

> 42 weeks

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28
Q

What is the purpose of Oxytocin?

A

a cervical ripening method that is used to induce or augment labor
-hormone that is normally produced
Stimulates uterine contractions
High alert med

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29
Q

Risk Factors for Spontaneous Preterm Labor

A
  • african-american race
  • hx of a previous spontaneous preterm birth
  • underweight or obese
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30
Q

What is the priority intervention after assessing heart rate?

A

Monitor Fetal Heart Rate

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31
Q

Couplet

A

Mother/baby model of care

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32
Q

Diuresis

A

Begins about 12 hours after birth

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33
Q

Blood loss after birth is assessed, what is considered normal?

A
  • 500 mL of blood for vaginal delivery

- 1000mL of blood for c-section

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34
Q

What is the proper way to palpate the uterus?

A

Upper hand cupped over fundus

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35
Q

Hypovolemic Shock

A 
this is considered to be an emergency treatment situation
S&S
-persistent bleeding occurs
-woman feels weak
-woman appears anxious
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36
Q

Interventions for Hypovolemic Shock

A
  • give oxygen by nonrebreather face mask
  • tilt woman onto her side
  • provide additional/maintain IV
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37
Q

After birth, when must hospital personnel be present?

A

the first time woman get up

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38
Q

When is the risk for hemorrhage PP minimal?

A

By 2 weeks postpartum

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39
Q

In regards to post-anesthesia recovery when is the woman discharged?

A

When she has recovered from the anesthetic

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40
Q

What are some priorities of discharge for the mother?

A
  • How is she bonding with baby?
  • recovery from c-section
  • encourage bonding with baby
  • address financial concerns
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41
Q

What is the correct process or description of pelvic floor exercises?

A

“I pretend that I am trying to stop the flow of urine midstream.”

42
Q

Newborns’ and Mothers’ Health Protection Act of 1996

A

Allows for a minimum of 48 hours stay after a vaginal birth and 96 hours after c-section

43
Q

What is the leading cause of morbidity in postpartum?

A

postpartum hemorrhage

44
Q

uterine atony

A

marked hypotonia of uterus

45
Q

inversion of uterus

A

turning inside out

46
Q

hemorrhagic shock

A

this is a hypovelmic emergency

  • restore circulating blood volume
  • recognize early S&S, summon for help, continuous monitoring of status
47
Q

Idiopathic/immune thrombocytopenic purpura

A

autoimmune disorder of antiplatelet antibodies

48
Q

Von Willebrand Disease

A

type of hemophilia

49
Q

Postpartum infection

A

occurs within the genital tract after miscarriage

50
Q

Endometritis

A

infection of uterus lining

51
Q

postpartum depression

A

the prevalence varies based on definitions

-likely to occur with PPD

52
Q

postpartum psychosis

A

pp depression with psychotic features

53
Q

When monitoring for postpartum depression…

A

Watch for agitation, overreactions, complaints/suspcious; suicidal/homicidal ideations are symptoms of PPD
Tx for PP Depression
-screening for PP depression
-use of psychotropic meds & lactation

54
Q

in bipolar disorder, severe anxiety is common, what medications are used to treat this?

A

-olanzapine
-quetiapine
used as mood stabilizers

55
Q

preterm labor

A

diagnosed as regular contractions

56
Q

preterm birth

A

b/w 20 weeks and 36 weeks 6/7 days

57
Q

intrauterine growth restriction

A

inadequate fetal growth

58
Q

Fetal Fibronectin

A

diagnostic test for preterm labor

59
Q

tocolytics

A

given to arrest labor

60
Q

antenatal glucocorticoids

A

accelerates fetal lung maturity

61
Q

dystocia

A

lack of progress in labor

62
Q

dysfunctional labor

A

long, difficult/abnormal

63
Q

precipitous labor

A

lasts <3 hours

64
Q

cephalopelvic disproportion

A

AKA fetopelvic disproportion

65
Q

After Birth Hemorrhage

A

Risk Factors

  • 2 biggest are uterine atony & retained placenta/fragments
  • lacerations of the genital tract
  • inversion of uterus
66
Q

Assessment of Hemorrhage

A
  • uterine massage, uterotonics: oxytocin, methergine, expression of clots
  • frequently assess & monitor, brief explanations of interventions, comfort measures
  • uterine tamponade, uterine artery ligation, hysterectomy
67
Q

Integumentary System- physiologic adjustments

A

the skin is red for a few hours after birth; edema or bruising may be present; single palmar crease in some babies

68
Q

Extrusion Glabellar

A

newborn forces tongue outward

69
Q

tonic or neck “fencing”

A

If the infant faces one side the opposite arm and leg flex

70
Q

Stepping or Walking

A

When held vertically, infant will stimulate walking

71
Q

Babinski

A

All toes hyperextend

72
Q

Pull-to-sit

A

head lags until infant is in upright position

73
Q

Truncal incurvation

A

trunk is flexed

74
Q

Additional NB reflexes

A

yawning, stretches, burps

75
Q

caput succedaneum

A

edema of the scalp

76
Q

cephalhematoma

A

collection of blood between skull bone and its periosteum

77
Q

subgaleal hemorrhage

A

bleeding into subgaleal compartment

78
Q

Infant expected weight gain

A
  • 5-7 ounces weekly for first 6 months
  • 3-5 ounces for next 6 months
  • birth weight triples at 12 months
79
Q

Stranger fear develops

A

6 to 8 months

80
Q

Age infant rolls over

A

happens accidentally as a newborn and purposefully at 6 months

81
Q

Age infant grasps objects

A

2 to 3 months

82
Q

Age infant stands

A

by 1 year

83
Q

Age to sit

A

about 4 months

84
Q

Colic

A 
*crying and fussing
Risk Factors
-infant's diet
-smoking in the house
-imbalance of microflora 
Tx
-sometimes sedatives, antiflatulents, antispasmodic are used
-detailed hx of mother's diet, characteristics of cry, infant's diet
-milk-free diet for mom
85
Q

Sudden Infant Death Syndrome

A 
the sudden death of an infant
risk factors
-co-sleeping
-maternal smoking during pregnancy
-smoke in environment
86
Q

Preoperational phase of toddler

A

Piaget
involves sensorimotor skills starting with reflexes, cognition develops rapidly b/w 1 and 2 years of age and ends at age 4 years

87
Q

Tertiary Circular Reactions

A

active experimentation, applying knowledge to new situations, learning spatial relationships

88
Q

What is the final stage of sensorimotor development?

A

*Invention of new means
Ages 19-24 months
Poor Concept of Time
Imitation for behaviors

89
Q

Preoperational Phase

A

Piaget

  • begins about age 2 years
  • lasts until age 4
  • Does not yet think in operational patterns
90
Q

Language in Toddlers

A

at 1 year, one-word sentences are used with 25% vocalizations; by age 2 child uses multi-word sentences with 65% of language intelligible

91
Q

When is a toddler ready to toilet train?

A 
Age 18-24 months the child will
T- two or more hours with dry diaper
O-On and off
I-Interested in potty
L-likes sitting on the toilet
E-Experiencing regular BM
T- Tells you they have to go
92
Q

A characteristic of a toddler’s language development at 18 months is

A

Increasing level of comprehension

93
Q

What is the preschool period?

A

Ages 3-5 years

  • prepares child for school
  • increased attention span
  • Cooperative interaction with other children
94
Q

Initiative vs Guilt

A

Preschool age

  • development of super ego
  • feelings of guilt, anxiety, fear
  • learning right from wrong
95
Q

Trust vs. Mistrust

A

Infants trust comfort needs will be met

96
Q

Autonomy vs. Shame and Doubt

A

Id, Ego, superego

97
Q

Industry vs. Inferiority

A

Peer approval is a strong motivator

  • eagerness to develop skills
  • growing sense of independence
98
Q

Identity vs. Confusion

A

Teens work at the sense of self

99
Q

Intimacy vs. Isolation

A

Young adults struggle to form close relationships

100
Q

Generativity vs. Stagnation

A

Middle-aged feel a sense of contributing to the world to give back

Maternal Child Nursing (2 decks)

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