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4040 maternal child > mod 3 maternal > Flashcards

mod 3 maternal Flashcards

1
Q

sources of pain assoicaited with birth

A

tissue ischemia, cervical dilation, pressure/pulling on pelvic structures, distention of vagina and perineum

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2
Q

What factors affect tolerance and perceptions of pain

A

labor intensity, cervical readiness, fetal position, pelvic readiness, fatigue/hunger, caregiver interventions

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3
Q

Where in the spine does pain stimulus from the cervical dilation enter the spine

A

t10,11,12,L1

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4
Q

where does pain stimuli enter the spinal cord when It stems from the vagina and perineum

A

prudential nerve, S2/3/4

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5
Q

psychosocial factors of childbirth

A

culture, anxiety/fear, previous experiences, preparation, support system

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6
Q

What effects of medication do we monitor during labor

A

effect on fetus, maternal physiological alteration, complications, interactions

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7
Q

parenteral analgesics

opiods

A

demerol
stadol
nalbuphine

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8
Q

adverse effects of epidural

A

hypotensive, bladder distention, prolong labor, Cath migration, maternal fever, pruritus, Repritory depression, metallic taste

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9
Q

before choosing a birth control what should you consider

A

pt overall health, height, history
sex frequency
number of partners
want children?

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10
Q

withdrawl (coitus interruptus) pro and con

A

pro- free 99
con- can’t help myself, no STI protection

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11
Q

fertility awareness or cycle/ovulation tracking pros and cons

A

tracking basal body temp, cervical mucus, calendar method, abstinence
pro-free 99
cons- limits spontaneous sexy time :( 25% get pregnant still, can be hard if you have irregular cycles

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12
Q

Pro and con for use of diaphragm

A

16% get pregnant still
pro- inexpensive (lasts 2 yr)
con- needs to be fitted, no std protections, can’t be used on period, may cause irritation

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13
Q

pro and con of spermicide

A

can come in foam, jell, cream or film

pro- cheap and easy
con- can increase risk of STD due to skin irritation, 28-29% still get pregnant

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14
Q

cervical cap pro and con

A

pro- can stay in place for 48hr
con-must be fitted by doc, can’t be used during period

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15
Q

pro and con to female condom

A

pro- protections against sTI, conducts heat better then male condom
con- noisy?, 21% get pregnancy, cannot be used with Male condom

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16
Q

what Is something important to know as a health care provider when dealing with an Orth Evra Patch

A

HIGH RISK FOR DVT even over oral
change q7day s

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17
Q

success rate and potential risk associated with NUVA ring

A

99% effectice, 9% failure
risks- HTN, stroke, MI, Thrombosis

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18
Q

Depo is more elective in preventing pregnancy then the pill what are some pros and cons

A

pro- four times per year, highly effective
cons- cost is high, may cause spotting or other S/E, no protection against STD, increased risk of osteoporosis and mental irregularities

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19
Q

inplanon/nexplanon lasts up to 3 years after being implanted in the the upper arm. What are some pro and cons to discuss with the client

A

pro- last 3 years, highly effective
con- very expensive 400-800, may cause S/E, irregular bleeding, not STD protection

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20
Q

IUD pro and con

A

pro- long-lasting low maintaince
cons- irregular/heavy periods, more expensive, may cause S/E like uterine perforation, ectopic pregnancy and PID
check placement monthly

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21
Q

Transcervical sterilization is when an implant is placed into the Fallopian tubes that causes scare tissue to form around it to block it off. What are the pros and cons to this procedure

A

Pro- permanent, 100% effective
Con- takes months to become effective, may risk Pelvic infections, reversible, expensive, increased risk for ectopic pregnancy

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22
Q

list the contraptions choices from most to least effective

A

Implant, IUD, vasectomy, tubal methods- 99%
Birth control shot- 97%
Pill, Vag ring- 92-95%
condom, diaphragm, cervical cap, sponge - 84-89%

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23
Q

True or False? breastfeeding can inhibit ovulation

A

TRUE

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24
Q

Infertility is defines as unable to conceive. despite unprotected sex for 12 months. what are some common factors for this

A

alteration in sperm production
endometriosis
ovulation disorder
tubal occlusion

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25
Females causes of infertility
age, weight, medical, surgical, gynecological, sexual Hx, occupational and environmental exposure
26
Male causes for infertility
mumps during adolescence, SUD, exposure to teratogenic material
27
how is infertility determined | lab test ect.
semen analysis, pelvic exam, hormone analysis, endometrial biopsy, postcoital test (see interactions of sperm and cervical mucus, US
28
Nursing interventions for infertility
encouragement, explain role of specialist, monitor for S/E of infertility meds, provide info, make referrals for grief and infertility support groups
29
When and what is lactogenosis I
16-18 weeks (2nd trimester), preparing for milk production, produces prepartum milk or colostrum
30
When and what is Lactogenosis II
after delivery (4th trimester), 3-5 days after birth, nicknamed the "transitioning" period from colostrum to mature milk
31
lactogenosis III
10 Days after Lactogenesis II, mature milk is established
32
Describe colostrum
thin clear to yellow, produced from time of birth until mature milk comes in
33
describe engorgement
happens 24-48 hours after birth, happens because of an increase in blood and lymphatic fluid as milk production increases, the breast will be hard and tender, uncomfortable possible fever. May make it harder for baby to latch because the nipple can invert
34
What happens 72-96 hrs after birth
mature milks comes in (lactogenosis II) breast become full
35
When will nonbreastfeeding mothers "Dry Up"
1-2 weeks if breast are not stimulated. they still exp engorgement but resolves 3 days after delivery
36
The AAP and WHO both recommend breastfeeding EXCLUSIVLY until what age
6 months, after this you can introduce purees and breast feed up to 1 year (AAP) or 2 years (WHO)
37
What does breastfeeding decrease the risk of for the newborn
GI infection (NEC), celiac disease, crohns, asthma, otitis media, obesity, SID, DM, constipation, acute lymphocytic and myeloid leukemia, infection
38
breastfeeding benefits for the mother
decreased PP bleeding, more rapid involution of uterus, decreased risk for : ovarian/breast cancer, DM, HTN, HLD, CVD, RA, Osteoporisis
39
other benefits to breastfeeding | think more holistic aspects of care
less expensive, convent, reduces annual health care cost, environmentally friendly, specifically for infant, easily digested, promotes bonding
40
steps to breast feeding
place infant tummy to tummy nose to nip sad which breast to express milk or colostrum touch that to the infant's lips make sure the nose is not covered
41
contraindication to breastfeeding
HIV, HSV (active lesion on breast), active varicella, zoster on breast, lead >40mcg/dl HEPATITIS IS NOT A CONTRAINDICATION
42
Tip for moms in regard to breastfeeding
delay offering pacifier until breastfeeding is well established, use warm compress to engorge breast, room in with infant to promote breast feeding, stimulate breast q3hrs,
43
is nipple soreness considered normal?
NO, but possible first few days
44
what can cause nipple soreness
poor positioning/latching
45
treatment for nipple soreness or breakdown
creams (organic, lanolin *wool allergy*) breast shells, proper fitting bra Ice breast shield temp lube nip with milk
46
S/S for mastitis
erythema, fever, warmth, painful/tender breast, flu like symptoms
47
Tx for ,mastitis
Abx, pumping and breastfeeding, massage, Ice or heat, cabbage
48
how often should the mother pump If away from the baby
q3hr to keep stimulating to breast for 15 minute. add 5 minute for every newborn
49
how often should breastfeeding or feeding happen
the baby should be woken up every 2-3 hrs until back to birth weight. after that no more than 6 hours should pass between each feed
50
How much extra calories should the mom consume when breastfeeding
450-500 and hydrate
51
how long is breast milk good for at room temp, cooler, refrigerator, freezer, and deep freezer
room temp- 5-6 hrs cooler- 24hr refrigerator- 5-8 days freezer- 6 month deep freeze- 12 month
52
how many diapers should the baby have after DC
5-6 wet diapers
53
average loss of blood during mental cycle
20-80 ml
54
phases of mentration
proliferative phase- endometrium thickens secondary phase- endometrium prepares for implantation menstrual phase- if no implantation occurs, endometrium is excreted
55
What is amenorrhea
absence of menses during reproductive tears
56
what is primary amenorrhea
absence of menses by 16.5 without normal secondary sexual characteristics absense of both menarche and sexual characteristics
57
causes for amenorrhea
pregnancy, hormones, breastfeeding, BMI (eating disorders, poor nutrition), endocrine disorders, stress from major life events, athletes, PCOS, medication
58
what is secondary amenorrhea
absence of menses for 3 cycles or 6 months in women who previously had normal menses
59
nursing considerations for amenorrhea
nutritional status, weight, height, V/S, androgen levels (acne, face hair), delayed puberty (no face hair or axillary hair), educate over possible infertility, nutritional counseling, emphasize healthy lifestyle
60
lab test for amenorrhea
US, CT, pregnancy test, hormone, laparoscopy
61
treatment of amenorrhea
underlying cause, HRT, sugary, cyclic progesterone, GnRH(hypothalamic failure), Thyroid RH
62
What is primary dysmenorrhea
painful menses/pelvic pain, from increase prostaglandin production (cramping) by endometrium which causes contraction of uterus. Highest level of pain are experience for first 2 days
63
what is secondary dysmenorrhea
painful menstration from pelvic or uterine pathology
64
what are some causes of dysmenorrhea
endometriosis, adenomiosis, fibroids, pelvic inflammation, IUD, cervical stenosis, vag or uterine abnoramilities
65
manifestation of dysmenorrhea
sharp intermittent spasm in suprapubic area pain radiates to back of eg or lower back N/V/D fatigue fever HA/dizzy
66
assessment for primary and secondary dysmenorrhea
primary- cramping pain with menstration and physical exam is normal secondary- Hx shows cramping pain starting after 25 year old with pelic abnormality, hx of infertility, heavy mental flow, irregular cycle, little to no response to NSAIDs
67
assessment that is done for both dysmenorrhea
sexual hx, assess for inflammation and scarring bimanual pelvic exam in non mental phase of cycle, CBC, UA, pregnancy test, cervical culture, ESR, pelvic/vag US, laparoscopy
68
treatment for dysmenorrhea
NSAIDs, hormonal contraceptive, life style change, daily exercise, weight loss, smoking cessation, relaxation technique
69
hypomenorrhea
scanty menses
70
oligomenorrhea
infrequent menses, more than 35 days apart
71
menorrhagia
excessive menses
72
metrorrhagia
bleeding between periods
73
menometorrhagia
heavy bleeding during and between mental period
74
etiology of irregular uterine bleeding
pregnancy, hormones, fibroid, endometrial polyps or cancer, morbid obesity, steroid therapy, hypothyroidism
75
assessment for abnormal uterine bleeding
Hx, pelvic exam, CBC, pt, BHCG, TSH, transvaginal/pelvic US, endometrial biopsy, D&C
76
treatment for abnormal uterine bleeding
oral contraceptive, NSAIDs, iron replacement, D&C, endometrial ablation, hysterectomy
77
What is PMS or premenstrual syndrome
painful swollen breast, bloating/abd pain, HA, backache, depression, anxiety, irritability, behavioral changes before menses start and is it relieved when menses begin (less common teen and 20s more so in late 20 early 30)
78
What is PMDD premenstrual dysphoric disorder
(psychiatric) when symptoms are so bad that they interfere with ADLs
79
assessment of PMDD
symptoms clusters that last 3 months. compete Hx and physical to eliminate other factors, thyroid hormone
80
treatment for PMDD
lifestyle change (exercise 3-5x) reduce stress avoid caffeine a diet with high carb and water limit alcohol smoking cessation multivitamin, vitamin E, Ca++, Mg+ NSAIDs, oral contraceptive, diuretics
81
What is perimenopause
when ovarian function deminishes (4-5 yrs), stops after menopause, mid 40s through early 50s, decreased estrogen,
82
what is menopause
permanent cessation of menses, ovarian function defines as no menses for 1 year happens between ages 45-55
83
health issues associated with perimenopause and menopause
vasomotor symptoms (hot flash, vag dry, bad sleep), increased loss of bone and osteoporosis, increase risk for CVD, GU symptoms (UTI)
84
management of menopauses
HRT, botanical replacement, activity, lube, hydration
85
Osteoporosis s/s and treatment
loss of height, back pain, dowager hump Dx- H&P, dexa, bone density tx- med, Ca++ w/ Vit D, excersize
86

4040 maternal child (6 decks)

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