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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
Q

Females causes of infertility

A

age, weight, medical, surgical, gynecological, sexual Hx, occupational and environmental exposure

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26
Q

Male causes for infertility

A

mumps during adolescence, SUD, exposure to teratogenic material

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27
Q

how is infertility determined

lab test ect.

A

semen analysis, pelvic exam, hormone analysis, endometrial biopsy, postcoital test (see interactions of sperm and cervical mucus, US

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28
Q

Nursing interventions for infertility

A

encouragement, explain role of specialist, monitor for S/E of infertility meds, provide info, make referrals for grief and infertility support groups

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29
Q

When and what is lactogenosis I

A

16-18 weeks (2nd trimester), preparing for milk production, produces prepartum milk or colostrum

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30
Q

When and what is Lactogenosis II

A

after delivery (4th trimester), 3-5 days after birth, nicknamed the “transitioning” period from colostrum to mature milk

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31
Q

lactogenosis III

A

10 Days after Lactogenesis II, mature milk is established

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32
Q

Describe colostrum

A

thin clear to yellow, produced from time of birth until mature milk comes in

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33
Q

describe engorgement

A

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

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34
Q

What happens 72-96 hrs after birth

A

mature milks comes in (lactogenosis II) breast become full

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35
Q

When will nonbreastfeeding mothers “Dry Up”

A

1-2 weeks if breast are not stimulated. they still exp engorgement but resolves 3 days after delivery

36
Q

The AAP and WHO both recommend breastfeeding EXCLUSIVLY until what age

A

6 months, after this you can introduce purees and breast feed up to 1 year (AAP) or 2 years (WHO)

37
Q

What does breastfeeding decrease the risk of for the newborn

A

GI infection (NEC), celiac disease, crohns, asthma, otitis media, obesity, SID, DM, constipation, acute lymphocytic and myeloid leukemia, infection

38
Q

breastfeeding benefits for the mother

A

decreased PP bleeding, more rapid involution of uterus, decreased risk for : ovarian/breast cancer, DM, HTN, HLD, CVD, RA, Osteoporisis

39
Q

other benefits to breastfeeding

think more holistic aspects of care

A

less expensive, convent, reduces annual health care cost, environmentally friendly, specifically for infant, easily digested, promotes bonding

40
Q

steps to breast feeding

A

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
Q

contraindication to breastfeeding

A

HIV, HSV (active lesion on breast), active varicella, zoster on breast, lead >40mcg/dl
HEPATITIS IS NOT A CONTRAINDICATION

42
Q

Tip for moms in regard to breastfeeding

A

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
Q

is nipple soreness considered normal?

A

NO, but possible first few days

44
Q

what can cause nipple soreness

A

poor positioning/latching

45
Q

treatment for nipple soreness or breakdown

A

creams (organic, lanolin wool allergy)
breast shells,
proper fitting bra
Ice
breast shield temp
lube nip with milk

46
Q

S/S for mastitis

A

erythema, fever, warmth, painful/tender breast, flu like symptoms

47
Q

Tx for ,mastitis

A

Abx, pumping and breastfeeding, massage, Ice or heat, cabbage

48
Q

how often should the mother pump If away from the baby

A

q3hr to keep stimulating to breast for 15 minute. add 5 minute for every newborn

49
Q

how often should breastfeeding or feeding happen

A

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
Q

How much extra calories should the mom consume when breastfeeding

A

450-500 and hydrate

51
Q

how long is breast milk good for at room temp, cooler, refrigerator, freezer, and deep freezer

A

room temp- 5-6 hrs
cooler- 24hr
refrigerator- 5-8 days
freezer- 6 month
deep freeze- 12 month

52
Q

how many diapers should the baby have after DC

A

5-6 wet diapers

53
Q

average loss of blood during mental cycle

A

20-80 ml

54
Q

phases of mentration

A

proliferative phase- endometrium thickens
secondary phase- endometrium prepares for implantation
menstrual phase- if no implantation occurs, endometrium is excreted

55
Q

What is amenorrhea

A

absence of menses during reproductive tears

56
Q

what is primary amenorrhea

A

absence of menses by 16.5 without normal secondary sexual characteristics
absense of both menarche and sexual characteristics

57
Q

causes for amenorrhea

A

pregnancy, hormones, breastfeeding, BMI (eating disorders, poor nutrition), endocrine disorders, stress from major life events, athletes, PCOS, medication

58
Q

what is secondary amenorrhea

A

absence of menses for 3 cycles or 6 months in women who previously had normal menses

59
Q

nursing considerations for amenorrhea

A

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
Q

lab test for amenorrhea

A

US, CT, pregnancy test, hormone, laparoscopy

61
Q

treatment of amenorrhea

A

underlying cause, HRT, sugary, cyclic progesterone, GnRH(hypothalamic failure), Thyroid RH

62
Q

What is primary dysmenorrhea

A

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
Q

what is secondary dysmenorrhea

A

painful menstration from pelvic or uterine pathology

64
Q

what are some causes of dysmenorrhea

A

endometriosis, adenomiosis, fibroids, pelvic inflammation, IUD, cervical stenosis, vag or uterine abnoramilities

65
Q

manifestation of dysmenorrhea

A

sharp intermittent spasm in suprapubic area
pain radiates to back of eg or lower back
N/V/D
fatigue
fever
HA/dizzy

66
Q

assessment for primary and secondary dysmenorrhea

A

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
Q

assessment that is done for both dysmenorrhea

A

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
Q

treatment for dysmenorrhea

A

NSAIDs, hormonal contraceptive, life style change, daily exercise, weight loss, smoking cessation, relaxation technique

69
Q

hypomenorrhea

A

scanty menses

70
Q

oligomenorrhea

A

infrequent menses, more than 35 days apart

71
Q

menorrhagia

A

excessive menses

72
Q

metrorrhagia

A

bleeding between periods

73
Q

menometorrhagia

A

heavy bleeding during and between mental period

74
Q

etiology of irregular uterine bleeding

A

pregnancy, hormones, fibroid, endometrial polyps or cancer, morbid obesity, steroid therapy, hypothyroidism

75
Q

assessment for abnormal uterine bleeding

A

Hx, pelvic exam, CBC, pt, BHCG, TSH, transvaginal/pelvic US, endometrial biopsy, D&C

76
Q

treatment for abnormal uterine bleeding

A

oral contraceptive, NSAIDs, iron replacement, D&C, endometrial ablation, hysterectomy

77
Q

What is PMS or premenstrual syndrome

A

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
Q

What is PMDD premenstrual dysphoric disorder

A

(psychiatric) when symptoms are so bad that they interfere with ADLs

79
Q

assessment of PMDD

A

symptoms clusters that last 3 months. compete Hx and physical to eliminate other factors, thyroid hormone

80
Q

treatment for PMDD

A

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
Q

What is perimenopause

A

when ovarian function deminishes (4-5 yrs), stops after menopause, mid 40s through early 50s, decreased estrogen,

82
Q

what is menopause

A

permanent cessation of menses, ovarian function
defines as no menses for 1 year
happens between ages 45-55

83
Q

health issues associated with perimenopause and menopause

A

vasomotor symptoms (hot flash, vag dry, bad sleep), increased loss of bone and osteoporosis, increase risk for CVD, GU symptoms (UTI)

84
Q

management of menopauses

A

HRT, botanical replacement, activity, lube, hydration

85
Q

Osteoporosis s/s and treatment

A

loss of height, back pain, dowager hump

Dx- H&P, dexa, bone density

tx- med, Ca++ w/ Vit D, excersize

86
Q
A

4040 maternal child (6 decks)

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