OB/WOMENS HEALTH Flashcards
A client at 32 weeks gestation goes into cardiac arrest. What is the nurse’s best action while performing CPR for this client?
Perform chest compressions slightly higher on the sternum.
- During pregnancy, the heart is displaced toward the left because the growing uterus pushes upward on the diaphragm, particularly in the third trimester.
- The uterus should also be manually displaced
Preterm birth is defined as ______.
Birth before 37 weeks and 0 days gestation.
What is strongly associated with preterm labor, particularly when untreated?
INFECTION: Periodontal disease, UTIs
Other risk factors of preterm birth include:
- Hx of spontaneous preterm birth in a previous pregnancy
- Previous cervical surgery
- Tobacco/drug use
- <17yo
- > 35 yo
First signs of uterine rupture:
- Abnormal fetal heart rate and patterns
- Constant abdominal pain
- Loss of fetal station
- Sudden cessation of uterine contractions
Nonshivering thermogenesis:
Neonates are unable to generate heat by shivering due to their lack of muscle tissue and immature nervous systems; they produce heat by increasing their metabolic rates through NST.
Brown adipose tissue:
Developed in the third trimester; metabolized for thermogenesis when available
-Once BAT is depleted, NST is less effective and the neonate may experience cold stress, possibly leading to death
Clinical manifestations of cold stress:
- Neuro = AMS (irritability or lethargy)
- Cardiovascular = bradycardia
- Respiratory = tachypnea early, followed by apnea and hypoxia
- GI = high gastric residuals, emesis, hypoglycemia
- Musculoskeletal = hypotonia, weak suck and cry
* Frequent temp monitoring is the best method to assess if an infant is cold
FTT RF:
- Poverty
- Social or emotional isolation
- Cognitive disability or mental health disorder
- Lack of nutrition education
Systemic disease characterized by HTN and proteinuria after the 20th gestational week with unknown etiology
Pre-eclampsia
Eclampsia:
The onset of convulsions or seizures that cannot be attributed to other causes in a women with preeclampsia
What is the only cure for preeclampsia-eclampsia syndrome?
Delivery
Central nervous system depressant used to prevent/control seizure activity in preeclampsia/eclampsia clients:
Mag sulfate
Signs of mag toxicity:
- Decreased deep-tendon reflexes
- Respiratory depression
- Decreased urine output
Therapeutic mag level =
4-7
Ectopic pregnancy:
Occurs when a fertilized egg implants and begins to grow outside the uterine cavity, frequently in the fallopian tubes. If untreated, continued growth can lead to fallopian tube rupture, resulting in hemorrhage
*Shoulder pain in a client with ectopic pregnancy indicated intra-abdominal bleeding from a rupture
Risk factors for pelvic inflammatory disease:
- Multiple sexual partners
- History of chlamydia or gonorrhea
- History of PID
- Partner with STI
- Lack of consistent barrier contraception use
- Age 15-25
Placenta accreta:
Condition of abnormal placental adherence in which the placenta implants directly in the myometrium rather than the endometrium.
Major complication of placenta accreta:
- Life threatening hemorrhage which occurs during attempted placental separation
- 2 large bore IVs and a blood type and crossmatch are priority in case of blood transfusion
The nurse should use sterile gloves during a vaginal exam in the presence of ruptured membranes. T/F
TRUE to prevent infection
What is a nitrazine pH test?
Inserted into the vagina to differentiate between amniotic fluid and vaginal fluid.
Blue color= indicates positive result and probable rupture of membranes
Yellow = negative result and membranes are intact
Asymptomatic hypoglycemia:
Newborns with BG <35mg/dL; if younger than 4 hours should be treated with feeding
Ideal BG for a newborn:
Greater than or equal to 40-45
-BG lower than 40-45 should be confirmed with a plasma blood sample, but the newborn should feed without waiting
Dietary sources of folic acid:
Preggo women need 400 mcg of folic acid per day
- Asparagus
- Turnip.mustard greens
- Fortified breakfast cereal
- Cooked dried beans
- Liver
- Broccoli
- Spinach
- Green peas
- Fresh-cooked beets
- Pasta
- RIce
- PB
Vaginal hematoma:
Formed when trauma of the tissues of the perineum occurs during delivery
-Client will report severe vaginal pain or a feeling of fullness
Inversion of the uterus:
Presents with a large, red mass protruding from the introitus
Uterine atony:
Boggy uterus on palpation and an increase in vaginal bleeding
Postpartum hemorrhage:
If excessive bleeding occurs after initial interventions, second line uterotonic drugs may be given: carboprost, methylergonovine (cx. in clients w/ high BP), misoprostol
Breast engorgement:
Ice packs, cold cabbage leaves, wear a supportive bra, ibuprofen
Infertility:
Diagnosed when a couple fails to conceive after 12 months (women age <35); or 6 months for women who are older than 35
