Obstetrics Test Flashcards
Immediately following delivery of the baby, the new mother’s breasts produce _________________, a thin yellowish fluid that contains extra calories and protein, as well as important antibodies
colostrum
Colostrum is usually secreted for ______ to _____ days after birth and is then replaced by the mother’s breast milk
2-3 days
______________________ requires the mother to take in extra calories and fluids
Breastfeeding
5 elements of assessment in the APGAR test
- appearance
- pulse rate
- grimace
- activity
- respiratory effort
BUBBLEHE
- breasts
- uterus
- bladder
- bowel
- lochia/labia
- episiotomy
- hemmorhoid/homan’s sign
- emotional status
In terms of episiotomy or c-section incision assessment, what does REEDA stand for
Redness –inflammation, Ecchymosis –bruising, Edema –swelling, Discharge –from incision, Approximation of suture line
BABY BLUES? POST PARTUM DEPRESSION? OR POST PARTUM PSYCHOSIS?
- fatigue, anxiety, restlessness, sadness, let-down feeling
- lasts about 2 weeks
BABY BLUES
BABY BLUES? POST PARTUM DEPRESSION? OR POST PARTUM PSYCHOSIS?
- more serious, intense and persistent. Mother is unable to feel the love for her infant, irritable, guilt, sense of loss of self
- 2 categories: Moderate and Intense
POST PARTUM DEPRESSION
BABY BLUES? POST PARTUM DEPRESSION? OR POST PARTUM PSYCHOSIS?
- Feelings of harming the baby
- hallucinations
- Most severe type
POST PARTUM PSYCHOSIS
- Refers to gestational age
- Measured from the top of the symphysis pubis to the top of the uterine fundus
FUNDAL HEIGHT
- 20 cm=20 weeks; 10cm=10 weeks
FUNDAL HEIGHT
(1st day of last menstrual period (LMP) subtract 3 months and add 7 days.
Naegle’s Rule
HELLP
Hemolysis, Elevated Liver enzymes, Low Platelet count
TORCH
Toxoplasmosis Other – Hep A or B, Group B, Varicella, HIV Rubella (German Measles) CMV (Cytomegalovirus) Herpes Simplex (HSV 2)
this is is a complication of preeclampsia/eclampsia that includes liver damage
HELLP
PIH
Pregnancy Induced Hypertension
______________________ is a dangerous combination of high blood pressure, fluid retention, and high levels of protein in the urine of women after their 20 th week of pregnancy.
Preeclampsia
Preeclampsia is also sometimes called ________________
toxemia
Signs & Symptoms of Pre-eclampsia
- high blood pressure (above 140/90
- excessive weight gain (> 5 lbs in a week)
- sudden weight gain over 1 or 2 days
- retention of fluids, which causes the hands and face to swell
- reduction in the amount of your urine
Signs & Symptoms of eclampsia
- pain in the upper right side of abdomen
- disturbances to vision, such as seeing flashing lights
What is Rh factor
Rh incompatibility can happen only when the mother is Rh negative and the fetus is Rh positive. The mother does not have the Rh factor and the fetus does have the Rh factor
abnormal labour caused by any of the 5 major variables that affect labour
dystocia
ineffective contractions or maternal pushing efforts
dysfunctional labour
Complications of pregnancy:
- TORCH
- HELLP
- PIH
- Rh Factor
- Trauma
- Medical conditions
- Bleeding
- Abortion
- Ectopic pregnancy
- Placenta previa
- Abruptio placenta
- Hypertensive disorders
- Supine hypotensive syndrome
- Gestational diabetes
7 Complications in delivery and nursing implications
- dystocia
- dysfunctional labour
- pelvic structure variations
- mother’s responses
- fetal variations
- engagement of presenting part, station and fetal position
- prolapsed umbilical cord
happens when the umbilical cord precedes the fetus’ exit from the uterus. It is an obstetric emergency during pregnancy or labor that imminently endangers the life of the fetus
prolapsed umbilical cord
this is a central nervous system depressant that decreases the possibility of convulsions.
It lso relaxes smooth muscles and may decrease blood pressure to some degree.
magnesium sulfate
___________ ________________ refers to the relationship of the identified landmark on the presenting part of the four quadrants of the mother’s pelvis.
fetal position
Six possible positions:
- Right occiput anterior (ROA) mentum (RMA) sacrum (RSA)
- Right occiput transverse (ROT) mentum (RMT) sacrum (RST)
- Right occiput posterior (ROP) mentum (RMP) sacrum (RSP)
- Left occiput anterior (LOA) mentum (LMA) sacrum (LSA)
- Left occiput transver (LOT) mentum (LMT) sacrum (LST)
- Left occiput posterior (LOP) mentum (LMP) sacrum (LSP)
4 Phases of Labour
First Stage: Dilation and Effacement
Second Stage: Birth of Baby
Third Stage: Delivery of Placenta
Fourth Stage: Recovery
3 phases in the First Stage: Dilation and Effacement
Latent phase
Active phase
transition phase
WHAT PHASE OF LABOUR?
- ends when cervix is dilated 3 cm
- longest phase
- contractions occur every 10-20 minutes
- durations of contractions last 15 to 30 seconds
- intensity of contractions is mild and gradually becomes moderate
LATENT PHASE
WHAT PHASE OF LABOUR?
- begins when cervix is dilated 4 cm
- ends when cervix is dilated 8cm
- contractions every 3-5 minutes
- duration of contractions last 30-60 seconds
- intensity of the contractions is moderate progressing to
ACTIVE PHASE
WHAT PHASE OF LABOUR?
- begins when cervix is dilated 8 cm
- ends when cervix is dilated 10 cm
- contractions every 2-3 minutes
- duration of contractions last 60-90 seconds
- characteristics of the transition phase are: restlessness, hyperventilation, bewilderment and sometimes anger, difficulty following directions, focus on self, irritability, statements like “Don’t touch me”, nausea, occasionally vomiting, very warm feeling, perspiration on upper lip, increasing rectal pressure
- intensity of contractions is strong
TRANSITION PHASE
WHAT STAGE OF LABOUR?
- cervix dilated 10 cm
- contractions every 1-2 minutes
- duration of contractions 60-90 seconds
- strong intensity
SECOND STAGE: BIRTH OF BABY
ABCW OF Newborn assessment and care
- A-Airway
- B-Breathing
- C-Circulation
- W-warmth
2 THINGS INCLUDED IN Prenatal and post partum assessment
- BUBBLEHE
2. VITALS
Nursing care for pregnant mothers includes these 3 considerations:
- mothers should avoid becoming anemic
- mothers should avoid strenuous activity
- monitoring for cardiac failure and pulmonary complications
Nursing care during labour includes
- side lying position
- prophylactic antibiotic
- epidural
What are 2 anticoagulant therapies:
- heparin
- lovenox
