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AD 232 > Seminar day 1 > Flashcards

Seminar day 1 Flashcards

1
Q

intrapartal

A

labor and birth

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2
Q

gravida

A

how many times the woman has been pregnant; whether completed or not

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3
Q

para

A

number of pregnancies lasting more than or equal to 20 weeks

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4
Q

GTPAL

A 
gravida
term pregnancies
pre-term pregnancies
abortions (spontaneous or forced)
living children
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5
Q

SVD/NSVD

A

spontaneous vaginal delivery/normal SVD

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6
Q

C/S

A

c-section

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7
Q

VBAC

A

vaginal delivery after cesarean

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8
Q

Fundus

A

The upper rounded extremity of the uterus above the openings of the uterine (fallopian) tubes.

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9
Q

lochia

A

vaginal discharge after birth:
rubra, serosa, alba
scant, small, moderate, heavy
can last up to 6 weeks

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10
Q

peuperium

A

the period of about six weeks after childbirth during which the mother’s reproductive organs return to their original nonpregnant condition.

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11
Q

4th stage of labor assessment - vag delivery

A 
1st 1-2hours after birth:
q15min x 4
q30min x 2
q1hour x3
q4hour to complete first 24 hours
include:
BP
pulse
fundus
lochia
perineum

temp q4 for 24

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12
Q

postpartum ongoing (routine) assessment - shift

A 
head to toe
OB focal:
breasts
fundus
lochia
perineum
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13
Q

PP maternal temp guideline

A

less than or equal to 100.4 degree F (24hours) normal

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14
Q

considerations when pt has had duramorph

A

count RR q1hour x 24 hours
NO narcs in 1st 24 hours unless approved by anesthesia
have narcan bedside - reverse resp depression
most common SE = pruitis - itching
use nubain or benadryl - if not work, give narcan

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15
Q

epidural site

A

ice is best for pain

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16
Q

extremities assessment

A

look for edema - 3rd spacing
varicose veins are common
Homan’s sign - checking for DVT’s - dorsiflex foot and assess for pain - must be relaxed - don’t check if known DVT

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17
Q

perineum assess

A

lochia
lacerations
hemorrhoids - common

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18
Q

bladder assess

A

a full bladder will displace the uterus
encourage voiding q 2 hours
usually concentrated
lots of urine made - getting rid of excess from pregnancy

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19
Q

lacerations

A

1st degree = skin
2nd degree = muscle
3rd degree = capsule of anus but not through
4th degree = through anus

ICE!!

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20
Q

breastfeeding nutrition

A

need 500 calories extra - in form of protein

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21
Q

maternal role adjustment

A

taking in
taking hold
letting go

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22
Q

taking in

A 
can be up to 48 hours
concerned about self
pain
food
thirst
difficult to make decisions
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23
Q

taking hold

A 
around d/c
showered
own clothes
hair/make up
feeling better, starts asking questions 
participate in baby care
best time to teach
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24
Q

letting go

A

can take up to 1-2 weeks

incorporates NB into family system

25
Q

lochia

A

scant, small, moderate, heavy - in relationship to time

pad completely saturate is about 100 ml’s

26
Q

diastasis of rectus abdominus muscle

A

separates for the uterus to grow
surgical mesh may be used for large ones
when turns on side, stomach feels weird
touch chin to chest - makes muscle contract and can palpate edges

27
Q

immediate assessment and care of NB

A

establish respirations
prevent heat loss - dry baby, skin to skin
APGAR at 1 min and 5 min
safety - ID bands
promote parental attachment - skin to skin for 2 hours or until first feeding
meds - vit K, erythromycin ointment

28
Q

establishment of respirations

A

most critcial adjustment for NB right after birth
result of pressure change, chilling, noise, light, etc..
normal = 30-60/minute, irregular, count 60 seconds

29
Q

signs of respiratory distress

A

grunting (early sign)
nasal flaring (early sign)
retractions (later sign)
cyanosis (even later sign)

30
Q

brown fat

A

source of heat unique to NB’s
greater thermogenic activity than regular fat
prematures have less than term - increased risk heat loss
don’t want them to have to use this
KEEP WARM!

31
Q

types of heat loss

A

evaporation
conduction
convection
radiation

32
Q

evaporation

A

occurs when liquid is converted to vapor
vaporization of moisture from skin after birth

dry baby after birth/bath

33
Q

conduction

A

the loss of heat from warm body surface to cooler surfaces in direct contact - placing infants on cold scale, blankets, wet linens, x-ray plates

place infant on pre-warmed warmer/scale
skin to skin with mom/dad
place barrier

34
Q

convection

A

flow of heat from the body surface to cooler ambient air, contact with cold air
cold drafts, O2 admin

wrap infant in blankets, hats
increase room temp
look at placement of baby in terms of air system

35
Q

radiation

A

the loss of heat from the body surface to a cooler solid surface NOT in direct contact, but in relative proximity, a vacuum
infant near cold object

keep infant away from cold windows or walls

36
Q

normal NB temp ranges

A

97.6-99 axillary

if less, radiant warmer

37
Q

normal NB HR ranges

A

(100 - APGAR) 110-160
count full minute
apical

38
Q

APGAR

A 
activity - muscle tone
pulse
grimace - reflex irritability
appearance - skin color
respirations
39
Q

activity muscle tone APGAR scoring

A

absent - 0
arms and legs flexed - 1
active movement - 2

40
Q

pulse APGAR scoring

A

absent - 0
below 100 - 1
above 100 - 2

41
Q

grimace - reflex irritability APGAR scoring

A

no response - 0
grimace - 1
sneeze, cough, pull away - 2

42
Q

appearance - color APGAR scoring

A

blue-gray, pale all over - 0
normal, except for extremities - 1
normal over entire body - 2

43
Q

respirations APGAR scoring

A

absent - 0
slow, irregular - 1
good, crying - 2

44
Q

assessment of the NB at time of birth

A 
resp
apical pulse
temp
weight, length, head circumference
head to toe
45
Q

vernix caseosa

A

A white cheesy substance that covers and protects the skin of the fetus and is still all over the skin of a baby at birth

46
Q

lanugo

A

fine, soft hair, especially that which covers the body and limbs of a human fetus or newborn.

47
Q

milia

A

tiny white bumps that appear across a baby’s nose, chin or cheeks. Milia are common in newborns but can occur at any age. You can’t prevent milia. And no treatment is needed because they usually disappear on their own in a few weeks or months.

48
Q

mongolian spots

A

very common in any part of the body of dark-skinned babies. They are flat, gray-blue in color (almost looking like a bruise), and can be small or large. They are caused by some pigment that didn’t make it to the top layer when baby’s skin was being formed.

49
Q

flammeus nevus (port wine stain, stork bite)

A

a large congenital vascular malformation nevus having a purplish color; it is usually found on the head and neck and persists throughout life

50
Q

erythema toxicum

A

a common harmless rash that appears in at least half of all infants who are carried to term

51
Q

head assessment

A

molding
caput succedaneum
cephalhematoma

52
Q

caput succedaneum

A 
fluid acculumation
pressure from vaginal birth
will reabsorb in a few days
crosses suture line
appears at birth
53
Q

cephalhematoma

A 
blood accumulation
torn blood vessels
doesn't cross suture line
if growing = active bleeding
few weeks for reabsorption
at risk jaundice
appears few hours PP
54
Q

NB bath

A

delay until stable temps - 2 above 98 degrees
wash head last
dry!

55
Q

NB labs

A

TCB - transcutaneous bilirubin-based hours age
glucose per protocol - above 40mg/dL
CBC - not routine
blood cultures - no routine

56
Q

NB glucose indicated if

A 
mother with diabetes
LGA
SGA
preterm
s/sx
57
Q

breastfeeding positions

A

football
cradle - hardest
cross cradle - best to teach
side lying

58
Q

breastfeeding latch

A

nose to nipple
baby’s mouth open wide
help baby to breast

59
Q

breastfeeding times

A

8-12 times in 24 hours
q2-3 hours(beginning of feed to beginning of next feed)
about 15-20 minutes per breast
don’t skip feedings

AD 232 (2 decks)

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