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Maternity > Study mix > Flashcards

Study mix Flashcards

1
Q

What is considered PIH?

A

new development of htn AFTER 20 weeks, w/o protein in urine, BP greater than 140/90

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2
Q

What is considered Preeclampsia?

A

BP over 140/90 after 20 weeks
proteinuria > .3 g in 24 hrs
Maybe Edema

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3
Q

What is considered Severe Preeclampsia?

A

BP 160/110
Proteinuria over 5 mg
Less than 500 mL of urine output
Headache, visual disturbances, epigastric pain, edema

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4
Q

Name the symptoms of preeclampsia from head to toe.

A

Headache, Visual disturbances, periorbital swelling, edema, epigastric pain, clonus, hyerreflexia

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5
Q

Risk factors for PIH

A

1st pregnancy, POC, chronic HTN, older than 35, multi pregnancies, Diabetes, family hx, late prenatal care

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6
Q

How do we manage PIH? What happens if it is severe?

A

bedrest, BP monitoring, daily weight, fetal surveillance, high protein diet
C-section

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7
Q

Manifestations of Magnesium toxicity

A

Respiratory rate less than 12, absences of deep tendon reflexes, sweating and flushing, hypotension, confusion, lethargy

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8
Q

What is the therapeutic level of magnesium?

A

4- 8mg/dL

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9
Q

What are the seizure precautions?

A

provide a quiet environment, pad side rails, bed in low positions, make sure oxygen and suction is available, have mom lay on left side

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10
Q

Risk factors for gestational diabetes.

A

Obesity, chronic HTN, age 30 or older, family hx, prior birth of large infant, stillbirth, hx of GDM

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11
Q

How do we screen for GDM?

A

1 hour glucose challenge test between 24-28 weeks

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12
Q

Effects of Diabetes on pregnancy?

A

PIH, UTIs, hydramnios, ketoacidosis, PROM, preterm labor, difficult labor, injury to birth canal, C/S, postpartum hemorrhage

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13
Q

Effects of diabetes on fetus?

A

death, congenital anomalies, macrosomia, IUGR, birth injury, hypoglycemia, RDS, hyperbilirubinemia

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14
Q

Risk factors for ectopic pregnancy

A

hx of one, failed tubal ligation, IUD, older than 35, STD

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15
Q

Signs and symptoms of ectopic pregnancy

A

missed period, sudden severe lower abdominal pain, spotting

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16
Q

Treatment for ectopic pregnancy if tube is intact

A

Methotexate and salpingostomy

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17
Q

Treatment of ectopic pregnancy if tube ruptures

A

Control bleeding, salpingectomy

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18
Q

Signs and symptoms of placenta previa

A

Painless bleeding in last half of pregnancy

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19
Q

Management of placenta previa

A

No vaginal examinations or pitocin, fetal monitoring, prepare for C/S

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20
Q

What is abruptio placenta?

A

separation of normally implanted placenta before fetus is born

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21
Q

Dangers of abruptio placenta on fetus

A

anoxia, excessive blood loss, preterm labor

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22
Q

Dangers of abruptio placenta on mother

A

hemorrhage and hypovolemic shock

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23
Q

Signs and symptoms of abruptio placenta

A

bleeding (can be concealed), abdominal pain, uterine hyperactivity with poor relaxation, uterine tenderness

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24
Q

Signs of concealed hemorrhage

A

Increase in fundal height, hard abdomen, signs of hemorrhage, late decels,

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25
Q

What is preterm labor?

A

labor between 20 and 37.6 weeks

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26
Q

S/S of preterm labor

A

Contractions, sensation of baby balling up and or pushing down, cramps, vaginal discharge

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27
Q

When is mother cultured for GBS?

A

at 35-37 weeks

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28
Q

Frequency of contractions

A

beginning of one contraction to beginning of the next

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29
Q

Duration of contractions

A

beginning of one contraction to end of same contraction

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30
Q

Acme

A

period where contraction is the most intense

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31
Q

Decrement

A

Period where contraction relaxes

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32
Q

Effacement

A

thinning and shortening

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33
Q

Dilation

A

opening

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34
Q

What is the normal blood loss for a vaginal delivery and c-section?

A

500 mL for vaginal, 1000 mL for C/S

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35
Q

Normal range of heart rate and respirations for baby

A

110-160 bpm; 30-60

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36
Q

What are the 4Ps?

A

powers, passage, passenger, and psyche

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37
Q

Powers involve

A

contractions and pushing

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38
Q

Fetal lie

A

orientation of long axis of fetus to long axis of mother

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39
Q

Attitude

A

relationship of fetal body parts to one another

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40
Q

What is normal attitude?

A

flexion

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41
Q

Types of fetal presentation

A

cephalic, breech, or shoulder

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42
Q

Labor onset theories

A

increase prostaglandins, oxytocin, increased stretching and pressure of uterus and cervix

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43
Q

Normal signs of labor

A

bloody show, dilations, increased vaginal mucus, softening, energy spurt, lightening

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44
Q

What is considered true labor?

A

increased contractions and discomfort, effacement and dilation

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45
Q

What is considered false labor?

A

inconsistent contractions, nonchanging cervix

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46
Q

What are the stages of labor?

A

first = effacement and dilation
second = delivery of fetus
third = delivery of placenta
fourth = postpartum

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47
Q

stages of first stage of labor

A

latent, active, and transition

48
Q

Cervical dilation of the 3 phases of the first stage of labor

A

latent = 0-3 cm
active = 4-7 cm
transition = 8-10 cm

49
Q

Effleurage

A

gentle massage during or between contractions

50
Q

Nursing care for epidural

A

bolus 500-1000 mL of LR before, frequent vital signs, catheter insertion, monitor leg movement

51
Q

Epidural side effects

A

hypotension, bladder distention, fever, prolonged 2nd stage, catheter migration

52
Q

Side effects of duramorph

A

Nausea and vomiting, pruritis, respiratory depression

53
Q

Where is the toco placed?

A

on top of uterus

54
Q

Limitations of external monitors

A

mobility, repositioning of transducers, can’t assess strength of contraction, obese women

55
Q

Fetal scalp electrode requirements and where is it placed.

A

requires dilation ROM, placed on fetal presenting part

56
Q

Intrauterine pressure catheter (IUPC

A

sterile catheter inserted directly into uterus and measures uterine pressure

57
Q

Limitations of IUPC

A

requires ROM and dilation, can cause trauma, risk for infection, maternal position can give inaccurate readings

58
Q

Classifications of variability

A

absent, minimal, moderate, and marked

59
Q

Early decelerations

A

head compression which are okay

60
Q

Late decelerations

A

uteroplacental insufficiency

61
Q

Variables

A

cord compression

62
Q

What is the purpose of variability?

A

determines oxygenation

63
Q

What is considered minimal variability?

A

less than 5 bpm

64
Q

What is considered moderate variability?

A

6-25 bpm

65
Q

What is considered marked variability?

A

greater than 25 bpm

66
Q

Reasons for decreased variability

A

fetal sleep, drugs, tachycardia, prematurity, hypoxia, CNS abnormalities, hypoxemia

67
Q

What is considered an acceleration?

A

> 32 weeks must be 15 bpm above baseline for 15 seconds but less than 2 minutes
<32 weeks must be 10 bpm above baseline for 10 seconds or more but less than 2 minutes

68
Q

What is considered a prolonged acceleration?

A

increase in FHR for 2 minutes but less than 10 minutes

69
Q

What happens if accelerations are longer than 10 minutes?

A

a change in FHR baseline

70
Q

What is a prolonged deceleration?

A

a decrease in FHR of 15 bpm or more for 2 minutes but less than 10 minutes

71
Q

What can cause prolonged decelerations?

A

maternal hypotension, fetal hypoxia, hemorrhage, cord prolapse, cord compression, uterine rupture

72
Q

Interventions for variables or late decels

A

reposition, bolus, oxygen, stop pitocin,

73
Q

Dystocia

A

describes any difficult labor or birth

74
Q

What is considered a dysfunctional labor?

A

ineffective pushing, no fetal descent, effacement, or dilation

75
Q

Main sign of shoulder dystocia

A

Turtle sign

76
Q

Macrosomia is any infant that weighs over..

A

4000g (8 lbs 13 oz)

77
Q

What is shoulder dystocia?

A

delayed or difficult birth of shoulders

78
Q

Is shoulder dystocia an emergency? Why?

A

Yes; cord can be compressed

79
Q

How is shoulder dystocia solved?

A

McRoberts Maneuver and suprapubic pressure

80
Q

What is done if PROM occurs before 36 weeks? Past 36 weeks?

A

given tocolytics to slow delivery process; delivery of fetus

81
Q

Precipitous labor

A

birth that occurs within 3 hours of the onset of labor

82
Q

What is an important management of a precipitous labor?

A

fetal oxygenation

83
Q

Purpose of bishop score

A

used to estimate how easily a woman’s labor can be induced

84
Q

What is being scored for bishop scoring?

A

dilation, effacement, fetal station, cervical consistency, cervical position

85
Q

What is cord prolapse?

A

It slips down after ROM and can be compressed between fetus and pelvis

86
Q

What factors increase risk for cord prolapse?

A

ROM and fetus is at a high station, fits poorly in pelvis inlet, hydramnios

87
Q

What can cause uterine rupture?

A

Previous uterine surgery, high parity with thin uterine wall, abdominal trauma, intense contractions, medications

88
Q

Signs and symptoms of uterine rupture

A

abdominal pain or feeling that something ripped, chest or shoulder pain, hypovolemic shock, hemorrhage, impaired fetal oxygenation,

89
Q

How is uterine rupture treated?

A

stabilize mom, delivery via c-section

90
Q

Order of meds for postpartum hemorrhage

A

Pitocin
Methergine
Cytotec
Hemabate

91
Q

What would be some indications for a C-Section?

A

dystocia, cephalopelvic disproportion (CPD), PIH, active herpes, fetal distress, prolapsed cord, breech, hemorrhage

92
Q

What are some C-section complications?

A

Infection, atelectasis, paralytic ileus, UTI, hemorrhage

93
Q

What are factors that increase risk for postpartum hemorrhage?

A

Overdistention of uterus, prolonged labor, precipitous labor, c-section, use of forceps or vacuum

94
Q

What are 2 major causes of early hemorrhage?

A

uterine atony and trauma to birth canal

95
Q

What is pueperal infection?

A

bacterial infection after childbirth; fever of 38 C (100.4 F) after the first 24 hours

96
Q

How can you differentiate postpartum blues from postpartum depression?

A

postpartum blues lasts for 2 weeks and mother will still be capable of caring for baby, past 2 weeks and not able to care for baby indicates postpartum depression

97
Q

Signs and symptoms of postpartum blues

A

fatigue, irritability, weeping, anxiety

98
Q

Signs and symptoms of postpartum depression

A

less interest in environment, unable to feel pleasure or love, feelings of unworthiness, guilt, shame

99
Q

What is surfactant and what is its purpose?

A

it is produced as lungs mature and reduces surface tension within alveoli

100
Q

What does APGAR stand for?

A

Appearance, pulse, grimace, activity, respiratory effort

101
Q

What are the signs and symptoms of TTN?

A

high respirations of 120, retractions, nasal flaring, grunting, and mild cyanosis

102
Q

Interventions for TTN

A

Supplemental oxygen, IV or gavage feeding to prevent aspirations

103
Q

What causes respiratory distress syndrome?

A

Insufficient production of surfactant

104
Q

Signs and symptoms of RDS

A

begin within 4 hours of birth, tachypnea, retractions, nasal flaring, grunting, wet breath sounds

105
Q

What is retinopathy of prematurity? When does it occur?

A

damage from immature blood vessels in retina of eye; less than 36 weeks of gestation or if they weigh under 1500 g

106
Q

What can be done for ROP?

A

cryotherapy, laser surgery, give vitamin E

107
Q

What is the range for blood glucose for infant?

A

40-45

108
Q

What are some interventions for hypoglycemia?

A

early feedings, D5, IV bolus w/ D10

109
Q

Signs and symptoms of hypoglycemia of baby

A

tremors, cyanosis, convulsions, tachypnea, cardiac arrest

110
Q

What is the management for SGA?

A

check for hypoglycemia, frequent feedings, regulate temperature, respiratory support

111
Q

What is the management for LGA?

A

check for injuries from birth and respiratory complications, hypoglycemia

112
Q

What do you check/monitor when Duramorph is given?

A

respiratory depression, no narcotic use during that 24 hours, check for itching

113
Q

What is Terabutaline used for and what is the dosage?

A

slows contractions; 0.25 mg

114
Q

When would you withhold Methergine?

A

if BP is 136/90

115
Q

What is the normal dosage for Vitamin K?

A

1mg/0.5 mL

Maternity (1 decks)

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