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Maternal-Newborn (Josh) > T2- Advance Organizer (Josh) > Flashcards

T2- Advance Organizer (Josh) Flashcards

1
Q

APGAR:

What Activity gets a 1?

A

arms and legs flexed w/ little movement

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2
Q

The part of the fetus that lies closest to the internal os of the cervix?

A

Presenting Part

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3
Q

When would we see Lochia Alba?

A

10-14 days after birth

***yellow to whight

***leukocytes, decidua, epithelial cells, mucus, serum, and bacteria

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4
Q

How long can lochia be seen post birth?

A

4-8 wks

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5
Q

Nursing actions for Variable Decel?

A

Change mom position

Elevate legs

Increase IV fluids

Palpate uterus to check for tachysystole

Stop oxytocin

Administer O2

Call MD

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6
Q

How long does Phase 1 of Stage 1 last?

A

Primagravia = 6-8 hrs

Multigravida = 4-5 hrs

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7
Q

How long does the Active Phase of Stage 1 last?

A

3-6 hrs

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8
Q

Should the bladder be palpable after delivery?

A

NO

they need to void to empty it to allow fundus to contract

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9
Q

— are expected irregular fluctuations of the baseline FHR that are an indicator of fetal well being.

A

Variability

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10
Q

Usual duration of UC during Phase 3?

A

45-90 secs

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11
Q

Before AROM, what must first happen?

A

presenting part needs to be engaged to prevent cord prolapse

woman needs to be free from infection

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12
Q

Which Decel is caused by impairment of placental/oxygen exchange?

A

Late

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13
Q

At station -3 is said to be at which Station?

A

3 cm ABOVE the ischial spines

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14
Q

What is the usual length of Stage 2?

A

Nulliparas: 50 mins

Multiparas: 20 mins - 3 hrs (depending on anasthesia)

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15
Q

What would Marked Variability be a sign of?

A

D-fib

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16
Q

APGAR:

What appearance gets a 1?

A

pink centrally

bluish extremities

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17
Q

Uteroplacental Insufficiency causes which type of Decel?

A

Late Decel

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18
Q

What color of AF could indicate an infection?

A

Yellow (thick cloudy color)

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19
Q

What APGAR scores are we looking for?

A

10 is best, 8 or 9 is good

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20
Q

When would we see Lochia Serosa?

A

3-4 days after birth

***pal pink or brown

***old blood, serum, leukocytes and tissue debris

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21
Q

Which Opioids did we talk about?

A

Dilaudid (Hydromorphine)

Meperidine

Normeperidine

Fentanyl

Sufenta - more potent than Fentanyl

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22
Q

Which class of meds should we NEVER give?

A

Benzos

***will affect thermoregulation of infant

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23
Q

APGAR stands for …

A 
Appearance
Pulse
Grimace
Activity
Respiratory
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24
Q

How do opioids affect mom and baby?

A

decrease maternal HR and BP

affects fetal oxygenation

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25
Q

Before epidural, what do we give?

A

IV bolus (1000mL in less than 30 mins)

***increase epidural space

***protects from hypotensive episode

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26
Q

Opioid Agonist Antagonists:

A

Butorphanol Tartrate (Stadol)

Nalbuphine HCl (Nubain)

***may precipitate withdrawal symptoms in opioid dependent moms and newborns

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27
Q

For the first 2 hours after birth, what amount of discharge should we see?

A

like that of a heavy menstrual period

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28
Q

Should we give Naloxone (Narcan) if mother or infant is opioid dependent?

A

NO

causes abrupt withdrawal

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29
Q

If the fundus has deviated to the RIGHT of the mom’s umbilicus, what should we do?

A

encourage to void to decrease size of bladder

***catheter if necessary

30
Q

What can result from ataractic drugs like Promethazine?

A

mom gets sleepy,

baby gets sleepy,

moderate variablity becomes minimal b/c baby is asleep

31
Q

APGAR:

What Respiratory effort gets a 1?

A

slow, irregular breathing

weak cry

32
Q

At the Ischial Spines is said to be at which Station?

A

0

33
Q

What color of AF could indicate meconium?

A

Greenish Brown

34
Q

APGAR:

What Grimace (reflex irritability) gets a 1?

A

facial movement only

35
Q

What do we give if baby has respiratory depression?

A

Stimulation

Fluids

***stadol can cause some resp depression and will not be reversed by Narcan

36
Q

Which type of Decels must be periodic?

A

Early and Late

***Variable can be either Episodic or Periodic

37
Q

After an epidural, how often are vitals charted?

A

q 5 mins for fist 20 mins

q 30 mins after 20 mins

38
Q

APGAR:

What pulse gets a 1?

A
39
Q

Usual duration of UC during Phase 1?

A

30-45 secs

NOT regular

40
Q

When the bladder is distended, what does this indicate?

A

uterus will be boggy and above and to the right of the woman’s umbilicus

41
Q

Intervention for Variable Decel?

A

Caused by cord compression

  • Turn mom
  • Stop oxytocin
  • Administer O2
  • Call MD
42
Q

Which Decel is a ‘mirror image’ of the contraction?

A

Early Decel

***don’t chart!

***needs no intervention

43
Q

What do we consider a an acceleration of FHR longer than 10 mins?

A

considered a change in baseline

44
Q

What is the usual length of Stage 3?

A

5-30 mins

***if more than 30 mins, it’s a problem

45
Q

What causes Early Decels and when would we see them?

A

Fetal Head Compression

Phase 2 of Stage 1

Stage 2 (when mom is pushing)

46
Q

When would we see Lochia Rubra?

A

post birth

***bright red and may contain small clots

47
Q

If mom gets a hypotensive episode, what is nursing action?

A

Turn mom

Increase fluids

Administer O2

Elevate legs (10-20 degrees)

Call MD (order for ephedrine)

48
Q

What would happen if we fail to give IV Bolus before Epidural?

A

Hypotensive episode (systolic falls below 100)

No accels or moderate variability for baby (nonreassuring FHR)

49
Q

Where the the PMI usually located?

A

fetal back

***below umbilicus if cephalic presentation

***above umbilicus if breech

50
Q

Which Decel is likely caused by a cord compression?

A

Variable Decel

***V looks like a Vice

51
Q

Where should the fundus be in the 4th stage?

A

firm, midline, and halfway b/t umbilicus and symphysis pubis

52
Q

After ROM, check temp —- and call Doc if it is higher than —

A

q 2 hr

38c (100.4)

53
Q

Usual frequency of UC during Phase 2?

A

3-5 mins

54
Q

Usual frequency of UC during Phase 3?

A

2-3 mins apart

55
Q

Usual duration of UC during Phase 2?

A

40-70 secs

56
Q

Variability levels:

Absent =
Minimal =
Moderate =
Marked =

A

Absent = 0 or undetectable

Minimal 0-5 bpm

Moderate = 6-25 bpm

Marked = > 25 bpm

57
Q

What accels are we looking for at 32 wks?

What about 33 wks or more?

A

10 x 10

15 x 15

58
Q

S/S of Uterine Infectoin

A

Pain in lower abdomen

Fever

Foul-smelling discharge

Rapid HR

Swollen, tender uterus

59
Q

Usual frequency of UC during Phase 1?

A

5-30 mins

60
Q

What do Barbituates do to the neonate?

A

CNS depression

***avoid if birth is within 12-24 hrs

61
Q

What will a Variable Decel look like on the strip?

A

abrupt drop (30 secs)

periodic or non-periodic

62
Q

What could cause tachycardia (FHR > 160)?

A

mom having a fever

prolonged rupture of membranes

Drugs:

  • atropine
  • hydroxyzine
  • terbutaline
  • cocaine or meth
63
Q

— are visually apparent, abrupt increase in FHR above the baseline.

A

Accelerations

***onset to peak

64
Q

During Stage 3, when would we give Pitocin?

A

we don’t give Pitocin during stage 3

***we give high dose of Pitocin AFTER delivery of placenta

65
Q

What is the minimal amount of time we want b/t contractions?

A

at least 2 minutes to allow for perfusion to fetus

66
Q

What is the maximum length that Stage 3 should be?

A

30 mins

***Call nurse if it lasts longer

67
Q

Nursing intervention for Occiputposterior position?

A

Change mother’s position often to facilitate baby to move to OA position

Counter pressure on mom’s back (sacrum)

Hip squeeze to push the pelvis back into a relaxed position to relive pressure of stretch

68
Q

What is Fetal Bradycardia and what could cause it?

A

FHR

69
Q

What can cause fetal head compression and which Decel would it lead to?

A

Early Decel

  • UC
  • Vag exam
  • Fundal pressure
  • Placement of internal monitoring node
70
Q

Relationship b/t the long axis (spine) of fetus with long axis (spine) of mom?

A

Fetal Lie

71
Q

In order to apply an IUPC or an ISE, what must first happen?

A

rupture of membranes

72
Q

How long does the Transition Phase of Stage 1 last?

A

20-40 mins

Maternal-Newborn (Josh) (29 decks)

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