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Maternal-Newborn (Josh) > T4 - Advance Organizer (Josh) > Flashcards

T4 - Advance Organizer (Josh) Flashcards

1
Q

How many times per day does a mom need to do a kick count?

A

High Risk = 2-3 x’s day

Low Risk = 1-2 x’s day

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2
Q

How many times per day does a mom need to do a kick count?

A

High Risk = 2-3 x’s day

Low Risk = 1-2 x’s day

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3
Q

How many fetal movements should mom feel in a one hour kick count?

A

5-6

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4
Q

No fetal movements within – is serious and requires a visit to doctor.

A

12 hrs

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5
Q

Why would diabetic mom need less insulin during first trimester?

A

Baby taking up some blood sugar

N/V can cause sugar loss

Human Placental Lactogen (HPL) is secreted (it’s an insulin antagonist)

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6
Q

What happens to insulin requirements in 2nd and 3rd Trimesters?

A

increases by as much as 4 x’s normal need

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7
Q

What weeks of gestation are insulin needs the highest?

A

36-40 wks

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8
Q

Which A1c levels show good control?

fair control?

poor control?

A

Good = 2.5-5.9%

Fair = 6-8%

Poor = > 8%

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9
Q

What is normal HCT in pregnancy?

Hgb?

A

HCT = 33

Hgb = 11

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10
Q

— increases Iron absorption.

— decreases iron absorption.

A

Vit C

Milk, Tea, and Coffee

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11
Q

How much Folic Acid should mom receive during pregnancy?

A

400 mg/day

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12
Q

What is a Reactive NST?

A

2 Accels (15x15) in 20 min period

***if less than 32 wks, 10x10

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13
Q

During labor, what glucose level do we want to maintain for mom?

A
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14
Q

During labor, monitor glucose —-.

A

hourly

***more in second stage b/c voluntary pushing requires more energy

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15
Q

— helps stabilize blood sugar postpartum.

A

Breastfeeding

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16
Q

Why do we need to maintain the integrity of diabetic mom’s nipples if she’s breastfeeding?

A

diabetics are more prone to infection so any cracks can lead to mastitis

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17
Q

What happens to insulin needs upon expulsion of placenta?

A

fall dramatically

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18
Q

What levels are we looking for in the 1 hr (50g) OGTT?

A
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19
Q

How many fetal movements should mom feel in a one hour kick count?

A

5-6

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20
Q

No fetal movements within – is serious and requires a visit to doctor.

A

12 hrs

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21
Q

Why would diabetic mom need less insulin during first trimester?

A

Baby taking up some blood sugar

N/V can cause sugar loss

Human Placental Lactogen (HPL) is secreted (it’s an insulin antagonist)

How well did you know this?
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22
Q

What happens to insulin requirements in 2nd and 3rd Trimesters?

A

increases by as much as 4 x’s normal need

How well did you know this?
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2
3
4
5
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23
Q

What weeks of gestation are insulin needs the highest?

A

36-40 wks

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24
Q

Which A1c levels show good control?

fair control?

poor control?

A

Good = 2.5-5.9%

Fair = 6-8%

Poor = > 8%

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25
Q

What is normal HCT in pregnancy?

Hgb?

A

HCT = 33

Hgb = 11

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26
Q

What numbers constitute a positive 3 hr OGTT?

A

> 140 or > 145

***avoid caffeine and smoking for 12 hrs before test

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27
Q

How much Folic Acid should mom receive during pregnancy?

A

400 mg/day

28
Q

What is a Reactive NST?

A

2 Accels (15x15) in 20 min period

***if less than 32 wks, 10x10

29
Q

During labor, what glucose level do we want to maintain for mom?

A
30
Q

During labor, monitor glucose —-.

A

hourly

***more in second stage b/c voluntary pushing requires more energy

31
Q

Why is infant of diabetic mom at risk for hypoglycemia shortly after birth?

A

Baby has been dealing with mom’s high glucose levels in utero

When placental supply is cut off, the baby has all this excess insulin and a much lower supply of glucose

***remember, baby pancreas produces insulin at 10 wks gestation

32
Q

Why do we need to maintain the integrity of diabetic mom’s nipples if she’s breastfeeding?

A

diabetics are more prone to infection so any cracks can lead to mastitis

33
Q

What happens to insulin needs upon expulsion of placenta?

A

fall dramatically

34
Q

What levels are we looking for in the 1 hr (50g) OGTT?

A
35
Q

If 1 Hr OGTT is positive, what do we do?

A

Do a three hour test

36
Q

When is the 3 hr (100 G) OGTT positive for diabetes?

A

when two or more values are met

37
Q

3 Hr (100 g) OGTT Values:

Fasting =
1 hr =
2 hr =
3 hr =

A

Fasting = > 95
1 hr = > 180
2 hr = > 155
3 hr = > 140

38
Q

What are the targeted glucose levels during pregnancy in relation to meals?

A

Fasting = 60-99

1 hr post meal = 100-129

2 hr post meal =

39
Q

2/3 of daily insulin is given at – and 1/3 is given at –

A

breakfast

evening

40
Q

When would we do a C/S for HSV2 client?

A

if active lesions are present in the birth canal

41
Q

Which type of diabetic meds are seldom used during pregnancy?

A

oral meds

42
Q

Instructions regarding exercise for diabetic pregnant client?

A

Monitor Closely

15-30 mins walking for 4-6 times/wk

Snack of protein or complex carb BEFORE exercise

Monitor glucose before, during, and after exercise

43
Q

What numbers constitute a positive 3 hr OGTT?

A

> 140 or > 145

***avoid caffeine and smoking for 12 hrs before test

44
Q

What test is given to newborn of HIV mom?

A

ELISA test which looks for presence of HIV antibodies

45
Q

What does MSAFP look for?

A

Alpha Fetoprotein, which is produced in FETAL gestational tract and liver

increasing levels are detectable in maternal serum b/t 14-34 wks

46
Q

What are elevated levels of Alpha Fetoprotien indicative of?

A

Neural Tube defects

Abdominal Wall defects

47
Q

Cocaine can lead to ——

A

placental abruption

48
Q

Why is infant of diabetic mom at risk for hypoglycemia shortly after birth?

A

Baby has been dealing with mom’s high glucose levels in utero

When placental supply is cut off, the baby has all this excess insulin and a much lower supply of glucose

***remember, baby pancreas produces insulin at 10 wks gesttaion

49
Q

What serum glucose level are we looking for in newborn?

A

40-60

50
Q

How do we treat hypoglycemia in newborn?

A

early and often breastmilk

formula

D5W

***NGT if can’t suck well

51
Q

When is the greatest risk for a mom who has cardiac insufficiency?

A

28-32 wks b/c fluid volume peaks

52
Q

S/S of Cardiac Decompensation

A

Fatigue

Dyspnea, Cough (feels smothered)

Weak, thready pulse

Tachycardia (> 100)

Bradycardia (> 25)

Orthopnea

Crackles at base of lungs

Cyanosis

53
Q

What should we remember for a cardiac client during 2nd stage of labor?

A

no pushing or bearing down

54
Q

What will the FHR strip look like for a cardiac patient mom?

A

late decels due to poor placental perfusion

55
Q

Where can a client contract Toxoplasmosis?

A

Raw Meat

Cat Litter

56
Q

What does RPR test for?

A

Syphillis

**could lead to spontaneous abortion or PTL

57
Q

When would we do a C/S for HSV2 client?

A

if active lesions are present in the birth canal

58
Q

When should HIV mom get medications?

A

Zidovudine after 14 wks gestation orally

IV during labor

59
Q

When should infant get ZDV if mom had HIV?

A

~ 6 months (weeks???)

60
Q

Delivery plan for HIV mom

A

No pitocin to avoid lacerations

no scalp electrodes

no episiotomy

no breastfeeding

61
Q

What test is given to newborn of HIV mom?

A

ELISA test which looks for presence of HIV antibodies

62
Q

When are pregnant women screened for Hep B?

A

all are screened early on

at risk screened in 3rd trimester

63
Q

What is treatment for newborn r/t Hep B mom?

A

given immune globuline at birth to prevent skin surface contamination

repeated at 1 and 6 months

64
Q

Cocaine can lead to ——

A

placental abruption

65
Q

What if mom is less than 32 weeks and has complications from HELLP?

A

give corticosteroids to help with fetal lung development

66
Q

What if mom is > 34 wks and has complications from HELLP?

A

go ahead and deliver

67
Q

Question 27

A

Question 27

Maternal-Newborn (Josh) (29 decks)

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