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NUR 209 - Maternaty > Test 1 A > Flashcards

Test 1 A Flashcards

1
Q

3 stages of labor

A

Laboring
complete dilation-delivery
placental delivery

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2
Q

Laboring stage description

A

cervix is dilating and contractions become more frequent

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3
Q

complete dilation- delivery description

A

the cervix is fully dilated and the woman is able to push and deliver the baby

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4
Q

Placental Delivery description

A

placenta is delivered

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5
Q

3 Phases of Stage 1 of labor

A

Early latent
Active
Transitional

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6
Q

Early Latent Phase - brief

A

pt is feeling light contractions that feel like menstrual cramps and is capable of normal activity

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7
Q

Active Phase - brief

A

pt feels pressure on rectum/bladder as well as moderate-strong palpable visable contractions

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8
Q

Transitional Phase- brief

A

pt feels intense ctx at regular intervals feels the urge to push

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9
Q

Non-pharm Ix to alleviate pain

A

Guided imagery
Breathing
hydrotherapy
general comfort measures

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10
Q

Positions recommended for labor

A

Squatting
kneeling
side-lying
Semi-sitting

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11
Q

What is GBS

A

group B strep

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12
Q

% of women that get GBS

A

1 in 4

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13
Q

GBS vs strep throat

A

strep throat is caused by group A strep

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14
Q

how is GBS Dx

A

ID’d by vaginal swab

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15
Q

When and How is GBS treated

A

during labor

with IV ATB such as penicillin

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16
Q

How does baby get GBS

A

Unknown but believed through contact with vaginal fluids during delivery

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17
Q

S&S of GBS in babies

A 
Fever
difficulty feeding 
difficulty breathing 
Lethargy
Irritability 
Jaundice
Seizures
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18
Q

How many babies get GBS

A

about 1000 in US/yr

about 2-3 dies/yr

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19
Q

how is GBS treated in babies

A

with IV ATB

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20
Q

complications of GBS

A

pneumonia
meningitis
septicemia

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21
Q

Early latent phase dilation

A

0-3 cm

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22
Q

Active phase dilation

A

4-7 cm

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23
Q

Transitional phase dilation

A

> 8 cm

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24
Q

Stage 2 dilation

A

should be 10 cm

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25
Q

ELP mom feels what

A

ctxs feel like menstrual cramps (q5 for 30-40s)
Does not look like in labor, generally comfortable
Can continue with day
Excited/Anxious
Able to move around
Back ache

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26
Q

ELP Ix

A

Encourage to walk around

Can eat and drink

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27
Q

AP mom feels what

A

Palpable, visible, consistent ctx ( 2-3 min for 40-60s )
Ctx of moderate to strong pain
Trembling legs
Increased pressure on bladder and rectum

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28
Q

AP Ix

A

Offer support
meds for pain
Benefits from ambulation between ctx
—also repositioning, distraction, and breathing

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29
Q

TP mom feels what

A 
Most demanding, tired 
Strong ctx q 1,1.5-2 min for 60-90s
Hard to ambulate
Feels urge to push
Increasing sensitivity
May become emotional 
Increased pressure on rectum
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30
Q

TP Ix

A

No meds after 7cm?

Educate not to push until 10cm otherwise may cause tearing

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31
Q

S2 mom feels what

A

urge to push with contractions

ring of fire?

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32
Q

S2 Ix

A

Reassure if she poops
Different positioning for birthing
Pushing while breathing, helps for fetal O2
Have warmer ready, delivery table with materials ready

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33
Q

PD mom feels what

A

mild contractions

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34
Q

PD Ix

A

> 20 min for PD means retained placenta -> RF for hemorrhage

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35
Q

Postpartum cord actions

A

Delayed cord clamping allows for more blood to go to baby

get blood from cord for testing

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36
Q

Epidural - when HoT

A

give 1000 mL bolus IV to prevent bottoming out

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37
Q

Epidural CI

A

preeclampsia, CV disease

if healthy and obese its ok

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38
Q

Contraction strengths

A

Strong - forehead
moderate- chin
mild - nose

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39
Q

when are meds given

A

after 3 cm dilation

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40
Q

IBUBBLEHER - I

A

ID and IV

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41
Q

IBUBBLEHER - IV

A

Assess: for insertion site, dressing, tubing,rates, and soln
phlebitis
infiltration
infection

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42
Q

Phlebitis SS

A

Pain
swelling
redness
temp

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43
Q

Phlebitis Tx

A

warm compress and nonsteriod agent

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44
Q

Infiltration SS

A

swelling in nearby tissues
skin cool
firm
pale

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45
Q

Infiltration Tx

A

DC IV

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46
Q

Infection SS

A

redness
discharge
temp

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47
Q

IBUBBLEHER - B - Inspection

A

Breast - inspect size, sym, shape, nipple (erection, flatness, redness, bruising, open wounds, mastitis, colostium)

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48
Q

IBUBBLEHER - B Palp

A

fullness soft engorgement firmness, lumps

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49
Q

if breast engorged

A

Apply heat for <5 min to help with flow (>5 min may make things worse) before feeding
After feeding cold compress for 10 min
Gently massage and compress B when baby pauses sucking to help drain
Well-fitted bra or bra-less
Hand expression or pump helps soften nipple to help baby latch on
Single use of pump helps with engorgement

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50
Q

Mastitis SS

A 
Infection of breast 
breast pain
swelling 
warmth
fever
chills
nipple discharge/ pus
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51
Q

IBUBBLEHER - U - finding loci

A

Uterus - after birth fundus is btwn symphysis and umbilicus

after 12H back in umbilicus then contracts 1 finger a day

52
Q

IBUBBLEHER - U - why left or right

A

if right side -> badder full and can stop contractions

53
Q

IBUBBLEHER - U - firmness

A

firm the U with massage and express if boggy

bogginess can cause hemorrhage

54
Q

IBUBBLEHER - U - massage

A

one hand cups against uterus at symph to support U

other hand is cupped to massage and gently compress fundus toward lower U segment

55
Q

IBUBBLEHER - B 1 - assess

A

Bladder- Assess for distention incontinence retention UTI esp if pt had foley

56
Q

IBUBBLEHER - B1 - when and how much void

A

woman should void normally within 1H after vag birth and 12 H after Csection
>30 mL

57
Q

IBUBBLEHER - B1 - urine assess

A

color odor clarity amount

58
Q

IBUBBLEHER - B2 - assess

A

for sounds in all 4Q
abd distention and pain
should have mvmt in 2-3 days
Ask about movements size color and shape

59
Q

IBUBBLEHER - B2 Ix

A

Softeners PRN

60
Q

IBUBBLEHER - L

A

Lochia

61
Q

Lochia rubra

A

dark red occuring for a few days after delivery

made up of blood, bits of fetal membrane, decidua (uterine lining), meconium , cervical discharge

62
Q

Lochia serosa

A

pinkish brown at 4-10 D
WBCs > RBCs
wound discharge from placenta and other sites and mucus from cervix

63
Q

Lochia alba

A

whitish yellow at 10 - 28 D

for turbid fluid draining consisting of decidual cells mucus WBCs and epithelial cells

64
Q

IBUBBLEHER - E

A

Episiotomy

65
Q

IBUBBLEHER - H /H

A

Hemorrhoids and Homan’s sign

66
Q

IBUBBLEHER - E2

A

Emotional status

67
Q

IBUBBLEHER - R

A

Rubella

68
Q

IBUBBLEHER - E - Redness

A

0- none
1- with in 0.25 cm of incision bilaterally
2- with in 0.5 cm ‘’
3- beyond 0.5 cm ‘’

69
Q

IBUBBLEHER - E - Oedema

A

0-none
1- Perineal, <1 cm from incision
2 - Perineal, and or btwn 1-2 cm from incision
3- Perineal , and or vuluar, >2 cm from incision

70
Q

IBUBBLEHER - E - Ecchymosis

A

0- none
1- with in 0.25 bilateral or 0.5 unilateral
2- bwtn 0.25 -1 cm bilateral or 0.5 - 2 cm unilaterally
3- >1 cm bilaterally or 2 cm unilaterally

71
Q

IBUBBLEHER - E - Discharge

A

0-none
1- serum
2- serosan-guinous
3- bloody, purulent

72
Q

IBUBBLEHER - E - Approximation

A

0- close
1- skin sep <3cm
2- skin and SQ fat sep
3- skin, SQ fat, fascia layer sep

73
Q

IBUBBLEHER - Hemorrhoids

A

increased RF bc of pressure and of pushing

Assess for by visually looking for bulging around anus

74
Q

IBUBBLEHER - hemorrhoids - SS

A

itching
bleeding
discomfort when sitting or during bowl mvmts

75
Q

IBUBBLEHER - Hemorrhoids - Tx

A

cool compress
stool softeners
more fibre
anesthetics

76
Q

IBUBBLEHER - Homans sign

A

Dorsiflexion sign –> DVT

+ if pain in popliteal region and calf as foot is dorsiflexed

77
Q

Homans sign procedure

A

Leg/knee extended, examiner forcefully dorsiflexes ankle

78
Q

Homans sign Ix

A

Teach for ROM and light activity

79
Q

IBUBBLEHER - Emotional status

A

80% during first week peaking at 3-5 days because of hormonal changes
becomes: sensative cries irritable anxious and has mood swings

80
Q

Postpartum depression Ix

A 
> 2 weeks 
observe behavior 
ask how they do 
establish who to call in case
to prevent shaken baby syndrome
81
Q

Postpartum depression SS

A 
sad hopeless empty overwhelmed 
cries more than usual or no reason
over anxious or worrying
moody irritable restless
oversleeping 
trouble concentrating and remembering
loss of interest 
eats too little 
withdrawing
82
Q

IBUBBLEHER - R

A

Rubella- confirm immunity

if need vax teach to avoid preg until 1M after MMR and best until immunity confirmed

83
Q

Normal signs of Pregnancy (11)

A

NV, C, heart burn, backache, ptyalism, urinary frequency, insomnia, leg cramps, anemia, nasal stuffiness, varicose veins

84
Q

Pregnancy - NV

A

normal for 1T, severe can cause ctx

85
Q

Abnormal signs of Pregnancy

A

fluid leaking, seeing spots, headache, leg cramps, facial edema, vaginal bleeding

86
Q

Pregnancy - fluid leaking

A

norm at 40 wks, but not <38 wks can be a result of miscarriage, leaking can be urine

87
Q

Pregnancy - C

A

increased emptying time, and decreased motility; not normal when pain or no sounds;
Ix: fluids, exercise and fiber

88
Q

Pregnancy - seeing spots

A

assess for HA and HT, related to preeclampsia

89
Q

Pregnancy - heartburn

A

P causes lower esoph muscle to relax and upper displacement of stomach; Liver pain can manifest as heart burn sensation related to preeclampsia

90
Q

Pregnancy - backache

A

3T change in balance;

abn bc it could be labor

91
Q

Pregnancy - ptyalism

A

excessive salivation caused by starch

92
Q

Pregnancy - decreased fetal movement

A

mvmt sign of healthy baby (normal is 7-10/hr)

usually bad try eating

93
Q

Pregnancy - urinary frequency

A

caused by uterine enlargement; abn bc UTI can cause preterm ctx or bleeding

94
Q

Pregnancy - insomnia

A

ask about stressors

95
Q

Pregnancy - vaginal bleeding

A

abn amount dependent could be UTI

96
Q

Pregnancy - leg cramp

A

norm when baby on sciatic nerve; abn bc could be DVT

97
Q

Pregnancy - nasal stuffiness

A

more E causes more and or nose bleeds

98
Q

Pregnancy - anemia

A

normal bc of hemodilution

99
Q

Pregnancy - facial edema

A

abn assess for HT or HA, moonface, related to preeclampsia

100
Q

Pregnancy - HA

A

normal but ask more Q as it could be related to preeclampsia

101
Q

Pregnancy - varicose veins

A

normal but worry about clots

102
Q

foods with folic acid

A

raw leafy greens, legumes (beans and peanuts), OJ, fortified cereal and pasta

103
Q

foods with Fe

A

meats, greens, eggs, grains, enriched cereals, dried fruits, tofu, nuts

104
Q

Lochia amounts

A

Scant - < 1in
light - < 4in
moderate - < 6 in
heavy - saturated with in 1 hr

105
Q

CV changes in pregnancy

A

95% develop a murmur, increase in total volume by 45% (plasma by 40-60, 1200-1600; RBCs 20 -30% 250-500 mL), HoT when supine, CO increases by 50%

106
Q

blood flow changes in pregnancy

A

more flow to placenta, kidneys, skin, breasts; inf vena cava and iliac vein exp more obstruction by uterus causing varicose veins —- more fibrogen so RF blood clots

107
Q

Respiratory changes in pregnancy

A

more O2 needs by 20% — no change in RR but deeper breathing— more likely to feel dyspnea

108
Q

Mouth changes in pregnancy

A

E causes reversible gingivitis and hypertrophy — ptyalism — bleeding gums —Ix eat small f meals

109
Q

Esoph changes in pregnancy

A

pyrosis

110
Q

stomach changes in pregnancy

A

P causes less movement and emptying

111
Q

LI and SI changes in pregnancy

A

less movement and emptying but more nutrient absorption but less B vitamins; causes increased constipation

112
Q

Liver and gall bladder changes in pregnancy

A

P changes gall emptying increasing RF gallstones — 3t more AKP and less albumine and less protein

113
Q

Pituitary gland changes in pregnancy

A

more prolactin — less FSH and LH — P inhibits O until birth

114
Q

Thyroid changes in pregnancy

A

grows helps with fetal brain dev

115
Q

parathyroid changes in pregnancy

A

smaller in 1t then grows

116
Q

pancreas changes in pregnancy

A

fluctuates I, woman can dev HoGly between meals or at night, but can dev gestational DM

117
Q

Adrenals changes in pregnancy

A

more cortisol for glucose and aldo for salt absorb

118
Q

human chorionic gonadotropin hCG

A

grows corpus luteum and mks EP ; mks preg test +

119
Q

E

A

mk by Placenta – stim growth of uterus and its flow– stim growth of breast ducts – changes skin and exocrine ducts

120
Q

P

A

prevents spont abortion
stim breat lobules
relaxes sphincter smooth muscles
stores fat

121
Q

human chorionic somatomammotropin hCS

A

more gluc avail for baby

122
Q

Relaxin

A

inhib uterine activity, softens cervix tissue

123
Q

Metabolism changes in pregnancy

A

more wt
more water metabolism (6.5-8.5 L)
Dependent edema closer to term
more carb metab

124
Q

Presumptive signs of Pregnancy

A 
Amenorrhea 
NV
fatigue
urinary frequency
breast and skin changes 
vaginal and cervical color changes 
fetal movement
125
Q

probable signs of Pregnancy

A 
abd enlargement 
cervical softening (Goodells sign)
Bollottemant 
Braxton Hicks ctx
palp fetal outline 
uterine souffle (confusion with mothers pulse)
pregnancy test
Hegors sign (lower uterine segment easily compressable and flexable )
126
Q

Positive signs of Pregnancy

A

FHR auscultation
Fetal movements felt by examiner
visualization of fetus

127
Q

Special actions for VS for pregnant woman

A

prefer manual BP and used 5th korotkoff sound (>140/90 bad)
Apical pulse for 1 m
RR 16-24

NUR 209 - Maternaty (7 decks)

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