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VN 34 OB & Pedi > Test 2 > Flashcards

Test 2 Flashcards

1
Q
  1. Hyperemesis gravidarum nursing intervention (Slide 6)
A

• Medication as order
o B6
o Phenergan
o Reglan
o Zofran
• Decreasing trigger factors
• Carbohydrates can decrease nausea (crackers in am)
• Assisting the woman with regaining fluid balance
• If admitted priority will be IV fluids and electrolyte replacement

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2
Q
  1. Ectopic pregnancy manifestations and risks (Slide 8)
A

Manifestation:
• Missed menstrual period
• Nausea and vomiting
• Pelvic pain
• Shoulder pain
• Vaginal spotting
• Light bleeding

Risk:
• STIs
• Tubal Ligation
• IUD

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3
Q
  1. MMR vaccine nursing considerations (pg. 259)
A

• Given after labor
• Do not get preganant the 28 days after MRR because can be tetragenic to fetus

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4
Q
  1. Placenta previa manifestations (Slide 9)
A

• Painless
• Bright red bleeding during pregnancy due to an abnormally implanted placenta that is too close to or covers the cervix
• Monitor in third trimester for painless and bright red bleeding

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5
Q
  1. Abruption placenta manifestations (Slide 9)
A

• Dark red
• Painful bleeding cause by the premature separation of the placenta from the wall of the uterus at any time before the end of labor
• Abdomen may be ridged. This is an emergency!!!!

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6
Q
  1. Amniocentesis reason for having and considerations (Slide 17)
A

Consideration:
• Performed 15-20 weeks, enough fluid at this time
• Amniocentesis can also be done for preterm labor establish lung maturity

Reasons:
• Advanced maternal age (generally accepted as older than 35)
• Previous offspring with chromosomal anomalies
• History of recuurct pregnancy loss
• Ultrasound diagnosis of fetal anomalies
• Abnormal MSAFP, triple-marker screen, or multiple screen
• Previous offspring with a neural tube defect
• Both parents known carries of a recessive genetic trait (such as cystic fibrosis, sickle cell anemia, or Tay-Sachs disease

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7
Q
  1. Teratogens risk (Slide 22)
A

• Week 2-8 post the greatest risk
- can cause birth defects in the developing fetus

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8
Q
  1. Preeclampsia nursing interventions; manifestations (Slide 16 &17)
A

Manifestation:
• BP at or greater than 140/90
• Headaches
• Visual changes including floaters
• Edema (pitting)
• Proteinuria-2+ pf higher on dipstick
• Nausea
• Epigastric pain
• FOID

Nursing Interventions:
• Accurate BP
• Daily Weights
• Bed Rest: side lying
• Output
• Seizure precautions
• Monitor respiratory rate PRIORITY!!!
• Monitor neurological status
• Pharmacology administration as order (magnesium sulfate)
• Only cure is delivery
• Pre-eclampsia (mild) at home-perform daily kick counts an report change of symptoms

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9
Q
  1. Iron, folic acid, nutrition during pregnancy (Slide 24)
A

• Iron-deficiency anemia requires iron supplements and a diet high in iron-rich foods
o Meats
o Lentils/beans
o Egg yolks
o Spinach
o Dried fruit
o Eat with vitamin C for better absorption

• Vitamin A
o Too much can be toxic to the fetus
o Too little can stunt fetal growth and cause impaired dark adaptation and …?

• Folic Acid (VB9): poor folic acid intake increases the fetal risk for neural tube defects (NTD)
Diet should include at least 400mcg of follic acid per day
o Dark green leafy vegetables
o Meat
o Legumes
o Nuts
o Eggs

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10
Q
  1. GTPAL (Slide 14)
A

• G: Gravida
o The total number of pregnancies

• T: Term
o The number of pregnancies that need at term (at or beyond 38 week’s gestation)

• P: Preterm
o The number of pregnancies that ended after 20 weeks and before the end of 37 weeks’ gestation

• A: Abortions
o The number of pregnancies that ended before 20 weeks’ gestation

• L: Living
o The number of children delivered who are alive when the history is taken

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11
Q
  1. Gestational diabetes nursing interventions (Slide 18)
A

• Occurs only in pregnancy and disappears at delivery
• About a 30% risk of developing diabetes
• Screening at 24-28 weeks 1 hr GTT, followed by 3hr GTT
• If pregestational good blood glucose control can help progression
• Start with diet, move to insulin if not controlled

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12
Q
  1. GDM complications (Slide 18 & FC)
A

• Spontaneous Abortion (SAB)
- Polyhydramnios
- Maternal HTN
- Large for gestational Age (LGA)
o Hypoglycemia

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13
Q
  1. MSAFP reasons (Slide16)
A

(Maternal serum alpha fetal protein)
• 16-18 weeks

• Elevated could mean neural tube defect:
o Anencephaly (failure of the brain to develop normally)
o Spina Bifida (failure of the spine to close completely during development)

• Low MSAFP level:
o Down syndrome

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14
Q
  1. Early sx of pregnancy (Slide 2) Presumptive, Probable Positive Sign
A

• Presumptive (possible) sign: Subjective data
o Breast tenderness
o Missed period
o Frequent urination
o Back pain
o Mood changes
o N/V and fatigue

• Probable signs: Objective sign
o Positive test either urine or blood

• Positive signs: Diagnostic confirmation (definite)
o Ultrasound
o Fetal heartbeat
(Priority thought for Amenorrhea is pregnancy)

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15
Q
  1. HIV, HSV, and pregnancy nursing considerations (Slide 27)
A

• HIV: Prophylactic medication to keep viral loads down
o Will need formula teaching

• HSV: if active lesion will need cesarean preventative antivirals in third trimester
• MMR: will need prior to discharge
• Chlamydia and Gonorrhea: increased risk of PTL
• Trichomoniasis: Flagy/PTL

• Torch- Toxoplasmosis, other (hepatitis B, Syphilis, varicella, and herpes zoster), rubella, CMV, and HSV)
o Prevention of infections is the best treatment strategy because many of the TORCH infections do not have effective treatment

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16
Q
  1. RhoGAM considerations (Slide 21)
A

o Rhogam prevent formation of Rh Antibodies

17
Q
  1. NST considerations (Slide 18)
A

o The no stress test measures fetal heart rate acceleration patterns. A reactive NST is reassuring
o A reactive 2 acceleration in 20 minutes is good
o Non reactive requires further testing and after 40 minutes of no activity, a BPP is needed

18
Q
  1. Magnesium sulfate nursing considerations
A

o Check for toxicity level is at a high risk
o Monitor Respiratory; risk if less than 12
o Monitor for level of consciousness
o Monitor decrease deep tendon reflex

19
Q
  1. Exercise, travel, and pregnancy (Slide 20 page 59))
A

Exercise:
• Within normal limits.
• Nothing that can cause trauma to the baby
• Regular aerobic exercise conditions the heart, lungs, muscle, and other organs in preparation for the increase demands of pregnancy

Travel:
•
•

20
Q
  1. MAB, complete AB etc. Slide
A

• Threatened Abortion:
o Vaginal bleeding or spotting; possibly cramping; no cervical dilatation. Symptoms may resolve and the pregnancy may progress to term, or threatened Abortion can lead to one of the other types

• Inevitable Abortion:
o Cramping and spotting or vaginal bleeding with cervical dilataion; amniotic fluid may leak

• Incomplete Abortion:
o Some, but not all, of the products of conception (fetus, membranes, and placenta) are expelled

• Complete Abortion:
o All of the products of conception (fetus, membranes, and placenta) are expelled

• Missed Abortion:
o The fetus dies, but remains in utero. Signs of pregnancy (nausea, breast tenderness) decrease, and the fundus does not grow as expected in a normal pregnancy and may regress (get smaller). No fetal heart tones are present

• Habitual (Recurrent Abortion:
o The loss of three or more consecutive pregnancies before the fetus is viable

21
Q
  1. Integumentary system changes during pregnancy (Slide 10)
A

Chloasma (mask of pregnancy):
o Brown blotchy areas on the forehead, cheeks, and nose
o May be permanent or it might regress between pregnancies

Linea nigra:
o The skin in the middle of the abdomen may develop a darkened line due to hormonal changes

Striae (stretch marks):
o May develop on the abdomen in response to elevated glucocorticoid levels

22
Q
  1. Danger Signs (Slide 21)
A

o Visual disturbances/blurred vision
o Headaches
o Epigastric pain
o Edema extremities and facial
o Excessive, rapid weight gain
o Pain
o Signs of infection-odor
o Vaginal bleeding-avoid drainage
o Persistent vomiting
o Absence or decrease in fetal movement once felt

23
Q

HIV&HSV

A

HIV
o A woman who has HIV during preqnancy is at risk for transmitting the
infection to the fetus during pregnancy or childbirth and to the newborn
while breast-feeding
o Receiving appropriate antiretroviral treatment during pregnancy and childbirth and avoiding breast-feeding the newborn substantially reduce the risk of perinatal transmission of HIV to the infant

HSV
o Treatment during pregnancy often includes a 1- to 2-week course of
therapy with acyciovir for a first episode of HSV.
o Suppressive therapy may be ordered beginning at 36 weeks’ gestation
because this seems to reduce the risk of an active outbreak at the time of
delivery

VN 34 OB & Pedi (17 decks)

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