Unit exam #1 - Maternal Flashcards
Acrocyanosis
bluish discoloration of hands feet but pink trunk
APGAR assessment
Routine rapid assessment of the newborn’s overall status and response to resuscitation.
it is scored In 5 domains
heart rate, respiratory rate, Muscle tone, Reflex irritability, and color
how is heart rate on the Apgar scored
0 is absent /
1 slow <100 bpm /
>100 bpm or equal to
how is respiratory effort measured on the Apgar scoring
0 Absent/
1 Slow, weak cry/
2 good cry
how is muscle tone measured on the Apgar scoring
0 Flaccid/
1 some flexion of extremities/
2 well flexed
how is the grimace
measured on the Apgar scoring
0 no response/
1 grimace/
2 cry
how is color measured on the Apgar scoring method
0 blue, pale/
1 body pink, extremities blue/
2 completely pink
Acetaminophen
NSAID for treatment of fever and for postpartum period to relieve pain to relieve discomfort
Albuterol
Beta adrenergic agonist
causes increased heart rate and Gi disturbances
(emergent use to relieve a bronchospasm)
Amlodipine
Calcium channel blocker
used to treat during hypertensive episode of patient and Lowers the heart rate e
Aspirin
Analgesic / antipyretic
used as a preventive measure for preeclampsia
Beta2-adrenergic agonist
Relaxes uterine smooth muscle
what patients should you not give these to? Women with known or suspected heart disease, preeclampsia with severe features or eclampsia, pregestational or gestational diabetes, or hyperthyroidism
SE? Hyperglycemia
Betamethasone
used to prevent preterm birth and create surfactant for fetal development
Calcium Gluconate
antidote for magnesium sulfate / Magnesium toxicity
given over 3 minutes
Estrogen
treatment of endometriosis in adolescents can be available in a patch form
Folic acid
supplement use for deficiency of folate to prevent birth defects
prevents NTD
Guifensin
mucolytic to thin secretions for children with RSV, croup, CF to thin secretions and allow for easier breathing
Gentamicin
Broad-Spectrum Antibiotics
they can be given during pregnancy to prevent chioriamniotis during labor (infection of the genitourinary tract)
given after Cesarean Birth to prevent infection of anaerobic microorganisms.
Hydrocodone
mild form of opioid for postpartum /postoperative pain treatment
iron supplement
Iron deficiency
and prenatal care to make hemoglobin and red blood cells
should be administered between meals for greater absorption
labetalol
Beta blocker lowers your hr and blood pressure
used in hypertensive emergency state for mom
Magnesium Sulfate
Used for treatment of preeclampsia
can be given IVP
can cause warmth, flushing, diaphoresis and burning at the IV site
Methylprednisolone
used to decrease inflammation and minimize further injury / to prevent hyperemesis in hyperemesis gravidarum
Montelukast Sodium
Leukotrienes
block inflammatory and bronchospasm effects used for children to treat asthma ages 12 months of age and older for maintenance through controlled use of beta agonists. and steroids.
Pancreatic Enzyme
Long-term use for cystic fibrosis management
has to be taken 30 minutes before every meal
Prostaglandin
Cerevidil insert and Prepidil gel
the insert should be removed after 12 hours of active onset labor or earlier if adverse effects occur
the gel is administered through a catheter may be administered every 6 hours for cervical ripening
Adverse effects: Fever, chills, Nausea, vomiting, and uterine tachysystole with or without an abnormal FHR and pattern
Rhogam administration
unsensitized mothers at 28 weeks gestation and within 72 hours after birth or following miscarriage or therapeutic abortion
Placenta Previa
the placenta is implanted in the lower uterine segment it can completely cover the cervical os or partially or is close enough to the cervix to cause bleeding when the cervix dilates or the lower uterine segment effaces
Placental abruption
what is it? premature separation of the placenta from uterine wall
what causes it? smoking, hypertension, HELLP syndrome, and cocaine
symptoms of placental abruption? Vaginal bleeding, abdominal pain, back pain
how would you manage this?
early delivery and fetal condition assessment
Cystic Fibrosis
what is it? common autosomal recessive genetic disorder
what is the pathophysiology of CF? the exocrine glands produce excessive viscous secretions
what systems are affected? Respiratory and digestive system
what causes it? genetics
how do they diagnose it?
sweat chloride test for newborn, a genetic or carrier test etc.
HELLP syndrome
what is it? laboratory diagnosis for a variant of preeclampsia that involves hepatic dysfunction characterized by hemolysis (H), elevated liver enzymes (EL), and low platelet count (LP)
what are the important aspects of car seat safety?
put the seat in rear facing position because a frontal crash would result in it being spread over the head, neck and back and the car seat supports the spine. The car seat should have a 5 point safety harness, put a tightly rolled towel on the sides of the head to keep the head in place.
what does GTPAL stand for
Gravita (number of pregnancies)/ Term (the number of pregnancies that ended in term birth 37-42 weeks)/ Preterm (number of pregnancies that ended in preterm births 35 and under weeks)/ Abortion / living children
what is a term birth?
37 weeks and 0 days and beyond including early, full, late term and post births
Alpha-fetoprotein screening
screening test for neural tube defects such as spina bifida or encephalopathy in pregnancy as an early detection screening tool.
Ambivalence
having conflicting feelings simultaneously
what does it look like? mom is pregnant but mom is sad life is ending
Amniocentesis
what is it? it is a screening test where amniotic fluid is obtained to screen for early detection of different chronic conditions of the fetus usually performed at 15 weeks gestation or after from the cells for Early screening of defects
Anticipatory Guidance
what is it? it is what will occur at that age range and to teach parents what will be coming soon
Atraumatic care
what is it? provision of therapeutic care in settings, by personnel and through the use of interventions that minimize or eliminate the psychological and physical distress experienced by children and their families in the health care system
Biophysical profile
what is it? Noninvasive dynamic assessment of a fetus that is based on on acute and chronic markers of fetal disease
Biophysical profile scoring system is based upon
Fetal breathing movements/ Fetal Movements/ Fetal tone/ Amniotic fluid and Non stress test
what does the breath sound of Rails means
circulatory overload, too rapid transfusion, and transfusion of excessive quantity of fluid
fine and coaurse crackles
what does the breath sound of wheezes mean
Inflamed pleural surfaces of lung
what does the breath sounds of crackles means
possible fluid overload
how is concealed hemmorhage identified
Increasing fundal height
Naegeles rule
what is it? it is used to estimate the due date of mom
how do you calculate it? date of last menstrual period - 3 calendar months + 7 days + 1 year
when do you score a Apgar
1 minute after birth / 5 minutes after birth
Object Permanence
the object is not visible but still exist but the child thinks it is gone
from birth to 2 years old of sensiormotor stage
Oral glucose tolerance test
a screening tool to check for Gestational diabetes Mellitus
checked after an hour but if you fail it you have to do a 3 hour test
when is the test scheduled? 24-28 weeks
Preterm Birth
birth that happens between 20 weeks to 36 6/7 weeks
Preterm Labor (S/S, diagnostic test, complications)
What are the S/S? change in type of vaginal discharge (watery, mucus, or bloody)/ increase In amount of vaginal discharge/ constant low, dull backache/ pelvic or lower abdominal pressure/ Mild abdominal cramps with or without diarrhea/ regular or frequent contractions or uterine tightening, often painless/ ruptured membranes
what would be the diagnostic for preterm labor? shortened cervical length, Fetal Fibronectin
What are the Complications? Intrauterine infection, cord prolapse, umbilical compression and placental abruption
Preterm Premature rupture of membranes PPROM
rupture of membranes before 37 weeks
what causes it? weakening of amniotic membranes
Premature rupture of membranes PROM
membrane rupture before 37 0/7 weeks of gestation
Pseudomonas aeruginosa
or staphylococcus aureus Acute otitis external infection of ear from swimming
common in 5 - 14 years old peaks In summer.
Rubella (titer, vaccination, S/S)
what is it? a subcutaneous injection of rubella vaccine is recommended in the postpartum period prior to discharge from the birth facility
purpose of the vaccine? to prevent the possibility of contracting rubella in future pregnancies; it is given for measles, mumps, rubella (MMR) vaccine.
what is the titer reading? 1:8 or less or enzyme immunoassays level <0.8
what are the signs and symptoms of Rubella? Fever, transient arthralgia, rash and lymphadenopathy
Toxoplasmosis
can come from pregnant woman being around cat poop and eating raw meat
Infant reflexes
Moro, Babiniski, Tonic neck, dancing/stepping
What is the moro infant reflexes
newborn lays in supine position on a bed and crying with arm extended outward fingers fanned out and knees bent
What is the Babinski infant reflexes
beginning of the heel stroke upward along lateral aspect of the foot, then move finger across ball of foot
what is the Tonic neck infant reflexes
supine neutral position, turn head quickly to on side
what is the dancing/stepping infant reflexes
hold infant vertically under arms or on trunk, allowing one foot to touch table surface
Gestational Diabetes
what is it? diagnosed during the second or third trimester of pregnancy increased blood glucose levels
what are the S/S? hyperglycemia
how do you diagnose it? positive glucose tolerance test
Fundal Height
measurement of the height of the uterus above the symphysis pubis and an indicator of fetal growth or 3 cm variation of growth
FLACC
PostOperative pain scale for 2 months to 7 years old
what does FLACC stand for
Face/ Legs/ Activity/ Cry/ Consolability
How do you score the face
0 No particular expression or smile/
1 Occasional grimace or frown, withdrawn, disinterested/
2 Frequent to constant frown, clenched jaw, quivering chin
how do you score the legs on the FLACC scale
0 Normal position or relaxed/
1 Uneasy, restless, tense/
2 Kicking, or legs drawn up
what is the activity scoring on the FLACC post operative scale
0 lying quiet, normal position, moves easily/
1 squirming, shifting back and forth, tense/
2 arched, rigid or jerking
what is the cry scoring for the FLACC scale
0 no cry/
1 moans or whimpers occasional complaint/
2 crying steadily, screams or sobs, frequent complaints
what is the consolability scoring on the flacc scale
0 content, relaxed/
1 reassured by occasional touching/
2 difficult to console or comfort
Fetal kick count
it is an noninvasive, inexpensive and simple to understand and usually does not interfere with a daily routine. it is an assessment test to see if the fetus is well oxygenated
One of the way is to count once a day for 60 minutes. 10 movements should be counted in a 12- hour period.
head control Gross motor development
prone infants move baby head parallel and side to side
at 3 months old hold head well beyond the planes of the bodies
4 months old lift their head and front portion of their chest approximately lately 90 degrees above their chest
4-6 months old head control is well established
Magnesium level in pregnant mom
4 to 7
Rolling over gross Motor development
5 months old turn from abdomen to back
6 months back to abdomen
parachute reflex is at 7 months old
sitting gross motor development
2-3 months the back is uniformly rounded
3-4 months convex cervical form
4 months old convex lumbar curve
7 months old infants can sit alone leaning forward on their hands for support
8 months old sit well without support and explore in lying position
10 months old prone to sitting
Locomotion Gross motor development
4-6 months old increasing coordination of their arms
6-7 months old able to bear all of their weight on their legs with assistance
9 months old stand while holding onto furniture and pull themselves to the standing position
11 months walk while holding onto furniture or with both hands held
1 years old walk with one hand held.
Gross motor Development 3 years old
ride a tricycle and jump forward. walk up the stairs with alternating feet
Erikson stages for birth to 1 year old
acquiring a sense of trust while overcoming sense of mistrust
includes primary narcissism grasping, biting
Erikson stages for 18 months to 3 years
autonomy v shame and doubt
eriksons stages 3-6 years old
initiative v guilt issue or purpose
Eriksons stages 6-12 years
industry v inferiority
Deep tendon reflexes
biceps or patella or clonus
absence of deep tendon reflexes are associated with Magnesium Toxicity
age-appropriate play activities for infant
Social-affective play/ Sense-pleasure play/ Skill play( infant can grasp)/ Unoccupied behavior ( daydream )/ Dramatic, or pretend, play (11-13 months)/ games
what is the assessment sequence for children
Non-invasive to Invasive
What would you order a clean-catch urine specimen for?
provide information about pregnant person’s hydration status (specific gravity, color, amount)/ nutritional status (ketones)/ infection status (leukocytes)/ or the of possible complications such as preeclampsia (proteinuria)
Diplopia
blurred vision (early sign of increased ICP in children)
Discomforts of pregnancy
N/v, constipation, and pyrosis (heartburn)
Dysuria associated with pregnancy
can indicate a UTI (cystitis, acute urethritis)
Embryonic period
weeks 1 and 2 : no susceptive to teratogenesis. Death of embryo and spontaneous abortion common.
Weeks 3 to 8: main embryonic period and highly sensitive to major congenital anomalies.
weeks 9 to 38: fetal period and less sensitive to functional defects and minor anomalies
what is the highly sensitive period contain
NTD, developmental delay, truncus arteriosus, atrial septal defect, ventricular septal defect, cleft lip, glaucoma
how long does the stage of the embryo last
day 15 until approximately 8 weeks after conception
what effect does cocaine have on the placenta?
Placental abruption ( separation from uterine walls)
what effect does smoking have on the fetus
it can increase vaginal bleeding during pregnancy and delivery
how can exercise help during pregnancy
helps with weight management and reducing the risk of gestational diabetes, cesarean birth, and giving birth to a big baby.
what is the reccomended exercise for pregnant women
150 minutes of moderate-intensity aerobic activity spread throughout the week
what are the most common food allergies for infants
Eggs, milk, peanuts, tree nuts, fish, shellfish, wheat and soy
how to chart for growth chart documentation
Weight between 5 to 95th percentile, maintained curve, did not maintain curve
Family-centered care
fathers can participate in birth by being part of the process of cutting the cord, catching the baby
Doula can present for caring experience
what is part of immunization documentation?
Lot number, site/location, expiration, manufacturer, date and time given, vaccine information sheet from CDC
where do you administer a shot for a child 0-12 months
vastus lateralis
what is preterm birth?
20-35 weeks
twin-to-twin transfusion
the weakling twin eats the healthy twin only in mono/mono
what is the type of multiple gestation that the twin in different sacks same placental
Mono/diamnitioc
what type of multiple gestation is it when there are separate placentas
Dicschlorionic/diamnioitic
what is the language development for a 3-6 year old
initiative v guilt
what is the Erickson stage for 6-12 years old
Industry v Inferiority
what is the Erickson stage of 12 to 18 years old
Identity v role confusion
what is an infants language development
crying, first few weeks of life should decrease at age of 12 weeks old, after the 1st year the infant cries for attention, fear, and frustration/ 5 to 6 weeks old make the small syllables such as mama, 2 months old they can make single vowel sounds/ 3 to 4 months old consonants are added/ 6 months old they imitate sounds/ they ascribe meanings to the words at 10 -11 months old/ at 9-10 months they understand the meaning of the word NO and obey simple commands/ 1 years old they say 3-5 words
what is a toddlers language development?
at 1 years old the use one word sentences/ 2 years old multiword sentences 2 or 3 words/ 3 years old children put words into simple sentences
Leopolds Maneuver
assessment of the fetus and sometimes for fetal size
(1)which fetal part is in the uterine fungus? (2) where is the fetal back located? (3) what is the presenting fetal part?
Teratogens
agents that cause birth defects when present in the prenatal environment, account for most adverse intrauterine effects not attributable to genetic factors
toddler regression
retreat from one’s present pattern of functioning to past levels of behavior such as a child refusing the potty chair
when is solid food introduction delayed
4-6 months of age
what is team birth components
- team huddles
- shared planning board
what are the 4 key behaviors of team birth
- promoting each member of the team
- eliciting patient preferences
- distinguishing plan for patient, baby, and labor progress
- setting clear expectations for next huddle
what is the purpose of the ultrasound for pregnant women
to examine the fetus
what is the anatomy of the umbilical cord
2 arteries 1 vein and Wharton jelly
infertility risk factors for males
hormonal disorders/ obesity/ testicular factors/ factors that affect sperm transport
Infertility risk factors for females
obesity, polycystic ovarian syndrome, strenuous exercise or endocrine dysfunction, cancer treatment, smoking, depression, environmental exposure to air pollution, heavy metals, and insecticides and inflammation and oxidative stress
What is the purpose of the non stress test
when there is decreased fetal movement
how do you score the biophysical profile based on fetal breathing movements
fetal breathing movements
score of 2 is at least one episode of fetal breathing movements of at least 30 seconds duration in a 30 min observation
Score of 0 is ABSENT
how do you score fetal movement of the biophysical profile
Score of 2 is at least 3 trunk/limb movements in 30 minutes
score 0 fewer than 3 episodes of trunk/limb movements in 30 minutes
how do you score the fetal tone for the biophysical profile
score of 2 at least one episode of active extension with return to flexion of fetal limb or trunk; opening and closing of hand considered normal tone
score of 0 absence of movement or slow extension/flexion
how do you score the amniotic fluid for the Biophysical profile
Score of 2 is the deepest vertical pocket >2cm
Score of 0 deepest vertical pocket less than or equal to 2 cm
how do you score non stress test on the biophysical profile
Reactive score of 2
nonreactive score of 0
what is the pattern of weight gain from first trimester
2 to 4 lbs
what is the reccomended weight gain for pregnancy for normal weight
25-35 lbs
What is an intrauterine growth restriction IUGR examples
STI syphilis and Gonorrhea
Preeclampsia
what is it? 20 weeks gestation proteinuria with gestational hypertension
what does it look like? Proteinuria 20 weeks pregnant, visual symptoms, pulmonary edema, impaired liver function
what does the nurse do to treat it? Magnesium sulfate
what are some signs of presumptive signs of pregnancy
3-4 weeks breast changes/ 4 weeks amenorrhea/ 4-14 weeks Nausea and vomiting/ 6-12 weeks urinary frequency/ 12 weeks fatigue/ 16-20 weeks quickening
what is the probable signs of pregnancy
5 weeks Goodell sign/ 6-8 weeks Chadwick sign/ 6-12 weeks hegar signs/ 4-12 weeks positive pregnancy test (serum)/ 6-12 weeks positive urine pregnancy test/ 16 weeks Braxton hicks contractions/
16-28 weeks ballottement
what are the positive signs of pregnancy
5-6 weeks visualization of fetus by real-time ultrasound examination/ 6 weeks fetal heart tones detected by ultrasound/ 16 weeks visualization of fetus by radiographic study/ 8-17 weeks fetal heart tones detected by doppler ultrasound stethoscope/ 17-19 weeks detected by fetal stethoscope/ 19-22 weeks fetal movements palpated by examiner/ Late pregnancy fetal movements visible to examiner
what happens to the weight of an infant at 6 months
doubles
what happens to the weight at 12 months
it triples
how does height change at 1 years
50% increase
what vaccines should be given at birth
Hep B/ RSV
what vaccines should be given at 1 and 2 months
Hepatitis B
what vaccines should be administered at 2-6 months
Rotavirus/ TDAP/ Influenzae/ pneumonococcal conjugate/ Polio virus
when should the 3rd dose of hep B be given
6 months
