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Maternity > Week 1 > Flashcards

Week 1 Flashcards

1
Q

who defines is family

A

patient

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2
Q

G/P
- G

A

gravida
- number of pregnancy gone past 20 weeks

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3
Q

G/P
term - term - term - term

A

gone to term - preterm - abortion - living

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4
Q

G2 P2-0-0-2

A

G2: number of preg gone past 20 weeks
P2: term
0: preterm
0: abortion
2: living

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5
Q

EDC

A

due date

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6
Q

primigravida

A

pregnant for the first time

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7
Q

multigravida

A

2 or more pregnancies

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8
Q

who might have longer labor

A

primigravida

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9
Q

precipitous

A

quick birth

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10
Q

who is going to have a precipitous birth multi or primi

A

multi

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11
Q

SVD

A

spontaneous vaginal delivery

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12
Q

LDRP

A

labor
delivery
recovery
postpartum

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13
Q

PP

A

post partum

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14
Q

C/S

A

cesarean section

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15
Q

typical hospital stay for vginal birth

A

1-2 days

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16
Q

how long does the mom and newborn have to stay and why

A

24 hours so complete the new born screening

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17
Q

postpartum peroid
- begin and end

A

delivery to the return of the reproductive system to the non pregnant state (6-8 weeks)

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18
Q

post partum is also called

A

puerperium (4th trimester)

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19
Q

puerperium

A

4th trimester
- post partum

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20
Q

involution

A

returns to pre pregnant state

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21
Q

within 12 hours of birth where will the fundus be palpated at

A

1cm above the umbilicus

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22
Q

fundus descends how much per day

A

1-2 cm

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23
Q

what does a boggy fundus feel like

A

soft

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24
Q

what is happening when the fundus is boggy

A

uterus cannot clamp down and usually there will be hemorrhage

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25
Q

when should the fundus not be palpable

A

2 weeks PP

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26
Q

subinvolution

A

uterus is not clamping down

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27
Q

what is sub involution usually caused by

A

retained placental fragments

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28
Q

why do we need to inspect the placenta after delivery

A

ensure no piece is left in the uterus

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29
Q

what can a full bladder contribute to

A

hemorrhage since the uterus cannot clamp down
also contributes to the fundus moving to the side making it hard to feel where it is located at

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30
Q

endo oxytocin

A

from the brain

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31
Q

exo oxytocin

A

Pitocin med

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32
Q

golden hour

A

1st hour after birth

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33
Q

what does breast feeding do for the uterus and clamping down

A

helps clamp down due to secreted oxytocin during breast feeding

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34
Q

when do we give a bolus of pit

A

after the baby is born

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35
Q

afterpains are going to be stronger in who

A

multi woman (loss of uterine tone)
over distened uterine muscle because its more the uterus has to clamp down
- multifetal (twins)
- polyhydraminos
- macrosomia

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36
Q

polyhydramnios

A

increase amniotic fluid

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37
Q

macrosomia

A

large baby

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38
Q

will the after pains be noticeable during pregnancy

A

yes

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39
Q

will after pains be notable during administration of oxytocin

A

yes

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40
Q

placental site is normally healed when

A

6wks pp

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41
Q

if placental does not separate in 30 min

A

bimanual exam

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42
Q

lochia is

A

combination of blood, mucus, and tissue discharged from uterine lining

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43
Q

3 types of lochia

A

rubra
serosa
alba

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44
Q

rubra lochia

A

red/brown
heavyish flow
smaller clots
1-3 days

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45
Q

serosa lochia

A

pink/brown
small amounts of blood
very little amounts of clots
3-10 days

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46
Q

alba lochia

A

yellowish white
WBC, tissue, bacteria
10-14 days but can last longer

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47
Q

what is abnormal with all lochia

A

foul odor

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48
Q

saturation of perineal pad in ____ mins or less is considered excessive and may indicate PPH

A

15 mins

49
Q

normal vaginal delivery blood loss

A

<500

50
Q

normal CS blood loss

A

<1000

51
Q

1mL of blood on linens =

A

1 g in weight

52
Q

round cervix

A

never gone through labor

53
Q

slit like cervix

A

gone through labor

54
Q

besides the vaginal and uterus what is the other most important organ in L and D

A

bladder

55
Q

presence of free flowing bright red blood may indicate

A

cervical laceration

56
Q

if bleeding we

A

massage the fundus

57
Q

if the patient is bleeding but you massage the fundus and it is firm what might it be

A

cervical laceration

58
Q

hematoma

A

accumulation of blood in pelvic tissue

59
Q

s/s of hematoma

A

unrelenting pain
pressure in vagina or rectum

60
Q

late signs of hematoma (aka blood loss)

A

tachy
increase RR
low BP

61
Q

episiotomies that are healing well are only visible when

A

pt is laying on side

62
Q

episiotomies heal within

A

2-3 weeks

63
Q

what is abnormal with an episiotomies and may be signs of infection

A

redness
warmth
swelling
discharge
separation from edges

64
Q

1st degree tear

A

superficial to muscle

65
Q

2nd degree tear

A

extends through the muscles of the perineal3

66
Q

3rd degree

A

through anal sphincter

67
Q

4th degree

A

involves anterior rectal wall

68
Q

uterthral tear

A

upward from the vaginal towards the urethra

69
Q

not uncommon to void excess of _______mL per day during first several days PP

A

3000

70
Q

colostrum is secreted when

A

shortly after birth

71
Q

is colostrum high or small volumes

A

small since the infants stomach is so small it does not need alot

72
Q

what should we educate to the mom not wanting to breast feed

A

tight bra and ice to decrease swelling and stimulation
- No hot shower this will stimulate the breast to make more milk

73
Q

HR, SV, and CO _________ immediately after giving birth

A

increase

74
Q

due to the hemodynamic changes what might be a result

A

orthostatic hypotension

75
Q

education on ortho hypo

A

sit slow and dangle

76
Q

normally increased blood volume is eliminated within first ___ weeks after delivery

A

2

77
Q

pregnancy is a ________ state

A

hypercoaguble state
- due to increase in fibrinogen and clotting factors

78
Q

since pregnancy is hypercoaguble this means they are at risk for

A

DVT

79
Q

why might WBC increase after birth

A

boys response to wound in uterus

80
Q

what is a common complaint of PP

A

headache

81
Q

why might headache be caused

A

hormonal shift or spinal from epidural

82
Q

TX for hormonal headache

A

decrease light and noise
increase caffeine

83
Q

TX for spinal headache

A

blood patch

84
Q

preeclampsia can occur for ____ weeks after delivery

A

4 weeks

85
Q

what do mothers need to be taught if they go to ED

A

they are in the PP peroid

86
Q

what changes in the musculoskeletal

A

change in center of gravity
- increase fall risk

87
Q

joints where might not return to normal

A

feet

88
Q

atony

A

bleeding
- lack of tone (boggy)

89
Q

what is the most frequent cause of uterine bleeding after birth

A

atony

90
Q

why might atony be caused

A

retained placental fragments

91
Q

we should always screen for what before discharge

A

depression

92
Q

what might be common during the childbirth phase

A

tremors or chills

93
Q

C section is a post op patient, what should we manage

A

abdominal dressing
LOC
IV
I and O
cardiac
Bowel sounds
Lung sounds
IS
pain
anesthesia

94
Q

BUBBLEHE

A

breast
uterus
bowel
bladder
loch
episiotomy
homans sign (DVT)
emotions

95
Q

when breastfeeding, why should the baby have the whole areola in the mouth not just the nipple

A

it could lead to tissue damagef

96
Q

firm breasts mean

A

milk is in

97
Q

we need to assess for what of the fundus

A

height
location
tone

98
Q

patient should void every

A

2 hours

99
Q

why might fundal assessments be uncomfy in CS patients

A

assessing right above scar

100
Q

bowel Q

A

last BM
passing gass
distension

101
Q

for assessment of lochia and episiotomies we need to assess for

A

bleeding, amount, color, character, odor

102
Q

prevent infection

A

hand washing and perineal hygiene of the peri bottle

103
Q

what position should the patient be in when assessing for episiotomies

A

side

104
Q

do we do homans sign and why

A

no because you can dislodge the clot

105
Q

what to assess for in DVT

A

redness
warm
pedal pulses
ambulation

106
Q

emotions
assess between

A

family members

107
Q

REEDA

A

redness
ecchymosis
edema
discharge
approximation

108
Q

perineal care

A

ice packs
peri bottle
analgesics

109
Q

if our patient is sitting down, how might we instruct them so they do not put pressure on perineum

A

tightening glutes prior to sitting to avoid pressure on perineum

110
Q

what to assess for during the transition to parent hood

A

feelings about self
relationships of family origin
social support networks
relationship with partner and infant

111
Q

maternal adaption 3 phases

A
  1. talking in or dependent phase
  2. taking hold
  3. letting go or interdependent phase
112
Q
  1. taking in or dependent phase
A

first 24 hours after birth
meet her basic needs
(love self)

113
Q
  1. taking hold
A

2-3 days to several weeks
care of newborn and competent mothering
(love self)

114
Q

3.letting go or interdepent phase

A

forward movement of family as unit
(love us)

115
Q

avanced maternal age

A

> 35 years

116
Q

sibbling adapation

A

regression

117
Q

discharge starts on

A

admission

118
Q

blurred vision and severe headaches might be a sign of

A

blood pressure

119
Q

POST BIRTH warning signs

A

P: pain in chest
O: obstructed breathing
S: seizures
T: thoughts of harming

B: bleeding (excessive)
I: incision not healing
R: redness in calf
T: >100.4 temp, foul smelling discharge
H: headache that does not improve with Tylenol

Maternity (8 decks)

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