Week 1 Flashcards
1
Q
who defines is family
A
patient
2
Q
G/P
- G
A
gravida
- number of pregnancy gone past 20 weeks
3
Q
G/P
term - term - term - term
A
gone to term - preterm - abortion - living
4
Q
G2 P2-0-0-2
A
G2: number of preg gone past 20 weeks
P2: term
0: preterm
0: abortion
2: living
5
Q
EDC
A
due date
6
Q
primigravida
A
pregnant for the first time
7
Q
multigravida
A
2 or more pregnancies
8
Q
who might have longer labor
A
primigravida
9
Q
precipitous
A
quick birth
10
Q
who is going to have a precipitous birth multi or primi
A
multi
11
Q
SVD
A
spontaneous vaginal delivery
12
Q
LDRP
A
labor
delivery
recovery
postpartum
13
Q
PP
A
post partum
14
Q
C/S
A
cesarean section
15
Q
typical hospital stay for vginal birth
A
1-2 days
16
Q
how long does the mom and newborn have to stay and why
A
24 hours so complete the new born screening
17
Q
postpartum peroid
- begin and end
A
delivery to the return of the reproductive system to the non pregnant state (6-8 weeks)
18
Q
post partum is also called
A
puerperium (4th trimester)
19
Q
puerperium
A
4th trimester
- post partum
20
Q
involution
A
returns to pre pregnant state
21
Q
within 12 hours of birth where will the fundus be palpated at
A
1cm above the umbilicus
22
Q
fundus descends how much per day
A
1-2 cm
23
Q
what does a boggy fundus feel like
A
soft
24
Q
what is happening when the fundus is boggy
A
uterus cannot clamp down and usually there will be hemorrhage
25
when should the fundus not be palpable
2 weeks PP
26
subinvolution
uterus is not clamping down
27
what is sub involution usually caused by
retained placental fragments
28
why do we need to inspect the placenta after delivery
ensure no piece is left in the uterus
29
what can a full bladder contribute to
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
30
endo oxytocin
from the brain
31
exo oxytocin
Pitocin med
32
golden hour
1st hour after birth
33
what does breast feeding do for the uterus and clamping down
helps clamp down due to secreted oxytocin during breast feeding
34
when do we give a bolus of pit
after the baby is born
35
afterpains are going to be stronger in who
multi woman (loss of uterine tone)
over distened uterine muscle because its more the uterus has to clamp down
- multifetal (twins)
- polyhydraminos
- macrosomia
36
polyhydramnios
increase amniotic fluid
37
macrosomia
large baby
38
will the after pains be noticeable during pregnancy
yes
39
will after pains be notable during administration of oxytocin
yes
40
placental site is normally healed when
6wks pp
41
if placental does not separate in 30 min
bimanual exam
42
lochia is
combination of blood, mucus, and tissue discharged from uterine lining
43
3 types of lochia
rubra
serosa
alba
44
rubra lochia
red/brown
heavyish flow
smaller clots
1-3 days
45
serosa lochia
pink/brown
small amounts of blood
very little amounts of clots
3-10 days
46
alba lochia
yellowish white
WBC, tissue, bacteria
10-14 days but can last longer
47
what is abnormal with all lochia
foul odor
48
saturation of perineal pad in ____ mins or less is considered excessive and may indicate PPH
15 mins
49
normal vaginal delivery blood loss
<500
50
normal CS blood loss
<1000
51
1mL of blood on linens =
1 g in weight
52
round cervix
never gone through labor
53
slit like cervix
gone through labor
54
besides the vaginal and uterus what is the other most important organ in L and D
bladder
55
presence of free flowing bright red blood may indicate
cervical laceration
56
if bleeding we
massage the fundus
57
if the patient is bleeding but you massage the fundus and it is firm what might it be
cervical laceration
58
hematoma
accumulation of blood in pelvic tissue
59
s/s of hematoma
unrelenting pain
pressure in vagina or rectum
60
late signs of hematoma (aka blood loss)
tachy
increase RR
low BP
61
episiotomies that are healing well are only visible when
pt is laying on side
62
episiotomies heal within
2-3 weeks
63
what is abnormal with an episiotomies and may be signs of infection
redness
warmth
swelling
discharge
separation from edges
64
1st degree tear
superficial to muscle
65
2nd degree tear
extends through the muscles of the perineal3
66
3rd degree
through anal sphincter
67
4th degree
involves anterior rectal wall
68
uterthral tear
upward from the vaginal towards the urethra
69
not uncommon to void excess of _______mL per day during first several days PP
3000
70
colostrum is secreted when
shortly after birth
71
is colostrum high or small volumes
small since the infants stomach is so small it does not need alot
72
what should we educate to the mom not wanting to breast feed
tight bra and ice to decrease swelling and stimulation
- No hot shower this will stimulate the breast to make more milk
73
HR, SV, and CO _________ immediately after giving birth
increase
74
due to the hemodynamic changes what might be a result
orthostatic hypotension
75
education on ortho hypo
sit slow and dangle
76
normally increased blood volume is eliminated within first ___ weeks after delivery
2
77
pregnancy is a ________ state
hypercoaguble state
- due to increase in fibrinogen and clotting factors
78
since pregnancy is hypercoaguble this means they are at risk for
DVT
79
why might WBC increase after birth
boys response to wound in uterus
80
what is a common complaint of PP
headache
81
why might headache be caused
hormonal shift or spinal from epidural
82
TX for hormonal headache
decrease light and noise
increase caffeine
83
TX for spinal headache
blood patch
84
preeclampsia can occur for ____ weeks after delivery
4 weeks
85
what do mothers need to be taught if they go to ED
they are in the PP peroid
86
what changes in the musculoskeletal
change in center of gravity
- increase fall risk
87
joints where might not return to normal
feet
88
atony
bleeding
- lack of tone (boggy)
89
what is the most frequent cause of uterine bleeding after birth
atony
90
why might atony be caused
retained placental fragments
91
we should always screen for what before discharge
depression
92
what might be common during the childbirth phase
tremors or chills
93
C section is a post op patient, what should we manage
abdominal dressing
LOC
IV
I and O
cardiac
Bowel sounds
Lung sounds
IS
pain
anesthesia
94
BUBBLEHE
breast
uterus
bowel
bladder
loch
episiotomy
homans sign (DVT)
emotions
95
when breastfeeding, why should the baby have the whole areola in the mouth not just the nipple
it could lead to tissue damagef
96
firm breasts mean
milk is in
97
we need to assess for what of the fundus
height
location
tone
98
patient should void every
2 hours
99
why might fundal assessments be uncomfy in CS patients
assessing right above scar
100
bowel Q
last BM
passing gass
distension
101
for assessment of lochia and episiotomies we need to assess for
bleeding, amount, color, character, odor
102
prevent infection
hand washing and perineal hygiene of the peri bottle
103
what position should the patient be in when assessing for episiotomies
side
104
do we do homans sign and why
no because you can dislodge the clot
105
what to assess for in DVT
redness
warm
pedal pulses
ambulation
106
emotions
assess between
family members
107
REEDA
redness
ecchymosis
edema
discharge
approximation
108
perineal care
ice packs
peri bottle
analgesics
109
if our patient is sitting down, how might we instruct them so they do not put pressure on perineum
tightening glutes prior to sitting to avoid pressure on perineum
110
what to assess for during the transition to parent hood
feelings about self
relationships of family origin
social support networks
relationship with partner and infant
111
maternal adaption 3 phases
1. talking in or dependent phase
2. taking hold
3. letting go or interdependent phase
112
1. taking in or dependent phase
first 24 hours after birth
meet her basic needs
(love self)
113
2. taking hold
2-3 days to several weeks
care of newborn and competent mothering
(love self)
114
3.letting go or interdepent phase
forward movement of family as unit
(love us)
115
avanced maternal age
>35 years
116
sibbling adapation
regression
117
discharge starts on
admission
118
blurred vision and severe headaches might be a sign of
blood pressure
119
POST BIRTH warning signs
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
