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nur 2038 > exam 2: OB + Newborn > Flashcards

exam 2: OB + Newborn Flashcards

1
Q

GTPAL

A

Gravida: # of pregnancies
Term: # born at term
Preterm: # born preterm
Abortions/Miscarriages
Living: # of living children

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2
Q

Naegele’s Rule

A

LMP + 7 days + 9 months

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3
Q

discomforts during pregnancy

A
  • n/v
  • syncope
  • urinary frequency/urgency
  • increased vaginal discharge
  • SOB
  • fatigue
  • heartburn
  • edema
  • varicose veins
  • hemorrhoids
  • leg cramps
  • back pain
  • constipation
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4
Q

antepartum diagnostic tests

A
  • H&H: may decrease d/t increased plasma volume
  • Rh factor/blood type and cross
  • ultrasound
  • genetic testing
  • amniocentesis (rule out genetic disorders, risk for infection)
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5
Q

gestational diabetes

A
  • if mom has fasting glucose >126 or random higher than 200
  • glucose tolerance test (50g glucose): after 1 hour >140, after 3 hours >130-140= positive
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6
Q

impact of chlamydia and gonorrhea on fetus/newborn

A
  • eye infections
  • blindness
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7
Q

impact of trichomoniasis on fetus/newborn

A
  • premature ROM
  • infection
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8
Q

impact of syphilis on fetus/newborn

A
  • deafness
  • congenital abnormalities
  • death
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9
Q

impact of HSV on fetus/newborn

A
  • neonatal infections
  • encephalopathy
  • death
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10
Q

impact of HPV on fetus/newborn

A
  • transmission to newborn
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11
Q

placenta previa

A

placenta forms in lower portion of uterus and blocks birth canal
may require c-section for delivery

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12
Q

signs of placenta previa

A
  • painless
  • bright red vaginal bleeding
  • vital signs and FHR normal
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13
Q

interventions for placenta previa

A
  • assess for bleeding
  • no vaginal exams (makes bleeding worse)
  • leave pulse ox on
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14
Q

placental abruption

A

premature separation of the placenta

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15
Q

signs of placental abruption

A
  • painful
  • dark red vaginal bleeding
  • fetal distress
  • shock
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16
Q

interventions for placental abruption

A
  • immediate delivery
  • continuous fetal monitoring
  • oxygen for mom
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17
Q

abortion

A

loss of pregnancy before 20 weeks

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18
Q

fetal death

A

loss of pregnancy after 20 weeks

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19
Q

preeclampsia

A

BP disorder diagnosed after 20 weeks
BP >140/90

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20
Q

risk factors for preeclampsia

A
  • HTN
  • diabetes
  • obesity
  • aging
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21
Q

assessment findings for preeclampsia

A
  • weight gain
  • swelling
  • vision changes
  • protein in urine
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22
Q

interventions for preeclampsia

A
  • bed rest
  • reduce stimuli
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23
Q

5 P’s of labor

A
  • passenger
  • passage
  • powers
  • psyche
  • positioning
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24
Q

impending signs of labor

A
  • lightening/dropping
  • Braxton Hicks contractions increase
  • cervical changes
  • nesting
  • weight loss
  • spontaneous ROM
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25
Q

false labor

A
  • contractions go away with activity
  • contractions are irregular with no progression
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26
Q

true labor

A
  • strong, regular, close contractions
  • fetus becomes engages
  • cervix begins to dilate and efface
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27
Q

baseline for fetal HR

A

110-160

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28
Q

FHR patterns

A
  • accelerations
  • variable decelerations
  • early decelerations
  • late decelerations
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29
Q

accelerations

A
  • an increase of FHR by 15 bpm with fetal movement
  • normal :)
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30
Q

variable decelerations

A
  • cord compression
  • irregular shape, duration, and decline
  • interventions: d/c oxytocin, turn on left side, give o2
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31
Q

early decelerations

A
  • head compression
  • uniform shape, mirrors contractions
  • no interventions needed
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32
Q

late decelerations

A
  • placental insufficiency
  • occurs after peak of contraction
  • emergent intervention required
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33
Q

first stage of labor

A

latent: cervical dilation 1-4 cm, mild contractions, 15-30 min apart, duration is 30 seconds
active: 4-7cm, moderate contractions, 3-5 min apart, duration is 30-45 sec
transition: 8-10 cm, severe contractions, 2-3 min apart, duration is 45-90 sec

34
Q

interventions for first stage of labor

A
  • encouragement
  • discuss birth plan
  • keep comfortable
  • encourage void
  • breathing techniques
  • music therapy
  • rest
35
Q

second stage of labor

A

latent: laboring down
active: pushing
- cervical dilation is complete, mom feels like she could push or needs to poo

36
Q

interventions for second stage of labor

A
  • positioning
  • be ready for baby
  • goal is safe delivery
37
Q

third stage of labor

A
  • expulsion of placenta
  • typically occurs 5-30 min after baby delivery
38
Q

interventions for third stage of labor

A

-ensure placenta is intact
- monitor for signs of PPH
- promote bonding
- assess fundus

39
Q

OB procedures during labor

A
  • induction –> meds such as oxytocin
  • amniotomy –> AROM
  • episiotomy
  • external version
  • forceps delivery
  • vacuum extraction
  • c-section
40
Q

complications of labor

A
  • premature ROM –> infection risk
  • prolapsed umbilical cord (MED EMERGENCY)
  • vena cava syndrome –> baby and uterus push up against the heart, causing hypotension when laying down
  • preterm: 22 weeks-37 weeks –> bedrest, tocolytics
  • precipitous labor –> lasts less than 3 hours, higher risk of PPH
  • dystocia: prolonged, difficult labor
  • uterine inversion: can happen 10-30 min after delivery
41
Q

postpartum period

A

starts immediately after birth up until 6 weeks after delivery

42
Q

expected changes during postpartum

A
  • fundal height decreases 1 cm per day, not palpable at 10 days PP
  • lochia decreases
  • distention and engorgement of breasts (milk production)
  • changes in urinary patterns (loss of elasticity and tone)
  • return of menses 3-6 months
  • return of normal stools, hemorrhoids common
43
Q

types of lochia

A

rubra: bright red, day 1-3
serosa: brownish pink, day 4-10
alba: white day 11-14

44
Q

how long after delivery should breastfeeding be initiated?

A

1 hour

45
Q

benefits of colostrum

A
  • dense in nutrients
  • provides passive immunity to baby
46
Q

BUBBLEE

A

Breast
Uterus
Bowels
Bladder
Lochia
Episiotomy
Emotions

47
Q

PPH

A

more than 500 mL blood loss after vaginal birth or more than 1000 mL blood loss after c-section
usually happens within 4 hours after delivery

48
Q

risk factors for PPH

A
  • assistive birth
  • large birth weight
  • placenta previa/abruption
  • multiple pregnancies
  • hx PPH
49
Q

assessment findings in PPH

A
  • SOB
  • heavy bleeding (bright red blood, clots)
  • hypotension
  • tachycardia
  • restlessness/anxiety
  • boggy uterus on fundal massage
50
Q

PPH treatment

A
  • fundal massage (stimulates uterus to contract)
  • give blood
  • oxygen
  • oxytocin (helps firm uterus by causing it to contract)
51
Q

gestational age

A

-preterm: less than 37 weeks
late preterm: 34-37 weeks
term: 37-41 weeks, 6 days
postterm: more than 42 weeks

52
Q

normal reflexes of newborns

A
  • sucking/rooting
  • swallowing
  • palmar/plantar grasp
  • moro
  • startle
  • babinski
53
Q

alterations in newborn skin

A
  • vernix: skin protectant, looks like cheese
  • lanugo: peach fuzz body hair for extra warmth
  • mongolian spot: blue/black pigmentation on low back or booty, common in darker skinned ethnicities
54
Q

s/s of hypoglycemia in newborn

A
  • tremors
  • lethargy
  • hypotonia
  • hypothermia
  • weak suck
  • diaphoresis
  • poor feeding
55
Q

biggest contributor to hypoglycemia in the newborn is ______

A

cold stress

56
Q

newborn calorie requirement

A

120 calories/kg/day

57
Q

types of heat loss in newborns

A
  • convection- loss from cooler air (cold room)
  • radiation- loss from cooler surface not in direct contact (unwrapped baby nect to window)
  • evaporation- loss from wet body (wet diaper, after bath)
  • conduction- loss from cooler surface in direct contact (cold scale)
58
Q

nursing interventions for jaundice

A
  • maintain normal skin temp (97.7-98.6)
  • monitor stool (best way to eliminate bilirubin is to poo it out)
  • encourage feedings
  • phototherapy
  • monitor for worsening, eating patterns, and number of wet diapers
59
Q

indication for vitamin K injection

A

activates clotting factors and is found in normal gut flora.
since babies don’t have a developed gut flora, they’re at a higher risk for bleeding

60
Q

the newborn is likely to demonstrate ___ in response to infection

A

hypothermia

61
Q

indication for erythromycin at birth

A

-prevents against eye infections and potential blindness caused by gonorrhea that the baby could’ve been exposed to during delivery
- state-mandated med, give within an hour of delivery

62
Q

respiratory distress syndrome

A

respiratory complication in the newborn, especially in premature infants d/t insufficient surfactant in the lungs

63
Q

s/s of RDS

A
  • tachypnea
  • nasal flaring
  • grunting
  • retractions
  • apnea
  • pallor
  • cyanosis
  • diminished lung sounds
64
Q

RDS interventions

A
  • monitor ABGs, O2
  • reposition
  • administer surfactant via ET tube
65
Q

prevention of SIDS

A
  • back to sleep, tummy to play
  • no smoking
  • immunizations
  • firm bedding, no blankets or stuffed animals
  • no co-sleeping
  • pacifier with sleep
66
Q

cold stress

A

a period of inadequate temperature regulation

67
Q

what does cold temperature increase

A
  • metabolism
  • O2 consumption
68
Q

characteristics leading to heat loss

A
  • little subcutaneous fat
  • blood vessels close to the surface
  • greater surface area
69
Q

s/s of cold stress

A
  • lethargy
  • pallor
  • poor feeding
  • hypoglycemia
  • respiratory distress
70
Q

nonshivering thermogenesis (NST)

A
  • initiated by skin receptors
  • stimulation of sympathetic nervous system
  • utilization of brown fat
71
Q

evaporation

A

occurs during birth, bathing, wet linens or clothes, or insensible water loss from moisture on skin

72
Q

conduction

A

occurs when the infant comes in contact with cold objects or surfaces (ex: scale, cold hands, stethoscope)

73
Q

convection

A

occurs when drafts come from open doors, air conditioning, or air currents

74
Q

radiation

A

occurs when the infant is near cold surfaces (ex: window, air conditioner)

75
Q

types of jaundice

A
  • physiologic
  • breastfeeding
  • pathologic
  • breast milk
76
Q

physiologic jaundice

A

occurs after the first 24 hours of life

77
Q

breastfeeding jaundice

A
  • lack of sufficient intake
  • develops in the first few days of life
78
Q

pathologic jaundice

A
  • begins in the first 24 hours
  • associated with blood incompatabilities
79
Q

breast milk jaundice

A
  • delayed onset
  • related to composition of mother’s milk
80
Q

SIDS etiology

A
  • brainstem abnormality
  • stressors (sleep position, sleep environment)
  • critical development period
  • NOT associated with apnea or immunization
81
Q

SIDS risk factors

A
  • sleep position
  • bed space (soft surface, fluff)
  • sleep environment (temperature, co-bedding)
  • exposure to smoke (prenatal, secondhand smoke)
  • family hx SIDS
  • age (2-4 mo., 90% of SIDS deaths before 6 mo.)
  • race (#1: native american, #2: african american, #3: caucasian)
  • prematurity/low birth weight

nur 2038 (3 decks)

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