ATI Maternal Newborn Flashcards

1
Q

When to be refitted for a diaphragm

A

every two years, 20% of weight change after pregnancy

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2
Q

Diaphragm education

A

should remain in place for 6 hours after sex but not more than 24 hours
reapply spermacide for each act of intercourse

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3
Q

oral contraceptions common side effects

A

nausea, breast tenderness, fluid, retention, breakthrough bleeding, headache

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4
Q

contraindications for oral contraceptives

A

smokers and a history of blood clot, stroke, CVD, hypertension

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5
Q

signs from thromboembolic events

A

DVT (leg pain, swelling), PE (chest pain, SOB), stroke (vision issues, weakness, numbness, slurred speech), MI (chest pain, sweating, GI upset)

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6
Q

Medroxyprogesterone side effects

A

decrease in bone density, thromboembolic events

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7
Q

medroxyprogesterone key teaching

A

patients should increase intake of calcium and vitamin D

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8
Q

Side effects of an IUD

A

increased risk of ectopic pregnancy, pelvic inflammatory disease, uterine perforation

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9
Q

IUDs key teaching

A

Patient should report foul smelling discharge, change in IUD string length, fever, chills, pain with intervourse

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10
Q

what is transcervical sterilization

A

flexible agents inserted into the fallopian tubes, resulting in scarring
effectiveness is delayed for 3 months
alternative contraceptives needed until confirmation of a blocked fallopian tube
not for post partum

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11
Q

Risks with transcervical sterlization

A

perforation, increased risk of ectopic pregnancy

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12
Q

What is tubal ligation

A

Severance burning of fallopian tubes can be done postpartum

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13
Q

risks with tubal litigation

A

risks associated with surgery, increase risk of ectopic pregnancy

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14
Q

what is a vasecetomy

A

severance of vas deferens

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15
Q

vasectomy education

A

alternate form of BC needed for 20 ejaculations, follow up testing for sperm count important, reversal is possible

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16
Q

infertility definition

A

inability to conceive for a long period of time, at least 12 months

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17
Q

diagnostic procedure for infertility

A

semen analysis - FIRST
hysterosalpingography - checks for the patency of fallopian tubes using contrast dye - NO SHELLFISH/IODINE ALLERGY
laparoscopy - observation and assessment of internal organs under general anesthesia

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18
Q

presumptive signs of pregnancy

A

can be explained by OTHER conditions
amenorrhea, n/v, urinary frequency, breast changes, quickening, uterine enlargment

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19
Q

probable signs of pregnancy

A

Hegars sign, Chadwick sign, Goodells sign, ballottement, Braxton hicks, a positive test

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20
Q

positive signs of pregnancy

A

fetal heart sounds, fetal movement felt by provider, visualization of fetus on ultrasound

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21
Q

calculating due date

A

add 9 months plus 1 week from last menstrual period

22
Q

fundal height

A

measured from the symphysis pubis to the top of the fundus
fundal height = gestational age

23
Q

GTPAL

A

gravidity - # of times pregnant
term birth - # births carried to term
preterm births - # of births before
abortion - number of abortions and miscarriages
living = living children

24
Q

cardiovascular changes during pregnancy

A

increase in cardiac output (30-50) and HR

25
Q

respiratory changes during pregnancy

A

oxygen needs increase, lung capacity decreases, RR increases

26
Q

cervical changes during pregnancy

A

becomes softer, blue purple color

27
Q

breast changes during pregnancy

A

larger breast

28
Q

skin changes during pregnancy

A

chloasma - brown patches on the face
linea nigra - a line that runs from the navel to the pubic bone
striae gravidarum- stretch marks

29
Q

supine vena cava syndrome

A

maternal hypotension due to weight of the uterus on the vena cava

30
Q

supine vena cava syndrome prevention

A

Teach the patient to lay on the left side in semi fowlers position or place wedge under one hip when supine

31
Q

Rh Factor

A

The indirect Coombs test determines if the mother is Rh negative or Rh positive
for Rh negative patients repeated 24-28 weeks administer RhoGAM at 28 weeks

32
Q

group B streptococcus

A

vaginal, anal culture was taken at 35-37 weeks

33
Q

one hour glucose tolerance test

A

taken at 24-28 weeks
no fasting required
result should be less than 140 mg/dl

34
Q

3 hour glucose tolerance test

A

if the first test was over 140
fasting is required

35
Q

maternal serum alpha-fetoprotein

A

taken at 15-22 weeks to screen for down syndrome (low) and for neural tube defects (high)

36
Q

weight gain during pregnancy

A

total weight gain should be 25-35 lbs for total pregnancy
1st trimester - 2.2. lbs - 4.4 lbs
2nd and 3rd 1 lb per week
overweight - 15 - 25 lbs
underweight - 28-40 lbs

37
Q

additional calories needed during pregnancy

A

no additional calories during 1st semester
340 extra cals during 2nd trimester
462 extra cals during 3rd trimester
breastfeeding 450-500 extra caks

38
Q

Maternal phenylketonuria

A

Genetic disease that causes the amino acid phenylalanine to build up in the body, posing a risk of birth defects in the fetus

39
Q

PKU patient teaching

A

adhere to PKU diet 3 months prior to pregnancy and through pregnancy
monitor blood levels during pregnancy

40
Q

PKU diet

A

avoid foods high in protein
meat
fish
poultry
nuts
eggs
dairy

41
Q

preparation for ultrasound

A

Drink 1 quart of water prior to the procedure, better reflects sound waves

42
Q

biophysical profile

A

uses real-time ultrasound technology to assess fetal well being
score from 8-10 is normal
lowe than 8 can mean asphyxia

43
Q

scoring of a biophysical profile

A

reactive FHR - +2 non-reactive - 0
fetal breathing movement - 1 or more eps for 30+ secs = +2
gross body movements - 3 or more body/limb extensions with the return to flexion +2, 3 or less = 0
fetal tone - 1 or more episodes of extension with a return to flexion +2
amniotic fluid volume - 1 pocket greater than 2 cm in 2 perpendicular planes +2, less = 0

44
Q

nonstress test

A

a noninvasive test that measures FHR response to fetal movement performed during the 3rd trimester. acoustic vibration device may be used to awaken a sleeping fetus. mom pushes button when she feels fetal movement

45
Q

indications for nonstress test

A

decreased fetal movement, diabetes, gestational HTN, post maturity

46
Q

interpretation of results for nonstress test

A

Reactive - NORMAL FHR has a normal rate, moderate variability, and accelerates more than 2 times in a 20 min time period
non-reactive - ABNORMAL FHR does not accelerate sufficiently with fetal movements

47
Q

contraction stress test

A

more invasive test used to measure FHR response to contractions, nipple stimulations or pitocin use to induce contractions
can lead to preterm labor

48
Q

indications for a contraction stress test

A

nonreactive stress test, high risk pregnancies

49
Q

interpretation of results contraction stress test

A

Negative - normal finding. no late decelerations of FHR with three contractions in 10 mins
positive - abnormal finding, late decelerations present in 50% or more contractions, may mean uteroplacental insufficiency

50
Q

amniocentesis

A

amniotic fluid is aspirated under ultrasound guidance
performed after 14 weeks

51
Q

alpha-fetoprotein

A

high levels associated with neural tube defects, low levels associated with the chromosomal disorder
empty bladder prior
risks - amniotic fluid emboli, hemorrhage, infection, leakage of amniotic fluid, premature rupture of membranes, miscarriage

52
Q

chorionic villus sampling

A

the portion of the placenta is aspirated through catheter to assess for chromosome abnormalities
10-13 weeks gestation
provides earlier diagnosis
can cause chorioamnionitis, premature rupture of membranes, miscarriage