Chapter 12. Nursing Management During Nursing Flashcards Preview

OB Pedi > Chapter 12. Nursing Management During Nursing > Flashcards

Flashcards in Chapter 12. Nursing Management During Nursing Deck (34)
Loading flashcards...
1

Isotretinoins/accutane

Used to treat acne. Can result in miscarriage and birth defects.

2

Alcohol misuse

Feel alcohol syndrome and other birth defects. Should cease intake before conception

3

Antiepileptic drugs

Women who are on these drugs should be prescribed a lower dose before conception.

4

Diabetes preconception

There's a threefold increase in birth defects among infants of women with type I and type II diabetes. This is reduced if Properly managed

5

Folic acid deficiency

A supplement at least 400 mcg reduces the occurrence of neural tube defects by two thirds

6

Hepatitis B

Preventing infection and women of childbearing age prevents transmission to the infants and eliminates the risk to the woman. This could include hepatic failure, liver carcinoma, cirrhosis, and death.

7

HIV/AIDS

If known before conception, antiretrovirals treatment can be given along with information that can help prevent mother to child transmission.

8

Hypothyroidism

The dosages of levothyroxine for treatment increase during early pregnancy. It needs to be adjusted for proper neurological development of the fetus.

9

PKU/maternal phenylketonuria

Women diagnosed with PKU as infants have increased risk for delivery neonates with intellectual disability. This can be prevented when mothers adhere to a low phenylalanine diet before conception and continuing throughout the pregnancy

10

Rubella seronegativity

Rubella vaccination helps prevent congenital rubella syndrome

11

Period of greatest risk to embryo

Between day 17 and 56 after conception.

12

Obesity

Neural tube defects, preterm delivery, diabetes, c-section, hypertensive and thromboembolic disease. Weight-loss and nutritional intake before pregnancy reduces these risks

13

Oral anticoagulant

Warfarin is teratogen. They should be changed to a different anticoagulant before pregnant

14

STIs

Chlamydia and gonorrhea are associated with ectopic pregnancy, infertility, chronic pelvic pain. They could result in fetal death or substantial physical and developmental disabilities, including intellectual disability and blindness. Women's be screened early

15

Smoking

Preterm birth, low birth weight, and other adverse outcomes is associated with smoking. They can be prevented if they stop smoking before or during early pregnancy.

16

Diabetes testing

Should be tested at the first prenatal visit if high risk which includes women over 25, overweight, have polycystic ovarian syndrome, history of gestational diabetes, and a positive history of family diabetes. High risk populations include Hispanic, black, Asian, Arab, Afro Caribbean, Mediterranean, and native American.

Fasting plasma glucose 126 mg/dL
Hemoglobin A-1C at least 6.5%
Random plasma glucose 200 mg/dL
Normally tested from 24 to 28 weeks

17

Nageles rule

Subtract three months from the first day of her last menstrual period and then add seven days.

Margin of error is plus or -2 weeks

Less accurate if the cycles are irregular, if the woman conceived while breast-feeding, before her regular cycle is established after childbirth, or after discontinuing oral contraceptives

Ultrasound is the most accurate method of dating a pregnancy

18

Gravid

The state of being pregnant

19

Gravida

A pregnant woman. Gravidarum I/primigravida is the first pregnancy, gravida II/secundigravida is the second pregnancy. Nulligravida never pregnant. Multigravida pregnant at least third time

20

Para

The number of deliveries at 20 weeks or greater that a Woman has, regardless of whether it was born alive or dead.

Nullipara never offspring after 20 weeks
Multipara a woman 2 or more

21

Gravidity

The number of times that a woman has been pregnant, irrespective of the outcome

22

GTPAL

G-gravida, including current pregnancy
T-term gestations 38-42
P-preterm 20-37
A-#ending before 20 weeks
L-children currently living

If an extra p, it is the same as L

23

Appointment schedule

Every four weeks up to 28 weeks
Every two weeks from 29 to 36 weeks
Every week from 37 weeks to birth

Weight and blood pressure compared to the baseline. Urine testing for protein, glucose, ketones, and nitrates. Fundal height to assess fetal growth. Assessment for quickening/fetal movement. Assessment of fetal heart rate.

24

Fundal height measurement

From the top of the pubic bone to the top of the uterus/fundus with the client lying on her back and knees slightly flexed. This is termed McDonald's method.

25

Fetal movements

While sitting or lying record mmovvements. Notified Dr. if there's not at least 10 within one hour. This needs to be done around the same time everyday

The second option is to lie on the left side for one hour after meals, Count how many movements she felt in one hour, needs to be at least 4, if not wait one more hour to see if you can feel 4 more movements

26

Danger during the first trimester

Spotting or bleeding, painful urination, persistent vomiting, fever abovve100, lower abdominal pain with dizziness and shoulder pain, which could indicate ruptured ectopic pregnancy

27

Danger during the second trimester

Regular contractions, pain in calf, rupture of membranes, absence of fetal movement for more than 12 hours.

28

Dangers during the third trimester

sudden weight gain, periorbital or facial edema, severe abdominal pain, headache with visual changes, decreases in fetal movement, any of the other warning signs

29

Preterm labor

If experiencing cramps occurring every 10 minutes accompanied by a low backache, just stop what she is doing and lie down on her left side for one hour and drink 2 to 3 glasses of water. If they do not stop she needs to go into the doctor

30

Amniocentesis

Detects chromosomal abnormalities and hereditary metabolic defects in the fetus. Performed in the second trimester, usually between 15 and 18.

While under ultrasound a 5 inch needle is inserted to withdraw fluid. Empty bladder prior to procedure. Fetal heart rate monitoring is done for 20 minutes. RhoGAM maybe given if the woman is Rh negative. Assess maternal vital signs and fetal heart rate every 15 minutes for an hour. Observe for bleeding and drainage. Report fever, leaking fluid, vaginal bleeding, uterine contractions, or change in fetal activity.