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OB FINAL MOD 5-7 > Chapter 17-20 objectives > Flashcards

Chapter 17-20 objectives Flashcards

1
Q

Uterine Involution

A

The uterus deflating

after birth U+2

6-12hr after birth: U

Lowers 1cm per day

Day 7: between U and symphisis pubis

Day 14; non palpable

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2
Q

Subinvolution

A

Involution doesnt occur properly

Can cause PP hemorrhage

Risk factors

LGA, Multipara, multifetal pregnancy 
Chorioamnionitis
Retained placental fragments
Polyhydraminos
Prolonged/precipitous labor
Drugs
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3
Q

Normal Lochia time

A

Rubra: 1-3 days, red, small clots

Serosa: 4-10 days, pink/brown, serosanguinous

Alba: 1-3+ weeks, yellow-white or clear

Should be decreasing in amount each day.

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4
Q

What constitutes heavy lochia/bleeding

A

Saturated in 1hr = heavy

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5
Q

Epesiotomies

A

Heal in 3-4 weeks

Observe for 
Redness
Swelling
Ecchymosis
Discharge
Approximation

Watch for hemorrhoids; if there use ice, sitz bath, perineal care, topical anesthetics

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6
Q

Epesiotomy healing interventions

A

Clean area after each void or defecation

Pat dry front to back

Clean hands before and after changing pads

Epsom salts to sitz baths

Remove/apply pads front to back

Kegels

Protein and vit. C

Change pads q2-3 hr

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7
Q

How is excess plasma vol. removed in pregnancy

A

Diuresis: up to 3,000mL/day for a couple days PP

Diaphoresis: sweaty hoe

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8
Q

How do blood values change in pregnancy

A

WBC increase during labor and PP

Hgb and Hct drop from blood loss

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9
Q

Normal blood loss birth

A

500mL vaginally

1000mL C section

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10
Q

Whats the deal with clotting factors in delivery

A

ELEVATED- RISK FOR DVT IN PP MOTHERS

Use ted hose and SCDs !!!!

Assess for edema, heat, tenderness and fever

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11
Q

Messed up GI in delivery/PP

A

constipation: MOBILIZE

Assess bowel sounds, pain, tone

Watch for Paralytic Ileus or distention post C section

High fiber, fluids, stool softeners

Stop narcotics duh

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12
Q

Diastatis Recti

A

Separation of L side of abs w R side(OOF)

Can heal in ~6 weeks PP with exercise

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13
Q

Melasma

A

Spots on face, will fade after birth

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14
Q

PP ovulation

A

Ovulation can occur before first menses- early as 3 weeks PP, all ovulation returns by 6 months

Breastfeeding delays return of menstruation

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15
Q

What hormone is responsible for milk production

A

ProLACTin

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16
Q

What hormone is responsible for milk ejection

A

Oxytocin

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17
Q

Signs of mastitis

A

Pain on one side of breast

Elevated WBC (hard to tell tho cuz elevated normally PP)

High temp (38C+)

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18
Q

Breast care if breastfeeding

A

No soap on nips

Rub milk into nipple

Air dry nipples

Ensure proper latch

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19
Q

Breast care if not breastfeeding

A

Well fitting bra/sports bra

Ice

No breast stimulation

Milk analgesic

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20
Q

How frequently should PP mom be assessed

A

Hour 1: Q15min

Hour 2: Q30min

Hours 3-24: Q4 hours

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21
Q

Puerperal phases of developmental tasks for mothers

A

Taking In: 1-2 days. Focused on her own physiological needs. Very dependent. Must integrate birth experience into real life- designate pregnancy is over.

Taking Hold: 3-7 days. Become more independent. Attention transitions to newborn. May become anxious. Very teachable period.

Letting go: >7 days. Letting go of pre-baby life, fully accepting baby. Relationship with partner refocused.

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22
Q

Postpartum blues

A

First week, ends within 2 weeks.

Irritability, mood swings, anxiety.

Let mother know that it is normal and validate feelings.

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23
Q

How are postpartum blues differentiated from postpartum depression

A

SCREENING

Edinburgh Postnatal Depression Screen EDPS before discharge!

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24
Q

When is RhoGam indicated

A

Mother Rh-, baby Rh +

25
Q

When should baby have adequate surfactant

A

34-36 weeks

26
Q

Non shivering thermogenesis in baby

A

Metabolism of brown fat to produce heat

27
Q

Evaporation heat loss baby

A

Air drying of skin=cooling

Dry infant asap

28
Q

Conduction heat loss baby

A

Direct contact w/ cold object

Skin to skin contact important to keep babie warm

29
Q

Convection heat loss baby

A

COLD AIR MAKE BABY COLD

30
Q

Radiation heat loss baby

A

Heat to cooler objects not in direct contact

Don’t put baby by cold window

31
Q

Cold stress

A

Increases metabolic rate, metabolism of brown fat causing inc. need for O2

Low surfactant- exacerbation of respiratory distress

Hypoglycemia from using glucose to heat body–> glucose metabolization–>metabolic acidosis and can interfere w/ bilirubin transport-> jaundice

32
Q

ToRCHeS infection

A

Toxoplasmosis

Rubella

Cytomegalovirus (CMV)

Herpes/HIV

Syphillis

33
Q

Toxoplasmosis signs symptoms effects

A

From cat feces/raw meat

Maternal Sx: Lymphadenopathy

Newborn Sx: Blueberry muffin lookin ass head

Hydrocephalus

Intracranial calcification

34
Q

Rubella signs symptoms effects

A

Respiratory droplets

Maternal Sx: Rash, lymphadenopathy, arthritis

Newborn Sx: Blind, deaf

Cataract/deafness
Blueberry muffin head

35
Q

CMV signs symptoms effects

A

Sexually transmitted, organ transplant

Mother Sx: Like Mono

Newborn Sx:Blueberry muffin
Hearing loss,
Seizures
Petechia
Periventricular calcifications
36
Q

HIV signs symptoms effects

A

Mother Sx: AIDS

Newborn Sx: Recurrent infections (SCID- severe combined immune deficiency), chronic diarrhea

37
Q

Herpes 2 signs symptoms effects

A

Mother: Herpetic lesions

Newborn: herpetic lesions, encephalitis

38
Q

Syphilis signs symptoms effects

A

Maternal: 3 stages syphilis

Newborn: Hyrops fetalis, deafness, short maxilla, hutchinson teeth (two spikes per tooth)

39
Q

Hyperthermia

A

Babies too warm, use brown fat can get metabolic acidosis. Use more O2 than can take in

40
Q

Normal newborn vitals

A

Temp: 97.7-99.5 (36.5-37.5C)

Pulse: 120-160

RR: 30-60

41
Q

Physiologic Jaundice

A

Transient hyperbilirubinemia

Not present in first 24 hr of life

Bili level over 5

Rate of bili level rise fall important

42
Q

Non-physiologic jaundice

A

Can be first 24 hr.

Abnormalities causing excess destruction of erythrocytes

43
Q

Breastfeeding and Jaundice/Early onset jaundice

A

Breastfeeding can cause high bilirubin levels if not fed enough.

Risks: poor suck, not enough colostrum intake (colostrum is a laxative, cant expel bilirubin via meconium)

44
Q

What immunoglobulin crosses the placenta for da baby

A

IgG!

45
Q

Newborn urinary

A

Kidneys immature

Void in first 12-24hr life

Uric acid present, risk for dehydration, fluid imbalance

46
Q

First period of reactivity

A

Begins at birth, lasts for 30min.

Infant active, lookin at wtf goin on

go to sleep after

47
Q

Second period of reactivity

A

Lasts 4-6 hours

Active, poopin, may regurgitate.

48
Q

APGAR

A 
Activity
Pulse
Grimace (reflex)
Appearance
Respiration
49
Q

Activity APGAR

A

0 points; Absent

1 point; Flexed arms and legs

2 points; Active

50
Q

Pulse APGAR`

A

0 points; absent

1 point; below 100bpm

2 points; over 100bpm

51
Q

Grimace APGAR

A

0 points; floppy

1 point; Minimal response to stimulus

2 points; proper response to stimulus

52
Q

Appearance APGAR

A

0 points; blue, pale

1 point; Pink body, blue extremities

2 points; Pink

53
Q

Respiration APGAR

A

0 points; absent

1 point; Slow, irregular

2 points; Loud cry

54
Q

Normal newborn weight and size range

A

19-21 inches (48-53cm)

~7lbs 8oz

Head 33-35 cm, 13-14in circumference

55
Q

SGA

A

below 10th percentile

Under 2500g

56
Q

AGA

A

Between 10th and 90th percentile

between 5lb 2 oz to 8lb 12 oz

57
Q

LGA

A

Weight above 90th percentile

Over 4000g

58
Q

IUGR

A

Deviation in expected growth pattern caused by adverse conditions

OB FINAL MOD 5-7 (2 decks)

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