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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
When should baby have adequate surfactant
34-36 weeks
26
Non shivering thermogenesis in baby
Metabolism of brown fat to produce heat
27
Evaporation heat loss baby
Air drying of skin=cooling Dry infant asap
28
Conduction heat loss baby
Direct contact w/ cold object Skin to skin contact important to keep babie warm
29
Convection heat loss baby
COLD AIR MAKE BABY COLD
30
Radiation heat loss baby
Heat to cooler objects not in direct contact Don't put baby by cold window
31
Cold stress
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
ToRCHeS infection
Toxoplasmosis Rubella Cytomegalovirus (CMV) Herpes/HIV Syphillis
33
Toxoplasmosis signs symptoms effects
From cat feces/raw meat Maternal Sx: Lymphadenopathy Newborn Sx: Blueberry muffin lookin ass head Hydrocephalus Intracranial calcification
34
Rubella signs symptoms effects
Respiratory droplets Maternal Sx: Rash, lymphadenopathy, arthritis Newborn Sx: Blind, deaf Cataract/deafness Blueberry muffin head
35
CMV signs symptoms effects
Sexually transmitted, organ transplant Mother Sx: Like Mono ``` Newborn Sx:Blueberry muffin Hearing loss, Seizures Petechia Periventricular calcifications ```
36
HIV signs symptoms effects
Mother Sx: AIDS Newborn Sx: Recurrent infections (SCID- severe combined immune deficiency), chronic diarrhea
37
Herpes 2 signs symptoms effects
Mother: Herpetic lesions Newborn: herpetic lesions, encephalitis
38
Syphilis signs symptoms effects
Maternal: 3 stages syphilis Newborn: Hyrops fetalis, deafness, short maxilla, hutchinson teeth (two spikes per tooth)
39
Hyperthermia
Babies too warm, use brown fat can get metabolic acidosis. Use more O2 than can take in
40
Normal newborn vitals
Temp: 97.7-99.5 (36.5-37.5C) Pulse: 120-160 RR: 30-60
41
Physiologic Jaundice
Transient hyperbilirubinemia Not present in first 24 hr of life Bili level over 5 Rate of bili level rise fall important
42
Non-physiologic jaundice
Can be first 24 hr. Abnormalities causing excess destruction of erythrocytes
43
Breastfeeding and Jaundice/Early onset jaundice
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
What immunoglobulin crosses the placenta for da baby
IgG!
45
Newborn urinary
Kidneys immature Void in first 12-24hr life Uric acid present, risk for dehydration, fluid imbalance
46
First period of reactivity
Begins at birth, lasts for 30min. Infant active, lookin at wtf goin on go to sleep after
47
Second period of reactivity
Lasts 4-6 hours Active, poopin, may regurgitate.
48
APGAR
``` Activity Pulse Grimace (reflex) Appearance Respiration ```
49
Activity APGAR
0 points; Absent 1 point; Flexed arms and legs 2 points; Active
50
Pulse APGAR`
0 points; absent 1 point; below 100bpm 2 points; over 100bpm
51
Grimace APGAR
0 points; floppy 1 point; Minimal response to stimulus 2 points; proper response to stimulus
52
Appearance APGAR
0 points; blue, pale 1 point; Pink body, blue extremities 2 points; Pink
53
Respiration APGAR
0 points; absent 1 point; Slow, irregular 2 points; Loud cry
54
Normal newborn weight and size range
19-21 inches (48-53cm) ~7lbs 8oz Head 33-35 cm, 13-14in circumference
55
SGA
below 10th percentile Under 2500g
56
AGA
Between 10th and 90th percentile between 5lb 2 oz to 8lb 12 oz
57
LGA
Weight above 90th percentile Over 4000g
58
IUGR
Deviation in expected growth pattern caused by adverse conditions

OB FINAL MOD 5-7 (2 decks)

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