Exam 1 Flashcards
1
Q
what age is considered an old maternal age?
A
over age of 35
2
Q
what does the baby need to become independent in after birth?
A
- their respiratory system
- their circulatory system
- their ability to thermoregulate
- their ability to produce a source of glucose
3
Q
how much fluid is in a newborn’s lungs?
A
about 80-110 mL
4
Q
why do c-section babies have more fluids in their lungs compared to normal newborns?
A
because they aren’t being squeezed out and the fluid isn’t being ejected
5
Q
ductus arteriosus location
A
between pulmonary artery and aorta
6
Q
foramen ovale location
A
between right and left atrium
7
Q
what is common in a newborn due to their foramen ovale and ductus arteriosus not closing?
A
they might have murmurs for the first 6 months, then should close
8
Q
normal newborn heart rate
A
100-160 beats/min
9
Q
how is NB circulation changed?
A
with adequate respiratory function
10
Q
during sleep, what might be a normal HR?
A
80-100 beats/min
11
Q
during crying, what might be a normal HR?
A
180 beats/min
12
Q
how long should apical HR be counted?
A
a full minute
13
Q
apgar score
A
initial assessment of vital functions; assess HR, RR, muscle tone, reflex irritability and color
14
Q
when is an apgar score taken?
A
at 1 minute after birth and 5 minutes after birth
15
Q
normal RR for a newborn
A
30-60 per min
16
Q
since NB RR are irregular often, what is the best way to check for them?
A
by watching their abdomen since they are nose breathers
17
Q
what is important to know about a NB’s temperature immediately after birth?
A
it drops rapidly
18
Q
what is the best way to assess for a NB temperature?
A
axillary; rectal is not advised
19
Q
normal temp of a NB
A
97.7-100.0
20
Q
how long does a NB temp take to stabilize?
A
24 hours
21
Q
what is the best way to keep a NB warm besides using a heater?
A
skin-to-skin (kangaroo care)
22
Q
what body temperature would be concerning and why?
A
anything under 97.9; below 97.5 is correlated with poor brain growth and increased mortality
23
Q
explain brown fat
A
- metabolized for heat production
- develops at 26-30 weeks
- depletes by 2-5 weeks of age
- more rapidly depleted by cold stress (hypothermia)
24
Q
what are effects of hypothermia?
A
- resp. distress
- hypoglycemia
- loss of weight
- jaundice
25
what can the nurse do to keep the baby warm?
- dry and wrap in warm blanket
- cover head with hat
- place under radiant heat source or on mom's abdomen
26
what can hyperthermia cause?
increased metabolic rate and increased need for glucose and oxygen
27
what is the NB stomach capacity and when do they empty their stomach?
5-10 mL at birth (30-90 when stretched) and empties within 2-4 hours
28
what occurs in the first period of reactivity?
- it is from birth to 30-60 minutes
- NB is alert, responsive, rapid HR and resp., strong suck
- best time to feed
29
what occurs in the period of inactivity?
- lasts 60-100 minutes
- NB sleeps, recovers from birth
- bowel sounds audible
30
what occurs in the 2nd period of reactivity?
- occurs at 4-8 hours of age and lasts 4-6 hours
- awake/alert, rapid color changes
- meconium, void, feed
31
what is common in a NB since their cardiac sphincter is immature?
regurgitation of food; must burp in between feedings
32
how much weight is a NB expected to lose?
5-7% of their birth weight
33
meconium stool
black, tarry, no odor; passed within 12-48 hours after birth
34
what would it mean if the meconium is passed before birth?
could be a sign of fetal distress
35
transitional stool
3-4th day; greensih/loose
36
newborn stool
5-6th day; depends on type of feeding
37
breastfeeding stools
- occurs on 4th day
- light yellow stools
- sweet smelling
- seedy
- goes 3-4 times a day
38
bottle-feeding stools
- occurs on 4th day
- pale yellow to light brown stools
- more odor than breastfed: sour milk odor
- 2 stools per day
- firmer consistency
39
normal WBC count in NB
9,000-30,000/mm (avg. 17,000) ~ higher due to inflammatory process in beginning of life
40
normal bilirubin count in NB
1-4 mg/100mL
41
normal blood sugar in NB
50-60 mg/dl x 3 days
60-70 mg/dl after 3 days
*we worry more about hypoglycemia
42
why do NBs have leukocytosis when first born?
due to stress of labor, not an infectious process
43
when does urine production begin and what is it used for?
it begins in the 12th week of fetal life and is a component of amniotic fluid
44
when should a NB's first void be?
by 24 hours of life, then 6-10 times/day
45
how is a NB's urine?
it is very dilute for the first 3 days due to the decreased ability to concentrate urine
46
what does the NB liver play a role in?
- iron storage (from mom) for RBC production
- carbohydrate metabolism
- conjugation of bilirubin
- coagulation
47
what is given when a NB is born to help with clotting?
vitamin K
48
where is vitamin K given and what is the maximum a NB can be given?
given in the vastus lateralis and 1 mL is the maximum
49
why is a prophylactic eye ointment given to a NB?
to prevent ophthalmia neonatorum caused by gonorrhea or chlamydia
50
IgG
passive immunity from mom
51
IgM
produced by fetus/NB
52
IgA
produced by infant 6-12 weeks after birth
53
when do antibodies get transferred to fetus?
in the 3rd trimester and when breastfeeding
54
is fever a reliable sign of infection?
NO; low body temperature is more indicative of a bacterial infection
55
caput succedaneum
edema of scalp caused by pressure from cervix; disappears in 3-4 days
56
cephalohematoma
blood between skull bone and periosteum; caused by pressure on maternal pelvis or birth trauma; resolves in 3-6 weeks; increases risk of hyperbilirubinemia
57
signs of neurologic integrity
NB's ability to console himself, sleep and wake, and respond to voices
58
what kind of cry is concerning?
high pitched cries and weak cries or no cries
59
blink reflex
protects eye from an object coming near
60
rooting reflex
when the cheek is stroked and the NB will turn their head that direction; works with breast feeding too
61
sucking reflex
when lips are touched, NB sucks; disappears in 3-4 months
62
if a baby is not taking fluids by mouth due to feeding tube, what should be offered to them to stimulate the sucking reflex?
they should be offered a pacifier
63
moro (startle) reflex
NB will raise her arms and cry when startled
64
how does vision work in a NB?
can see best at 8-12 inches (why we do cradle hold); sensitive to light; prefer human face
65
how does hearing work in a NB?
it is well developed and respond to mother's voice most often; listen best to a quiet voice
66
how does smell and taste work in a NB?
well developed in 6 days
67
how does touch work in a NB?
most sensitive at mouth and hands
68
preterm babies
born before 37 weeks
69
term babies
born between 37-40 weeks
70
post-term babies
born after 40 weeks
71
what gestation babies tend to be more prone to hypoglycemia?
small and large gestational age babies
72
macrosomia
when mom has high BG levels the fetus will receive high glucose levels
73
when does the fetus secrete their own insulin?
10-14 weeks
74
acrocyanosis
hands and feet are blue; may be due to baby being cold or poor circulation
75
hypospadias
urethral openeing under penis
76
epispadias
urethral opening on top of penis
77
how long do each trimesters last?
1st = from LMP through 13th week
2nd = 14th week - 26th
3rd = 27th week - 40
78
how do you start counting when a pregnancy began?
start with the first day of missed menstrual period
79
gravida
any pregnancy, regardless of duration
80
nulligravida
never been pregnant
81
primigravida
pregnant for the first time
82
multigravida
second of subsequent pregnancy
83
para
counts births after 20 weeks, regardless of outcomes; does not count infants, just births
84
GTPAL
Gravida
Term deliveries (37 weeks and up)
Preterm births (between 20 and 36 6/7 weeks)
Abortion
Living children
85
when does ovulation occur?
14 days before the first last day of the cycle
86
what do the urine tests test for?
human chorionic gonadotropin (hCG) ~ when sperm and egg come together, this is created
87
what might higher than normal levels of hCG be seen with?
- molar pregnancy
- ectopic pregnancy
- abnormal gestation (DS)
- multiple gestation
88
what might a decrease in hCG be seen with?
impending miscarriage
89
what does hCG do?
preserves function of corpus luteum and ensures a continued supply of estrogen and progesterone
90
where is the uterus in 12-14 weeks of gestation?
right above the symphysis pubis
91
where is the uterus 20-24 weeks of gestation?
above level of umbilicus
92
where is uterus 36 weeks gestation?
touches xyphoid process
93
lightening
occurs at about 38-40 weeks gestation; when the pressure in the pelvis lightens
94
operculum
mucus plug ~ protects body from pathogens entering in the vagina
95
goodell sign
softening of the cervix ~ noticeable during first 3 months
96
chadwick's sign
violet or bluish discoloration of the vaginal mucous membrane and cervix
97
ballottement
between 16-18 weeks, can bounce fetus gently and have it rebound
98
during the 2nd and 3rd trimesters what will occur with the breasts?
colostrum might be present
99
what might occur with the respiratory system?
nasal stuffiness or congestion
100
supine hypotensive syndrome
- enlarged uterus may press on the vena cava and the aorta which reduces blood flow to the right atrium
- this lowers BP and causes dizziness and will also reduce blood flow to the placenta
- AVOID LAYING SUPINE!
101
recommended weight gain for women of normal pre-pregnancy weight
25-35 pounds
102
recommended weight gain for overweight women
15-25 pounds
103
what might occur in a pregnant moms urine?
glucosuria: trace amounts may spill into urine due to kidneys inability to filtrate the glucose
104
what are the three signs of pregnancy categorized as?
- presumptive = changes felt by woman
- probable = changes observed by an examiner
- positive = those that can be attributed only to the presence of a fetus
105
oxytocics
uterine stimulants: stimulate uterine contractions to promote labor
106
tocolytics
uterine relaxants: suppression of preterm labor
107
what does it mean for the cervix to be "ripe"?
it shortens, softens, and dilates; must be ripe before drugs can be given
108
what drugs promote cervical ripening?
prepidil, cervidil, cytotec
109
most widely used agent for cervical ripening and controlling postpartum hemorrhage
misoprostol (cytotec)
110
what does pitocin (oxytocin) do during labor?
it causes uterine contractions but does NOT ripen the cervix
111
when would we not be able to administer pitocin?
- fetal lungs are not mature
- cervix is not ripe
- patient had previous c-section or uterine surgery
- patient has genital herpes
- cephalo-pelvic disproportion (CPD)
112
what drug develops the fetal lungs?
betamethasone
113
antidote for magnesium sulfate
calcium gluconate
114
where does fertilization occur?
in the outer third of the fallopian tube
115
how long is an ovum fertile for after ovulation?
24 hours after
116
how long can sperm survive?
48-72 hours but most are only fertile for 24 hours
117
zygote
when sperm and ovum unite: 23 chromosomes from each zygote so the zygote has 46 chromosomes
118
functions of amniotic fluid
- cushions and protects
- controls embyro temp.
- allows freedom of movement for the fetus
119
what does the umbilical cord consist of?
one large vein that carries oxygenated blood to the baby and two small arteries that carry unoxygenated blood from the baby to the mom
120
explain both sides of the placenta
- maternal side - "A" = "dirty duncan"
- fetal side - "B" = "shiny shultz"
121
what time during a pregnancy would be most susceptible to teratogens?
the embryonic stage (week 3-8)
122
when is the most crucial time period for developmental disorders?
during the first 3 months
123
when can mom begin to feel fetal movement?
20th week
124
when do fetal lungs mature?
usually by the 36th week
125
main advantage of a male condom
protects from pregnancy and STI's
126
what is the permanent way to avoid contraception?
tubal ligation or vasectomy
127
disadvantages of oral contraceptives
- need to take pill daily at same time
- can be cosly
- not an option for smokers > 35 years
- not an option for h/o thromboembolic disease
- does not offer STI protection
128
infertility
inability of a couple to achieve conception after a year of unprotected sex (6 months if the woman is over age 35) or the inability to carry a pregnancy to a live birth
129
subfertility
reduced fertility in both partners
130
secondary infertility
couples have one successful pregnancy and are unable to conceive or sustain a second pregnancy
131
what is the usually the first approach when trying to diagnose infertility?
- semen analysis
- extensive interview
- physical exams of both
- lab tests for both
132
hysterosalpingogram (HSG)
shows if tubes are blocked; can cause uterine clamping after since uterus is trying to get dye out
