FINAL EXAM** Flashcards
new updated (122 cards)
1
Q
Menstrual Disorders
3 Common problems:
A
Dysmenorrhea (painful periods)
Menorrhagia (heavy bleeding)
Amenorrhea (no periods)
the treatment for these are NSAIDs, hormone therapy, lifestyle changes
2
Q
Dyspareunia 3 causes
A
dyspareunia=painful intercourse
3 causes: Endometriosis, vaginal dryness (menopause), infection
3
Q
What is infertility and the first test
A
No pregnancy after 1 year of trying
First test: Basal body temperature chart (tracks ovulation)
-temp every morning w basal thermometer
4
Q
Whats HELLP syndrome
A
Hemolysis
Elevated Liver enzymes
Low Platelet count
5
Q
Uterine Rupture s/s
A
Sudden sharp abdominal pain
Loss of contractions
Fetal heart tones disappear
Rigid/tender abdomen
6
Q
What is left side lying good for
A
late decels or hypotension
7
Q
Physiologic Jaundice (Normal)
A
AFTER 24 hours of life (usually 2–3 days old)
8
Q
🔴 Pathologic Jaundice (Abnormal)
A
WITHIN 24 hours of life
Often due to hemolysis (ABO or Rh incompatibility, sepsis)
9
Q
🔴 Placenta Previa key signs
A
Bright red bleeding
Painless
Soft uterus
Often occurs in 2nd or 3rd trimester
10
Q
You should never perform a _________ during placenta previa and should immediately _________
A
vaginal exam: notify provdier
(avoid anything in the vagina)
11
Q
In late pregnancy, what does lying flat do ?
A
compresses the inferior vena cava, reducing venous return to the heart.
low cardiac output=dizzy, pale, nauseous, low BP
12
Q
What to do with a new born who is hypoglycemic
A
Begin feeding the infant immediately
13
Q
What does Betamethasone do?
A
stimulate fetal lung maturity
14
Q
What does Terbutaline do?
A
Tocolytic (slows contractions)
15
Q
What does Oxytocin do?
A
Stimulates contractions (used for labor induction—not preterm labor)
16
Q
latent phase of labor
A
0–3 cm
Mild contractions, mom is excited/talkative
17
Q
active phase of labor
A
4–7 cm
Moderate contractions, more focused
18
Q
transition phase of labor
A
8–10 cm
Irritable, N/V, trembling, “I can’t do this” feeling
19
Q
second phase of labor
A
10 cm → delivery
Pushing, strong urge to bear down
20
Q
the most common cause of postpartum hemorrhage
A
uterine atony
(doesnt close all the way back)
21
Q
ikely source of bright red bleeding despite firm uterus
A
lacerations
22
Q
What is a Non-Stress Test?
A
a noninvasive way to check fetal well-being by monitoring the fetal heart rate (FHR) in response to fetal movement.
23
Q
Nonreactive NST
A
-Possible distress
-Extend test, BPP or CST
Only 1 acceleration
Accelerations that are <15 bpm or <15 seconds
24
Q
What to do if NST is nonreactive:
A
stimulating the fetus (e.g., vibroacoustic stimulation)
If still nonreactive → order a biophysical profile (BPP) or contraction stress test (CST)
25
🚼 Classic Signs of NAS:
High-pitched cry
Hyperactive reflexes, tremors
Yawning, sneezing
Poor feeding, diarrhea
Increased muscle tone
Sleep disturbances
26
🧠 postpartum blues, also called "baby blues"
Starts within the first week postpartum
Peaks around day 4–5
Symptoms: tearfulness, mood swings, feeling overwhelmed
**Resolves within 2 weeks without medical treatment
27
postpartum Depression
Lasts >2 weeks, interferes with function
28
Postpartum psychosis
Involves hallucinations, delusions, or thoughts of harm
29
Epidural side effect
hypotension due to vasodilation from sympathetic blockade
Hypotension leads to decreased placental perfusion → fetal bradycardia
30
What is Leopold’s maneuvers
help determine fetal position, lie, and the best location to auscultate the fetal heart.
31
| Fetal Position | Best FHR Location |
|
| Cephalic, back left | Left lower quadrant
| Cephalic, back right | Right lower quadrant
| Breech, back left | Left upper quadrant
| Breech, back right | Right upper quadrant
review
32
Magnesium sulfate toxicity
↓ Respirations (<12/min = red flag)
↓ Reflexes
↓ Urine output
Cardiac arrest (in severe cases)
33
💉 Mag Sulfate Antidote
Calcium gluconate
34
🔬 The Coombs test confirms:
That maternal antibodies are attached to the baby’s red blood cells
A positive Coombs = immune cause of hemolysis
35
Postpartum Hemorrhage s/s
bright red bleeding (lochia rubra)
Saturating a pad in <1 hour
Boggy uterus (should be firm)
Dizziness, lightheadedness → signs of blood loss
36
🩺 Nursing Priorities: in PPH
fundal massage
weigh pads/assess blood loss
VS (*BP,HR)
notify provider
37
Respiratory distress syndrome (RDS) ⚠️ Key Signs
Tachypnea (RR > 60)
Nasal flaring
Grunting
Intercostal/subcostal retractions
Cyanosis (in severe cases)
38
Newborn sepsis s/s
hypothermia
Poor feeding, lethargy
Respiratory distress (grunting, flaring)
Apnea, hypotonia
39
When is RhoGam given?
28 weeks and within 72 hours after delivery (if the baby is Rh-positive)
40
What is prolapsed umbilical cord
The cord slips through the cervix ahead of the presenting part (head, butt, etc.)
It can get compressed, cutting off oxygen to the baby
The fetal heart rate drops—usually bradycardia
41
🔴 Priority actions (in order): for prolapsed umbilical cord
1 Relieve pressure on the cord
-Use a sterile-gloved hand to lift the presenting part off the cord
2 Position in knee-chest or Trendelenburg
-This uses gravity to take pressure off the cord
3 Call for help & prepare for emergency C-section
4 Apply oxygen, increase IV fluids, monitor FHR
42
Early Decelerations cause and treatment
Head compression, no tx needed
-this mirrors a contraction
43
Variable decelerations cause and treatment
Cord compression; reposition mom
44
Late decelerations cause and treatment
Placental insufficiency: Turn to left side, stop Pitocin, give O2, fluids, notify HCP
45
what med is used in severe preclampsia and is used to prevent seizures
mag sulfate
46
how do oxytocic meds control bleeding
promotes contractions
47
severe preeclampsia s/s
Severe headache
Visual disturbances
High blood pressure
Proteinuria
eclampsia
48
Perineal pain after birth pt teaching
apply ice up to 24hr after birth
after 24hrs warm bath sitz help
49
Progestin-only birth control pills used for
breastfeeding mothers
50
Oxytocic meds should not be used when ___________
uterus is firm
51
engorgement occurs when______
The breasts fill with milk and fluid
-painful and swollen
52
Uterine atony presents as
soft or boggy
53
What is uterine atony
the uterus does not contract or tighten properly after delivery
-this leads to bleeding
-tachy and hypotension
54
What is normal postpartum
mild cramping
light lochia rubra
feeling chilled
55
What does retained placental fragments look like
Dark red vaginal bleeding after c section
firm,midline uterus
56
signs of hypovolemic shock
low blood pressure, tachycardia, and dizziness
57
Tubal ligation?
permanent and irreversible procedure where the fallopian tubes are surgically blocked or sealed to prevent pregnancy.
58
Risk Factors for Sepsis
Premature birth (preterm infants are at a higher risk)
Low birth weight (especially under 2500 grams)
Maternal infections (e.g., Group B strep, chorioamnionitis, UTI)
Prolonged rupture of membranes (more than 18 hours)
Invasive procedures (e.g., intubation, central lines)
Immature immune system (especially in premature infants)
**Maternal history of STIs (e.g., HIV, chlamydia, gonorrhea)
59
Signs of Sepsis:
temperature instability (either hypothermia or fever)
Respiratory distress (tachypnea, grunting, nasal flaring)
Poor feeding or vomiting
Lethargy or irritability
Pale or mottled skin (poor perfusion)
Cardiovascular instability (tachycardia, hypotension)
Changes in blood glucose (hypoglycemia or hyperglycemia)
Abnormal laboratory findings (e.g., elevated C-reactive protein (CRP), positive blood culture)
60
Signs of NAS:
Tremors or twitching of the arms or legs
Excessive crying, especially high-pitched
Feeding difficulties, poor sucking or swallowing reflex
Vomiting, diarrhea
Poor weight gain, failure to thrive
Respiratory distress (tachypnea, nasal flaring)
Sweating, fever
Hypertonia (muscle tightness) or hypotonia (floppy limbs)
61
NAS assessment
Finnegan Neonatal Abstinence Scoring System (FNASS): Used to assess the severity of withdrawal symptoms.
62
Signs of Hypoglycemia:
Tremors or shakiness
Poor feeding or weak sucking
Lethargy or irritability
Respiratory distress or tachypnea
Pale or cyanotic skin
Seizures (in severe cases)
63
hypoglycemia prevention
Early feeding: Encourage breastfeeding or provide formula if breastfeeding is not possible.
Maintain body temperature to prevent cold stress
64
Jaundice can lead to what
kernicterus
65
Umbilical Cord Care:
Keep the area clean and dry
expose to air
watch for s/s infection
66
Care of the Circumcision:
Keep the area clean (plain water)
Petroleum jelly (like Vaseline) is often applied to the area after each diaper change to protect the wound from sticking to the diaper and to promote healing.
s/s infection
no tight clothing
7-10 days
67
Normal Newborn Weight Loss
Can lose up to 7-10% of birth weight in first few days
Regained by 10–14 days of life
68
determine adequate intake
at least 6-8 wet diapers per day
feeds about 8-12 times per day
69
breastfeeding practices
hould have more areola in the mouth than just the nipple.
at least 8-12 times per day
Try different positions
quiet envirnoment
70
Formula Feeding Best Practices:
about 2-3 ounces per feeding
typically every 3-4 hours
burp baby after
71
Rooting Reflex:
When the baby’s cheek or mouth is stroked, they will turn their head toward the stimulus and open their mouth, ready to latch for feeding. This helps the baby find the breast for breastfeeding.
72
Sucking Reflex
This reflex is triggered when something touches the baby’s lips or mouth, causing the baby to begin sucking. It is essential for feeding and nourishment.
73
Moro Reflex (Startle Reflex):
When the baby is startled by a loud noise or sudden movement, they will extend their arms and legs, then quickly draw them back in. This reflex is often seen when babies feel like they are falling or are startled.
74
Grasp Reflex:
When something touches the baby’s palm or soles of their feet, they will automatically grasp or curl their fingers around the object. It’s essential for bonding, especially during skin-to-skin contact.
75
Stepping Reflex:
If you hold the baby upright with their feet touching a flat surface, they will make stepping motions as if they are walking. This reflex usually disappears by 2 months.
76
Tonic Neck Reflex (Fencing Reflex):
When the baby’s head is turned to one side, the arm on that side will extend, and the opposite arm will bend, resembling a “fencing” pose. This reflex typically disappears by 6-7 months.
77
Heel Stick Test (Newborn Metabolic Screening):
What it tests: This test screens for genetic, metabolic, and endocrine disorders such as phenylketonuria (PKU), hypothyroidism, and sickle cell disease.
When it's done: Typically done between 24-48 hours after birth.
78
Hearing Screening
What it tests: Screens for hearing loss or deafness in newborns.
When it's done: Usually performed before discharge from the hospital.
79
Pulse Oximetry newborn screening
What it tests: Screens for critical congenital heart defects (CCHD) by measuring the oxygen levels in the baby’s blood.
When it's done: Performed at 24-48 hours of life.
80
What 3 meds are given to newborns
vitamin k, hep b vaccine, Erythromycin Ointment
81
vit k vaccine
Vitamin K is given to prevent hemorrhagic disease
IM within 6 hrs
82
hep b vaccine
at birth, 1-2 months, 6-18 months
IM
83
Erythromycin Ointment:
prevent ophthalmia neonatorum, an eye infection caused by gonorrhea or chlamydia.
within 1 hour of birth.
84
Definition of Postpartum Hemorrhage (PPH):
blood loss >500 after vaginal
>1000 c section
usually first 24 hrs
-secondary pph can occur after
85
4 causes of postpartum hemorrhage
Uterine atony
Retained placental tissue
Lacerations, tears, or episiotomy
Coagulation disorders
86
Immediate Care for Postpartum Hemorrhage
massage fundus
admin oxytocic meds
iv fluids
position l lateral
87
Disseminated Intravascular Coagulation (DIC)
a life-threatening condition characterized by the abnormal formation of blood clots throughout the bloodstream, followed by the consumption of clotting factors and platelets, leading to severe bleeding
88
Signs of DIC:
Petechiae (small red or purple spots on the skin).
Ecchymosis (bruising).
Excessive bleeding from injection sites, incision sites, or mucous membranes (e.g., gums, nose).
Low blood pressure and signs of shock.
Tachycardia and oliguria (low urine output).
Abnormal laboratory findings:
Decreased platelets.
Prolonged PT (prothrombin time) and aPTT (activated partial thromboplastin time).
Low fibrinogen levels.
Elevated D-dimer (a breakdown product of fibrin).
89
Prevention of DVT
early ambulation
compression stockings
hydration
Anticoagulant therapy
Avoid prolonged immobility
90
Signs of DVT:
Swelling in one leg (especially the calf).
Pain or tenderness in the leg, often worsened by standing or walking.
Redness or warmth
Difficulty walking or a feeling of heaviness
91
Complications of DVT:
Pulmonary embolism (PE): If a clot breaks loose and travels to the lungs, it can cause a life-threatening pulmonary embolism, which may result in respiratory distress, hypoxia, and cardiovascular collapse.
Post-thrombotic syndrome: Chronic pain, swelling, and ulcers in the affected leg due to long-term venous insufficiency.
92
Routine Care After Birth
monitor VS
assess uterus
peri care
-Assess the perineum for swelling, bruising, or infection, and make sure there are no signs of hemorrhage
93
laceration care
clean the area with mild soap and water, apply cold packs for the first 24 hours to reduce swelling, and use sitz baths for comfort after 24 hours.
94
Routine Labs After Birth
CBC (H&H)
blood type and rh factor
urinalysis
95
if a baby is _________ the mother should get the rhogam vaccine within 72 hrs of delivery
rh positive
96
Routine Vaccinations after birth
- if mother non immune, rubella
Tdap (prevents pertussis)
97
urine output after birth
3000ml or more each day fro first 3-4 days
98
Monitoring for Fluid Imbalances:
Low blood pressure, tachycardia, or low urine output may indicate dehydration or hypovolemia
99
What to do first Prolapsed Umbilical Cord
First Action: Relieve pressure on the cord to prevent fetal hypoxia
-knee chest position
-insert sterile glove in vagina
-admin 02
-prepare for c-section
100
what to do first Shoulder Dystocia:
call for help
McRoberts maneuver: Flex the mother's thighs toward her abdomen to straighten the pelvic curve and attempt to free the shoulder.
Suprapubic pressure: Apply pressure just above the pubic bone to dislodge the anterior shoulder.
Deliver the posterior arm: If the above steps don’t work, attempt to deliver the posterior arm to reduce the diameter of the shoulder.
101
what to do first Uterine Rupture:
First Action: Call for help immediately, as this is a life-threatening emergency.
Administer IV fluids and oxygen
prepare for c section
102
what to do first Meconium in Amniotic Fluid
First Action: Assess fetal well-being and prepare for potential complications.
103
Signs of Chorioamnionitis
Chorioamnionitis is an infection of the amniotic sac and fluid, and it's a common cause of preterm labor.
Signs and Symptoms:
Fever (most common)
Tachycardia (in both the mother and fetus)
Uterine tenderness or contractions
Foul-smelling amniotic fluid
Leukocytosis (high white blood cell count)
Abdominal pain or chills
Increased heart rate in the fetus (due to fetal distress)
104
Treatment of Preterm Labor
monior fetus and assess contractions
Tocolytics, stop contractions
hydration
antibiotics
105
d) medical indications for Cesarean section
fetal distress
Shoulder dystocia
breech presentation
Placenta previa
Placental abruption
Active genital herpe
106
Signs of True Labor:
Regular contractions
the bloody show
contractions with activity
107
false labor
irregular contractions
contractions stop w activity
108
Care During Transition Phase of Labor
support
comfortable position
hydration
pain relief
delivery
109
Hypotension from epidural
prevention: give IV fluids prior and during
110
Functions of the Placenta
Nutrient and Oxygen Transfer:
Waste Removal
immunologic Protection
barrier
111
Fetal Circulation
Oxygenated blood from the mother enters the fetus through the umbilical vein
he blood enters the right atrium of the fetal hear
-The lungs are not used for oxygen exchange in utero because the fetus gets oxygen from the placenta
112
% of unintended pregnancies
45%
113
danger signs in 1st trimester
(0-13 weeks)
- Vaginal bleeding
- Severe nausea/vomiting (hyperemesis gravidarum)
- Cramping, abdominal pain
- Fever or chills
- Burning on urination
114
danger signs in 2nd trimester
(14-26 weeks)
- Vaginal bleeding
- Leaking of fluid (possible PROM)
- Absence of fetal movement (after 20 wks)
- Contractions, backache, pelvic pressure (preterm labor)
115
danger signs in 3rd trimester
(27-40 weeks)
- Severe abdominal pain
- Decreased fetal movement
- Sudden weight gain, facial/hand swelling, headache, visual changes (signs of preeclampsia)
- Leaking of fluid or bleeding
- Signs of labor before 37 weeks
116
leopold’s Maneuvers
Leopold's maneuvers are four systematic palpations to determine:
Fetal lie and presentation (e.g., head vs. butt at fundus)
Fetal position (back vs. limbs)
Engagement in pelvis
Descent of presenting part
117
APGAR score is done at ____ and _____
1 and 5 mins
<7 = bad
118
Naegele’s Rule (EDD)
First day of LMP + 7 days, then subtract 3 months
119
1st trimester weight gain
1-4.5 lbs
120
2nd and third trimester weight gain
1lb a week
121
total pregnancy weight gain
25-35
122
cycle of violence
tension bulidng >acute battering>honeymoon
