Final Exam Flashcards

1
Q

Maternity practice- what is this?

A

Focuses on a high-quality family experience. We’re childbearing is seen as a normal and healthy event

Parents are prepared for the changes that take place during pregnancy, labor, and delivery.

They also prepare for changes in family dynamics after the birth

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2
Q

Calcium how to obtain in a diet?

A

Increase by 50% when pregnant

DRI is 1200mg

Supplements should be taken for women who don’t drink milk or are under 25 years old because bone density is not complete

Take separately from iron supplements for better absorption. Take with vit D

Calcium sources: cereals, legumes, nuts, dried fruits, broccoli, green leafy veggies, canned salmon, sardines with bones

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3
Q

Presumptive, probable, positive

Signs of pregnancy?

A

Presumptive- amenorrhea (no period), nausea, breast tenderness, deepening pigmentation, urinary frequency, quickening

Probable- goodells sign, chadwicks sign, hegars sign, McDonald’s sign,abdominal enlargement, Braxton’s Hicks contractions, ballottement , striae, positive pregnancy test

Positive - fetal heartbeat, fetal movement felt by examiner, ultrasound visualization of fetus

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4
Q

Exercise during pregnancy- goal?

A

Goal should be maintaining fitness not improvement or weight loss

Mild to moderate exercise during pregnancy is beneficial during pregnancy but extreme exercise should be avoided such as hot yoga weight loss, weight lifting, elevated temp

Good for heart, bones, muscles, joints, overall well-being, circulation

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5
Q

What influences of labor pains

A

Contractions of the muscles of the uterus

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6
Q

Prenatal vitamins

A
Folic acid -.4mg/day 
Protein - 60 g/day
Calcium -1200mg
Iron-16 mg 
Fluids 

Preganant teens may need more

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7
Q

RH negative blood- what is this? Schedule to receive immune globulin ?

A

During pregnancy problems can occur if you are RH negative and your fetus is Rh positive. It is called Incompatibility

Given to prevent blood cells from attacking positive blood type in baby’s. (Building antibodies)

Given at 38 weeks and with in 72 hours after delivery to protect against future preganacys

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8
Q

Fetal heart heard at what gestation?

A

8-12 weeks

7 weeks ultrasound

Hard to hear under 12 weeks with a Doppler

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9
Q

Define placenta previa ?

Delivery options?

Treatments ?

A

Painless bright red bleeding, low lying placenta, not contacting with cervix, - can do vaginal birth

partial = covering small amount,

Complete is covering completely -c-section only , treatments ?

Treatment - bed rest ? C section

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10
Q

What is SIDS?

Prevention?

A

Sudden infant death syndrome

Back to sleep, place nothing in crib

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11
Q

What is HPV? Vaccine/prevention ?

A

Human papillomavirus infection that can cause cancer or genital warts through sexual contact - vaccine is Gardasil vaccine to prevent cancer

Repeat a 7 years??

Prevention - gardasil shots , safe sex?

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12
Q

Different types of twins ( monozygotic, dizygotic, conjoined and identical)

A

Mono- one egg- identical

Dizygotic- two eggs-fraternal

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13
Q

Benefits of breastfeeding?

Calories needed?

Possible complications

and how to know if baby is getting enough?

A

Benefits- ? Nutrients to baby, save money, reduces allergies, promotes bonding

Calories- ? Same as when pregnant

Breast engorgment , mastitis

Know baby is getting enough of have 6 wet diapers a day

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14
Q

Gate control Theory during labor?

A

Explains how pain impulses reach the brain, pain is transmitted through small- diameter nerve fibers .

However the stimulation of large diameter nerve fibers temporarily interferes with the conduction of impulses through small diameter fibers. Techniques to stimulate large diameter favors and close the gate too painful impulses include massage, Palm and fingertip pressure, and heat and cold applications.

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15
Q

Contractions?

Phases, frequency, duration , Braxton Hicks , false labor , true labor

Relaxation between?

A

Phases:

Increment: the period of increasing strength

Peak or acme- the period of greatest strength

Decrement - the period of decreasing strength.

Duration is the start of one contraction to the end of the same contraction

Frequency is the beginning of one contraction to the beginning of the next contraction

Braxton Hicks are irregular contractions

False labor is contractions that help prepare the woman’s body and the fetus for true labor

True labor contractions will become progressively more painful and regular, about every 2 to 5 minutes

Relaxation between contractions helps infantsReceive oxygen between periods of rest

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16
Q

Fetal lungs- when are they fully developed?

Glucocorticoids?

A

37 weeks

Glucocorticoids- are giving before birth to speed up lung development

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17
Q

Nursing interventions after delivery?

Fundus- normal vs abnormal?

A

Fundus should firm, if soft or boggy then massage .

?

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18
Q

Mag sulfate and calcium gluconate ?

Uses and nursing interventions ?

A

Mag sulfate- can help stop preterm labor, Protect the fetus in developing Sarabel palsy, monitor vital signs every hour, respiration rate , lung sounds, signs of fluid overload,Urine output, deep tendon reflexes, bowel sounds

Calcium- To adverse effect in newborn of mag sulfate

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19
Q

Gestational diabetes - risk factors , expectations to resolve ?

A
GDM- macrosomnia 
Polyhydration 
Still birth 
Hx of having larger babies 
Hx of having GD in other pregnancies 

Expectations to resolve ?

Metformin
Diet/exercise
Insulin

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20
Q

Infant vaginal discharge and scrotal swelling - causes, normal vs. abnormal?

A

Psudomenses- puffy labia
Vaginal discharges from a new born girl - can look bloody or white - this is normal from maternal hormones
- check anus for patency/ infection/ by rectal temp

Scrotal swelling is normal - palpate to make sure both testicles have descended into scrotal sac. (Cryptorchidism - abnormal)

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21
Q

PKU - what is this and when given ?

A

Test done for PHENYLKETONURIA

A birth defect that causes an amino acid called phenylalanine to build up in the body.

body can’t metabolize phenylalanine due to the absence of the phenylalanine-hydroxylase enzyme.

Screening is done after 24 hours and prior to 96 hours after delivery (1-2 days)

Heel stick

Low protein diet

If the infant has this disorder the formula starts in the first two months of life and can reduce disability and can also prevent severe mental retardation

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22
Q

Jaundice - causes , risk factors , why/when it likely develops ?

A

Never should develop before 24 hours

May lead to brain damage

Phototherapy keeps eyes closed and covered

Needs to be reported if it occurs in the first 24 hours of life

Why it happens - breast fed babies or liver isn’t mature enough in preterm babies to get rid of excess bilirubin.

Babies need to poop and pee the excess bilirubin out - yellow substance to replace old RBC

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23
Q

Infant retinopathy - causes?

A

Disorder of the developing retina in premature infants that can lead to blindness

Causes - premature babies -immature retinas , increase O2, Retinal detachment is the main cause of visual impairment and blindness in ROP.

is a disease that affects immature vasculature in the eyes of premature babies.

It can be mild with no visual defects, or it may become aggressive with new blood vessel formation (neovascularization) and progress to retinal detachment and blindness

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24
Q

Mensuration education ?

A

We are Born with all the eggs that we will have for our life

Eggs will age, that’s my older women have a harder time becoming pregnant or have more pregnancy difficulty

Ages 11 to 15 is when it starts for most girls

Some cycles are irregular in the first six months

Then the cycle will become more normal six months to a year after the first cycle

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25
Low sperm count - causes ?
``` High temp Infections Drug/ alcohol Tight firing clothes Hot tubs Saunas ```
26
Define oogenesis?
Mitosis in the ovum (development of egg)
27
Nursing diagnoses r/t labor and delivery
?
28
Congenital heart defects ? Signs and symptoms
Abnormal defect in the heart that develops before birth S/s- tired , stop eating due to tiredness , size (small for age can be an indicator) Abnormal heart rhythms, grey/blue tinted skin (cyanosis), SOB, increase respiration’s, swollen body tissue
29
RSV- S/S Nursing interventions
common, and very contagious, virus that infects the respiratory tract of most children before their second birthday chance of severe infection is greatest for: Babies born prematurely. Fever, severe cough, rapid or difficulty breathing ,bluish color of skin (cyanosis) NPO If respiration’s are greater than 60, breathing is the priority may need IV for nutrition Oxygen to maintain stat (needs order) Saline nasal drop Watch for grunting and retraction
30
PIH- S/S
Pregnancy induced hypertension (preeclampsia) High bp Proteinurea, Headaches, visual changes, Edema, nausea and vomiting, sudden weight gain Usually returns normal six weeks post pregnancy
31
Preschool - imaginary friends
Normal and is common
32
School age - friends
Children tend to play side by side rather than interactively Grade school kids have the same sex friends
33
Dehydration in infants ? S/S- earliest symptom?
``` Tachycardia - earliest sign No tears Dry mucus membrane Depressed fontanel Decreased LOC Hypokalemia 3.5-5 /electrolyte imbalances Thirst Muscle weakness ``` Replace fluid 20ml
34
Strep throat- risk factors, possible complications, treatment and follow up?
``` Contagious Take full course antibiotics Change toothbrush with in first 24 hours Saline gargle May lead to rheumatic fever ```
35
Cystic fibrosis- what is this? Treatment ?
An inherited life-threatening disorder that damages the lungs and digestive system. Mucus blacks airways Pancreatic enzyme necessary to help with digestion Increase fat and salt intake/foods Breathing difficulty CPT Can cause infertility Pneumococcal vaccine ,Sodium chloride Dietary supplement, Antibiotics, Penicillin antibiotic, and Cough medicine
36
Sickle cell disease? Maintenance?
A group of disorders that cause red blood cells to become misshapen and break down. Immunizations asap No iron Encourage fluids to prevent dehydration Increased volumes of urine, due to kidneys cannot concentrate urine When a child produces more urine, they also need to increase their fluid intake Do you hydration can trigger pain crises
37
Child abuse - s/s Triggers , Trust?
Bruce’s of multiple stages of healing Stories do not match Hovering parents Child has sexual relationships at a young age
38
Emancipation- what is this? Rights?
A legal mechanism by which a minor is freed from controlled by their parents or guardians, and the parents or guardians are freed from any legal and all responsibility towards the child Laws vary by state A child can sign for medical care for their child and self ? A child younger than 18 has a baby becomes an emancipated once they have the baby?
39
Impetigo? What is this? How is this contracted ?
Commonly contagious bacterial infection usually found in the mouth Keep clean, antibiotics, easily spread to others Staphylococcus aureus carriers, infection is thought to be spread by the person from their nose or other area to the skin
40
Normal child development ? Self concept ?
View of oneself fluctuates and is molded by the demands of parents, peers, teachers, and others Risk for low self-esteem if they cannot gain view of self
41
Cleft lip- post op nursing interventions
Avoid crying after repair, keep clean with dropper, feed would drop her, keep up right with head support
42
Celiac disease- diet and treatment
An immune reaction to eating gluten, a protein found in wheat, barley, and rye. Intestinal biopsy, gluten-free diet
43
Intussusception -signs and symptoms?
A slipping of one part of the intestine into another part just below it, small intestine opens into the ascending colon Generally occurs in boys between three months and six years High fever, and infants severe pain in abdomen, loud cries, straining efforts, kicking and drawing of legs towards abdomen, green or greenish yellow vomit, BMs Diminished with little flatus, Blood and mucus with no feces is common – known as jelly stool
44
Hypokalemia -s/s?
Related to muscular or cardiac function Weakness or muscle spasms, dysrhythmias – ECG changes, muscle breakdown
45
Define glomerulonephritis ?
Acute inflammation of the kidneys Formally called Bright’s disease, is an allergic reaction to a group of streptococcal infection. It may appear after the patient has had scarlet fever or skin infections
46
Atrial septal defect -what is this? Signs and symptoms?
ASD Involves an abnormal opening between the right and left atria. Blood that already contains oxygen is forest from the left atrium back to the right atrium Signs and symptoms – most patients do not have symptoms. The defect may be recognize when a murmur is her during a routine health examination
47
Epistaxis- signs and symptoms ? Treatment ?
Nosebleeds -Leading from the nostril, nasal cavity, or nasal pharynx Treatment includes direct pressure, do not tell head back, categorization packing
48
Femur fracture - possible complications?
Can cause growth issues and children A spiral femur fracture and a young child may indicate child abuse and must be referred to an assessment team immediately
49
Absence seizures- signs and symptoms?
Temporary loss of awareness that results in lack of succeeding in the learning environment Symptoms include appearing to stare into space for a few seconds, As if they are not paying attention,lip-smacking, island fluttering, chewing motions Afton recognized when in an intelligent child is referred for medical evaluation because of unexplained failure to achieve in school
50
Haemophilus influenza meningitis? Treatment ?
Inflammation of the brain and spinal cord Influenza is the most common cognitive agent Peak incidents for bacterial meningitis is between six and 12 months of age If a child cannot touch chin to chest usually a sign of meningitis, sensitivity to light, and severe headache Treated with antibiotics
51
Reye’s syndrome - signs and symptoms?
A rare but serious condition that causes confusion, swelling in the brain, and liver damage. Avoid aspirin, Afton comes on after a viral syndrome, persistent vomiting
52
Pertussis? What is this? Priority nursing diagnosis?
Highly contagious bacterial disease aka whooping cough Vaccinate - Tdap Watch airway - aspiration - pneumonia is a big risk for pts
53
Endometritis- s/s? Education? Treatment ?
Tender/ inflammation/enlarged inner lining of the uterus Severe cramping Foul smelling lochia Fever Tx- IV antibiotics, culture and sensitivity of Uterine cavity Nursing care – Teach women progression of lochia because infection often occurs after just charge, followers, Analgesics, observe for absent bowel sounds, abdominal distention, N/V
54
Newborn skin- 38 weeks vs 40 weeks vs 42 weeks , after birth ?
38-most of the vernix and lanugo protecting the skin is gone 40- 42 weeks - skin dry and peeling After birth?
55
Newborn complications ? S/s?
?
56
APGAR score - calculated ?
A score less than seven we need to work on bringing that score up Scored on a scale of 0-10 A: appearance 0-blue all over 1:blue in arms and legs 2: no blue P: pulse 0: no pulse 1: less than 100bpm 2: greater than 100 bpm G: grimace 0: no response 1: cry when stimulated 2: sneezing,coughing, pulling away when stimulated A: Activity 0: no movement 1: some 2: active R:respiration’s 0-none 1-weak/slow/irregular 2-strong cry
57
Vulva hematoma - s/s?
Vulvar tissue is crushed against the pelvic bone plane, Severe pain, sense of pressure in the Vulva,Penis or wreck dumb, unable to urinate, pulse and respiration increase, blood pressure falls May develop signs of hypovolemic shock due to blood loss
58
Define involution ?
Rolling or turning inward Reduction in the size of the uterus after delivery
59
Cold stress ? (Newborn) Nursing interventions
Caused by hypothermia, increased energy to generate body heat causes increased respiratory rate and oxygen consumption Nurses should dry the infant, please infant in radiant warmer, please hat on the infants head, wrap infant in warm blanket
60
Post partum depression S/s
May last for two weeks or more, can be hormonal or caused by sleep deprivation , if it last longer than two weeks then they start to look at if this is depression
61
Down syndrome - Newborns skin after birth? (Palm)
Single palmer crease ?
62
Nursing care for child with asthma ?
Inhaled steroids – rinse mouth after use due to yeast Rescue inhaler carry with at all times Can be triggered by infections, exercise, allergies, cold air
63
Pink eye (conjunctivitis)?
Itchy, red, watery eyes Treated with antibiotic drops