Final Exam Notes Flashcards
1
Q
What time period does antepartum consist of?
A
From the moment you become pregnant to the moment you deliver
2
Q
EDC/EDD stands for?
A
Estimated date of delivery
3
Q
Thyroid issues in pregnancy can cause?
A
multiple miscarriages
4
Q
Lordosis means?
A
spine curvature
5
Q
cervical os means?
A
opening of cervix
6
Q
When are fetal heart tones not present?
A
in a tubal pregnancy
7
Q
When is a mildly elevated white count normal?
A
during pregnancy
8
Q
What lab value is always lower in pregnancy?
A
hemoglobin
9
Q
What should be checked during 2nd trimester?
A
blood glucose
10
Q
Goodell’s Sign refers to?
A
When the vaginal portion of the cervix becomes softer due to vascularization
11
Q
Chadwick’s Sign refers to?
A
Bluish appearance to the cervix; probable sign of pregnancy.
12
Q
Oxytocin is known as?
A
Labor hormone (contracts uterus), the ‘love’ hormone
13
Q
Relaxin causes?
A
relaxation of uterus
14
Q
Embryonic Stage time period?
A
is from conception through the end of 8th wk of pregnancy
15
Q
Fetal Stage time period?
A
Week 9-Birth
16
Q
Full Term time period?
A
38-40 weeks after conception
17
Q
Naegele’s Rule is calculated how and for what reason?
A
Last Menstrual Period-3 months + 7 days
18
Q
Four Types of Pelvis and most common/favorable?
A
Gynecoid (most common and favorable); Android, Anthropoid, Platypelloid
19
Q
GTPAL means?
A
Gravida, Term, Preterm, Abortions, Living Children
20
Q
Gravida definition?
A
Total number of pregnancies
21
Q
Leopold’s Maneuver is what?
A
Feeling for baby’s head and back to determine the position of the baby.
22
Q
How is fundal height measured?
A
By measuring the distance from the pubic symphysis to the highest part of the uterus
23
Q
What should a pregnant woman take for headaches?
A
Tylenol Only; not safe over 20 wks.
24
Q
What is a stable HR in a baby?
A
110-160
25
Where are Braxton Hicks felt?
Only in front of the uterus; caused by uterine irritability.
26
What can a pregnant woman do to decrease urine loss?
Kegel Exercises
27
What age defines a geriatric mother?
Over 35
28
What is a normal amount of fetal kicks per hour?
10 or more.
29
What problem can happen if there is not enough amniotic fluid?
Baby can have kidney problems.
30
Nuchal cord means?
Umbilical cord wrapped around baby's neck
31
Placental circulation is?
The direction of flow is different from that in the normal body
32
Why is psyche important in a laboring mom?
It is difficult for the uterus to dilate if mom is trying to maintain control and has anxiety.
33
Fetal Attitude refers to?
Relation of fetal body parts to each other
34
Fetal Lie means?
Orientation of long axis of fetus to long axis of woman; can be longitudinal or transverse
35
What positions are best for a baby delivery?
LOA or ROA
36
How are contractions measured?
From the beginning of one to the beginning of the next
37
What is the key for a ticket to stay in L&D?
Progressive cervical changes
38
What are signs of true labor?
Contractions 45 seconds to 1 minute, for greater than one hr and increasing in intensity; symmetrical, regular, predictable contractions and do not stop
39
Latent Phase of labor consists of?
30-45 second contractions; every 5-20 mins apart
40
Active Labor consists of?
Dilation from 4 to 7 cm; contractions 45-60 seconds long and 2-5 mins apart, membranes may rupture
41
Transition phase consists of?
8-10cm dilation, 60-120 second long intense contractions with rest periods of 30-90 seconds; this stage lasts 10-60 minutes
42
2nd Stage of Labor happens when?
Pushing, fully dilated
43
3rd Stage of Labor happens when?
Delivery of Placenta; risk of hemorrhage increases as length of 3rd stage increases
44
What should you do if fetal distress is present?
Turn Pitocin off if being induced; give fluid bolus of Lactated Ringers, change maternal position, FHR
45
When is APGAR score assessed?
At 1 and 5 minutes
46
What is the purpose of a fundal massage?
It reduces the risk of hemorrhage in mom
47
Which infectious agent is the most prevalent and significant in health care settings?
Bacteria
48
What are some possible reservoirs for infectious agents?
People, animals, soil, food, water, milk, inanimate objects
49
What is a portal of exit?
A means for a micro-organism to leave its source
50
What are some common portals of exit?
Respiratory, blood, GI (feces, saliva, vomit) and GU (vaginal secretions, urine) systems, breaks in skin or through tissue.
51
Incubation Period
Organisms growing and multiplying
52
Prodromal Stage
Person is most infectious (vague and nonspecific signs of disease)
53
Full stage of Illness
Signs and symptoms present
54
Convalescent period
Period of recovery
55
What are the Stages of Infection?
Incubation period, Prodromal Stage, Full stage of Illness, Convalescent period
56
What are some cardinal signs of infection?
Redness, heat, swelling, pain, loss of function
57
What are some lab values indicating infection?
Elevated WBC (normal 5-10k), elevated erythrocyte sedimentation rate, presence of pathogens in urine, blood, cultures or sputum
58
What are the four major categories of hospital acquired infections?
CAUTI's (catheter UTI), surgical site infection, central line associated bloodstream infection, ventilator associated pneumonia
59
Risk factors for VRE
Prolonged hospitalization, long-term use of vancomycin, recent surgery, compromised immune system
60
What is the body's defense against infection?
inflammatory response, immune response, normal flora
61
What is the primary immune response?
Antibodies
62
What do antibodies do?
Bind with antigens to inactivate an immune response
63
T/F Immune function declines with aging.
True
64
Passive immunity (natural) means?
Immunity passed from mom to baby via breastmilk, placenta
65
Passive immunity (artificial) means?
Antibodies produced in another animal or person and given to at-risk individual to prevent disease after exposure
66
Active Immunity (natural) means?
exposure to antigen naturally
67
Active Immunity (artificial) means?
Antigen given in form of vaccine to stimulate antibody production
68
What is an inactivated vaccine?
A vaccine that is given to stimulate production of antibodies, but the microorganism has been killed
69
What is a live vaccine?
Microorganism exists in the vaccine in a weakened form
70
Which live vaccines are contraindicated in pregnancy and immunocompromised patients?
MMR (immunocompromised) & Var (pregnancy and immunocompromised)
71
What are three distinct roles of the nurse?
Patient advocate, collaborator, coordinator
72
What are some of the national patient safety goals? (NPSG)
Patient identification, improve staff communication, medication safety, safe use of alarms, infection prevention, identify patient safety risks (mental health assessment), prevent surgical error
73
What are keys to effective collaboration by the RN?
Inform, empower, assist in goal setting, be patient-centered
74
What are outcomes of successful collaboration?
Reduced use and cost of resources, improved patient safety.
75
Covert conflict means?
Avoiding and ignoring
76
Overt conflict means?
Openly disagreeing and confronting
77
What is the basic cell of the nervous system?
A neuron
78
How many pairs of cranial nerves are there?
12
79
How many pairs of spinal nerves are there?
31
80
What function do cranial nerves serve?
sensory, motor or mixed
81
What function do spinal nerves serve?
motor and sensory activities; each with a specific function
82
What are somatic reflexes?
skeletal muscle contraction
83
What are autonomic reflexes?
Reflexes that activate cardiac, smooth muscle, and glands
84
How long does white matter grow steadily?
For the first four decades of life
85
What is the limbic system responsible for?
The drive for basic needs, melatonin release, circadian rhythm, emotions
86
Which neurological system is linked to addiction?
The limbic system
87
What is increased intracranial pressure?
A condition or trauma that causes pressure within the cranial vault
88
What are consequences of increased intracranial pressure?
Cerebral edema, increased ICP, and decreased cerebral perfusion
89
What are risk factors for ICR problems in the elderly?
degenerative diseases and/or conditions, falls
90
What are risk factors for ICR problems in adolescents and young adults?
Trauma, MVA, ATV accidents
91
What are risk factors for ICR problems in infants and toddlers?
accidents, congenital defects
92
What is important to know when assessing LOC?
Your patient's baseline
93
What is evident in deep brain injuries?
Vital sign changes
94
Full consciousness definition
A&Ox4
95
Disorientation definition
Not oriented to person, place, time
96
Obtundation definition
Lethargic
97
Stupor definition
Awakes with vigorous or painful stimuli
98
Semicomatose definition
Painful stimuli may result in stirring
99
Coma definition
Unarousable; nonpurposeful response
100
Deep Coma definition
brain-dead
101
What are the most common nursing assessment findings on those with affected intracranial regulation?
Motor & mental functioning issues
102
What can increased ICP cause?
Increased ICP restricts blood flow, causing ischemia
103
What is Caloric testing?
Hot or cold stimuli on face.
104
What is an abnormal sign in Romberg testing?
ataxia (swaying)
105
What is a positive (abnormal) Brudzinski sign?
Pain when flexing head to chest (meningitis sign)
106
What is a positive (abnormal) Kernig sign?
Pain when flexing knees and hips or straightening legs
107
Which is a worse sign, decorticate or decerebrate posturing?
Decerebrate
108
What can you do to prevent dysfunction in intracranial regulation?
Have a good diet, exercise regimen, no tobacco, be safe!
109
What is active transport?
A process in which energy moves substances against the concentration gradient (high to low, low to high); moves things back and forth
110
What lab values are higher in the blood if you are not well hydrated?
Sodium, Potassium and hematocrit
111
What is osmosis?
The movement of water across cell membranes from less concentrated solution to more concentrated solutions
112
What is colloid osmotic pressure?
A form of osmotic pressure that is exerted by proteins (albumin) in a blood's plasma that pulls water into the circulatory system
113
What does osmolality mean/refer to?
thickness of solutes
114
What happens in a hypertonic solution?
It shrinks/squishes a cell
115
What happens in a hypotonic solution?
It enlarges a cell
116
Diffusion goes from a ___ concentration to a ___ concentration
high, low
117
Filtration is the ....
movement of fluid and solutes together across a membrane from one compartment to another; it is like putting coffee through a filter
118
Sodium lives ____ the cell
outside
119
Potassium lives ___ the cell
inside
120
How much fluid intake should a normal individual have per day?
2500 ML/day
121
How much fluid output should an individual have per day of urine?
1400-1500 ML's of urine
122
How can you maintain homeostasis within the body?
Drink water, limit salt, consume potassium
123
Potassium is responsible for?
Skeletal, cardiac and smooth muscle function
124
What is calcium responsible for and where is most found?
Regulating muscle contractions (Cardiac), most is found in skeletal system
125
What is Magnesium responsible for?
Operating the sodium potassium pump, regulating cardiac and neuromuscular function, relaxing muscle contractions
126
What is Bicarbonate?
A major body buffer that regulates acid-base balance
127
How are babies different with fluid loss?
Babies lose a lot of fluid when they have diarrhea.
128
Does stress increase or decrease production of ADH?
Increase
129
What can beta-blockers help with?
Reducing the response to adrenaline
130
What are signs of fluid volume excess?
Neuro: Changes in LOC, confusion, headaches, seizures
Respiratory: Pulmonary congestion
Cardiovascular: Bounding pulse, high BP, JVD, S3 heart sounds, tachycardia
GI: Anorexia, nausea
Edema: pitting edema
131
What should you assess for fluid volume deficits?
Hypotension, weak pulses, perfusion, LOC, muscle strength, electrolytes, CBC, specific gravity--urine
132
Electrolytes balance the ____ in your body
fluid
133
Electrolytes balance your __ level
pH
134
Homeostasis occurs via ____, _____, and ____ _____
diffusion, osmosis and active transport
135
Fluid overload in the body is held in ______ _____ in an effort to store it until the body can process it.
interstitial spaces
136
When providing holistic care, whose perspective should we use to look at life?
The patient's
137
What are components of the holistic nursing assessment?
The assessment of the entire physical body, the use of our five senses during the exam and the use of caring and being present during assessment.
138
What is culture shock?
The feelings a person experiences when placed in a different culture
139
What is world view?
How any person or culture perceives or understands the world of others
140
How is health viewed in the West?
As an absence of disease, food impacts health in good & bad ways, independence/individualism is valued
141
How is health viewed in the East?
Health is a state of harmony involving mind, body and spirit; food can heal imbalances, there are cultural healers
142
What does acculturation mean?
The process of accepting another culture as your own
143
What are Tanner Stages?
Stages of sexual maturation
144
What are the five stages of the sexual response cycle?
Desire, Arousal, Plateau, Orgasm, Resolution
145
STI's can lead to infertility and PID. T/F
True
146
STI's can cause major issues or death in newborns. T/F
True
147
T/F A person exposed to HIV is two to five times more likely to acquire HIV than a person who does not have an STI.
True
148
Which STI is the leading cause of infertility?
Chlamydia
149
What does integrity mean?
Doing the right thing even when no one is looking; admit your mistakes
150
The Nurse Practice Act is written by _______
legislatures
151
Who does the Nurse Practice Act protect?
The public
152
What are the steps of the nursing process in order?
Assessment, diagnosis, planning, implementation, evaluation
153
What is the Patient Self-Determination Act?
An act mandating health care facilities to inform patient's of their right to make decisions about their medical care
154
What are the 5 rights of delegation?
Right task, circumstance, person, direction, supervision
155
T/F The National Counsel of State Boards of Nursing oversees the state boards, develops licensure exams and deals with national standards for nurses and protects the public instead of the nurse.
True
156
What can a nurse never delegate?
Assessments, client teaching, evaluations
157
What main idea is behind the primary level of prevention?
To prevent disease or illness
158
What main idea is behind the secondary level of prevention?
To detect and treat an illness
159
What main idea is behind the tertiary level of prevention?
Educate the client to prevent further issues
160
What are some barriers to access of health care?
Lack of health insurance, lack of a PCP, uneven distribution of services (underserved areas), perceptions to an individual of need
161
What are signs of skin cancer?
Asymmetry, Uneven border, variety of color, large diameter, any change in mole appearance or size.
162
Cold increases inflammation T/F
False; cold decreases inflammation.
163
T/F Heat increases inflammation
True.
164
Maceration definition
Too wet
165
What are signs of an infection?
errhythema, necrosis, purulent drainage, smell
166
Dehiscence definition
Partial or total separation of wound layers
167
Evisceration definition
Total separation of wound with perfusion
168
What is the Braden Scale?
A measure used to predict risk for pressure ulcers.
169
What are the five principles of ethics?
Beneficence, Autonomy, Justice, Fidelity, Veracity
170
What are the five values from the Code of Ethics?
Altruism, Social Justice, Integrity, Autonomy, Dignity
171
Nonmaleficence definition
One ought not inflict harm
172
Beneficence definition
One ought to prevent harm
173
Veracity definition
Full disclosure
174
What is a normal pH range of body fluids?
7.35-7.45
175
What are the three systems that work together to maintain a normal range of pH?
Buffer System, Respiratory System, Renal System
176
Which system acts first in maintaining a normal pH?
The buffer system; Bicarb 24-28 mEq/L; used up quickly, not effective long-term
177
Which system acts second in maintaining a normal pH?
Respiratory system; the person blows off acid, which causes respiratory alkalosis; less effective over time
178
Metabolic acidosis in the Respiratory drive causes..
Increased respiratory rate; must fix the issue via blowing off CO2 or hyperventilate (Kussmal respirations)
179
The renal system is used to compensate for respiratory imbalances T/F
True
180
Renal compensation is the slowest compensation T/F
True
181
Renal compensation is the most powerful method of compensation T/F
True
182
Renal compensation is effective in patients with renal failure. T/F
False; renal compensation is ineffective in patients with renal failure.
183
Terbutaline stops contractions by relaxing the uterus. T/F
True
184
Magnesium sulfate is given with pre-eclampsia and eclampsia to prevent seizures. T/F
True
