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Maternity Hesi > Gblandy > Flashcards

Gblandy Flashcards

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1
Q

Palpate for spongy, full feeling over symphysis

A

check urge to void when bladder is palpated

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2
Q

Kegel exercise

A

promote retoning

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3
Q

Should avoid within 4 hours of delivery

A

suspect retention if voiding is frequent and less than 100 mL per voiding

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4
Q

Deficient in vitamin B12

A

take supplements, multivitmains or drink milk 2-3 times a day

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5
Q

If iron protein and calcium is low

A

eat beans, fruit, dark greens, eggs and dairy, juice, ceral, yogurt and tufu

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6
Q

Cleansing breath

A

is a relaxed deep breath in through the nose and deep breath out through the mouth. Used at the beginning and end at each contraction.

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7
Q

Slow paced breathing

A

is initaiated when woman can no longer walk or talk through contractions SWALLOW AND FAST BREATHING

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8
Q

An unhealthy fetus

A

will develop no reassuring FHR patterns in response to uterine contractions

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9
Q

Late deceleration are indicative of

A

UPI

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10
Q

To assess for fetal well-being a

A

recording of at least three contractions in 10 minutes must be obtained

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11
Q

Cytotec Misoprostol

A

Is a drug that stimulates uterine pregnancy and manages postpartum hemorrhage.
Repeat until 3 or more contractions in 10 minutes/Bishop score of 8 or higher

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12
Q

Exercise to prepare for labor

A

teach the woman to do pelvic tilt exercise, pelvic rocking exercise and breathing exercise

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13
Q

Considerations for cytotec

A

maintain supine or side lying position for 30-40 minutes after insertion, intitates oxytocin for labor no sooner than 4 hours after last dose of misoprostol.

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14
Q

False labor

A

often stops when walking or changing positions, can be felt in the back or abdomen above the navel (no lower back pain.

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15
Q

Kick counts

A

instruct the client to notify HCP if there are fewer than 10 counts in two consecutive 2 hours period (fewer than 3 movements in one hour). Fetal movements that stop for 12 hours. Severely disturbed fetus, impeding fetal death and immediate delivery.

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16
Q

Placenta previa

A

painless bright red
possible signs of shock (decreased BP, weak and rapid pulse, cool and clammy skin, colored ashen or gray). monitor blood loss (weigh pads). ***clients with placenta abruption and previa should undergo no abdominal or vaginal manipulation.

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17
Q

Pregnancy test hormone

A

HcG

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18
Q

STD Pregnancy what you shouldn’t do

A

Do not breast feed if a woman has HIV, CMV, Gonorrhea (untreated) and Syphilis (untreated)

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19
Q

Sulfa Drugs

A

are used cautiously in lactating mothers because they cab be transferred to the infant in breast milk.

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20
Q

Syphilis

A

leads to spontaneous abortions and if visible lesions present in client with genital herpes C-section is recommended

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21
Q

Chlamydia

A

preterm labor, rupture of membrane, low birth weight and can be treated with Doxycycline or Azithromycin

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22
Q

Gonorrhea

A

miscarriage, amniotic infection fluid, chorioamnionitis, preterm birth and IUGR

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23
Q

Strep B

A

UTI, choriamnioitis, preterm birth

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24
Q

HPV

A

Dystocia from lesion and excess bleeding from lesions and cauliflower like warts

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25
Q

Syphilis

A

miscarriage, preterm birth, IUGR, stillbirth preterm birth and can be treated with penicillin

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26
Q

PID

A

POS, chandler sign, vaginal discharge, risk for ectopic pregnancy

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27
Q

HIV

A

treated with Zidovudine and HEP B shot

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28
Q

Terbutaline

A

Preterm GBS
Tachycardia is the major side effects of tocolytics (stop labor drugs.
with hold meds if the pulse is greater that 120
can cause hypokalemia and hyperglycemia. Check K and glucose level before giving it.
Notify HCP if signs of pulmonary edema and FHR greater than 180 bpm. Antidote: Propanolol

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29
Q

Third trimester-dysuria

A

Discomfort/ burn/ pain when urinating

Contact HCP for dysuria because it could be a STD or UTI

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30
Q

Food in labor

A

Ice chips and clear liquids only oral intake during labor

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31
Q

Meconium stain

A

decreases FHR
yellow-green or gold yellow and it can decreased FHR may indicate fetal stress
Fetal distress sign: decrease or absent fetal activity, unusual or extreme fetal activity

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32
Q

Pitocin

A

tachysystolic contractions. The uterus is the most sensitive to becoming tetanic at the beginning of infusion. the client must always be attended and contractions monitored. contractions should last no longer than 90 seconds to prevent fetal hypoxia

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33
Q

Pitocin has the potential of causing tetanic contraction

A

contractions coming so frequently that they merge into one sustained contraction which can result in premature separation of the placenta, uterine rupture, cervical tearing, excessive bleeding postpartum, as well as severely restricting oxygen supply to the fetus.

34
Q

Preeclampsia

A

women with chronic hypertension may acquire preeclampsia or eclampsia
Hypertension develops after 20wks fo gestation in previously normotensive women
Reduced kidney perfusion

35
Q

HELLP

A

Hemolysis (HCT 34-45), Elevated, Liver enzymes (AST 5-43), Low, Platelet count (150-400k)

36
Q

After birth

A

tendency to have boggy uterus with heavy flow

37
Q

Methergine

A

use it with caution in client with hypertension or preeclampsia because it causes vasoconstriction

38
Q

Prolapsed cord

A

Place in Trendelenburg or knee chest position

39
Q

if cord prolapse is detected

A

the examiner should position the mother to relieve pressure on the cord or push the presenting part off the cord until immediate C-section is done

40
Q

Intervention of cord prolapse

A

Do not attempt to push the cord into the uterus. Monitor the FHR.
Assess the fetus for hypoxia. Administer face mask oxygen and prepare for emergency C-section.

41
Q

Prostaglandin gel

A

softens cervix to induce labor
contraindication for clients with asthma (can cause bronchospasm, wheezing), check temperature every 1-2 hours and never give when woman is in labor or before delivery of the placenta

42
Q

First stage of Labor

A

Take temperature every 4 hours until the membrane ruptures, then every hour 100.4 temperature is normal

43
Q

Transition-Labor

A

is the third phase of labor
8-10 cm cervical dilation
changed behavior
sudden nausea
contraction severe 11/2 minutes apart, 60-90 seconds duration
assess FHR every 15 minutes in transition stage
Stop continuous infusion of anesthesia at the end of stage 1 or during transition to increase effectiveness of pushing

44
Q

Variable decelerations

A

tachycardia caused mainly by cord compression
change in maternal position (knee chest or left side)
stimulate fetus if indicated
Discontinue oxytocin if infusing
administer oxygen at 10mL by tight face mask
elevate legs
increase IV rate

45
Q

Bethamethasone

A

RDS in new born
stimulates fetal lung maturity, prevent/ reduce severity of respiratory depression
transient decrease in breathing (72hours)
Assess blood glucose in mom

46
Q

Five signs of respiratory Distress

A 
Tachypnea
cyanosis
flaring nares
expiratory grunt
retractions
47
Q

Cephalhematoma

A

1st action newborn
problem corrects itself
as hematoma resolves, hemolysis of RBCs occurs and jaundice can result (hyper bilirubin)
Report yellow tinge

48
Q

Cold stress

A

new born
first step and number one priority in managing the new born is to prevent heat loss
keep baby under radiant warmer or in isolette and skin to skin with mother with blanket
if an infant is cold stressed, warm slowly over 2-4 hours because rapid warming may produce apnea

49
Q

Signs infant is cold

A

prolonged acrocyanosis
skin mottling
tachycardia
tachypnea

50
Q

Neonate produce heat by nonshivering thermogenesis

A

which involves the burning of brown fat

51
Q

Neonate is easily stressed

A

by hypothermia and develops acidosis as a result of hypoxia (increased RR). If neonate needs glucose, feed them.

52
Q

Congenital heart defects

A 
infant
mom may have epilepsy
mom may have rubella
if the mom titer is low she should receive the rubella vaccine after delivery and be instructed no to get pregnant within 3 months
Breast feeding moms can get vaccines
53
Q

Signs of infant with congenital heart defect

A

weak cry, cyanosis worsening with crying
lethargy, hypotonia and flaccidity
persistent bradycardia or tachycardia
tachypnea or other signs of respiratory distress
Decreased or absent femoral or pedal pulses
Transfer to NICU
limit stimulus (no pacifier)

54
Q

Hypoglycemia

A

LGA-new born
can occur with cold stress or because mom had gestational diabetes the nurse should assess for hypoglycemia
perform heel stick
Normal glucose is 40-80
sign of hypoglycemia: high pitched cry, jitterness

55
Q

Positive Ortolani sign

A

clicking with abduction

56
Q

Apgar score

A 
Acrocyanosis =1 point
7-10 good
4-6 needs moderate resuscitative efforts
0-3 severe need for resuscitation
Vital signs and FHR assess vital signs every 30 mins for 2 hours, then every 1 hours for 4 hours or until stabilized
57
Q

Circumcision

A

If yellow excaudate occurs don’t not wipe it off, because it is normal but if redness, swelling, discharge, odor occurs, it is a sign of infection

58
Q

New born spit up

A

Vomiting is a common sign of digoxin toxicity. This symptom is often overlooked because infant commonly spit up.

59
Q

New born temperature

A
  1. 7-99.4

hypothermia: warmer and with mom in blanket

60
Q

Petechiae at birth

A

Petechiae all over body indicates low platelet count and infection
On face, neck, body baby had face presentation at birth

61
Q

Boggy Uterus

A

First, perform fundal massage observe for amount and size of expelled clots, then have the client empty their bladder. Recheck fundus every 15 minutes for 1 hours then every 30 minutes for 2 hours
prevent hemorrhage
if it does not become firm, sign of bleeding from uterine atony
sign of sub involution (uterus doesn’t not go back to normal size)

62
Q

Hemorrhage

A

postpartum BP

hypotension

63
Q

Full bladder

A

is one of the most common reason for uterine atony or hemorrhage in the first 24 hours after delivery

64
Q

Increased RR

A

hemorrhage, more than one saturated pad every 15 minutes

65
Q

What immediate action should the nurse take when post partum hemorrhage is detected?

A

perform fundal massage
notify HCP if the fundus does not become firm with massage
count pads to estimate blood loss
Increase IV fluids
Administer oxytocin infusion as prescribed

66
Q

Postpartum assess

A 
assess fundal height and firmness
assess perineal integrity
check for signs and symptoms of thromboembolism
assess pulse, respiration and BP
monitor VS every 4 hours for 24 hours
67
Q

Lochia

A

Lochia rubra-blood-tinged discharge 2-3 days
Lochia serosa-pale pinkish to brownish discharge lasting 1 week
lochia alba-thick, whitish-yellowish discharged with leukocytes and degenerated cells, last 4 weeks

68
Q

Postpartum hematoma

A

sign of hematoma developing in perineum
intense perineal pain
swelling and blue-black discoloration on perineum
pallor, tachycardia and hypotension (great blood loss), feeling of pressure in vagina, urethra and bladder
possible urinary retention, uterine displacement

69
Q

Postpartum hematoma interventions

A

prepare client for surgical incision if hematoma is large
apply ice pack to perineum to decrease swelling and pain
hypovolemia and anemia can occur without overt signs
Diet high in iron (because of blood loss)

70
Q

RhoGAM refusal

A

Blood product Jehovah witness

71
Q

Spinal Headache

A

Blood patch

leakage of cerebrospinal fluid into extradural space during placement of spinal anesthesia

72
Q

intrapartum herpes

A

can breast feed (if lesion on breast NO) and take Zovirax
cannot have Pitocin or take acyclovir
lesion-C-section no lesion vaginally

73
Q

Antepartum amniocentesis

A

gestational DM

used in diagnosing fetal defects

74
Q

Genetic counseling

A

provide an opportunity to teach and encourage women about healthy lifestyle during pregnancy

75
Q

Antepartum weight gain

A

Weight gain
1st trimester average weight gain is 1-2 kg
there after the recommended weight gain increases to about 0.5 kg per wk for under weight woman and 0.4 kg a week for a woman of normal weight. The recommended weekly weight gain for overweight women during the 2 and 3rd trimester is 0.3 kg and 0.2 or obese women.

76
Q

Involution

A

the return of he uterus to a non pregnant state

77
Q

new born cocaine exposure

A

Withdrawal
if cocaine addicted, position to avoid eye contact
swaddle the infant
use vertical rocking techniques
us a pacifier to counter poor organizational response to stimuli
if cocaine crosses the placenta and is found in breast milk cocaine is a recognized cause of placental abruption
premature, small baby, hypersensitivity to noise

78
Q

Emergency delivery action

A

women who experience emergency child birth are more likely to have high anxiety

79
Q

PP depression

A

difficult to fall asleep
loss of appetite
rejection of infant
irritability
if depression is identified, ask if the mother has thought about hurting herself or baby
use screen tools to assess whether the depressive symptom have progressed fro PP blues to PP depression

80
Q

Fundal height: Twins

A

woman should have empty bladder before and laying in supine with knee flexed
upper border of pubis symphysis to upper border of fundus
provides a gross estimate of the duration of pregnancy
the height of fundus in cm is approx. same number of weeks in gestation
12 weeks, fundal height may be around 20 cm (in a twin pregnancy, your uterus grows much faster)

Maternity Hesi (1 decks)

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