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Maternal health test 1 Flashcards

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1
Q

Cheap torches - congenital and perinatal infections

Can cause congenital conditions (present at birth) at birth if fetus is exposed to them in the uterus

A

Chicken, shingles

Hepatitis B, C, D, E

Enteroviruses, polio

Aids

Parvovirus B19

Toxoplasmosis

Other infections such as group b streptococcus, listeria, candida

Rubella

Cytomegalovirus

Everything else such as gonorrhea and chlamydia

Syphilis

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2
Q

Torch is the acronym of the 5 infections covered in the screening for infections at birth.

What is the screening called?

A

Toxoplasmosis

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3
Q

When and how to go about Abuse screening in pregnancy

what is it called?

Who to screen?

What to ask?

What to do if she says yes?

A

IPV screening

Ask patient in private, make it a safe process, nonjudgmental, have a safety plan in place

Screen all women and new patients, during new problems, annually, when pregnant in each trimester, GTT/PP visit

Keep it simple. Have you been injured by a partner in the last year?

Is there anyone that made you have axe against your will?

Is there anyone that made you feel unsafe? If yes? By whom? Number of times?

If yes.. inform that people are here to help she is not alone

Offer options but do not tell her what to do

Believe her and listen to her emphatically

Make a plan and offer resources

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4
Q

The practice of controlling the number of children in a family between births

A

Family planning

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5
Q

No drugs, devices, or surgical procedures are used to avoid pregnancy.

May be used by rhythm method(don’t have sexy during ovulation), calendar method, basal body temp/avoiding sex during fertile periods of the month based on body temperatures, hormone free, identifying fertile period, abstinence

A

Natural family planning

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6
Q

Different contraceptives?

A

Oral

Transdermal -estrogen and progrestone

Rings vaginal -

Implants subdermally -elective for 3 years

IUD device 3-5 years

Depo shot- every 3 months

Permanent - tubal ligation- snip Fallopian tubes (high risk for ectopic pregnancy) and vasectomy- vas deferens

Termination- has to be before 20-24 weeks

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7
Q

Drug use during pregnancy risk is higher when?

A

If homeless, poverty, partner uses drugs, preconception use

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8
Q

What does using drugs during pregnancy do to the fetus

A

Causes adverse catastrophic effects to fetus

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9
Q

What does using opioids during pregnancy do to the fetus

A

Risk of fetal growth restriction, abruptio placentae, fetal death, PTL, intrauterine passage meconium

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10
Q

What does using meth during pregnancy do to the fetus

What to do?

A

Small fetus for age

Low birth weight

Neurodevelopmental abnormalties

-encourage treatment stat

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11
Q

What does smoking during pregnancy do to the fetus

A

Premature labor

Premature rupture of membranes

Placenta previa

Fetus small for age

Resp issues in baby

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12
Q

Healthy people 2020 pregnant goals

A

Reduce HPV and cervical cancer by nurses educating patient with safer sex or abstinence and self examinations

Reduce breast cancer

Safety of LGBT people

Decrease teen sexual activity

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13
Q

What is involved in fetal circulation

A

Blood travels through the umbilical vein from the placenta to the fetus

Some blood circulated through the liver but most bypasses it through the ductus venosus and enters the inferior vena cava

It then enters the right atrium, passes through the foremen ovals, through the right ventricle , and into the aorta and suppling to upper and lower extremities and head

Then blood from head enters to the right atrium through the the right ventricle and into the the pulmonary artery. Most bypasses the lungs through the ductus arteriosus. Then to the pulmonary circulation, back to the right atrium, right ventricle, and aorta.

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14
Q

The umbilical cord contains how many vesicles?

Blood flows through what?

A

3 vessels: two arteries and one vein

Blood flows through the vein from placenta to the fetus

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15
Q

How blood flows through the vein and arteries to/from fetus

A

The umbilical vein carries oxygenated, nutrient-rich blood from the placenta to the fetus,

The umbilical arteries carry deoxygenated, nutrient-depleted blood from the fetus to the placenta

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16
Q

Reasoning for fundal measurements ?

A

To evaluate the gestational age of fetus

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17
Q

When to measure fundal height?

A

At first visit and every visit after 12 weeks

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18
Q

How should the fundal height measure?

A

The height should match the women’s gestational age.

Example- 12 weeks= 12 cm

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19
Q

Fundus to be where at 12 weeks?

16 weeks?

20 weeks?

22 weeks?

36 weeks?

40 weeks?

A

Just above pubis

16- between pubis and belly button

20- belly button

22- right above belly button

36-xiohoid process- pressure on lungs and GI

40-drop slightly into pelvis 4cm

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20
Q

Where should fundus be after birth?

1 hour-

1 day-

2 days-

7 days-

14 days-

Non-pregnant state is when?

A

1hour- at belly button (if slightly above have her urinate)

1 day- 1cm below belly button (umbilicus)

2 days- 2cm below belly

7 days- pubis

14- impalpable - onside pelvic cavity

6 weeks- non pregnant state uterus

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21
Q

GTPAL

A

Gravida

Term pregnancies

Preterm

Abortions

Living children

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22
Q

Gravida means?

A

The number of times a woman has been pregnant including abortions miscarriages pregnancy etc.

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23
Q

Term pregnancies

A

Born at 37 weeks or after

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24
Q

Preterm delivery’s ?

A

Born at 20-37 weeks (includes stillborn or alive)

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25
Abortions/miscarriages
Both spontaneous and induced
26
Living children
Includes twins/triplets add two or three
27
Used to calculate the child’s Expected date of birth or EDD (expected date of delivery)
Nagels rule
28
How to calculate nagels rule
Based on the first day of last period Add 7 days Subtract 3 months Plus one year? ``` Or LMP Add 7 days Add 9 months Plus a year ```
29
Dietary recommendations for pregnancy How many calories a day
No alcohol Supplements Foods high in vitamins and minerals (vitamin C, iron, folic acid, protein, increase water, calcium, vitaminD and omega 3) Need more iron after 12 weeks 300 more calories a day 1 year to 6 months before pregnancy should intake folic acid (b9) to reduce chances of neural tube defects (Calcium and folic acid - dark leafy greens)
30
Weight gain during pregnancy?
Weight gain of 35 pounds is acceptable depending on weight
31
Folic acid reduces the chance of deformities how ?
Helps regulate RBC development and Oxygen carrying - capacity in the blood Procedures DNA and RNA to help maintain normal brain function and stabilize mental health
32
Purpose of preconception care?
Encourage healthy lifestyles for families that desire pregnancy Identify and reduce risks during pregnancy or before (Taking folic acid, exercising, at regulation, no drugs or alcohol, maintaining healthy weight)
33
Absence of mentsturation most often due to pregnancy, but can be due to cycle issues or hormonal reasons
Amenorrhea
34
Painful mensuration that interferes with daily activities One of the most OBGYN complaints
Dysmenorrhea
35
What helps treat Dysmenorrhea What causes it?
Relaxation, using heat to increase blood flow, exercise or rest, NSAIDs/analgesics/diuretic Myron, Motrin Heating pad, diet changes, increase activity, I limit alcohol and chocolate Causes it - prostaglandins in menstural blood
36
Emergency contraceptives What to know
Plan b - take before 72 hours after sex Will not work if already pregnant Does not cause miscarriage or abortion
37
Self breast exams How often? When to do? Why? What to educate ?
Monthly (In the shower, 7-10 days after period ends because you want progesterone out of your system because it causes breast to become lumpy) Educate if you feel a lump see doctor immediately. The sooner it’s treated the better survival rate you have.
38
Contraception- both non hormonal
``` Abstinence Condoms Contraceptive sponge Copper IUD Tube tying ```
39
Hormonal contraceptives
Oral (synthetic estrogen) Transdermal patch Vaginal ring IUD Depo shot Sub-dermal Implant
40
HPV treatment
Warts- topical agents , green tea extract - cryotherapy (freezing), - CO2 laser surgery - electrotherapy - surgical removal Depending on severity and resistance to tx Gardicil prevents HPV-age 11-12 yo Can have cancerous strand
41
Presumptive s/s of pregnancy
``` Nausea and vomiting No period Breast tenderness Tired Quickening Weight gain Polyuria ``` ``` Ptyalism (increase saliva) Fatigue Nasal congestion Backache Leukorrhea- (thick white yellow vag discharge) Increased urination-polyuria Dyspepsia (indigestion) Gas Constipation Hemorrhoids Dental problems Leg cramps ```
42
Probable s/s of pregnancy
Hegars sign- softening of cervix-between uterus and vaginal portion of cervix Chadwick’s sign- bluish vagina and cervix Goodells sign- softening of cervix Ballottement- easy flexion or uterus when the examiners fingers pushes against the uterus and detects the presence of the fetus by return impact Positive pregnancy test- rising Hcg levels prompts a positive pregnancy test McDonald’s sign-indicates uterine enlargement Uterine enlargement-occurs as the fetus grows Mask of pregnancy- rash appears on the face due to hormonal influences
43
- softening of cervix-between uterus and vaginal portion of cervix - bluish vagina and cervix softening of cervix - easy flexion or uterus when the examiners fingers pushes against the uterus and detects the presence of the fetus by return impact - rising Hcg levels prompts a positive pregnancy test indicates uterine enlargement -occurs as the fetus grows rash appears on the face due to hormonal influences
Hegars sign- softening of cervix-between uterus and vaginal portion of cervix Chadwick’s sign- bluish vagina and cervix Goodells sign- softening of cervix Ballottement- easy flexion or uterus when the examiners fingers pushes against the uterus and detects the presence of the fetus by return impact Positive pregnancy test- rising Hcg levels prompts a positive pregnancy test McDonald’s sign-indicates uterine enlargement Uterine enlargement-occurs as the fetus grows Mask of pregnancy- rash appears on the face due to hormonal influences
44
Positive signs of pregnancy
Fetal heart tones Leopolds maneuver (manual external palpation of the fetal outline) Ultrasound of the fetal outline
45
When can you hear a fetus with a Doppler?
12 weeks
46
Purpose of amniotic fluid?
For growth and development It cushions the fetus and protects against mechanical injury , helps fetus maintain normal body temp and helps musculoskeletal development and lung development
47
Decreased amniotic fluid
Oligohydraminos
48
Increased amniotic fluid
Increased amniotic fluid
49
What is the umbilical cord used for ?
Used for blood flow to and from baby
50
Common and systemic way to determine the position of the fetus inside the uterus Determines presentation, lye, and fetal weight
Leopold’s
51
Swab testing of vagina and rectum of mother Used to detect the risk that they will Pass this bacteria to their newborns during birth, possibly causing a serious infection- GBS When is it checked?
Group B strep screening At 32-36 weeks
52
When to give rhogam ? and At how many weeks ?
Give to Rh(D) negative women- Check for Rh antibodies and if negative, rhogam is prescribed at 28-32 weeks pregnant
53
A problem of extreme nausea and vomiting causing electrolyte imbalance, severe dehydration and weight loss Nursing intervention When it usually occurs?
Hyperemesis gravidarium ——————- IV therapy Small more frequent meals Antiemetic for n/v ——————— During the first trimester
54
What is one at risk for if they don’t gain enough weight during pregnancy?
Risk for preterm labor. Increase calories by 300 every day for the 2nd and 3rd trimester
55
Week 1 in fetal growth and development
Fertilization occurs and the cyst is implanted by the end of the week
56
Weeks 2 in fetal growth and development
Yolk sac develops and amniotic cavity appears. Implantation is complete
57
Week 3 in fetal growth and development
Characteristics by the appearance of a primitive streak, skin teeth, mouth glands, nervous system, GU Tract, respiratory, digestive tract
58
Week 4 in fetal growth and development
Central nervous system, Brian and spinal cord
59
Week 8 in fetal growth and development
Upper and lower limbs Genitals Main organ systems
60
Week 9-12 in fetal growth and development
The fetal head is half the length of the crown Face Intestines Genitalia is distinguished
61
Week 13-16 in fetal growth and development
Skeleton and bones
62
Weeks 17-20 in fetal growth and development
Quickening Vernix Eyebrows and head Lanugo Testies and ovaries
63
Week 21-25 in fetal growth and development
Gains majority of weight Lungs Fingernails Eye movement
64
Week 26-29 in fetal growth and development
Can breath air Eyelids Toenails Spleen Bone marrow
65
Week 30-34 in fetal growth and development
Pupillary light reflex is present
66
Week 35-40 in fetal growth and development
The fetus has a strong hand grasp and orientation to light
67
Antepartum assessment
Testing involves use of EFM (electric fetal monitoring) or ultrasound to assess fetal well being or fetal heart rate and other characteristics during during this period from conception to labor
68
Leopolds maneuver position
Place her in supine position and stand behind her
69
Leopolds maneuvers 4 steps
1. Presentation (which body part is on top or bottom) head is smooth and round 2. Position (kicking, heart sounds, beat heard, hard and smooth head) 3. Presentation -move hands down abdomen and grasp lower uterine 4- attitude- head flexed and engaged in pelvis
70
Impairment in carbohydrate metabolism that first manifests during pregnancy
Gestational diabetes
71
Gestational diabetes - women that are at risk
Older than 25 Obese Polycystic ovaries Hx of GD Ethnicity Family hx of type 2 Stillbirth or miscarriage
72
GD infant at risk for ?
Large body size Congenital abnormalities Low bs Resp distress Jaundice Heart issues Low calcium
73
GD mother at risk for?
C-section Preeclampsia Preterm birth Maternal Organ damage Altered ABGs
74
When insulin is given in pregnancy-?
Watch fetus carefully with a a non-stress test Dont want baby to delivery early due to being so big Check for lung maturity with l/s ratio Watch blood sugar for baby post delivery (low bs)
75
What is placenta perfusion ?
Any time blood flow Is comprised to the fetus: ``` Preeclampsia Placenta previa Infarction Placenta hematoma Tumors Umbilical cord abnormalties Septal cysts Certain positions ```
76
Pregnancy issues of concern
Bleeding is not normal-painful/painless Placenta previa (placenta is lying over cervix) -ultrasound but not vaginal Placenta abruption
77
(placenta is lying over cervix) -painless bleeding Interventions
Placenta previa Bedrest,ultrasound but not vagina/c-section
78
placenta tears away from the uterus which causes this S/s? What may cause?
Placenta abruption Painful bleeding , distended rigid and hard abdomen Car accident, cocaine or HTN crisis
79
Consist of healthcare services that include: check-ups Patient counseling Screening to prevent illness, disease and other health related problems
Preventative care
80
Consists of applying specific measures with the aids of increasing oxygen delivery to the placenta and umbilical flow To reverse hypoxia (low oxygen) and acidosis
Intrauterine resuscitation
81
What to do for placental perfusion heart
Position upward lay lateral to | Left side

maternal child health RN (15 decks)

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