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Flashcards in Maternal Newborn Deck (64):
1

Hyperemesis gravidarum (severe vomiting and nausea with preganancy)

Indication that one has it?

Ketonuria - which occurs due to breakdown of fat due to malnutrition or starvation

Tachycardia / dehydration

Tachypnea



2

Indication of preeclampsia

Proteinuria

3

Nausea and vomiting during pregnancy?

Avoid not eating because it increases nausea

EatSmall frequent meals throughout the day

Eat foods that are served cold or at room temperature

Drinking fluids with meals increases nausea-Alternate every 2 to 3 hours between food and fluids

Eat a snack High in carbohydrates such as crackers before getting out of bed in the morning to decrease nausea

4

Who can transport the newborn to a different room?

Only facility staff with appropriate identification badges that indicate the nurse works specifically in the maternal newborn unit can transport newborns

Also the newborn must be in a designated bassinet

5

Interventions to treat breast engorgement During breast-feeding

Breast-feed the newborn every two hours during engorgement. This will soft in the breast and decrease pain

Drink enough fluids to satisfy Thirst

Apply cold pack compressed to the breast after feeding to decrease discomfort

A warm shower immediately before breast-feeding will soften the breasts

Use a breast pump during engorgement too soft in the breasts prior to breast-feeding

6

Hypotonic uterus (weak contractions) with vagina bleeding priority action of the nurse

Patient is at risk for postpartum hemorrhage

The first action the nurse should take is provide fundal massage to increase uterine muscle tone and move blood clots from uterus Which will decrease bleeding

Then...

Urinary cathedar to eliminate Bladder distention

Methylergonvine IM to enhance uterine contractions

Administer oxygen by face mask to increase o2 in cells


7

Butorphanol teaching?

This medication is an opioid medication which can cause:

dizziness, sedation, hallucinations

respiratory depression

Duration of action is 3 to 4 hours

constipation, nausea, vomiting, confusion, seems

8

What to report in second trimester of pregnancy

Frequent uterine contractions (can cause cervix to open early and start preterm labor)

9

Expected findings in pregnancy

Leukorrhea?

Hyper-pigmentation of face ?

Varcriose veins ?

Tingling of fingers ?

Leg cramp?

Wbc count of 15k

Labia edema

Firm fundus at belly button 6 hrs after birth

This is the whiteish discharge due to the hormonal changes that occur during pregnancy

This is known as the mask of pregnancy due to hormonal changes

Hormonal influence on the smooth muscle walls of veins

Tingling of fingers is a common discomfort of pregnancy cause by traction on the brachial plexus and slumping of the shoulders

Leg cramps are common and caused by compression Of the nerves by the enlarged uterus

Apply ice pack for labia edema and pain

10

Normal heart beat of newborn

110-160

100-180? While crying

11

Calcium level normal nb range?

7.6-10.4

12

Normal glucose for newborn ?

30-60

13

Normal newborn temp

97.7-99.5

14

Potential complication of pregnancy ?

Epigastric pain

15

Sign of postpartum hemorrhage and should be reported to doctor ?

Soaking a pad in 15 minutes or less

16

Expected findings in new born

Vernix in the skin folds

Positive Moro reflex from birth to 8 weeks

Apneic episode of 20 seconds or less - shallow and irregular respiration’s

17

What medication is contra indicated with the use of Nifedipine?

Magnesium sulfate (treatment of hypertension or sezures In preeclampsia) can cause weakness or paralysis

18

This medication is a hormone, which is used to facilitate the induction of labor or to control postpartum bleeding after expulsion of the placenta

Oxytocin

19

This is an antiemedic

Use for the prevention of nausea and vomiting

Promethazine

20

A Nurse should administer terbutaline to a client who is experiencing preterm labor by which route?

Subcutaneous-

It relaxes the smooth muscles and uterine activity. It should be administered every four hours

21

Mastitis teaching?

Warm compress to affected breast

Antibiotic medication

No underwire bra

Continue breast feeding

22

Contraception methods ?

Only water soluble lubricants should be used with Male condoms

The diaphragm should be left in place for at least six hours after intercourse

The sponge should be left in place for at least six hours but less than 24 hours after intercourse due to risk of toxic shock syndrome

The patch is changed weekly for three weeks following by one week in which the client does not wear the patch

23

How to prevent infant abduction

Ask the nurse to take care of the baby in the nursery when mother needs a nap – Never leave infant alone

Always wheel infant in a bassinet when transported to another location

Staff should always wear identification

Always make sure the newborn security band is in place – if removed alarm will sound

24

When to report maternal bp ?

Fetal hr ?

Fundal height ?

Weight?

140/90 or higher

110-160 is normal

Fundal height is same number of weeks of gestation plus or minus 2cm

Gain about .9 lbs per week in mom

25

Why folic acid is important ?

Prevent birth defects

Prevent neural tube defects and storage of iron in fetus liver

26

Best source of folate ?

0.5 cup- Dried peas (green split peas)

27

Tonic neck reflex?

Crawling reflex?

Moro reflex ?

Magnet reflex ?

Neck turned to one side

Placed on abdomen

Fingers form C shape

Pressure against soles of feet

28

How to prevent engorgement during lactation

Apply cold cabbage leaves or ice pack to breasts

Take mild analgesics

Wear well fitted bra with no underwire

Do not use pump or massage breasts because it can increase milk production

29

Consistent headache at 37 weeks of gestation? What does it mean

This could mean pre-clampSia

30

What does numbness of fingers at 26 weeks mean ?

Brachial plexus traction syndrome

Drooping of the shoulders

31

What to do for hypovolemic shock ?

Out in side or elevate right hip

Elevate legs 30 degrees

Administer oxytocic medication to increase contraction

Give 10L oxygen to improve oxygen

Insert urinary cathedar to monitor output

32

What medication causes uterine relaxation

Terbutaline

33

Formula feeding on newborn

Will drink about 15-30mL per feeding

Feed for 20-30 min

Burp through out feeding

34

Ecchymosis/edema pain of 6 out of 10 and fundus of 2cm above belly botton - what isnoriority ?

Help client to toilet to empty bladder first ...


Then breadfeeding , ice pack, pain meds

35

Infant car seat safety

Rear facing until 2 y old

Turn of airbag if no backseat

Place car seat at 45 degrees

Secure seat with cars seat belt

36

Normal findings during the postpartum. Within 24 hours of delivery?

Diuresis (increase urine)

Discharge of clear yellow fluid from the breasts which is called colostrum

Lower ab cramping due to the uterus decreasing in size

37

When does lochia serosa occur ? Pink or brown a vagina discharge

3 to 4 days after delivery

38

Hydrotherapy teaching?

You need to be active in labor before using it

Water temperature should be between 96.8 to 98.6

The client may retain in the tub for as long as they want as long as the fetal heart rate remains with an expected reference range with breaks after 30 to 60 minutes

The nurse will use a Doppler stethoscope to monitor the fetal heart rate

39

The mother is receiving magnesium sulfate and has preeclampsia. What to include in teaching?

Just your clients fluid intake to no more than 125 mL per hour to prevent fluid overload

Blood pressure should be taking every 15 to 30 minutes because hypotension is an adverse effect of the medication

The medication can cause respiratory depression and the nurse should monitor the clients respiratory status every 15 minutes

The fetal heart rate will be continually monitored while receiving this medication

40

Newborn normal labs ?

Hemoglobin?

Platelets ?

Glucose?

WBC?

14-24

150k-300k

30-60

9k-30k

41

What nifedipine does ?

Dexamethasone? (Glucocorticoid)

Glyburide?

Antiemetic/ metoclopramide?

Decrease uterine contractions

Acceleration of lung maturity

Control glucose

Decrease nausea

42

Indications of respiratory distress

Tachypnea – heart rate greater than 60 /minute

Nasal flaring

Retractions

Expiratory grunting

43

When to give phytonadione?

Needle?

Where?

Immediately after birth or after initial breast-feeding to prevent hemorrhagic disease

5/8- inch needs

Vastus lateralis

Single dose

44

Finding to report at 30 weeks ?

2+ urinary protein (preeclampsia)

45

Report to provider of 40 weeks active labor ?

Prolonged deceleration of FHR

Temp 100.4 or above

46

Normal contraction times in active labor

Q 3-5 min

47

What to do to promote comfort in client in active labor?

Breathing exercises

48

When to tell client to push?

10 cm in second stage

49

When should sedative be given in labor ?

No less than 12 hour prior to birth

50

When to give nerve block ? In labor

Second stage of labor 10-20 min before birth

51

Antidote for magnesium sulfate toxicity?

Calcium gluconate

52

Antidote for heparin toxicity

Protamine

53

Treatment of allergies And decreases the symptoms associated with histamines

Diphenhydramine

54

How to prevent supine hypotension at 16 weeks of gas station

Lay on left side with head elevated on a pillow

55

When apply stockings were vercose veins

Before getting out of bed

56

How much sodium to intake during pregnancy

1.5 to 2.3 g daily

57

Hep B instructions

Handwashing, and do not share razors or toothbrushes, use a condom, Do not share drinking glasses or silverware

Receive the hepatitis B immune Globin immediately

Begin receiving vaccine series within 14 days of last known exposure to the virus or following positive test result

It can be transmitted to the fetus but risk is reduced when infection occurs before the end of the third trimester

58

Normal labs ?

Bun ?

Hematocrit?

Creatine?

10-20mg

33 or higher

.5-1

59

Methylergonovine adverse effect

Herpertention

60

To report to the doctor at 36 weeks

Blurred vision because it is an indication of preeclampsia

61

The nurse should do what for the infant who is receiving phototherapy

Place mask over eyes

Position the infant every 2 to 3 hours during phototherapy

Is your infant is adequately hydrated

62

Circumcision plan of care teachings

Monitor the site for bleeding and apply gentle pressure with sterile guys at the site

Apply diaper loosely

Wash penis with plain warm water

Apply petroleum got to the penis for the first 24 hours after circumcision

63

How to bathe newborn?

Keep newborn wrap tomorrow washing her hair which will help prevent heat loss

Avoid checking power on to the newborn skin due to possible rest of inhalation

Hunted swabs can cause injury to the newborns ears. Use washcloth

Do not rent under running water due to possible temperature change

64

What do you teach a client who has a prescription for serious sulfate?

Increase fluid intake while taking this medication to at least 2 L of water per day to decrease constipation

Take on an empty stomach

Do not take with milk or tea

Vitamin C such as fruit increases absorption

Take a Mr. Smith and 13 hours at the scheduled time but do not double dose