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Maternity Flashcards

1
Q

Pre-eclampsia vs Eclampsia: diastolic BP

A

Mild - >90 but 110

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2
Q

Pre-eclampsia vs Eclampsia: proteinuria

A

Mild >o.3 but 5g in 24 HR specimen >3 on random dipstick

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3
Q

Pre-eclampsia vs Eclampsia: serum creatinine

A

Mild: normal
Severe: elevated

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4
Q

Pre-eclampsia vs Eclampsia: platelets

A

Mild : normal

Severe : elevated - more than 1.2 mg/do

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5
Q

Pre-eclampsia vs Eclampsia: liver enzymes (ALT AST)

A

Mild normal or minimal increase

Severe elevated levels

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6
Q

Pre-eclampsia vs Eclampsia: urine output

A

Mild normal

Severe : oliguria common decreased 500ml

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7
Q

Pre-eclampsia vs Eclampsia: severe unrelenting headache not attributable to another cause

A

Mild absent

Severe often present

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8
Q

Pre-eclampsia vs Eclampsia: persistent RUQ or epigastric pain or pain penetrating to the lower back; nausea and vomiting

A

Mild absent

Severe - maybe present and often precedes seizure

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9
Q

Pre-eclampsia vs Eclampsia: visual disturbances

A

Mild absent to minimal

Severe common

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10
Q

Pre-eclampsia vs Eclampsia: pulmonary edema, heart failure, cyanosis

A

Mild absent

Severe may be present

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11
Q

Pre-eclampsia vs Eclampsia: fetal growth restriction

A

Mild - normal growth

Severe - growth restriction , reduced amniotic fluid volume

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12
Q

What are signs of magnesium toxicity

A

Flushing
Sweating
Hypotension
Depressed deep tendon reflexes and CNS depression including respiratory depression

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13
Q

What is the antidote for magnesium?

A

Calcium gluconate

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14
Q

Signs of true labour

A

Contractions occur regularly, become stronger last longer and occur closer together
Cervical dilation and effacement is progressive
The fetus usually becomes engaged in the pelvis and begins to descend

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15
Q

Signs of false labour

A

Does not produce dilation effacement or descent
Contractions are irregular without progression
Activity such as walking often relieves false labour

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16
Q

Name the different breathing techniques

A 
Cleansing breathing 
Slow paced breathing
Modified paced breathing
Pattern paced breathing 
Breathing to prevent pushing 
Second stage breathing - several variations
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17
Q

Where is the epidural placed for a subarachnoid block

A

Spinal subarachnoid space at L3-L5
Administered just before birth
May cause maternal hypotension
Must lie flat for 8-12 hrs post injection

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18
Q

Describe a total placenta PREVIA

A

Internal cervical os is covered entirely by the placenta when the cervix is dilated fully

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19
Q

Describe partial placenta PREVIA

A

The lower border of the placenta is within 3 cm of the internal so but does not fully cover it

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20
Q

What is a marginal placenta PREVIA

A

Placenta is implanted in the lower uterus but it’s lower border is more than 3 cm from the cervical is

21
Q

Placenta PREVIA assessment

A

Sudden onset
Painless bright vaginal bleeding in the last half of the pregnancy

Uterus is soft relaxed and nontender

Fundal height may be more than expected for gestational age

22
Q

What should be avoided with placenta PREVIA

A

Any sort of vaginal manipulation or vaginal examination

23
Q

Treatment of placenta PREVIA

A

IV fluids
Blood products
Tocolytic medications
Rhogam may be prescribed

If heavy bleeding c-section may be performed

24
Q

What is abruptly placentae

A

Premature separation of the placenta from the uterine wall

After the twentieth week and before the fetus is delivered

25
Abruptio placentae assessment
Dark red vaginal bleeding - if bleeding is high in the uterus there can be an absence of visual blood Uterine pain or tenderness or both Uterine rigidity Severe abdominal pain Signs of fetal distress Signs of maternal shock if bleeding is excessive
26
Positions for abruptio placentae
Trendelenburgs position if indicated to decrease the pressure of the fetus on the placenta Lateral position with head of the bed flat if hypovolemic Shock occurs
27
In the postpartum period of a client with abruptio placentae what should you monitor for
Disseminated intravascular coagulation
28
Pre-eclampsia vs Eclampsia - systolic blood pressure
Mild - >140 160 based on two readings 6 hours apart
29
What are the causes of a vaginal hematoma
Operative delivery Forceps Injury to a blood vessel Can be life threatening
30
What is the assessment of a postpartum hematoma
Abnormal severe pain Pressure in the perineal area Sensitive bulging mass in the perineal area with discoloured skin Inability to void Decreased hemoglobin and hematocrit levels Monitor for signs of shock
31
What are the signs of shock due to hematoma
Pallor Tachycardia Hypotension if significant blood loss has occurred
32
What is the description of wilms tumour
Most common intraabdominal and kidney tumour of childhood Unilaterally and localized or bilaterally Sometimes metastasizes Peak is 3 years
33
Assessment of a child with wilms tumour
Swelling or mass within the abdomen - firm nontender confined to one side and deep within the flank ``` Urinary retention or hematuria or both Anemia Pallor anorexia and lethargy - anemia Hypertension Weight loss and fever Symptoms of lung involvement - dyspnea shortness of breath and pain in the chest if metastasis has occurred ``` DO NOT PALPATE THE ABDOMEN
34
What is Reye's syndrome
Acute encephalopathye Follows a VIRAL illness Characterized - cerebral edema and fatty changes in the liver
35
How is a diagnosis made for Reye's syndrome
Liver biopsy
36
Cause of Reye's syndrome
Unknown | Most commonly follows an illness - influenza or varicella
37
What should be avoided in Reye's syndrome
Administration of aspirin and aspirin containing products
38
What can be prescribed for Reye's syndrome
Ibuprofen Motrin iB
39
What is the goal of Reye's syndrome
Early diagnosis Early treatment - aggressive Maintain effective cerebral perfusion and control increasing ICP
40
Assessment of Reye's syndrome
History of systemic viral illness 4-7 days before the onset of symptoms Fever Nausea and vomiting Signs of altered hepatic function such as lethargy Progressive Neurological deterioration Increased blood ammonia levels
41
What is kwasaki disease
Acute systemic inflammatory disease
42
Cause of kwasaki disease
Unknown may be associated with an infection from an organism or a toxin Cardiac complication is the most serious - as aneurisms can develop
43
Acute phase symptoms of Kawasaki disease
Fever Conjunctival hyperemia Red throat Swollen hands rash and en,argument of cervical lymph nodes
44
Subacute stage of Kawasaki disease symptoms
``` Cracking lips and fissures Desquamination of the skin on the tips of the fingers and toes Joint pain Clinical manifestations Thrombocytosis ```
45
Symptoms of convalescent stage of Kawasaki disease
Child appears normal but signs of inflammation may be present
46
Medications to give those with Kawasaki disease
Aspirin for its antipyretic and anti platelet effects Immunoglobulin IV to reduce the duration of the fever and the incidence of coronary artery lesions and aneurysms - IV Immunoglobulin is a blood product so blood precautions when given
47
Description of fifths disease - agent - incubation - communicable period - source - transmission
- agent: human parovirus - incubation - 4 to 14 days; maybe 20 days - communicable period: uncertain but before the onset of symptoms in most persons - source: infected persons - transmission unknown possibly respiratory secretions and blood
48
Assessment of fifths disease
Before rash: asymptomatic or mild fever, malaise, headache, runny nose Stage of rash Erythema of the face slapped check appearance devlops and dissapears by 1-4 days 1 day after the rash on the face - maculopapular red spots appear symmetrically on the extremities; rash progresses from proximal to distal surfaces and may last a week or more Rash subsides but may reappear if the skin becomes irritated by the sun heat cold exercise or friction

NCLEX (10 decks)

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