Maternity Flashcards Preview

NCLEX > Maternity > Flashcards

Flashcards in Maternity Deck (62):
1

Nagele’s rule

(to estimate due date
-Requires that woman has 28-day menstrual cycle
-Subtract 3 mths and add 7 days to the first day of the last period; then add 1 year

2

Nulligravida

never been pregnant

3

Primigravida

first time

4

Multigravida

at least second pregnancy

5

Parity

Number of births carried past 20 weeks gestation (regardless of whether alive or not when born)

6

Nullipara

has not had birth at more then 20 weeks

7

Primipara

one birth after 20 weeks

8

Multipara

two or more pregnancies to stage of viability

9

GTPAL

*used to assess pregnancy outcomes
G = gravidity, number of pregnancies
T = term births, number born at term (longer than 37 weeks)
P = preterm births, before 37 weeks
A = abortions/miscarriages
L = number of living children
Example: female 26 weeks pregnant. Miscarriage at 10 weeks. 3 yr old born at 39 weeks.
G=3, T=1, P=0, A=1, L=1

10

difference between presumptive, probably, and positive signs of pregnancys

presumptive - signs & symptoms experience by woman
probable - signs from examiner
positive - scientific confirmation of pregnancy

11

Hegar’s sign

probable sign of pregnancy
■ Compressibility and softening of lower uterine segment (approx. week 6)

12

Goodell’s sign

probable sign of pregnancy
■ Softening of cervix (beginning of 2nd mth)

13

Chadwick’s sign

probable sign of pregnancy
■ Violet colouration of the mucous membranes of cervix, vagina, vulva (approx. week 4)

14

Ballottement

probable sign of pregnancy
■ Rebounding of fetus against examiners fingers on palpation

15

why should women take folic acid during pregnancy?

Prevents neural tube defects and orofacial clefts

16

what is abruptio placentae?

the premature separation of the placenta from the uterus

17

how many stages of labour are there?

4

18

describe latent phase (stage, frequencyduration of contractions, dilation, intensity of contractions)

stage 1, 15-30 min, 15-30 sec, 1-4 cm, mild

19

describe active phase (stage, frequencyduration of contractions, dilation, intensity of contractions)

stage 1, 3-5 min, 30-60 sec, 4-7 cm, moderate

20

describe transition phase (stage, frequencyduration of contractions, dilation, intensity of contractions)

stage 1, 2-3 min, 45-90 sec, 8-10 cm, strong

21

describe stage 2 of labour

complete dilation, progress measured by station, contractions q2-3 min, 60-75 sec, strong, urge to bear down, neonate born in 2nd stage

22

describe stage 3 labour

placental separation & expulsion 5-30 min after birth

23

describe stage 4 of labour

Period 1-4 hours after delivery

24

in induction, what is the desired labour pattern during infusion of Pitocin?

Frequency q2-3 minutes, duration 60 seconds

25

at what point should Pitocin be discontinued when infusing for induction?

if uterine contraction frequency is less than 2 minutes or duration longer than 90 seconds, or if fetal distress noted

26

what is placenta previa?

Improperly implanted placenta in lower uterine segment near or over the internal cervical os

27

characteristics of placenta previa

Sudden onset painless, bright red bleeding in last half of the pregnancy
Uterus soft, relaxed, nontender
Fundal height may be more than expected for gestational age

28

characteristics of abruptio placentae

Dark red vaginal bleeding (but could be absence of visible blood)
Uterine pain tenderness or both
Uterine rigidity
Severe abdominal pain
Signs of fetal distress

29

what is placenta accreta?

Abnormally adherent placenta

30

what is placenta increta?

Placenta penetrates into uterine muscle itself

31

what is placenta percreta?

Goes all the way through the uterus

32

what is the main concern with placental abnormalities?

hemorrhage and therefore shock

33

signs of fetal distress

FHR <110 bpm or >160 bpm
Meconium-stained amniotic fluid
Fetal hyperactivity
Progressive decrease in baseline variability
Severe variable decelerations
Late decelerations

34

what is a potential serious complication of intrauterine death?

DIC

35

signs of postpartum hematoma

severe pain
pressure
bulging mass perineal area, discoloured skin
inability to void

36

when should a woman worry about her elevated temperature?

temp of 38 is normal within first 24 hours d/t dehydration, a temp of 100.4/38 or greater after 24 hours postpartum indicated infection

37

is it ok for a woman with mastitis to continue breastfeeding?

Yes

38

what is the postpartum period?

immediately after birth to 6 weeks post delivery

39

what is involution?

Rapid decrease in size of uterus as it returns to nonpregnant state

40

what should a non-breastfeeding mother do about engorgement?

should not express milk
cool compressess, supportive bra, ibuprofen

41

what do newborn stools look like?

light yellow, seedy, watery, and frequent

42

in what order to you suction a newborn?

mouth first then nares

43

what are the indicators that make up the APGAR score?

Heart rate
Respiratory rate/effort
Muscle tone
Reflex irritability
Skin colour

44

what is the intervention for apgar score of 4-7?

Stimulate; rub newborn’s back; admin oxygen; rescore at specific intervals

45

what is the intervention for apgar score of 0-3?

Requires full resuscitation; rescore at specific intervals

46

what is the normal interval for apgar scoring?

at 1 minute, at 5 minutes, (and at 10 if needed)

47

normal newborn HR

resting 120-160 beats / min
Sleeping 80-100
Up to 180 if crying

48

normal newborn respirations

30-60 per minute, assess for full minute

49

normal newborn head circumference

33-35 cm

50

number and type of vessels that should be found in umbilical cord

2 arteries, 1 vein

51

when does pathological jaundice happen ad what does it mean?

within first 24 hours
hemolysis of RBCs

52

care for circumcision

petroleum jelly gauze, removed after first voiding post-circumcision

53

meconium

greenish black with a thick, sticky, tarlike consistency, usually passed within first 24 hours of life

54

what does meconium staining put the newborn at risk for?

meconium aspiration syndrome

55

what does HELLP syndrome stand for?

Hemolysis, Elevated Liver enzymes, Low Platelet count|
*severe form of preeclamspia

56

what is the clinical presentation of HELLP syndrome?

RUQ pain, Nausea, vomiting, malaise

57

when can fetal sex be determined?

usually by end of 12th week by visualizing external genitalia on ultrasound`

58

what is the cause of late decelerations?

uteroplacental insufficiency

59

what is the cause of variable decelerations?

cord compression

60

what is the significance of TORCH infections?

cause fetal abnormalities

61

what are the TORCH infections?

Toxoplasmosis, Other [parvo-B19/varicella zoster], Rubella, Cytomegalovirus, Herpes simplex virus

62

signs of ICP infants

bulging fontanels
irritability
high-pitched cry
increased head circumference
setting sun eyes (eyes appear t be looking down and prominent sclera over iris)