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Maternity NURS242 Flashcards

(78 cards)

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1
Q

Lochia Rubra

A

3-4 days dark red with small clots, no bad odor

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2
Q

Lochia Serosa

A

4-10 days, pink/brown no foul odor

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3
Q

Lochia Alba

A

11 days- 6 weeks yellow/light brown to white, stale odor

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4
Q

Cause of postpartum hemorrhage

A

Uterine atony, retained placenta, tract lacerations, placenta accreta, increta, percreta, uterine inversion, coagulopathy

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5
Q

Symptoms of postpartum hemorrhage

A

Cumulative blood loss >1000mL or symptoms of hypovolemia

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6
Q

How do you treat postpartum hemorrhage

A

Pitocin, methergine, hemabate, cytotec

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7
Q

Risk factors for Postpartum hemorrhage

A

Prolonged labor, uterine over distention, intrapartum infection, previous cesarean section, placenta issues, polyhydramnios, severe pre-eclampsia operative vaginal deliveries, maternal obesity, grand multiparity

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8
Q

Signs of early attachment

A

Feeding infant, consistency, seeking information, sensitive to newborns needs, cultural factors or barriers

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9
Q

Risk factors for postpartum depression

A

Prenatal depression, low self esteem, stress of child care, prenatal anxiety, life stress, lack of social support, marital problems, history of depression, single, low socioeconomic status, unplanned pregnancy, young maternal age

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10
Q

Symptoms of postpartum depression

A

Significant weight loss, insomnia, loss of interest or pleasure in daily activities, decreased energy or fatigue, feelings of worthlessness or guilt, persistent feelings of sadness intense mood swings

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11
Q

Expected physical findings taught at discharge

A

Involution, after pains, progression of lochia, breast changes, weight loss

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12
Q

Signs of complications after pregnancy

A

Breast tenderness, warm and reddened, blurry vision or severe headaches, leg pain or chest pain, thoughts of harming self or infant

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13
Q

Risk factors for vaginal hematoma

A

Vacuum or forceps delivery, prolonged second stage labor, episiotomy

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14
Q

Risk factors for metritis

A

C-section, prolonged rupture of membranes, prolonged labor, internal monitoring, meconium stained fluid, obesity, multiple cervical exams

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15
Q

Symptoms of metritis

A

Elevated temp, lower abdominal pain, uterine tenderness, tachycardia, subinvolution, lochia heavy and foul smelling

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16
Q

Nursing actions for infection

A

Up fluid intake, early ambulation, proper hand hygiene and peri care, antibiotics, pain management, remind to void, warm compresses

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17
Q

Risk factors for cystitis

A

Epidural anesthesia, overdistended bladder, Foley, operative vaginal deliveries, macrosomnia

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18
Q

Risk factors for wound infection

A

Obesity, diabetes, malnutrition, premature rupture of membranes, preexisting infection

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19
Q

Risk factors for thrombosis

A

C-section, metritis, decreased mobility, obesity

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20
Q

Nursing action for newborn with low temperature

A

Skin to skin, warm blankets, feed, increase room temp, preheated warmer with skin probe

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21
Q

SIDS recommendations

A

Lay on back to sleep, firm safe sleep surface, do not sleep with your baby, keep objects and blankets out of crib, prenatal care, avoid smoking and smoke exposure, avoid alcohol and drugs, breastfeed, offer pacifier at nap time and bed time, avoid over heating

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22
Q

How to breast feed

A

Pillow to support, newborn should completely face breast, ear shoulder and hip and aligned, woman should support breast, baby’s lips flang out and mouth around areola is wide open

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23
Q

Bottle feeding

A

1/2-1 oz per feeding during first few days of life feed every 3-4 hours. 2.5-3 oz per feeding by day 4 and gradually to 32 oz per day. Hold newborn during each feeding, burp half way through feeding

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24
Q

Three unbilical vessels that close after pregnancy

A

Ductus venosus, foramen ovale, ductus arteriosis

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25
Presumptive signs of pregnancy
Amenorrhea, fatigue, breast tenderness, nausea, vomiting, urinary frequency, hyperpigmentation of the skin, fetal movements, uterine enlargement, breast enlargement
26
Probable signs of pregnancy
Softening of the lower uterine segment, softening of the cervix, bluish purple coloration of vaginal mucosa and cervix, changes in shape and size of uterus, abdominal enlargement, Braxton hicks, ballottment
27
Probable signs of pregnancy
Uterine shape and size consistency can be changed by uterine tumors, polyps, infection, pelvic congestion, positive pregnancy tests
28
Positive signs of pregnancy
Ultrasound verification, auscultation of fetal heart tones, fetal movements felt by clinician
29
Maternal risks for gestational diabetes
Hydramnios, hyper/hypoglycemia, ketoacidosis, dystocia, retinopathy, pre-eclampsia, induction, cesarean, spontaneous abortion, preterm labor
30
Fetal risks for gestational diabetes
Macrosonmia, hypoglycemia, iugr, respiratory distress, cardiac, CNS, skeletal defects, hyperbilirubinemia
31
Risk factors for preeclampsia
Teens, over 35, existing hypertension, multiple gestation, obesity, gravida 1
32
How do you care for a newborn with withdrawal?
Do not over stimulate, provide quiet environment, swaddle, assess NAS, frequent small feedings, pacifier, meds as needed.
33
What are diagnostic tests for hyperbilirubinemia?
Total serum bilirubin, direct, coombs test, hemoglobin and hematocrit, blood incompatibility, electrolytes.
34
Symptoms of pre-eclampsia
BP over 140/90, proteinuria more than 300mg in 24hr urine, edema, headache, hyper-reflexia, clonus, blurred vision.
35
Pre-eclampsia to eclampsia
Thrombocytopenia, pulmonary edema, epigastric pain, confusion, seizures
36
How do you manage pre-eclampsia
Early identification, monitor BP, weight, urine protein, NST's, CBC, LFT, kidney function, urine protein, magnesium sulfate, CNS depressant, antihypertensive, emergency delivery
37
Antidote for magnesium sulfate
Calcium gluconate
38
HELLP syndrome
Hemolysis, elevated liver enzymes, low platelets, RUQ pain, malaise, flu symptoms, hemolytic anemia, liver necrosis, bleeding, stabilize, protect infant, blood products
39
What is the difference between placenta previa and abruptio placentae
Placenta previa is painless bleeding and can resolve on its own
40
Infertility risks for men
Toxic substance exposure, smoking, alcoholic, genitals exposed to high Temps, hernia repair, obesity, cycling, running, STI, undescended testicle, mumps after puberty
41
Infertility risks factors for women
Over or underweight, hormone imbalance, uterine fibroid, tubal blockage, cervical stenosis, chromosomal abnormalities, immune system disorders, chronic illness, STI, endometriosis, PID, smoking, alcohol, chemo, miscarriages, psychological stress
42
Male infertility management
Hormone therapy, lifestyle changes, antibiotics, surgical repair
43
Female treatment for infertility
Lifestyle changes like stress reduction, better nutrition, no smoking or alcohol, meds to stimulate egg production, surgery, antibiotics
44
Artifical insemination
Insertion of sperm directly into uterus best outcome when used with clomiphene
45
Gamete intrafallopian transfer
Removing egg outside body combine with sperm then place in fallopian tube and fertilization happens naturally
46
In vitro fertilization
Eggs fertilized in lab and transferred to uterus indicated for tubal obstruction, endometriosis, pelvic adhesions, and low sperm counts
47
Intracytoplasmic sperm injections
One sperm injected into cytoplasm in egg to fertilize it indicated for male infertility
48
Preimplantation genetic diagnosis
Identify genetic defects in embryos created through IVF
49
Gestational carrier
Lab fertilization with embryos transferred to a woman who will carry the pregnancy, legal issues
50
Psychological aspects of infertility
Crisis, stress, anxiety, depression, relationship strain, stress with extended family, social isolation, self esteem issues
51
Types of contraception
Subdermal implant, intrauterine device, injectable, combined hormonal contraceptives, barrier methods, standard days method, emergency contraception, female sterilization, male sterilization, abstinence
52
Pros to implant contraceptive
Long duration, low hormone dose, reversible, estrogen free
53
Cons of implant contraceptive
Irregular bleeding, weight gain, breast tenderness, difficult removal
54
IUD pros and Cons
Pros: immediately effective, can use during lactation Cons: menstrual irregularities, unknowingly expelled, increased risk of pelvic infection, check string placement
55
Injectable pros and cons
Pros: can be used by smokers and lactating women Cons: menstrual irregularities, office visit Q3 months, weight gain, depression
56
Male and female condom failure rate
Male 18% | Female 21%
57
Maternal and fetal risk for premature rupture of membranes
Maternal- infection | Fetal- low AFI, infection, cord issues
58
Treatment for premature rupture of membranes
Watch vitals, fetal monitoring, maternal lab values, bedrest with BRP, antibiotics if indicated
59
Preterm labor signs and symptoms
Abdominal, back, and pelvic pain, menstrual like cramps, pelvic pressure, urinary frequency, diarrhea
60
How to manage preterm labor
Tocolytic drugs, modified bedrest, IV hydration, antibiotics, corticosteroids
61
Betamethasone for fetal lung maturity
12mg IM q 24 hr x 2 stimulates the production of more mature surfactant in fetal lungs
62
It's Not My Time (tocolytics)
Indomethacin, Nidefipine, Magnesium, Terbutaune
63
Risks of a vaginal birth after cesarean and nursing actions
Uterine rupture baby dies, Assess fetal HR, ensure IV access, ensure blood products available, assess scar for separation, ensure OR team readily available
64
Risk of forceps assisted delivery
Cephalohematoma, nerve injuries, skin lacerations or bruising, skull fractures, intracranial hemorrhage
65
Risks for vacuum assisted delivery
Lacerations, hemorrhage, bladder trauma, extension of episiotomy
66
Why would someone need a C-section
Previous C-Section, placental abnormalities, dystocia, previous uterine surgeries, unsuccessful vacuum or forceps delivery, malpresentation, FHR difficulties, underlying medical condition
67
VEAL CHOP
Variable. Cord compression Early. Head compression Accelerated. Okay Late. Placenta insufficient
68
Latent first stage of labor
0-6cm contractions 30-45 seconds and 5-30 minutes apart
69
First active stage of labor
6-8 cm contractions 2-5minutes apart lasting 45-60 seconds
70
First transition stage of labor
8-10 cm contractions last 60-90 seconds and are 1-3 min apart
71
Why would someone get induced
Chorionamnionitis, gestational diabetes, pre-eclampsia, eclampsia, premature rupture of membranes, post term pregnancy, fetal compromise, maternal medical conditions, fetal demise
72
Risks of pharmacological cervical ripening
Uterine hyperstimulation, nonreassuring fetal heart rate
73
Risks of amniotomy
Umbilical cord prolapse, cesarean birth, variable deceleration, infection, fetal injury, bleeding
74
Transcervicle balloon catheter risk
Infection, cervical trauma
75
Risks for osmotic dilators
Chorioamnionitis, cervical trauma
76
Primary infertility
Not able to conceive after one year of frequent attempts in women under 35 and 6 months in women older than 35
77
Secondary infertility
Women who have been pregnant in the past but cannot conceive or carry a baby presently
78
Six infant reflexes
Sucking, rooting, Moro, Palmar grasp, plantar grasp, babinski

Maternity (1 decks)

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