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Hurst Review > Maternity Nursing > Flashcards

Flashcards in Maternity Nursing Deck (48):
1

First Trimester:

Week 1 -13

2

Presumptive signs of pregnancy:

amenorrhea, N/V, frequency, and breast tenderness

3

what is the name of the hormone that causes amenorrhea?

Progesterone

4

Probable signs of pregnancy:

positive pregnancy test, goodell, chadwick, hegar, uterine enlargement, braxton hicks contractions, pigmentation/changes of skin

5

Goodell's Sign

softening of the cervix, second month

6

Chadwick's sign

Bluish color of vaginal mucosa and cervix; week 4

7

Hegar's Sign

softening of the lower uterine segment; 2nd/3rd month

8

Braxton Hicks contractions

throughout pregnancy; move blood through placenta

9

Pigmentation/Changes of Skin

Lina Nigra (dark line down abdomen), abdominal striae (stretch marks), facial chloasma (mask of pregnancy), darkening of areola

10

Positive Signs of Pregnancy

Fetal heartbeat (10-12 wks), Fetoscope (17-20wks), fetal movement, ultrasound

11

Gravidity:

number of times someone has been pregnant

12

Parity:

number of pregnancies in which fetus reaches 20 weeks

13

Viability

24 plus weeks= infant has ability to live outside uterus

14

Nutrition Teaching:

4 food groups, increase calories by 300 per day after 1st trimester, adolescent: increase calories by 500 after 1st trimester, increase protein 60g per day

15

Weight gain first trimester?

gain 4 pounds in first trimester

16

Why don't women like to take iron?

Causes constipation and GI upset

17

You should take iron with what vitamin?

Vitamin C helps absorb

18

Folic acid prevents what defect?

Neural Tube Defect

19

Daily dose of vitamin?

400 mcg/day

20

Danger signs:

sudden gush of vaginal fluid, bleeding, persistent vomiting, severe headache, abd pain, increased temps, edema, no fetal movement

21

Common discomforts:

N/V, breast tenderness, frequency, tender gums, fatigue, heartburn, increased vaginal secretions, nasal stuffiness, varicose veins, ankle edema, hemorrhoids, constipation, backache, leg cramps

22

Weight gain second trimester?

4 pounds per month

23

What is quickening?

Fetal movement

24

Expected weight gain third trimester?

no more than 1 pound a week

25

How is fetal position/presentation determined?

Leopold's maneuver

26

If pt is having contractions, should maneuvers be done during or between contractions?

Between

27

Signs of Labor:

Lightening, engagement, fetal stations, braxton hicks contractions, softening of cervix, bloody show, sudden burst of energy (nesting), diarrhea, rupture of membranes

28

What are we worried about if membranes rupture?

prolapsed cord

29

Non-stress test

Want to see two or more accelerations of 15 beats/min or more w/fetal movement, each increase should last for 15 secs and recorded for 20 min, and want it to be reactive

30

Accerlation:

FHR has an abrupt increase from baseline

31

Biophysical Profile Test

done in last trimester, but can be done at 32-34 weeks in high risk pregnancy (high risk pregnancy may have BPP every week or twice week in 3rd trimester); measurements done by u/s, each parameter counts 2 pmts (10/10 great); BPP measurement (HR, muscle tone, movement, breathing, amniotic fluid); observation time is 30 min, results evaluated

32

Contraction Stress Test (CST): Oxytocin Challenge Test

done when NST is nonreactive, performed on high risk pregnancies, determines if baby can handle stress of uterine contraction

33

Uterine contraction causes what?

decrease blood flow to uterus and placenta

34

What is deceleration?

blood flow decreases enough to cause hypoxia in fetus fetal heart rate will decrease from baseline HR

35

Do not want to see late decelerations?

uteroplacental insufficiency (placenta weakening)

36

Do you want a positive or negative CST?

negative

37

Early Decelerations

caused by physiological hypoxia from fetal head compression

38

Late Decelerations

caused by uteroplacental insufficiency

39

True Labor

Regular contractions, increase contraction frequency and duration, discomfort in back and radiates to abdomen, pain level increases w/activity

40

False Labor

irregular contractions, discomfort in just front abdomen, pain decreases w/activity

41

Epidural Position

Lie on left side, legs flexed, not as arched as w/lumbar puncture

42

When do you give an epidural?

Stage 1 at 3-4 cm dilation

43

Major complication w/epidural?

hypotension (monitor BP)

44

What should you give with epidural to help fight hypotension?

IVFS: Bolus w/1000mL of NS or LR

45

What position to prevent vena cava compression?

semi-folwers on side (alternate side by side hourly)

46

When should oxytocin be discontinued?

contractions are too often, contractions last too long, fetal distress

47

What position should client receiving oxytocin be placed?

any position except flat on their back, if fetal HR is unreassuring then put on left side to enhance uterine perfusion

48

What should be done w/infusion if late decelerations occur?

turn off