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Midterm Flashcards

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1
Q

What is involution?

A

The shrinking or returning to normal size of the uterus, cervix, and vagina after delivery.

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2
Q

First nursing interventions with a boggy uterus.

A

Fundal massage

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3
Q

Indications of a uterus displaced up and to the right.

A

full bladder

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4
Q

Signs of a cervical or vaginal laceration or tear.

A

Bright red blood.

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5
Q

Normal findings in a postpartum woman.

A

Breast, uterus, lochia, bladder, bowel, perineum, lower extremities, pain, maternal-newborn bonding, maternal emotional status

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6
Q

Medications to control bleeding in postpartum period.

A

Oxytocin, Methergine, Hemabate.

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7
Q

oxytocin (Pitocin)

A

Synthetic form of pituitary hormone that causes uterus to contract, the most common agent used for labor induction. And push down milk.

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8
Q

Methergine

A

Given to help control bleeding

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9
Q

Hemabate

A

Given to help control bleeding

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10
Q

Hormones needed for breast feeding.

A

Prolactin and Oxytocin

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11
Q

Prolactin

A

Stimulates the alveoli to produce milk and then release it.

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12
Q

Causes/risks to develop postpartum hemorrhage.

A

Blood loss >1000 mL. Causes: uterine atony- inability of the uterus to contract effectively; lacerations to the uterus, cervix, vagina, or perineum; retained placenta; and disruption in maternal clotting mechanisms.

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12
Q

Education regarding the rubella vaccine.

A

Problem if contracted while pregnant. Congenital rubella can result in spontaneous abortion, still born, preterm delivery, congenital abnormalities (hearing impairments, eye disorders, heart defects, and neurologic abnormalities such as mental retardation) Greatest risk is during the first trimester, first 11 weeks, this can result in multiple anomalies. Contracted after 20 weeks rarely results in birth defects.

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13
Q

Concerns for c-section patients.

A
  • The woman is 3x more likely to die. 2x as likely to be rehospitalized within 30 days of discharge. Hemorrhage. Infection. Pneumonia.
  • Newborns are 2x as likely to die. Respiratory distress. More difficult to take their first breath due to anesthesia. Scalp nick.
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14
Q

Care for a c-section patient, intervention to help with gas.

A

Early ambulation, lay on left side, analgesics, avoid hot, cold, and carbonated beverages, rectal suppositories or enemas.

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15
Q

Care for a c-section patient, intervention to help with DVT.

A

Early ambulation, TED socks, fluids.

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16
Q

Care for a c-section patient, intervention to help with constipation.

A

Encourage ambulation, and water/fluids avoiding hot, cold, caffeinated. Eat high fiber foods. Stool softener.

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17
Q

Care for a c-section patient, intervention to help with pain.

A

Locate the source, determine the characteristics, quality, timing, and relief after comfort measures. NSAIDs, ice packs, sitz bath.

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18
Q

Prevention of mastitis.

A

Infection of mammary gland. Wash hands, keep breast clean, lotion to prevent cracks, encourage to feed every 1.5-2 hours to enhance complete emptying of breast.

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19
Q

Vessels in a newborn cord.

A

The umbilical arteries take blood from the baby to get rid of carbon dioxide. The umbilical veins bring oxygenated blood to the baby. (AVA)

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20
Q

Naegele’s rule

A

Used to determine the pregnancy due date by adding 7 days to the date of the last menstrual period, then subtracting 3 months.

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21
Q

Multi

A

Many

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22
Q

Nulligravida

A

A woman that has never been pregnant.

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23
Q

Gravida

A

Total number of pregnancies a woman has had, including the present pregnancy.

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24
Para
The number of fetuses delivered after the point of viability (20 weeks' gestation), whether or not they are born alive.
25
Nulli
None or null
26
Primi
First or one
27
Multigravida
A woman who has had more than one pregnancy.
28
Parity
The outcome of previous pregnancies.
29
Age of viability
>20 weeks
30
Normal weight gain in pregnancy
25-35 pounds
31
Presumptive signs of pregnancy.
Missed period, nausea, fatigue, swollen breast, tender breast, frequent urination.
32
Anticipatory (impending) signs of labor
Baby has "dropped" ("lightening"), contractions, breath easier, urinate more, mucous plug is expelled 1-2 weeks before (sometimes), burst of energy (24-48 hours before), ripening or softening of the cervix,
33
How to figure GTPAL
``` G- Gravida: Total number of pregnancies a woman has had including the present pregnancy. T- Term deliveries P- Preterm deliveries A- Abortions L- Living children ```
34
5 placental hormones.
Human chorionic gonadotropin (hCG), human placental lactogen (hPL), Estrogen, Progesterone, Relaxin
35
Human Chorionic Gonadotropin (hCG)
Trophoblast secrets hCG to prevent destruction of corpus luteum and stimulates it to continue estrogen and progesterone until about week 11 when the placenta takes on this function.
36
Human Placental Lactogen (hPL)
- Stimulates maternal metabolism so nutrients are available to fetus, eg. protein, glucose, minerals - is an insulin antagonist, thus decreasing maternal metabolism of glucose - also prepares mother's body for lactation - regulates the glucose that is available for the fetus.
37
Estrogen
Stimulates development of uterine and breast tissues in the mom - allows for uterine enlargement - provides a rich blood supply to the lining and placenta.
38
Progesterone
A smooth muscle relaxant prevents uterine contractions by decreasing contractility - permits implantation and maintains the nutrient-rich endometrial lining - prepares mammary glands
39
Relaxin
Causes changes in collagen - joints become flexible; therefore moms are more prone to falls.
40
Goodell's sign
Softening of the cervix during pregnancy.
41
Hegar's sign
Softening of the uterine isthmus during pregnancy.
42
Chadwick's sign
The bluish-purplish color of the cervix, vagina, and perineum during pregnancy.
43
How is the sex of the baby determined.
The male sperm determines the sex of the child; XX = girl & XY= boy
44
Risk of German measles to the pregnant woman.
Spontaneous abortion, stillbirth, preterm delivery, and congenital abnormalities of varying severity. Hearing impairment (most common), eye disorders, heart defects, and neurologic abnormalities (up to and including mental retardation). If contracted in the first 11 weeks of pregnancy, can result in multiple anomalies. After 20 weeks rarely result in birth defects.
45
What makes a pregnancy high risk?
Health, age, medical history
46
What is CMV?
Cytomegalovirus; transmitted via body fluids, part of the herpes family, most common congenital viral infection. Can cause Down's syndrome, fetal alcohol syndrome, and neural tube defects. Fetus' greatest risk is within the first 20 weeks.
47
What is toxoplasmosis?
Infection caused by Toxoplasma gondii. Transmitted via undercooked meat and cat feces. The triad of symptoms for congenital toxoplasmosis is chorioretinitis, intracranial calcification, and hydrocephalus.
48
What is candidiasis?
White, cheesy-type vaginal discharge, severe itching, and discomfort.
49
What is rubella?
Virus that can cause spontaneous abortion, still birth, preterm delivery, congenital abnormalities.
50
What is an amniocentesis?
A diagnostic procedure whereby a needle is inserted into the amniotic sac obtains a small amount of fluid. A variety of biochemical, chromosomal, and genetic studies are possible using amniotic fluid.
51
Interventions for care in the postpartum woman- pain
Promote homeostasis, provide pain management, preventing infections, prevent injury from falls, promoting urinary elimination, promoting bowel elimination, preventing injury from thrombus formation, promoting restful sleep, promoting parent-newborn attachment
52
Signs of labor
Dilation, contractions,
53
What is implantation?
On about the sixth day after fertilization, the trophoblast develops fingerlike projections that helps it burrow into the nutrient rich endometrium. By the 10th day, the blastocyte has completely buried itself in the uterine lining.
54
What is embryo?
From the end of the second week of fertilization until the end of the eighth week.
55
What is fertilization?
Also called conception, occurs when the sperm penetrates the ovum.
56
What is supine hypotension syndrome?
When the woman lies flat on her back in the latter half of pregnancy, the uterus and its contents compress the aorta and vena cava against the spine. This decreases the amount of blood return to the heart; therefore, the cardiac output and the blood pressure falls.
57
What is teratogen?
A substance that causes birth defects. The severity of the defect depends on when during development the conceptus is exposed.
58
What is an ectopic pregnancy?
When the zygote implants in places other than the uterus.
59
Complete abortion
All of the products of conception (fetus, membranes, and placenta) are expelled.
60
Threatened abortion
Vaginal bleeding or spotting; possibly cramping; no cervical dilatation. Symptoms may resolve and pregnancy may progress to term, or threatened abortion can lead to one of the other types.
61
Inevitable abortion
Cramping and spotting or vaginal bleeding with cervical dilatation; amniotic fluid may leak.
62
Incomplete abortion
Some, but not all, of the products of conception are expelled. Most commonly, the fetus delivers and the placenta and membranes are retained.
63
Missed abortion
The fetus dies, but remains in utero. Signs of pregnancy (nausea and breast tenderness) decrease, and the fundus does not grow as expected in a normal pregnancy and may regress (get smaller). No fetal heart tones are present.
64
Habitual (recurrent) abortion
The loss of three or more consecutive pregnancies before the fetus is viable.
65
When would rhogam be given?
If the woman is Rh-negative and the baby is Rh-positive she will need a shot, within 72 hours of delivery.
66
What is an incompetent cervix?
AKA cervical insufficiency: results in painless cervical dilation with bulging of fetal membranes and parts through the external os in the second trimester. Pregnancy loss is frequently inevitable. Leading cause of habitual, or recurrent, abortion.
67
How is an incompetent cervix treated?
Standard treatment is cervical cerclage, purse-string type suture in the cervix to keep it from dilating.
68
What is preeclampsia?
Serious condition, the blood pressure rises to 140/90 mmHg or higher accompanied by proteinuria. This can develop into eclampsia. S&S of preeclampsia usually appear after the 20th week and resolve when pregnancy terminates.
69
What is eclampsia?
The presence of seizure activity or coma in a woman with preeclampsia.
70
When/who needs an episiotomy?
Baby's shoulders are stuck in the birth canal after the head is born, shoulder dystocia. The head will not rotate from an occiput-posterior position. The fetus is in a breech presentation. Instruments are used to shorten the second stage of labor.
71
Transverse lie
Long axis of the fetus is perpendicular to the long axis of the woman.
72
Breech presentation
feet or buttock presentation
73
External version
Manipulating the position of the fetus while in utero, to try to turn the fetus to a cephalic presentation.
74
Signs of preterm labor
Occurs after 19 wks & before 37 wks. Contractions, dilation
75
Risks for preterm labor
Extremes of maternal age (35), ethnic minority, low socioeconomic status, late/no prenatal care, smoking, alcohol or drug use, intimate partner violence, lack of social support, high levels of stress, long working hours with long periods of standing.
76
Causes of labor arrest
? When labor slows down during the active phase?
77
What is an amniotic fluid embolus
Rare obstetric emergency that frequently results in death or severe neurologic impairment of the woman and her fetus. AFE more resembles anaphylaxis and septic shock that it does pulmonary embolism.
78
Interventions for premature rupture of membranes (PROM) patient who is preterm
Onset of labor before the end of 37 weeks' gestation. Strict bed rest, pelvic rest, IV antibiotics may be given
79
What is APGAR?
Immediate assessment of the newborn, concerned with the success of cardiopulmonary, adaptation. This is done at 1 minutes and 5 minutes after birth and continued every 5 minutes until a score of <7.
80
APGAR score - what do the numbers mean?
Rating of heart rate, respiratory effort, muscle tone, reflex irritability, and color- giving each a rating of 0, 1, or 2.
81
What is erythema toxicum
Rash appears commonly on the chest, abdomen, back, and buttocks of the newborn. The rash is harmless and will disappear without treatment.
82
Ways to warm a newborn
swaddle, apply a cap, or skin to skin with mother.
83
Reasons why we dry the newborn after delivery.
Cold stress increases the amount of oxygen and glucose needed by the newborn, they can deplete glucose stores and develop hypoglycemia, respiratory distress. Also can develop metabolic acidosis if exposed to prolonged chilling.
84
How long does one breast feed; each session and overall length.
Every 1.5-2 hours, approximately 10-20 minutes per breast; when the newborn stops sucking vigorously.
85
Normal newborn findings.
Cardiopulmonary adaptation. Healthy cry, heart rate >100 bpm, pink color, Apgar score >7
86
Ways to clear the newborn's airway.
Bulb syringe and frequently suction secretions and mucus accumulations.
87
Circumcision, when is it done and why?
< UTI, < penile cancer, < disease, < STI, < complications, easier hygiene
88
When do the "soft spots" close?
2 fontanels the anterior and the posterior. The anterior closes about 12-18 months. The posterior closes within the first 3 months.
89
What is pseudomenstruation?
A blood-tinged mucous discharge from the vagina.
90
Grand multiparity
five or more pregnancies
91
Cause of boggy uterus
when the uterus does not contract effectively, blood clots collect in the uterus, which makes it even more difficult for the uterus to contract.
92
Boggy uterus feels...
The uterus feels soft and spongy rather, than firm and well contracted.
93
Lochia
Blood, mucus, tissue, and white blood cells compose the uterine discharge.

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