NPS-patient assessment Flashcards

1
Q

What are the 4 critical life functions?

A

Ventilation
Oxygenation
Circulation
Perfusion

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2
Q

What is the most important life function?

A

Ventilation

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3
Q

What life function is the biggest problem in neonates and peds?

A

Oxygenation

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4
Q

What is FAS

A

Fetal Alcohol Syndrome

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5
Q

Gravida (G)

A

Any pregnancy, regardless of how long, & including current pregnancy

I am G2

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6
Q

Para (P)

A

Birth after 20 weeks gestation regardless if the infant survives or not

I am G2, P2

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7
Q

Define Primigravida

A

Refers to a woman’s first pregnancy

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8
Q

Mother’s obstetrical history is described as G2, P1

A

This is moms second pregnancy, but the first pregnancy was carries passed at 20 weeks.

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9
Q

Define Macrosomia

A

An infant that is > 400g (8 lbs.)

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10
Q

Mother’s with Pregestational Diabetes Mellitus have an increased risk of what?

A

Pre-clampsia, hypertension, hypo & hyperglycemia, and more like to require a C- section

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11
Q

Define Toxoplasmosis

A

Route of maternal infection caused by protozoa, raw meats, cat feces, soil, etc.

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12
Q

Perinatal Maternal infection happens when?

A

Happens during or after delivery?

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13
Q

What is the most common perinatal infection? And how do you tx. mom and baby?

A

Group B Steptococcus Infection
Resembles IRDS, febrile, hypotensive, septic —> suspect if so !!
If mom has an infection assume baby has this
Determine if mom was tx’d with antibiotics prior to delivery

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14
Q

If newborn is febrile, hypotensive, septic, and has respiratory distress & mom has an infection…what should you suspect?

A

Group B Streptococcal Pneumonia

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15
Q

Define PIH

A

Pregnancy Induced Hypertension (PIH)- elevated blood pressure after 20th week of gestation (did not have prior to pregnancy) (140/90)

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16
Q

Define Pre-eclampsia

A

Maternal hypertension accompanied by proteinuria (protein in urine) and edema (pitting edema)

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17
Q

Eclampsia

A

Maternal hypertension accompanied by seizures and coma

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18
Q

What happens when Pre-eclampsia is not treated ?

A

Eclampsia occurs which means mom is at high risk for seizures and/or coma.

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19
Q

How is Maternal Hypertension tx’d?

A

Treat symptoms with balanced diet, bed rest, antihypertensive agents

Magnesium Sulfate may be used to lower BP and delay preterm delivery

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20
Q

When is Magnesium Sulfate used?

A

To lower BP in moms with maternal hypertension and delay preterm delivery of baby

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21
Q

2 ways to estimate gestational age

A
  1. Nageles Rule - DOB= first day of moms last period, subtract 3 months and add 7 days
  2. Fetal US- Diameter of fetal head or length of fetal femur
22
Q

What is BPP and what does it measure/evaluate?

A
Biophysical Profile (BPP)
Evaluates placental function and fetal well-being
23
Q

What are the 5 variables to BPP?

A
Fetal breathing movements
Fetal Movements
Fetal Tone 
Reactive fetal HR
Amniotic fluid volume
24
Q

Interpret results of BPP (Biophysical Profile)

A

8-10 = normal

6= repeat in 24 hours

< or equal to 4= repeat test same day if < 32 wks and then deliver if BPP is <6. Induce if older than 32 weeks.

25
Q

What procedure involves a needle being inserted through the mother’s abdominal wall into the amniotic sac in order to withdraw a sample of amniotic fluid.

A

Amnniocentesis

26
Q

AFI (Amniotic Fluid Index) is used to do what?

A

Quantify amniotic fluid volume

27
Q

AFI between 8-18 indicates what?

A

normal amount of amniotic fluid

28
Q

AFI 5-6 indicates what?

A

amniotic fluid is low- oligohydramnios

29
Q

AFI 20-24 is considered what?

A

amniotic fluid is high

30
Q

What does oligohydramnios mean?

A

Low amount of amniotic fluid

31
Q

What does polyhydramnios mean?

A

High amount of amniotic fluid

32
Q

What is IUGR and what is it most common with?

A

Inuterine Growth Retardation

Common in Oliohydraminos (reduced amount of amniotic fluid)

33
Q

Potter’s syndrome is common in what scenario? & what is it?

A

Common in Oligohydramnios and is a renal malformation

34
Q

What is erythroblastosis?

A

When moms WBC’s attack babies RBC

35
Q

How is L/S ratio measured?

A

From amniotic fluid during amniocentesis

36
Q

L/S ration 2:1 or higher indicates what?

A

Low risk of RDS and lung maturity

37
Q

L/S ration less then 2:1 indicates what?

A

High risk of RDS

38
Q

Explain S/A Ratio

A

Surfactant/Albumin Ratio

  • Newer and helpful in diabetic moms
  • Less expensive and more accurate
  • Levels > 55 mg/g indicate lung maturity ( high levels =good)
39
Q

S/A ratio of 55 is ???

A

Good! indicates lung maturity.

40
Q

What does the Coombs test evaluate?

A

Evaluates Blood type incompatibility

41
Q

What medications are utilized to induce labor?

A

Oxytocin (Pitocin or Syntocinon)

42
Q

Why are Tocolytic Agents used?

What is one commonly used Tocolytic Agent?

A

They are used to inhibit uterine contractions by relaxing smooth muscle in the uterine wall

Magensium Sulfate - Terbutaline

43
Q

Fetal HR less than 110 indicates?

A

Bradycardia/ fetal distress

44
Q

Fetal HR greater than 160 indicates what?

A

Tachycardia

45
Q

What is normal fetal HR?

A

110-160/min.

46
Q

Explain late decelerations (Type II)

A

They start after the contraction begins & cont after it ends and/or may show no change in HR with contractions.

This may result in neonatal distress, infections, asphyxia

Maternal 02 is administered

Considered a high risk delivery

47
Q

Explain variable deceleration’s (Type III)

A

Random

Indicates umbillical cord compression/ occlusion of fetal acidemia.

Considered a high risk delivery

48
Q

Normal fetal scalp pH (while in utero)

A

> 7.25

49
Q

FSp02 & what is normal?

A

Fetal Oxygen Saturation
40-70% = stable
<20% = hypoxemia and need for immediate delivery

50
Q

When are Maternal Steriod Administration given?

A

Corticosteriods are given to the mother intravenously before birth to stimulate surfactant production (enhance lung maturity)

Must be administered at least 24 hours prior to delivery

51
Q

Explain Placental Previa

A

Abnormally low implantation of the placenta in uterus

Dx w/ ultrasound and possible bleeding of mom

Tx w/ bedrest, monitoring, fetal HR monitoring, and possible c-section