OB Flashcards
(116 cards)
1
Q
Postpartum Period is defined as
A
interval from childbirth to return of the uterus to a NON-PREGNANT state (DOES NOT go back to pre pregnant)
2
Q
Inovulation
A
the shrinking of the uterus
3
Q
factors that promote inovulation
A
early/frequent ambulation uterine contractions (2-3 days postpartum) breast feeding (release oxytocin/petocin)
4
Q
by what week should the uterus no longer be palpable
A
2nd week postpartum
5
Q
Subinvolution
A
failure of the uterus to return to a non-pregnant state
6
Q
factors that cause subinvolution
A
full bladder multiparius women (increased risk of hemmorhage) prolonged labor (>18 hours) anastesia (epidural) infection retained placenta fragments
7
Q
characteristics of colostrum
A
increased nutrients/antibodies
low in fat
high protein
8
Q
what does a fundal rub do
A
makes the uterus contract and prevents hemmorhage
9
Q
estimated blood loss for a vaginal delivery
A
500mL
10
Q
estimated blood loss for a C-section
A
1,000mL
11
Q
what should you have the patient do before performing a fundal rub
A
empty their bladder
12
Q
how long does the post partum period last
A
6 weeks
13
Q
lochia rubra is seen when
A
after birth
3-4 days
14
Q
lochia serosa (pink/brown) is seen when
A
22-27 days post partum
15
Q
lochia alba (white) is seen when
A
up to 6 weeks post partum
16
Q
what should you assess when looking at lochia
A
amount
color
odor
17
Q
what is considered heavy lochia
A
saturated peri-pad within 1 hour
18
Q
episiotomy
A
purposeful cut of the perineum
19
Q
how long does it take for a perineal laceration to heal
A
2-3 weeks
20
Q
concerns surrounding an episiotomy
A
infection
comfort
21
Q
education/treatment for episiotomy
A
ice to perineum increase fiber stool softeners encourage urination ease fear of voiding sitz bath
22
Q
indications for a c-section
A
baby is large
baby is in distress (decrease in HR)
23
Q
post partum care for a c-section
A
bed rest for 12 hours wear SCD's (sequental compression devices on calves) for DVT/blood clots check incision site infection control STILL HAVE TO DO FUNDAL RUBS
24
Q
how long do clotting factors stay elevated after birth
A
6 weeks
25
what can the mother take for soreness/pain
Ibuprofen
26
what can happen to a womans hair after birth
becomes coarse/falls out (due to hormones)
27
when is it normal to see elevated WBC's
during the post partum period (6 weeks)
28
if a woman is Rubella Equivical, what does this mean
she needs the MMR vaccine
29
what is important education regarding the MMR vaccine when given post partum
avoid pregnancy for 28 days
| it DOES NOT transfer through breast milk
30
what does it mean when the uterus is displaced to the left
the bladder is full
31
what can a full bladder cause in the post partum period
they inhibit uterine contractions
| can cause hemmorhage
32
how early can a menstrual cycle return after giving birth
as soon as 28 days
33
what is a normal characteristic of the first 3-4 menses after birth
heavy bleeding
34
does bowel motility increase or decrease after birth
decrease
35
what is important for pregnant women regarding bowel movements
stool softeners
| eat high fiber
36
what is the headache caused by an epidural called
spinal headache
37
what causes a spinal headache
leaking of the spinal fluid from the epidural space
38
how is a spinal headache diagnosed
if the mom lays flat/supine, the headache will go away
39
what should you do for a spinal headache
call anesthesia, will perform a blood patch
40
biggest education to give parents regarding their newborn
```
SAFETY
varify ID of anyone who enters the room
call to verify
security tags on the newborn
be aware of what they post on social media
```
41
what does a uterus displaced to the right mean
placenta fragments
| holding onto a clot
42
does a gush of blood after the mom stands mean a sign of hemmorhage
no, blood was pooling when sitting
43
how long is the first period of reactivity
30 minutes after birth
44
heart rate of newborn is typically
120-160 bpm
45
what can normally indicate respiratory distress in a newborn but is normal in the first period of reactivity
grunting and nasal flaring
46
Moros Reflex
also known as the startle reflex
| something makes the baby jerk
47
second period of reactivity
2-8 hours
48
what occurs in the second period of reactivity
meconium is passed (black, tarry, sticky stool)
| have up to 24 hours to pass it
49
neonatal period
birth-28 days
50
what are the 6 important things that occur in the neonatal period
```
establish/maintain respirations
experience circulatory changes
ingesting/digesting nutrients
eliminate/regulate weight
learn to regulate temperature
establish relationships
```
51
how long is the passive immunity sufficient for the baby from mom
3 months
52
what are the characteristics of the GI system at birth
sterile and immature
53
how long does the baby have to pass meconium before there is cause for concern
24 hours
54
normal characteristics of the female reproductive system at birth
vaginal discharge
spotting
edema
vernix (cheese-like)
55
normal characteristics of the male reproductive system at birth
two palpable testes
| hydrocele
56
hydrocele
fluid in the scrotum
| resolves without treatment
57
Hypospadias
urethra is on the ventrial space of the penis
58
Epispadias
urethra is on the dorsal side
59
Ortiolanis Maneuver
femoral head moves in and out
| checks for hip displasia
60
treatment for hip displasia in baby
double diaper
harness
surgery
61
Unconjugated/Indirect Jaundice characteristics
can cross the BBB
can cause neurotoxicity (Kernicterus)
fat-soluble
62
Kernicterus
neurotoxicity caused by Jaundice
63
Conjugated/Direct Jaundice characteristics
water soluble
| excreted in waste (feed baby so it poops/pees)
64
what is pathologic jaundice caused by
maternal newborn blood type incompatibility
65
education given to parents for jaundice
```
starts in sclera
works its way down the body
may be lethargic, not wanting to eat
keep the baby near a window
feed plenty
phototherapy
```
66
what is important to do when a baby is receiving phototherapy
```
protective goggles
diaper on
check hydration status
monitor temperature
I's/O's
```
67
what can persistant tachycardia mean in a newborn (>160)
anemia
hypovolemia
sepsis
hyperthermia
68
what can persistent bradycardia mean (<100)
heart block
| hypovolemia
69
RBC's at birth
elevated due to fetal circulation being less effective at oxygen exchange
70
WBC's at birth
normal to be elevated
71
Platelets at birth
decreased
(immature live/GI)
decreased clotting factors
not able to synthesize Vitamin K (give supplemental Vitamin K)
72
oxygen flow of newborn
oxygen poor=right side
| oxygen rich=left side
73
what does the cutting of the cord do
increases BP
| increases perfusion to the lung
74
what occurs in Cold Stress
oxygen drops
75
as a baby learns to breathe, what occurs
they become better eaters
76
alveoli are lined with what to make breathing easier
surfactant
77
when does the transition from intrauterine to extrauterine begin
when the umbilical cord is clamped
78
s/s of respiratory distress in an infant
```
retractions (can see)
stridor (can hear)
episodes of apnea
acracyanosis (blue/purple of feet and hands after 24 hrs)
central cyanosis (mouth/chest)
```
79
Caput Succedaneum
normal
edema of the head
crosses OVER the suture line
80
Cephalhematoma
DOES NOT cross over the suture line
well defined
blood between skin and skull
81
what can cephalhematomas cause
Jaundice when they begin to break down
82
Mongolian Spots
look like bruises
coccyx/back
IMPORTANT: document, look like bruises
83
Nevi (Stork Bites)
flat pinkish/red birthmark/rash
found on forhead/eyelids/back of neck
fade, dont always go away
84
Erythema Toxicum
newborn rash
no treatment
no lotion
85
Babinskis
big toe flexes, others fan out
| disappears 1-2 yrs (if it lasts longer, neuro damage)
86
Palmers Grasp
place object in hand, grasp
87
Plantar Grasp
curl toes around the object
88
why are newborns at risk for heat loss
very thin layer of fat
| blood vessels are close to the surface
89
APGAR tells us
how the baby is transitioning to extrauterine life
90
what is assessed with an APGAR score
```
HR
RR
Muscle Tone
Irritability
Color
```
91
what occurs if the APGAR is <7
repeat every 5 minutes until it is greater than 7
92
0-3 means what for APGAR
severe distress
93
4-6 on APGAR means
moderate distress
94
what is the priority as soon as a baby is born
to establish RR
95
what can increase/help establish RR
tactile stimulation (dry the baby)
skin to skin
cap on the head
96
how should you use bulb suction
MOUTH then NOSE
| nose first causes aspiration of what is in the mouth
97
where should you check a newborns O2 Sat
preductal (right hand)
98
what is an expected finding of the 02 Sat as soon as the baby is born
low (can be as low as 60)
| poor because of oxygen being shunted to the lungs
99
when does the anterior fontanel close
around 18 months
100
how many vessels should be in the umbilical cord
3
101
what are the 3 standard medications a newborn receives
```
Erythromyocin (antibiotic for eyes)
Vitamin K (needed for clotting)
Hepatitis B (mom must sign consent form)
```
102
where is a babies BGL taken
lateral aspect of the heel
103
what is considered hypoglycemia for a baby
<45
104
how is a CCHD (Critical Congenital Heart Defect) test performed
look at O2 Sat
preductal (right hand)
Postductal (either foot)
tested at same time
105
what must occur for the newborn to pass a CCHD test
>95%
must be within 3% of each other
even if both in range, must be within 3% of each other
106
Hyperbilliruibinemia is also known as
Jaundice
107
what must happen after a circumcision in order for the baby to be discharged
must void
108
education for mom regarding circumcision
hygiene
keep gauze pad and ointment on it
never a dry gauze pad, it will stick
109
what promotes lactation/lactogenesis
decrease in progesterone
| release of prolactin
110
what hormone is ESSENTIAL for lactation and is released because of nipple stimulation
oxytocin
111
what two things is Oxytocin responsible for in lactation
milk ejection
| milk let down
112
what is the proper way to unlatch a baby from the breast
place finger in mouth to release suction
113
what are contraindications to breast feeding
baby has Galactosemia (inability to process protein in milk)
| if mom has active TB or HIV
114
what are the recommendations regarding breast milk and babies
only breast milk for 6 months
| receive breast milk for 2 years
115
what is important to educate on with formula feeding
DONT PROP BOTTLE
| burp after 15mL (if spitting up during feeding, burp more frequently)
116
when should complementary feeding begin
at 6 months
| wait 3-5 days before introducing new foods
