OB/Peds Final Flashcards by Nurse EMT

The four P’s of labor

Psyche-emotional and mental state of mom

Passageway-boney pelvis; cervix; vagina

Passenger-fetus; size of skull; Fetal accommodation (lie, presentation, attitude, position, and station)

Powers-contractions

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Newborn reflexes

Rooting- looking to feed

Suck- suckles on object placed in mouth

Moro- startle

Palmar grasp- will grasp anything placed in hand

Stepping- held in upright position, they move feet as if they’re stepping

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Most important goal of a woman with gestational diabetes?

Glycemic control-check the A1C
Then:
Diet, Exercise, Med management

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Contractions

Composed of three phases: increment, acme, and decrement

Duration: measured from the beginning of the increment to the end of the decrement.

Frequency: measured from the beginning of the increment to the beginning of the next increment; includes the contraction and the period of relaxation.

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Stages and Phases of Labor

Stage 1: Dilation
Phase 1: Latent phase
Phase 2: Active phase
Phase 3: Transition phase
Stage 2: Birth
Stage 3: Delivery of Placenta
Stage 4: Recovery

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Stage 1

Dilation; onset of true labor through full dilation of cervix at 10 cm

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Phase 1

Latent Phase; Contractions of true labor through dilation of cervix to 4 cm

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Phase 2

Active Phase; cervical dilation of 4 cm to 8 cm

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Phase 3

Transition Phase; Cervical dilation of 8 cm to 10 cm aka complete dilation

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Second Stage

Birth; Complete cervical dilation through birth; typically 20 mins to 60 mins

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Third Stage

Delivery of Placenta; From birth to delivery of the placenta; <30 mins

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Fourth Stage

Postpartum (recovery); from delivery of the placenta through 2-4 hrs post delivery; high risk for PP hemorrhage

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Blood vessels that go through the umbilical cord

3 blood vessels (2 arteries, 1 vein). Arteries carry deoxygenated blood from the fetus to the placenta.
Vein carries oxygenated blood from the placenta to the fetus

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Female Anatomy

Vestibule, Vagina, Cervix (lower part of the uterus), Uterus, Fallopian tubes, Ovaries

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Path that sperm travels

Testes (seminiferous tubules), epididymus, vas deferens, seminal vesicle, prostate, urethra, vagina, cervix, uterus, fallopian tube, ovum

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Naegles Rule

Add 7 days, subtract 3 months, change year as needed

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GTPAL

Gravida- Total # of pregnancies

Term- # of pregnancies that ended at 38+ wks

Preterm- # of deliveries [20,37] wks

Abortion- # of pregnancies ending before 20 wks

Living children- # of children alive at the time Hx is taken

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Menstrual Cycle

Ovarian Cycle: Follicular Phase (CD 1-CD 14; Follicle growth; follicle secretes estrogen)
Luteal Phase (CD 15-CD 28; Corpus Luteum secretes progesterone)

Uterine Cycle:
Menstrual phase (CD 1-CD 5-ish)
Proliferative Phase (end of period to CD 14; lining responds to hormones and thickens)
Secretory phase (CD 15-CD 26; progesterone maintains and thickens lining)

Ovulation:
CD 14; preceded by an LH spike

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Fetal Heart Rate Tracing

Baseline: between 110 and 160 bpm; normal variability are fluctuations between 6 and 25 bpm

Accelerations: reassuring; spontaneous elevations

Early decels: reasurring; caused by fetal head pushing on structures in birth canal; looks like an upside down contraction; peak is at the acme; stops by the end of the contraction

Variable decels: non-reassuring; jagged, erratic shape; can happen at any time; thought to be caused by pressure on cord

Late decels: non-reassuring; smooth, U-shape; begin late in the contraction and recover after the contraction has ended; associated with uteroplacental insufficiency (diminished or deficient blood flow to the uterus and placenta).

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Supine Hypotension Syndrome

preggo laying on their back, pressure from the wt of the amniotic fluid puts pressure on the vena cava and aorta decreasing blood flow for mama
S/S: Dizziness, lightheadedness, dec HR in fetus.
Tx: roll on side

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Risk factors for PP hemorrhage

Precipitous delivery, macrosomic baby, preeclampsia, Hx of hemorrhage, perineal laceration, episiotomy, clotting disorders, fetal demise

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Fetal circulation changes

Foramen Ovale: bypasses pulmonary circuit; gateway between the atria

Ductus Spinosus: bypasses liver circulation

Ductus Arteriosus:
directs blood from pulmonary trunk to aorta (thereby bypassing the lungs)

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Fertile window in cycle

Study These Flashcards

CD 12- CD 15

Where does fertilization take place?

Study These Flashcards

Fallopian tube

If happens outside of the fallopian tube: likelihood of ectopic is high

APGAR

Ideal: 7-10 A: Appearance/Color 2 = all pink 1 = blue hands/feet P: Pulse 2 = HR > 100 bpm 1 = HR > 60 bpm G: Grimace/Reflex Irritability 2 = cries/sneezes when stimulated 1 = grimaces when stimulated A: Activity aka muscle tone (is the baby moving?) 2 = brisk movements, maintains flexion 1 = minimal flexion of extremities R: Respiratory Effort 2 = strong, vigorous cry 1 = weak cry, slow or difficult respirations

Placental Abruption

The premature separation of the placenta from the uterine wall. S/S: Bright red, painful, vaginal bleeding; frequent contractions Risk Factors: Acute HTN, preeclampsia, chronic HTN, advanced maternal age, multiparity, trauma, cigs, R-OH, cocaine use,

Concerning BP in pregnancy

>140/90

Vertex

Head down fetal positioning

Dilation

cm of cervical opening; 0-10cm

Effacement

Thinning of the cervix; 0-100%

Normal wt gain during pregnancy

25-35 lbs

Wt of 12 mo old should be _______ from newborn wt

tripled

Fine motor skills to find when screening a 10 mo old

- Use of crude pincer grasp | - Grab a rattle by the handle

Immunizations given at a 4 mo old Well Baby Visit

- Polio (IPV) - Pneumococcal (PCV) - Rotovirus (RV)

Possible sign of child abuse during a physical exam?

Burn not treated

Which situation should the nurse explore for possible emotional abuse?

Kid did not remind mom of appointment

A nurse is working with a group of caregivers for kids that are dying. Which statement indicates caregiver is in the depression stage of anticipatory grief?

"I used to love playing board games with my son. Now that just makes me feel sad."

Child has had difficulty learning to walk. Child attempts to pull up to stand. Can’t get legs uncrossed and beside each other. Kid stands on toes. Different from other kids. Type of Cerebral palsy?

Spastic

Nurse is assisting care of a client with suspected meningitis and decreased LOC. Nursing action to take?

NPO

Nurse admitted 6 yr old with tonic-clonic seizure disorder. Characteristics of TC seizure?

- Preceded by sight, sound, taste, or smell - Loss of control of bowel and /or bladder - Jerking muscle movements - Rigid muslce phase

When working with a 12 yr old with DM Type 1. Asked "why can't I take pills instead of shots like my grandmother?"

A: Your body does not make it's own insulin so you need injections to replace it

Most common S/S in an adolescent with bulimia?

Dental carries

13 yr old girl with scoliosis. She is angry and does not want to wear the brace because it is big and ugly. Which statement is most appropriate?

Let her pick out an article of clothing that makes her feel good.

LPN is working with RN to develop a place of care of a kid with asthma

- Prevent symptoms | - Prevent reoccurence

Developing a plan of care in a kid with rheeumatic fever. Nursing intervention taking the highest priority is?

Promote rest periods and bed rest

Care provider ordered furosemide for CHF in a child. Nurse knows this is used to?

Eliminate additional fluid

Incidence of Vit D def in US is less than many countries. Reason?

Some foods in the US have been fortified with Vit D

Caregiver of child with Hx of ear infection. Son just said his urine looked funny and he has a HA and puffy eyes. He had a fever 2 days ago. Temp down to 100 F. See provider because he may have?

Acute glomerulonephritis

Caregiver brings 7 yr old son to peds office for bedwetting even after being potty trained for two years (inc at night). They had just been on a fishing trip. The child is shy, skiddish, and will not make eye contact. What need to be ruled out?

Possible sexual abuse on fishing trip

12 year old female has not started her period yet goes to ped office for well check. She states that she DOES NOT want to get her period. Correct statement for the nurse?

What have you heard and what makes you so worried?

Reinforcing caregiver info with mother of 5 y/o twins. UTI information for twin girls. Her 5 y/o son never got them. Accurate state to give parents?

A girls urethra is much shorter and straighter than a boys so it's easier for them to get UTIs

Caring for a child admitted for acute glomerulonephritis? What clinical manifestations could be be seen?

Tea colored urine

Teaching an inservice program for a child with nephrotic syndrome. Which give and accurate understanding of the diagnosis?

Malnourished but appears chubby

Caring for a child with AIDS. Which precautions to take?

Standard precautions

Adolescent girl at peds office with severe abd pain. PID is diagnosed. Third time diagnosed. What is the appropriate action of the nurse?

Take child to a separate room and ask about sexual activity

In understanding the body and its function. It protects from microorganisms. Major role of the?

Immune system

OB/Peds Final Flashcards

(56 cards)