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ob test 2 Flashcards

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1
Q

normal blood loss vaginal and c section and how much gram-ml

A

500ml vaginal
1000ml c section
1gm to 1ml

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2
Q

3 causes of uterine atony

A

preeclampsia
prolonged use of mag sulfate
prolonged use of betamethasone

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3
Q

What is the balloon called for the uterus and one thing to remember

A

Bakri post-partum balloon you can use this on a c section.

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4
Q

What to look for when the fundus is hard but the woman is still bleeding? 4

A

Laceration, episiotomy, hematoma, retained tissue

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5
Q

What is the first-line treatment for post hem? 2 ways?

A

Potocin IV or IM

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6
Q

hemabate what is it why do we use it?

A

For postpart hem it’s man-made oxytocin and it is a long-term drug.

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7
Q

Misoprostal what is it why do we use it? one thing to remember about it

A

Anti-ulcer we use it off label for hem but inserting into vagina or rectum. It is very painful

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8
Q

Methergrine why do we use it? One thing about it?

A

Post hem it causes problems with nursing so we try to avoid it.

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9
Q

Lysteda why do we use it how do we use it

A

IV push promotes clotting

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10
Q

What is puerperal infection 2 things to remember about risks and 2 signs

A

It is when bacteria infects the uterus or surrounding tissues in birth instrument -assisted birth multiple vag exams even before labor foul-smelling lochia WBC-high in pregnancy we are watching trend

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11
Q

How do we assess the perineum?

A

REEDA

Redness, edema, ecchymosis, discharge, approximation.

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12
Q

Time frame for baby blues and when to go to doctor?

A

first 3-10 days lasting a few days to a week or two when it lasts more than two weeks

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13
Q

When does postpart depression show up? when is the most common time?

A

4-6weeks later most common time is 3 months

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14
Q

One tool used to assess postpart depression

A

Edinbrugh postnatal depression scale EPDS

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15
Q

One thing to remember about post part

A

Men can have it two but react with anger and other ways

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16
Q

How much can a newborn stomach hold? when to burp? why regurg?

A

1-2tsp After every oz or between breasts weak sphincters

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17
Q

How often do newborns eat?

A

Every 2-3 hours

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18
Q

What to remember about the neonates stomach?

A

It is sterile and does not produce vit k because there is no bacteria.

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19
Q

What is meconium and one thing about it

A

Black tar stool from amniotic fluid and they may poop in the womb if they are stressed.

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20
Q

What is kernicterus what causes it what are the numbers?

A

Build up of bilirubin causes toxicity greater than 18

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21
Q

When will jaundice appear in newborn two things

A

3 days if from breakdown of RBC

sooner if it is a different problem

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22
Q

Neonate bp and hr WNL

A

pulse- 120-160

BP 60-80/40-45

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23
Q

Normal respiratory findings in a neonate 3

A

Irregular, 30-60 some fluid in lungs for 24 hrs so might hear crackles

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24
Q

What is kidney function percent in a neonate at birth

A

About 30-50 percent

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25
Why are neonates more prone to dehydration
Most of their water is extracellular
26
3 things about urine in a neonate
They can't concentrate urine well Don't handle drugs well brick dust urine is normal
27
spinal in neonate 2 things
No curves, soft mostly cartilage
28
What is molding
Crainial sutures overlap as a result of labor and delivery resolves in 24 hours
29
What do you want to see with neonates and how to swaddle them
Flexed and swaddle flexed with hands by their face
30
Never
Swaddle a baby and leave alone
31
Desquamates and what does this mean
Skin peeling in neonate and normal
32
Skin and jaundice and babes
Ruddy is normal can blanch to check color or look at mouth or sclera
33
Mottling and newborn
Means they are cold
34
milia how to deal with it
Small white/yellow spots on face from clogged sebaceous glands Normal don't touch it
35
Erythema toxicum
Newborn acne from moms hormones. Normal
36
Telangiectatic
Pale pink or red spots on face or neck normal will fade might not go away
37
Mongolian spots and one thing to remember
Black/blue spots in babe record so in the future they don't think it is child abuse.
38
``` Cephalhemeatoma is one thing wherex2 What will happen x2 what to watch for ```
Collection of blood from ruptured vessles does not cross suture line parietal bone and periosteum can be unilateral or bilateral Will stop bleeding because of pressure blood will get reabsorbed into body in a few weeks Hyperbilirubinemia
39
Caput succedaneum 3
Localized swelling long labor or vacuum crosses suture line
40
``` Subgaleal hematoma What is it? Where? From? When? Identifier? What happens? ```
``` Hemorrhagic birth injury between the scalp and aponeurosis From vacuum extract With in 12-72 hours Crosses suture nothing to stop bleeding NICU ```
41
3 things about vision and a newborn
Light sensitive Likes light/dark contrast Focuses about 12 in from face
42
Hearing and infant 3
Recognizes voices from in utero Turns head toward sound hearing is acute
43
Taste and baby
Sweet and sour
44
What sense is least developed in a newborn
Touch/ pressure
45
When is APGAR done what do the score ranges mean? and One thing to remember about it
``` 1 min and 5 mins 8-10-excellent 4-7 need stimulation 0-3 needs resuscitation The nurse needs to do it ```
46
What does APGAR stand for? how are they scored?
``` Appearance (Color) Pulse (HR) Grimace (Reflex irritability) Attitude (mm tone) Respirations 0-2 ```
47
How to use a bulb syringe
Mouth first then nose
48
optimal temp in newborn and where was it taken
97.7-99.5 axillary
49
What does cold stress do to the baby? 3
Hypoglycemia, respiratory distress, acidosis
50
Evaporation Convection Radiation Conduction
E-Wet C-lg surface area transfer heat to air R-Heat goes to cooler things not in contact with babe C- Heat loss goes to cooler things in contact with baby
51
Identification 2 things
Prints of both infants feet and one of mom right index finger 2 bands for baby 1 for mom and 1 for whoever she designates
52
What is a normal newborn Bloodsugar?
45
53
When to encourage Breastfeeding after birth?
With in 1 hr
54
Vital signs during transition?
q15mins
55
When Will vit k production happen on its own in a newborn? When will a babe not be at risk for vit k bleeding?
1 week 6-15 weeks
56
llotycin
Drops in eyes to prevent bacterial infection
57
llotycin
Drops in eyes to prevent bacterial infection
58
3 things to remember during nursing care on a newborn
Wash hands nonsterile gloves until after birth gloves for diaper changes
59
2 things about cord
remove cord clamp in about 24 hours | cord falls off in 7-10 days
60
2 things about babe and sleep
newborn sleeps about 15-20hrs a day | 3-4 months sleeping on own
61
Weight loss in babe and when to be concerned
can lose 10 percent but we are worried at 7 percent
62
How often do we observe breast feeding?
At least once a shift
63
One thing that needs to be in formula
IRON
64
4 things that need to happen before a circumcision
void, vit k, after 24 hours, has not eaten in one hour
65
Gomco vs plastibell main difference
Plasti has a tie around it and will fall of and gomco needs to have dressings and vaseline
66
What does the nurse do at the beginning of anneuraxial admin
at bedside checking vitals every 3-5 mins
67
When does Hep b shot need to be given and one thing
With in 1st hour you need parental consent
68
Puerperium
The six week period when moms body is returning to normal
69
What does mom need to do before you assess the fundus post
pee
70
When should the size of the uterus return to normal?
6 weeks
71
Rubra serosa alba
r-first three days deep red with a few clots serosa- day 4-10 pink brown Alba 10-6 creamy white to light brown
72
What to know about the placenta site
Blood vessels compress to heal and can heal for 6 weeks
73
Peri bottle 3
Warm water each time they go to the bathroom blot dry until no discharge
74
What are tucks and dermoplast?
Tucks are medicated pads that decrease swelling and dermoplast is a numbing spray
75
When do you change moms pad?
after every void
76
Lab values postpartum in mom and time Clotting factors WBC blood volume
Increased CF 2-3 weeks Increased WBS 4-6 days Blood volume normalizes by 4 weeks
77
Temp and postpartum and mom
Slightly elevates in first 24 hours and when milk comes in
78
HR in postpart mom
Bradycardic for 6-9 days
79
Late stages of Shock 3
Increased HR decreased BP and decreased urine output
80
When will ovulation return? mens? and one thing to remember
``` O not nursing 2-4 weeks o nursing- 6 months mens not nursing 7-9 weeks Maybe weaning if nursing ovulation occurs before mens ```
81
Oxytocin and prolactin
O- In charge of let down | P-in charge of producing milk
82
When does engorgement usually take place?
3-5 days
83
How many times to breastfeed in 24 hours
8
84
Rule of five in post part
5 days of life- 5 poops- 5pees
85
In breast feeding, which is more important duration or frequency
Frequency
86
Maternal role therapy and days
Taking in phase- days 1-3 dependency Taking hold phase 3-10 control autonomy Letting go phase- 10-14 adjustment to new role
87
Partner stages post pat
Expectation reality transition to mastery
88
LATCH
``` L = Latch -on= The infant's ability to latch correctly onto the breat A = Audible swallowing = The amount of audible swallowing noted T = Type of nipple = The mother's nipple type C= Comfort = The mother's confort H= Help/Holding = The position used by the mother and the amount of help she requires ```

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