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AD 232 > Seminar day 1 > Flashcards

Seminar day 1 Flashcards

(59 cards)

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1
Q

intrapartal

A

labor and birth

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2
Q

gravida

A

how many times the woman has been pregnant; whether completed or not

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3
Q

para

A

number of pregnancies lasting more than or equal to 20 weeks

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4
Q

GTPAL

A 
gravida
term pregnancies
pre-term pregnancies
abortions (spontaneous or forced)
living children
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5
Q

SVD/NSVD

A

spontaneous vaginal delivery/normal SVD

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6
Q

C/S

A

c-section

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7
Q

VBAC

A

vaginal delivery after cesarean

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8
Q

Fundus

A

The upper rounded extremity of the uterus above the openings of the uterine (fallopian) tubes.

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9
Q

lochia

A

vaginal discharge after birth:
rubra, serosa, alba
scant, small, moderate, heavy
can last up to 6 weeks

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10
Q

peuperium

A

the period of about six weeks after childbirth during which the mother’s reproductive organs return to their original nonpregnant condition.

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11
Q

4th stage of labor assessment - vag delivery

A 
1st 1-2hours after birth:
q15min x 4
q30min x 2
q1hour x3
q4hour to complete first 24 hours

include:
BP
pulse
fundus
lochia
perineum

temp q4 for 24

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12
Q

postpartum ongoing (routine) assessment - shift

A 
head to toe
OB focal:
breasts
fundus
lochia
perineum
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13
Q

PP maternal temp guideline

A

less than or equal to 100.4 degree F (24hours) normal

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14
Q

considerations when pt has had duramorph

A

count RR q1hour x 24 hours
NO narcs in 1st 24 hours unless approved by anesthesia
have narcan bedside - reverse resp depression
most common SE = pruitis - itching
use nubain or benadryl - if not work, give narcan

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15
Q

epidural site

A

ice is best for pain

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16
Q

extremities assessment

A

look for edema - 3rd spacing
varicose veins are common
Homan’s sign - checking for DVT’s - dorsiflex foot and assess for pain - must be relaxed - don’t check if known DVT

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17
Q

perineum assess

A

lochia
lacerations
hemorrhoids - common

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18
Q

bladder assess

A

a full bladder will displace the uterus
encourage voiding q 2 hours
usually concentrated
lots of urine made - getting rid of excess from pregnancy

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19
Q

lacerations

A

1st degree = skin
2nd degree = muscle
3rd degree = capsule of anus but not through
4th degree = through anus

ICE!!

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20
Q

breastfeeding nutrition

A

need 500 calories extra - in form of protein

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21
Q

maternal role adjustment

A

taking in
taking hold
letting go

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22
Q

taking in

A 
can be up to 48 hours
concerned about self
pain
food
thirst
difficult to make decisions
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23
Q

taking hold

A 
around d/c
showered
own clothes
hair/make up
feeling better, starts asking questions 
participate in baby care
best time to teach
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24
Q

letting go

Study These Flashcards
A

can take up to 1-2 weeks

incorporates NB into family system

25
lochia
scant, small, moderate, heavy - in relationship to time | pad completely saturate is about 100 ml's
26
diastasis of rectus abdominus muscle
separates for the uterus to grow surgical mesh may be used for large ones when turns on side, stomach feels weird touch chin to chest - makes muscle contract and can palpate edges
27
immediate assessment and care of NB
establish respirations prevent heat loss - dry baby, skin to skin APGAR at 1 min and 5 min safety - ID bands promote parental attachment - skin to skin for 2 hours or until first feeding meds - vit K, erythromycin ointment
28
establishment of respirations
most critcial adjustment for NB right after birth result of pressure change, chilling, noise, light, etc.. normal = 30-60/minute, irregular, count 60 seconds
29
signs of respiratory distress
grunting (early sign) nasal flaring (early sign) retractions (later sign) cyanosis (even later sign)
30
brown fat
source of heat unique to NB's greater thermogenic activity than regular fat prematures have less than term - increased risk heat loss don't want them to have to use this KEEP WARM!
31
types of heat loss
evaporation conduction convection radiation
32
evaporation
occurs when liquid is converted to vapor vaporization of moisture from skin after birth dry baby after birth/bath
33
conduction
the loss of heat from warm body surface to cooler surfaces in direct contact - placing infants on cold scale, blankets, wet linens, x-ray plates place infant on pre-warmed warmer/scale skin to skin with mom/dad place barrier
34
convection
flow of heat from the body surface to cooler ambient air, contact with cold air cold drafts, O2 admin wrap infant in blankets, hats increase room temp look at placement of baby in terms of air system
35
radiation
the loss of heat from the body surface to a cooler solid surface NOT in direct contact, but in relative proximity, a vacuum infant near cold object keep infant away from cold windows or walls
36
normal NB temp ranges
97.6-99 axillary | if less, radiant warmer
37
normal NB HR ranges
(100 - APGAR) 110-160 count full minute apical
38
APGAR
``` activity - muscle tone pulse grimace - reflex irritability appearance - skin color respirations ```
39
activity muscle tone APGAR scoring
absent - 0 arms and legs flexed - 1 active movement - 2
40
pulse APGAR scoring
absent - 0 below 100 - 1 above 100 - 2
41
grimace - reflex irritability APGAR scoring
no response - 0 grimace - 1 sneeze, cough, pull away - 2
42
appearance - color APGAR scoring
blue-gray, pale all over - 0 normal, except for extremities - 1 normal over entire body - 2
43
respirations APGAR scoring
absent - 0 slow, irregular - 1 good, crying - 2
44
assessment of the NB at time of birth
``` resp apical pulse temp weight, length, head circumference head to toe ```
45
vernix caseosa
A white cheesy substance that covers and protects the skin of the fetus and is still all over the skin of a baby at birth
46
lanugo
fine, soft hair, especially that which covers the body and limbs of a human fetus or newborn.
47
milia
tiny white bumps that appear across a baby's nose, chin or cheeks. Milia are common in newborns but can occur at any age. You can't prevent milia. And no treatment is needed because they usually disappear on their own in a few weeks or months.
48
mongolian spots
very common in any part of the body of dark-skinned babies. They are flat, gray-blue in color (almost looking like a bruise), and can be small or large. They are caused by some pigment that didn't make it to the top layer when baby's skin was being formed.
49
flammeus nevus (port wine stain, stork bite)
a large congenital vascular malformation nevus having a purplish color; it is usually found on the head and neck and persists throughout life
50
erythema toxicum
a common harmless rash that appears in at least half of all infants who are carried to term
51
head assessment
molding caput succedaneum cephalhematoma
52
caput succedaneum
``` fluid acculumation pressure from vaginal birth will reabsorb in a few days crosses suture line appears at birth ```
53
cephalhematoma
``` blood accumulation torn blood vessels doesn't cross suture line if growing = active bleeding few weeks for reabsorption at risk jaundice appears few hours PP ```
54
NB bath
delay until stable temps - 2 above 98 degrees wash head last dry!
55
NB labs
TCB - transcutaneous bilirubin-based hours age glucose per protocol - above 40mg/dL CBC - not routine blood cultures - no routine
56
NB glucose indicated if
``` mother with diabetes LGA SGA preterm s/sx ```
57
breastfeeding positions
football cradle - hardest cross cradle - best to teach side lying
58
breastfeeding latch
nose to nipple baby's mouth open wide help baby to breast
59
breastfeeding times
8-12 times in 24 hours q2-3 hours(beginning of feed to beginning of next feed) about 15-20 minutes per breast don't skip feedings

AD 232 (2 decks)

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