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Maternal-Newborn (Josh) > T2- Advance Organizer (Josh) > Flashcards

T2- Advance Organizer (Josh) Flashcards

(72 cards)

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1
Q

APGAR:

What Activity gets a 1?

A

arms and legs flexed w/ little movement

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2
Q

The part of the fetus that lies closest to the internal os of the cervix?

A

Presenting Part

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3
Q

When would we see Lochia Alba?

A

10-14 days after birth

***yellow to whight

***leukocytes, decidua, epithelial cells, mucus, serum, and bacteria

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4
Q

How long can lochia be seen post birth?

A

4-8 wks

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5
Q

Nursing actions for Variable Decel?

A

Change mom position

Elevate legs

Increase IV fluids

Palpate uterus to check for tachysystole

Stop oxytocin

Administer O2

Call MD

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6
Q

How long does Phase 1 of Stage 1 last?

A

Primagravia = 6-8 hrs

Multigravida = 4-5 hrs

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7
Q

How long does the Active Phase of Stage 1 last?

A

3-6 hrs

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8
Q

Should the bladder be palpable after delivery?

A

NO

they need to void to empty it to allow fundus to contract

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9
Q

— are expected irregular fluctuations of the baseline FHR that are an indicator of fetal well being.

A

Variability

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10
Q

Usual duration of UC during Phase 3?

A

45-90 secs

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11
Q

Before AROM, what must first happen?

A

presenting part needs to be engaged to prevent cord prolapse

woman needs to be free from infection

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12
Q

Which Decel is caused by impairment of placental/oxygen exchange?

A

Late

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13
Q

At station -3 is said to be at which Station?

A

3 cm ABOVE the ischial spines

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14
Q

What is the usual length of Stage 2?

A

Nulliparas: 50 mins

Multiparas: 20 mins - 3 hrs (depending on anasthesia)

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15
Q

What would Marked Variability be a sign of?

A

D-fib

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16
Q

APGAR:

What appearance gets a 1?

A

pink centrally

bluish extremities

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17
Q

Uteroplacental Insufficiency causes which type of Decel?

A

Late Decel

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18
Q

What color of AF could indicate an infection?

A

Yellow (thick cloudy color)

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19
Q

What APGAR scores are we looking for?

A

10 is best, 8 or 9 is good

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20
Q

When would we see Lochia Serosa?

A

3-4 days after birth

***pal pink or brown

***old blood, serum, leukocytes and tissue debris

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21
Q

Which Opioids did we talk about?

A

Dilaudid (Hydromorphine)

Meperidine

Normeperidine

Fentanyl

Sufenta - more potent than Fentanyl

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22
Q

Which class of meds should we NEVER give?

A

Benzos

***will affect thermoregulation of infant

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23
Q

APGAR stands for …

A 
Appearance
Pulse
Grimace
Activity
Respiratory
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24
Q

How do opioids affect mom and baby?

A

decrease maternal HR and BP

affects fetal oxygenation

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25
Before epidural, what do we give?
IV bolus (1000mL in less than 30 mins) ***increase epidural space ***protects from hypotensive episode
26
Opioid Agonist Antagonists:
Butorphanol Tartrate (Stadol) Nalbuphine HCl (Nubain) ***may precipitate withdrawal symptoms in opioid dependent moms and newborns
27
For the first 2 hours after birth, what amount of discharge should we see?
like that of a heavy menstrual period
28
Should we give Naloxone (Narcan) if mother or infant is opioid dependent?
NO causes abrupt withdrawal
29
If the fundus has deviated to the RIGHT of the mom's umbilicus, what should we do?
encourage to void to decrease size of bladder ***catheter if necessary
30
What can result from ataractic drugs like Promethazine?
mom gets sleepy, baby gets sleepy, moderate variablity becomes minimal b/c baby is asleep
31
APGAR: What Respiratory effort gets a 1?
slow, irregular breathing weak cry
32
At the Ischial Spines is said to be at which Station?
0
33
What color of AF could indicate meconium?
Greenish Brown
34
APGAR: What Grimace (reflex irritability) gets a 1?
facial movement only
35
What do we give if baby has respiratory depression?
Stimulation Fluids ***stadol can cause some resp depression and will not be reversed by Narcan
36
Which type of Decels must be periodic?
Early and Late ***Variable can be either Episodic or Periodic
37
After an epidural, how often are vitals charted?
q 5 mins for fist 20 mins q 30 mins after 20 mins
38
APGAR: What pulse gets a 1?
39
Usual duration of UC during Phase 1?
30-45 secs NOT regular
40
When the bladder is distended, what does this indicate?
uterus will be boggy and above and to the right of the woman's umbilicus
41
Intervention for Variable Decel?
Caused by cord compression - Turn mom - Stop oxytocin - Administer O2 - Call MD
42
Which Decel is a 'mirror image' of the contraction?
Early Decel ***don't chart! ***needs no intervention
43
What do we consider a an acceleration of FHR longer than 10 mins?
considered a change in baseline
44
What is the usual length of Stage 3?
5-30 mins ***if more than 30 mins, it's a problem
45
What causes Early Decels and when would we see them?
Fetal Head Compression Phase 2 of Stage 1 Stage 2 (when mom is pushing)
46
When would we see Lochia Rubra?
post birth ***bright red and may contain small clots
47
If mom gets a hypotensive episode, what is nursing action?
Turn mom Increase fluids Administer O2 Elevate legs (10-20 degrees) Call MD (order for ephedrine)
48
What would happen if we fail to give IV Bolus before Epidural?
Hypotensive episode (systolic falls below 100) No accels or moderate variability for baby (nonreassuring FHR)
49
Where the the PMI usually located?
fetal back ***below umbilicus if cephalic presentation ***above umbilicus if breech
50
Which Decel is likely caused by a cord compression?
Variable Decel ***V looks like a Vice
51
Where should the fundus be in the 4th stage?
firm, midline, and halfway b/t umbilicus and symphysis pubis
52
After ROM, check temp ---- and call Doc if it is higher than ---
q 2 hr 38c (100.4)
53
Usual frequency of UC during Phase 2?
3-5 mins
54
Usual frequency of UC during Phase 3?
2-3 mins apart
55
Usual duration of UC during Phase 2?
40-70 secs
56
Variability levels: Absent = Minimal = Moderate = Marked =
Absent = 0 or undetectable Minimal 0-5 bpm Moderate = 6-25 bpm Marked = > 25 bpm
57
What accels are we looking for at 32 wks? What about 33 wks or more?
10 x 10 15 x 15
58
S/S of Uterine Infectoin
Pain in lower abdomen Fever Foul-smelling discharge Rapid HR Swollen, tender uterus
59
Usual frequency of UC during Phase 1?
5-30 mins
60
What do Barbituates do to the neonate?
CNS depression ***avoid if birth is within 12-24 hrs
61
What will a Variable Decel look like on the strip?
abrupt drop (30 secs) periodic or non-periodic
62
What could cause tachycardia (FHR > 160)?
mom having a fever prolonged rupture of membranes Drugs: - atropine - hydroxyzine - terbutaline - cocaine or meth
63
--- are visually apparent, abrupt increase in FHR above the baseline.
Accelerations ***onset to peak
64
During Stage 3, when would we give Pitocin?
we don't give Pitocin during stage 3 ***we give high dose of Pitocin AFTER delivery of placenta
65
What is the minimal amount of time we want b/t contractions?
at least 2 minutes to allow for perfusion to fetus
66
What is the maximum length that Stage 3 should be?
30 mins ***Call nurse if it lasts longer
67
Nursing intervention for Occiputposterior position?
Change mother's position often to facilitate baby to move to OA position Counter pressure on mom's back (sacrum) Hip squeeze to push the pelvis back into a relaxed position to relive pressure of stretch
68
What is Fetal Bradycardia and what could cause it?
FHR
69
What can cause fetal head compression and which Decel would it lead to?
Early Decel - UC - Vag exam - Fundal pressure - Placement of internal monitoring node
70
Relationship b/t the long axis (spine) of fetus with long axis (spine) of mom?
Fetal Lie
71
In order to apply an IUPC or an ISE, what must first happen?
rupture of membranes
72
How long does the Transition Phase of Stage 1 last?
20-40 mins

Maternal-Newborn (Josh) (29 decks)

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