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172 Cards in this Set

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Weight gain in pregnancy trimester 1:
Trimester 2,3:
3.5-5
0.9 lb per week thereafter
(>2 lb per week can relate to pre-eclampsia-edema)
Total weight gain in pregnancy should be:
25-30 pounds
At 20 weeks fundus should be at :

At 24 weeks fundal height is measured in cm above the:
umbilicus

symphysis equal to the number of weeks gestation
Plasma volume increases 25-40% at approx these weeks:
Which results in:
28-32
hemodilution and represent depleted vascular space, resulting in htn.
What foods are high in iron:
Green leafy veges,cereals, yellow veges, citrus fruits, egg yolks and dried fruits, fish and red meat.
What trimester does quickening occur:
2nd trimester
Why do we treat newborns eyes with antibiotic:
newborns can be affected by gonorrhea passing through the vaginal calnal.
How much calcium does a pregnant women need :
it is encouraged to eat/drink a quart of milk/yogurt daily
Calories should be increased by:
Folic acid daily:
300 a day

800-1000 mcg (diet and supplements)
Increase proteint to :
30 grams a day
What does TORCH stand for:
Toxoplasmosis, Other Agents,Rubella, Cytomegalovirus,Herpes Simplex (Torch Diseases)
At 8-12 weeks, this test is done to to see if genetic diagnosis can be noted in early pregnancy- (no fluid):
Chorionic Villi Sampling- tissue is removed.
This test is done in first trimester to determine abnormal fetal genetics OR fetal well being:
If done in 3rd trimester it is done because:
Amniocentesis

Fetal maturity check
Karotype determines:
Down syndrome(trisomy 21), sex linked disoreders and other trisomies.
Biochemical analysis determines:
AFP elevations can be related to :
Low levels may indicateL
60 metabolic distorders.

neural tube defects
Trisomy 21
What is the best predictor of extrauterine survival:
Lung maturity
With amniocentesis in first trimester bladder must be:
Last trimester bladder must be:
Full

Empty
What is a weight issue that s considered a risk factor on prenatal vist:
<100 lbs
>200 lbs
At what week in pregnancy should GBS be done:
35 weeks
If GBS positive what do we treat with:
Ampicillin 2 doses prior to delivery or once at least 4 hours prior to delivery
What test done with amniocentesis will reveal lung maturity:
Lecithin: sphingomyelin (L:S) ratio (unless mom is diabetic or has RH disease or fetus is septic)
Nursing care with amniocentesis includes:
Monitor FHR 1 hour after procedure, check VS and FHR q 15 minutes. GIve DC instructions: call for fever, bleeding,or leaking fluid from vagina, contractions or change in fetal movement
What prenatal labs are drawn in first tri:
CBC, UA, Blood types, RH factor,VDRL (syphilis) Rubellea, HEP B)
What test is checked at every office visit during pregnancy and why:
Urine is dipped- Can show protein, glucose, wbc, ketones. ( early dx of gest diabetes, poor kidney function , infection, pre-eclampsia)
Weeks 24-28 a ___ test is completed to check for:
Oral glucose tolerance test-
Does maternal insulin or glucose cross the placenta:
Glucose-
Insulin does not
Are oral hypoglycemic agents used during pregnancy:
NO- teratogenic to fetus
What STD cannot cross placenta but can transmitted during delivery:
gonorrhea
The ph of vaginal secretionss should be:
If amniotic fluid is suspected, which test is performed :
4.5-5.5

Nitrazine test- PH will be 7.0-7.5(amniotic fluid is higher) and paper will turn BLUE
If pregnant pt complains of hemorrhoids, what should the nurse advise:
cold compresses- increase fluid, stool softeners, gently reinsert into rectum.
Average caloric intake a day for pregnant women:
For lactating:
300
500
At what week in pregnancy can colostrum leak from breasts:
16th week
What is the main reason that body forms mucus plug:
To prevent infection
What oil glands in breast can cause oil to secrete from aerola:
Montgomery tubules
What foods are high in iron:
spinach,kidney beans,lentils,molasses,apricots, prunes and soy, raw aspargus, OJ
What vitamin is vegans deficient in:
Vit b 12-( only received from animal products)
What is ptylaism:
excessive salivation (caused by hormone surges) encourage pt to suck on ice or hard candy.
What is the caffeine limit a day in pregnancy:
300 mg a day= to
2-3 cups coffee
6 cups tea
5 sodas
In the first and third trimester what system is affected the most in mom:
Bladder- Bladder can extend to hold 1500ml
specific gravity is lowered, due to frequent urination.
Does filtrtation rate increase or decrease:
Increases,but reabsorption does not- causes glycosuria
Pregnant women should never lie on there:
back- it compresses inferior vena cava- side lying postion in best for fetus.
What foods contain folic acid:
lentils,strawberries,broccoli and chicpeas- (400-600 mcg a day, per Kirby, not Hesi)
What hormone decreased tone of smooth muscle which can lead to constipation:
progesterone-
What other causes can this hormone have:
Can cause decreased gastric acidity which leads to poor iron absorption-relaxed muscles of gallbladder, increases cholestetol stones which leads to gallstones.
How much does mother's blood volume increase in pregnancy:
30-35%, peaks at 30-34 weeks.
Fibrinogen increases how much:
40% and places mom at risk for blood clots
What role does pregnancy play on WBC's:
increases them up tp 9-15,000 over normal, peaks at 3rd trimester and returns to normal 6th week pospartum
What is better indicator of anemia hgb or hct:
HGB, hct will be increased due to increased plasma volume, rbc's will appear diluted.
What is the danger of vena cava syndrome:
Can cause lack of oxygen to get to fetus- caused by lying supine, have mom lie in side lying position.
S/S of vena cava syndrome:
Dizziness, pale, clammy skin, syncope,change in BP-if possible have pt use pillow to support R hip to displace uterus off major vessel.
At what week does nausea and vomiting decrease:
14th week, offer pt dry carbs to help with nausea.
What does fetal alcohol syndrome cause the fetus to be deficient in:
Protein
Folic acid
Thiamine
Zinc
What week should AFP done:
16-18 weeks
Increased level= neural tube defects
Decreased level= down syndrome
What will mother's pulse increase to in pregnancy:
In first and 2nd trimester BP will be:
10-15 bpm-palpitations are normal-heart hypertrophy-
Decreased, then nomalize in 3rd trimester.
What causes carpal tunnel syndrome in pregnancy:
edema compressing on median nerve of wrist.
Pelvic joints relax and seperate by hormone:
relaxin, released in 3rd trimester, waddle walk
Mother may experience nasal stuufiness and nose bleeds due to what hormone:
Estrogen
Stretch marks are primarily:
Inherired, genetic today-due to elastin production-
Increased estrogen and progesterone can cause what to skin:
Increase oil production which can lead to acne.
In what trimester is the mom most likely feel ambivalence:
First trimester
Nesting and reflection of own childhood happens in what trimester:
3rd trimester
What trimester does mother feel the best and as increased feeling on well being:
2nd trimester
What is it called when father starts to have sympathetic pain and symptoms like partner:
Couvade syndrome
Why should nipple stimulation be avoided in 3rd trimester:
can cause early contractions
Why is it important for pregnant woman to wear low heeled shoes:
Center of gravity is off with pregnancy could contribute to fall.
If pregnant women has bleeding after sex(minimal) should she be alarmed:
No- only if bleeding is caused for no apparent reason-
What culture only allows warm drinks after delivery:
Asian culture- no cold drinks allowed.- thought to cause excessive bleeding after delivery.
What is it called when one feels that their belief and values are best:
etnocentricism
When does lightening occur:
2 weeks prior to delivery, uterus shifts and drops allowing mother to have less dyspnea.
What age group as more complications in pregnancy:
Older age women- they have LBW, pre-term, abruptio placenta, and increased c-sections.
What age group is most likely to have the least prenatal care:
adolescents.
What is the first hormonal check that MD will order at first sign of pregnancy:
Progesterone- this is what maintains pregnancy and uterine lining from being shed.
What menstral history is vital on pre-natal visit:
LMP,length of menses, onset of menses, contraceptive hx(iud or bcp)
How does tobacco affect developing fetus:
can cause IUGR- low birthweight, compression and vasoconstriction of umbilical cord.
What is considered to be htn in a pregnant woman:
30 mm HG over systolic baseline OR 15 mmHG over diastolic baseline.
What is the schedule of prenatal visits:
every 4 weeks for 7 months
every 2 weeks until 36th week
every week until delivery
Sickle cell anemia is found in:
Tay-Sachs's found in:
Cystic fibrosis prevalent:
African americans
Jewish descent
Canada
Fasting blood sugar should be what in pregnancy:
After 1 hour glucose test:
After 2 hours glucose test:
After 3 hours glucose test:
<95
<180
<155
<140
How much glucose is given in test:
2 fasting blood sugarsm >95 may indicate:
100 grams iof glucose

gestational diabetes
Locate the placenta thorugh ultrasound because pregnancy could be:
over cervix or a ectopic pregnancy
Fatty maternal liver secretes and leaks into the fetus body, what test is done at 16-18 weeks:
AFP or Triple screen and it checks for trisomy of 18 or 21
A closed neural tube disorder may not be detected:
an open defect is easier to detect as spinal cord is on outside of body.
1 hour glucose is always done if greater than 95, MD orders:
3 hour glucose tolerance test.
Fasting blood sugar should be less than:
95
When does ovaries become inactive:
when placenta matures
What is it called when dilution of rbc's:
physiologic anemia in pregnancy
Cardiac output increases how much in pregnancy:
35-50% which equals 10-15 beats per minute
Diaphragm can be displaced up to how many cm:
4 cm which causes thoracic breathing
Oxygen consumption increase:
Tidal volume increases:
15-20%
40%
What is is called the mask of pregnancy:
Facial cholasms( hyperpigmentation of forehead and eyes)
What hormone supports maternal metabolic needs:
hPl
What three signs are the only positive signs of pregnancy:
Visualization by US (6wks)
Fetal heart tones(10-12 wks)
Fetal movement felt by examiner(18 weeks)
This is the relationship of fetal body parts to each other is the:
Attitude- baby should be in rounded back,with chin flexed on chest, thighs flexed at abdomen,legs flexed at knee. Arms are crossed over thorax and umbilical cord is between in arms and legs.
This is relationship of fetal longitudinal axis of mother's longitudinal axis:
Lie- Most common is vertex.
This refers to the part of the fetus that enters the pelvis first:
Presentation- cephalic is most common
The relationship of the presenting part to the four quadrants of marternal pelvis
The position- R or L
O=occiput, S= sacrum,M =chin
A-anterior, P=posterior
Most common position is:
With this position the baby's face:
ROA or LOA
facedown
The worst position coming out is:
Baby's face is:
ROP or LOP

face up
This is when the largest diameter of the presenting part has reached the pelvic inlet:
Engagement,this can be felt in vag exam
This the relationship of the presenting part to the ischial spines of the pelvis:
How is this measured:
Station
-5 to +4
the level of spine is zero station. When baby is crowning the station is +4
This can cause mom's cardiac output to be compromised when lying down:
For back pain have mom:
The mothers position- have mother lie on her side
all fours
This position can open pelvic outlet by 30 degress:
squatting
This is the involunatry contractions of the uterine muscle fibers:
Primary powers- it is like a pacemaker located in the upper uterine segment
3 phases of contractions:
In between phase is called the:
Increment, Acme and Decrement
Nadir
This is the phase of the contraction that blood flow is restored and utero placental fetal connection works to get oxygent to baby:
Nadir
Contractions are described by three things:
Frequency (2-3 min)
Intensity (felt by nurse OR internal fetal monitor)
Duration (1-2)
Whem mom wants to start pushing and is voluntary:
Secondary powers
The external monitor on the mom's tummy is:
Toco- this can measure frequency or duration. NOT intensity
FHR should be :
120-160
Changes in fetal heart rate by 2-3 bpm, beat to beat:
Short term
Long term is considered:
Moderate variability is 6-25 bpm, this is a good sign that shows the fetus is utilizing sympathetic and parasympathetic.
Short term variablity is either:
Absent or present
Head compression is caused by:
Early deceleration
Umbilcal cord compression is caused by:
Variable deceleration
These begin after the contraction starts and reach their intensity after the cotraction has peaked:
Late deceleration-
these do not return to baseline until well after the contraction is over.
If mom has late decelerations what should the nurse do:
Place mom in lateral positon, give 02 (8-10 liters), stop pitocin and call dr.
These occur suddenly, vary in duration and intensity, resolve abruptly and are caused by compression of umbilcal cord:
Variable decel
This is the pelvic inlet, mid pelvis and outlet:
The true pelvis
This is the portion above the pelvic rim:
False pelvis
This when the blood sugar is stable and glycemic control is good:
euglycemia
Most women have spontaneous rupture of membranes True of False
False, most women have to have membranes broken
Do contractions or rupture of membrand happen first:
Contactions, usually
If baby is is the ROP or LOP position what can nurse do:
Have mom from side to side to reposition baby.
Membranes must be ruptured prior to using this monitor:
Internal fetal scalp monitor
What is the sign of mag toxicity:
Low urine output
Low respirations
Low reflexes
Toxic levels are >8
Mag level to be therapeutic should be:
5-8
What does mag do for pre-eclampsia:
Raises seizure threshold, it is a smooth muscle relaxer.
How does a baby react with a mom on mag sulfate:
Floppy baby,which is normal suction and open airway provide O2
This is when hypertension develops in pregnancy:
Gestational HTN
Insulin needs change during pregnancy, how does it change:
First trimester- insulin decreases by nausea/vomitng
Second trimester: it normalizes and stablized
Third trimester: Increase 2-3 times the dose. R/T HPL
What happen with baby after delivery with gest diabetes:
Baby will be hypoglycemic
Who is at risk for developing gest diabetes:
hx of obesity, baby over 10 #'s, minority, maternal age>25
If you see the umbilical cord outside vagina, you must do this intervention:
Put mother in knee chest position- Push up on presenting part-to get pressure off of a cord. Apply 02 and call MD.
A rigid, painful, board like abdomen with vaginal bleeding classic sign of:
Abruptio placentae
What contributes to abruptio placentae:
Hypertension, abd trauma and cocaine abuse. Pt is at more risk for clotting disorder or DIC.
Abnormally implanted placenta near the cervix, with symptoms of painless bleeding after 20 wks gestation:
Placenta Previa
NST that is reactive means:
Fetus is reactive is GOOD-
Non reactive is BAD
Contraction stress test:
Is a NST with Pitocin, in this test Reactive is BAD- means mom will have to have C-section.
If pateient has pre-term labor what should nurse do:
Empty bladder, hydrate and bedrest. If contractions subside thery are Braxton Hicks.
True labor will cause the cervix to change true or false:
True
This is a test that is performed at 35th week, 30% of all women have this:
GBS, treat with Ampicillin of PCN at least 2 doses.
If mother has an incompetence cervix, pt will have to have:
Cerclage. Patient will have to be in trendelenburg position.
This htn is present prior to pregnancy:
Chronic HTN
What is the difference between PIH and pre-eclampsia:
Proteinuria
3 signs of pre-eclampsia:
Proteinuria
HTN
Edema
What is HELLP syndrome:
If patient has this what can't she have:
Hemolysis
Elevated liver enzymes
Low platelets
C-section (could bleed out)
If pt has epi-gastric pain or RUQ pain this could be s/s of:
HELLP
Why would a pt that has PIH in 35th week, why should they amniocentesis:
Check lung maturity- monitor for infections, rupture of membranes and contraction. Have pt sign consent and empty bladder.
Mother should be seen by DR as follows:
Every 4 weeks until 28 weeks
Every 2 weeks till 36 weeks
Weely until birth.
What is considered HTN in pregnancy:
140/90 or systolic change >30 or 13 > diastolic
Preeclampsia usually occurs after:
20 weeks and is specific to pregnancy
The first stage of labor begins at:
the onset of true contractions
The first stage of labor has 3 phases, what phase is when the cervix is 0-3 cm:
Latent phase, pt will be happy and talkative in this phase
When should mom start pushing, what stage:
2nd stage
This inhibits prostoglandins:
Progesterone- maintains pregnancy
Most difficult time to control in a pregant diabetic:
Late third trimester and in postpartum period- insulin needs drop sharply
Does insulin cross the placenta-breast barrier:
NO- insulin dependent women can breast feed.
Euglycemia is determined by:
60-100
Pt is completely dilated to 10 cm and is feeling the urge to push, what stage is this:
2nd stage
There is an outward bulging and thinning of the perineum and opening of the vagina:
Crowning
2nd stage labor lasts usually:
3 hours for primipara
30 min for multipara
The baby is born in this stage and averages 30 minutes for nullipara and multipara:
Third stage-Infants birth to placenta delivery
If mom is having a NST and it is non reactive at first , as the nurse we should:
Give mom fruit juice, stimulate fetus with music or touch. Wait one hour and reasses, baby might be sleeping.
NST is considered reactive if:
If 2 FHR accelerations in 20 minutes, reassuting of fetal well being. Accelerations must be 15-bpm over baseline with duration of 15 seconds.
Kick counts should be done in:
3rd trimester-have mom count 2 xdaily and should have 10 kicks in 12 hour period( at least 4 kicks per hour)
First stage of labor starts and ends with:
Full dilation of 10 cm. First stage is longest stage.
This phase is when effacement occurs, mom is talkative and excited this lasts usually:
Latent phase
Nulliparas- 8.6
Multiparas-5.3
The active phase, the cervix dilates from:
4-7 cm, progression of effacement and descent
Nulli-4.6
Multiparas-2-4
The transition phase is described as:
8-10 cm
Effacement complete
Contractions every 1.5-2 minutes- last 60-90 seconds
Primi-3.6
Multi- 30 min
This stage is crowning,episotomy, cardinal movements-dilation to delivery:
2nd stage- pt wants to push
Primipara's- 3 hours
Multipara's-30 minutes
This stage is delivery of baby and and placenta:
Third stage
30 minutes for nulli and mulit
The last stage is known as the recovery stage:
4th stage,monitor mom q15 x4,, 30 min for 2 hours,then q 1 hour.