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105 Cards in this Set
- Front
- Back
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A firm, rigid uterus with contractions (uterine hypertonicity) may indicate
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abruptio placentae
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A. E. of epidural and spinal anesthesia
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N/V, inhibited bowel and bladder sensations, bradycardia or tachycardia, hypotension, respiratory depression, allergic reaction and pruritus
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A. E. of epidural block
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maternal hypotension, fetal bradycardia, inability to feel the urge to void, loss of the bearing down reflex
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A. E. of pudendal block
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broad ligament hematoma, compromise of maternal bearing down reflex
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According to ATI, the client on MgSO4 should be on fluid restriction of what?
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100-125 mL/hour
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AFP can be measured from amniotic fluid between
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16-18 weeks gestation
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AFP is a protein produced by
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the fetus
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Amniocentesis may be performed
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after 14 weeks gestation
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An epidural block consists of what medicationss
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bupivacaine (Marcaine) along with an analgesic morphine (Duramorph) or fentanyl (Sublimaze)
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An increase of how many calories is needed during the second trimester?
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340
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Analysis of serum hCG following molar pregnancy should occur…
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every 1-2 weeks until levels are normal, every 2-4 weeks for 6 months, and every 2 months for 1 year
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Backache may be a sign of
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spontaneous abortion
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Before administering analgesics, the nurse needs to ensure that labor is progressing; this is done by performing a vaginal examination that reveals a cervical dilation of ___ cm with a fetus that is
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4 cm; fetus engaged
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CMV has what S/S?
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asymptomatic or mononucleosis-like symptoms
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CMV is transmitted when?
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by droplet infection from person to person in body fluids. Viruses may be latent and may be reactivated
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Contraindications to ECV include
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uterine anomalies, previous C-section, cephalopelvic disproportion, placenta previa, multifetal gestatoin, and/or oligohydramnios
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CVS can be performed
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at 10-12 weeks gestation
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Describe a Glucola Screening Test / 1-hour GTT
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50 g oral glucose load followed by plasma glucose analysis 1 hour later performed at 24-28 weeks of gestation; 140 or greater indicates positive
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Describe ampicillin administration for GBBS
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2g IV initially, followed by 1 g every 4 hours
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Describe Digoxin as a heart medicine
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(Lanoxin) - a cardiac glycoside that is used to increase CO during pregnancy, and may be prescribed if fetal tachycardia is present
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Describe GH
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begins after 20th week, B/P is 140/90 or greater OR an SBP increase of 30 or DBP increase of 15 from prepregnancy baseline; returns to baseline by 12 wks PP
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Describe heparin Na as a heart medicine
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an anticoagulant for PE, DVT, cyanotic heart defects, and rheumatic heart disease
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Describe Indomethacin (Indocin)
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an NSAID that suppresses preterm labor by blocking the production of prostaglandins, suppressing uterine contractions
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Describe mild preeclampsia
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GH with 1 or 2+ proteinuria and weight gain of more than 2 kg (4.4 lb) per week plus mild edema in upper extremities or face
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Describe penicillin G administration for GBBS
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5 million U initially IV bolus, then 2.5 million U intermittent IV bolus every 4 hours
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Describe severe preeclampsia
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B/P that is 160/100 or greater; proteinuria of 3 or 4+, elevated serum creatinine greater than 1.2 mg/dL, HA and blurred vision, hyperreflexia with ankle clonus, pulmonary or cardiac involvement, extensive peripheral edema, RUQ pain, thrombocytopenia
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Describe the criteria for fetal tone in a BPP
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at least 1 episode of extension with return to flexion
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Describe the uterine contractions that occur with preterm labor
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regular, frequency of every 10 minutes or greater, lasting 1 hour or longer
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Dick-Read Method
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refers to "childbirth without fear;" woman relaxes completely between contractions and keeps all muscles except the uterus relaxed during contractions
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Down syndrome may be indicated if the level of estriol is
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lower than normal
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Down syndrome may be indicated if the levels of hCG and Inhibin-A are
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higher than normal
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Effects of +GBBS include
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PROM, preterm labor and birth, chorioamnionitis, UTIs, and maternal sepsis
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Estriol is a protein produced by
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the fetus and placenta
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Examples of opioid analgesics
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meperidine hydrochloride (Demerol), fentanyl (Sublimaze), butorphanol (Stadol), and nalbuphine (Nubain)
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Female S/S of gonorrhea:
***Long-term effects of gonorrhea: |
lower abdominal pain; dysmenorrhea; urethral discharge; yellowish-greenish vaginal discharge; reddened vulva and vaginal walls
***PID, heart disease, arthritis |
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Fetal bradycardia may be caused by
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uteroplacental insufficiency, umbilical cord prolapse, maternal hypotension
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Fetal kick count should be performed
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2 or 3 times a day for 60 minutes each
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FHR can be heard by Doppler at
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10-12 weeks gestation
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FHR can be heard with U/S stethascope at
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16-20 weeks gestation
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GH (PIH) may result in what
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placental abruption, acute renal failure, hepatic rupture, preterm birth, and fetal and maternal death
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hCG is a hormone produced by
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the placenta
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If the patient is breastfeeding, how many extra calories are needed in the first 6 mo PP?
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330
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Indomethacin may result in what complication?
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PP hemorrhage r/t reduced platelet aggregation
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Indomethacin should only be used if gestational age is what
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less than 32 weeks
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Inhibin-A is a protein produced by
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the ovaries and placenta
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Leg cramps may occur
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During the third trimester
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List five medications used for heart disease
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Propranolol (Inderal), gentamicin (Garamycin), Ampicillin (Polycillin), Heparin sodium, Digoxin (Lanoxin)
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List risk factors of spontaneous abortion
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chromosomal abnormalities, maternal illness (such as DM type 1), advancing maternal age (AMA), premature cervical dilation, chronic maternal infections, maternal malnutrition, trauma or injury, anomalies in the fetus or placenta, substance abuse
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List S/S of MgSO4 toxicity
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loss of DTR, urinary output less than 30 mL/hour, respiratory depression less than 12/minute, Pulmonary edema, and/or chest pain
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List sesveral risk factors of abruptio placentae
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cocaine abuse resulting in vasoconstriction; cigarette smoking; PROM; short umbilical cord
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List some S/S of HIV/AIDS
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fatigue, diarrhea, weight losss, anemia
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Tocolytic therapy is contraindicated if
1. Cervix is dilated more than 2. Gestation is greater than |
1. 6 cm
2. 34 weeks |
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List three physical assessment findings for the patient with heart disease?
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hemoptysis, IUGR, decreased amniotic fluid
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Male S/S of gonorrhea
***Long-term effects: |
urethral discharge, painful urination, frequency
***PID, heart disease, arthritis |
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Molar pregnancy may cause vaginal bleeding when?
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16 weeks gestation
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Name some S/S of PIH
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oliguria, scotoma, dyspnea, diminished breath sounds, jaundice, rapid weight gain of 2 kg(4.4 lb) per week in the second and third trimesters
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PIH may occur after 20 weeks gestation. Symptoms of PIH before 20 weeks may indicate
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molar pregnancy
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Preterm labor is more likely in what age group?
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below 17 or over 35
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Quad marker screening is done at
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15-20 weeks gestation
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REMEMBER TO REVIEW EACH OF THE MECHANISMS OF LABOR!!!
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Important!
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What chronic disease and what medication are risk factors for Candida albicans?
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DM or oral contraceptives
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Rubella causes what S/S?
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joint and muscle pain, rash, mild lymphedema, fever, miscarriage, congenital anomalies, fetal death
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Rubella is contracted when?
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through children who have rashes or neonates who are born to mothers who had rubella during pregnancy
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Start measuring fundal height after
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12 weeks gestation
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Symptoms of chlamydia?
What type of vaginal discharge? |
Commonly asymptomatic; vaginal spotting and vulvar itching;
white, watery vaginal discharge |
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Synthetic dilators and sponges which ripen the cervix contain what
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Magnesium sulfate (lamicel)
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The client on MgSO4 should avoid what three foods?
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high in Na, high in caffeine, ETOH
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The client on terbutaline (Brethine) should have her fluid restricted to what and why?
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to 1,500-2,400 mL/24 hours to reduce the risk of pulmonary edema
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The client who is prescribed methotrexate should avoid what to prevent a toxic response to the medication?
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ETOH and vitamins containing folic acid
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The equivalent of 500-750mL/day of coffee can increase the risk of
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spontaneous abortion or fetal IUGR
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The risk factors for heart disease include
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preterm labor, miscarriage, and IUGR
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The S/S of toxoplasmosis are
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similar to influenza or lymphadenopathy; fever and tender lymph nodes
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The woman should avoid pregnancy for how many months following spontaneous abortion?
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2 months
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There should be how many fetal movements per hour?
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3
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tobacco during pregnancy results in
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LBW
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Toxoplasmosis is caused by
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consumption of raw or undercooked meat or handling cat feces
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Toxoplasmosis Tx is
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sulfonamides or a combination of pyrimethamine and sulfadiazine (potentially harmful to fetus, but parasite treatment is essential)
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What analgesics are used for epidural or spinal regional analgesia
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fentanyl (Sublimaze) and sufentanil (Sufenta)
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What does a PAP test screen for?
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cervical cancer, herpes simplex type 2, and/or HPV
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Dehydration stimulates the secretion of what to hormones?
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the pituitary gland to secrete an ADH and oxytocin
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When does the healthcare provider determine the client's classification of heart disease?
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At 3 and 7 months gestation
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What foods are high in folic acid?
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leafy veges, dried peas and beans, seends, and OJ; breads, cereals, and other grains are fortified
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What happens to pulse during pregnancy?
When? |
increases 10-15 bpm
around 20 weeks gestation |
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What happens to respiration during pregnancy
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increase by 1-2 bpm
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What is given to the patient with refractory hyperemesis gravidarum?
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Corticosteroids
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What is terbutaline (Brethine)
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a beta-adrenergic agonist that relaxes uterine smooth muscle by stimulating beta-2 receptors in the smooth muscle fibers to inhibit uterine activity
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What is the second most frequent cause of bleeding in early pregnancy?
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Ectopic pregnancy
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What medications are used for chlamydia?
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Broad spectrum antibiotics: azithromycin (zithromax), amoxicillin (Amoxil), erythromycin (Ery-tab)
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What medications are used to treat candida albicans?
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Antifungal agents: Fluconazole (Diflucan); OTC med is clotrimazole (Monistat)
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What physical assessment findings would be found in the patient with anemia?
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pallor, brittle nails, shortness of breath
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When administering general anesthesia, which medications should also be administered
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H2 receptor blocker such as ranitidine (Zantac) to decrease gastric acid production; metoclopramide (Reglan) to increase gastric emptying; short-acting barbiturate such as thiopental sodium (Pentothal) to render the client unconscious; succinylcholine chloride (Anectine), a muscle relaxant to facilitate passage of endotracheal tube
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When are sedatives effective
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first stage latent phase
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When cervical ripening is performed, hyperstimulation of the uterus may occur. What is the Tx?
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administer terbutaline (Brethine) sub-Q
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When does incompetent cervix occur
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around 20 weeks
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When is local infiltration pain relief effective
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second and third stages
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When is pudendal nerve block effective
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second and third stages
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When is S3 (heart sound) heard more easily?
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After 20 weeks gestation
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When should ECV be performed?
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after 37 weeks gestation
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When should the 1-hour GTT be performed?
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at initial visit for at-risk clients and at 24-28 weeks for all pregnant women
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When should you withhold terbutaline (Brethine)
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maternal heart rate is 120-140/min OR if there is chest pain or cardiac arrhythmias
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Which antiemetics may be given to the patient with hyperemesis gravidarum?
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Promethazine (phenergan) and metoclopramide (Reglan)
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Which drug causes evacuation of the uterine contents?
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methotrexate (MTX)
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Which medications are given for gonorrhea
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ceftriaxone (Rocephin) IM or azithromycin (Zithromax) PO; broad-spectrum antibiotics; given for 7 days
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Which vaccines should always be administered to clients with heart disease?
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influenxa and pneumococcus vaccines
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Which vitamin is given to the patient with hyperemesis gravidarum?
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Vitamin B6 - pyridoxine
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