Existing Psychosocial Risks Nursing Program 210 Exam 2

Front 1

Education, income, occupation, marital status, environment, habits, age, height and weight?

Back 1

Existing psychosocial risks

Front 2

Mirror adaptation to chronic conditions.
New problem elicits classic grief response.
Loss of normal pregnancy?

Back 2

High-risk pregnancy adaptation

Front 3

Alters pregnancy adaptation: fear, failure, anxiety and unrealisitic expectations?

Back 3

Infertility

Front 4

Early, mid, late, altered response, denial, late care, anemia, low birth weights, PIH, STIs, pelvic disfunction, encourage care, give concrete info, include dad, peer groups, teach by demo practice, delay and repeat?

Back 4

Adolescence

Front 5

Screen all women, document injury and impact discuss safety resource, use phrases like, "I care", "This is not your fault"?

Back 5

Partner violence cycle

Front 6

Leaves depression, disassociation, difficult mom/baby relationship, difficult with sexuality, LD may trigger flashbacks, PP model nurturing, refer?

Back 6

Sexual abuse

Front 7

Lack insight, ambivilant, STIs, SABs, abruptions, LBW, PTD, improved nutrition, refer to treatment SS, praise effort, reinforce benefits of decreased use
LD: one gentle but firm clear voice directs
PP: guidance, contact, identify cues, demo, low stimulation handling and feeding support for the baby

Back 7

Substance Abusers

Front 8

PP Mood Disorder

Days 3 to 10 - episodic crying, happy, sensitive?

Back 8

Baby Blues

Front 9

PP Mood Disorder

1 to 2 out of 1000, by day 14 times 2 to 3 months
- rapid shifts, confused, agitated, manic, 1 in 3 reoccur?

Back 9

Psychoses in PP

Front 10

PP Mood Disorder

Week 3 to 1 year, obsessive thoughts, inept, trapped, angry.

Back 10

PP Depression

Front 11

PP Mood Disorders

Contraindicated with Lithium
Caution with SSRI/TCA?

Back 11

Lactation

Front 12

Counsel Risks/benefit interact of pregnancy and condition + medications, get meds to the lowest safe does - 1 if possible?

Back 12

Care for existing medical conditions.

Front 13

Risk for crisis with decreased O2, infections, PIH, fetal IUGR/Loss, may need to do cultures for increased infections?

Back 13

Sickle Cell Anemia in pregnancy

Front 14

Provide folate, pain control, monitor cultures, hydrate during LD, give O2, lateral: PP, DMPA helps?

Back 14

Treatment for Sickle Cell pregnancy

Front 15

Inproves with pregnancy, may have PP relapse, limit doses of asprins + Nsaids, especially in late pregnancy 32-34 weeks?

Back 15

Rheumatoid Arthritis

Front 16

Risk for fetal loss, low platelets, thrombosis, PIH, may need a low dose aspirin + heparin?

Back 16

Antiphospholipid syndrome

Front 17

Flares risk hypertension/infarcts,treat wih moderate steroids OK/caution peg +BF?

Back 17

Lupus

Front 18

Seizures risk for hypoxia+acidosis; AEDs teratogenic, follow levels + control - treat with daily folic acid + Vit D, Vit K last 1-2 months?

Back 18

Epilepsy in pregnancy

Front 19

Improves in pregnancy, exhaustion in LD +pp, relapses pp?

Back 19

Multiple sclerosis in pregnancy

Front 20

Increased UTIs, dysreflexia, skin, unrecognized labor > culture, inspect, position, avoid distention/retention/edema?

Back 20

Spinal cord injury in pregnancy

Front 21

Can be equal, improved, stablized or worsen, hypoxia risks fetal loss; common meds are safe
In LD avoid Histamine release demoral/morphine
Exclusive BF delays + reduces child allergies?

Back 21

Asthma in pregnancy

Front 22

Worse in pregnancy; peptic ulcer inproves in pregnancy?

Back 22

Cholecystitis in pregnancy

Front 23

Crohn's med OK (Lomotel); supplement calcium, iron, folate?

Back 23

Inflammatory ulcerative colitis in pregnancy

Front 24

Mother lost 2o head injury, abd hemorrhage
Fetus lost 2o hypovolemic shunt, abruption
CPR/OR: tilt uterus, not Trendelenburg; lines for large amount fluid replacement; O2, catheter, NG; avoid uterine vasoconstricting pressors; US/monitor fetus as mom stable - ? C-sec
Kleihauer-Betke for fetal cells>RhoD IG

Back 24

Trauma / Surgery

Front 25

Checking to see if fetal cells have crossed with maternal cells, Rh-, Rh+; give Rhogam if needed?

Back 25

Kleihaur-Betke

Front 26

Waves, adbominalc/vag transucer
1st trim: date, location, viability, guide CVS
2nd trim: age, anomalies, placenta/fluid, genetic amnio
3rd trim: growth, position, placenta/fluid, BioPhysProfile, PercutUmbBlood Sample
Umbilical velocimetry if mother is hypertensive?

Back 26

Ultrasound

Front 27

Antepartum Fetal Surveillance

Reactive = 2 FHR accels 15 bpm+15 sec in 20 min vs nonreactive?

Back 27

NonStress Test

Front 28

Antepartum Fetal Surveillance

Increased FHR 15bpm?

Back 28

Vibroacoustic Stimulation

Front 29

Antepartum Fetal Surveillance

Intrauterine APGAR?

Back 29

BioPhysical Profile

Front 30

Antepartum Fetal Surveillance

NST, breathing, roll, tone; fluid vol?

Back 30

Acute

Front 31

Antepartum Fetal Surveillance

CTXS>late decels?

Back 31

Contraction Stress Test

Front 32

Adjusted risk ratio for down syndrome?

Back 32

Pregnancy-Associated Plasma Protein A Test

Front 33

Done @ 8-12 weeks and is a quick chromosome analysis of fetal tissue; risk for loss of the fetus; should go to someone who performs this procedure regularly?

Back 33

Chorionic Villus Sampling

Front 34

Done @ 14-18 week (early 12-14); for chromosome, metabolic, and neural tube defects?

Back 34

Amniocentesis

Front 35

Maternal serum AlphaFetoProtein, hCG, estriol, inhibin A?

Back 35

Triple/multiple marker

Front 36

If mother is Rh- getting an invasive procedure may get?

Back 36

Covered with a micro dose of Rhogam.

Front 37

Adjusted risk ratio for down syndrome?

Back 37

Pregnancy-Associated Plasma Protein A Test

Front 38

Done @ 8-12 weeks and is a quick chromosome analysis of fetal tissue; risk for loss of the fetus; should go to someone who performs this procedure regularly?

Back 38

Chorionic Villus Sampling

Front 39

Done @ 14-18 week (early 12-14); for chromosome, metabolic, and neural tube defects?

Back 39

Amniocentesis

Front 40

Maternal serum AlphaFetoProtein, hCG, estriol, inhibin A?

Back 40

Triple/multiple marker

Front 41

If mother is Rh- getting an invasive procedure may get?

Back 41

Covered with a micro dose of Rhogam.

Front 42

At 18-24 week (as increased antibody titer) increased bilirubin level = hemolysis RBCs; for fetal lung phospholipids
-Lecithin/Sphingomyelin ratio greater than or equal to 2:1
-Surfactant/Albumin ratio >49 mg/g
-Phosphatidyl Glycerol or PI present

Back 42

Late Amniocentesis

Front 43

RhoD IG to Rh- woman - Monitor VS, FHR 30-60min
- report fever, bleeding, fluid, pain

Back 43

Post CVS/amnio

Front 44

From 2 ova; incidence varies by race, age/parity, familial, technology?

Back 44

Dizygous

Front 45

One fertilized ovum divides; may share chorion; later, may be conjoined?

Back 45

Monozygous

Front 46

Excess FH sounds, unusual uterine size and severe Nausea and Vomiting
differing heart rates?

Back 46

Multiple gestations

Front 47

N/V, anemia, pressure effects in vascular/digestive/urinary, PIH, PTL, previa, dysfunctional labor, hemorrhage
-BP weekly, by 20wk-cervix, H&H, Uterine Activity?

Back 47

Mothers risks in Multiple Gestations

Front 48

Anomalies, IUFD-monozygous cord accidents, IUGR, PPROM, PTD, abnormal presentation
- serial U/S growth, NST, BPP, Doppler flow?

Back 48

Baby's risks in Multiple Gestations

Front 49

What does IUGR stand for?

Back 49

Intra-Uterine Growth Retardation

Front 50

Previa means?

Back 50

Placenta to close to the internal os.

Front 51

When the uterus has been stretched so much that it doesn't contract as efficiently.

Back 51

Dysfunctional Labor

Front 52

Analysis: Imb. Nutrition, Risk alt. Growth, Fatigue, Pain
Care: +300 kcal per fetus in 6 small meals, iron, folic acid, rest side-lying, elevate legs
Labor: ContinuousEFM of each fetus, staff + equip for each; possible C-sec /NICU
Lactation supply = demand, assist positions?

Back 52

Multiple Pregnancy Care

Front 53

Severe NV starts first 16 wks and leads to electrolyte imbalance, alkalosis, weight loss?

Back 53

Hyperemesis Gravidarum

Front 54

S/DX: hemoxoncentration, hyponatremia, hypokalemia?

Back 54

Hyperemesis Gravidarum

Front 55

Risk: metabolic acidosis > fetal loss/defect?

Back 55

Hyperemesis Gravidarum

Front 56

Therapy: IV fluids, potassium, NPO till no emesis, Reglan / promethazine IV/rectal, antihistamines, restart bland, separate wet?

Back 56

Hyperemesis Gravidarum

Front 57

This equals Graves'
DX: Increased T3, T4
-increase food/fluids, limit stress
-monitor weights, I&O, VS
-med: PropylThioUracil (PDA D) ?ok for BF

Back 57

Hyperthyroid

Front 58

DX: Increased TSH, low T3/T4
-med:synthroid may need increase (FDA A)
-if BF, watch for agitation; periodic T studies

Back 58

Hypothyroid

Front 59

Phenylketonuria: lack liver enzyme to convert phenlalanine to tyrosine
Risk: IUGR, microcephaly, MR, heart defect
genetic counsel
control Mom blood phenylalanine levels by strict diet before and during pregnancy +BF
-fetal levels 50% higher than maternal

Back 59

Maternal PKU