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135 Cards in this Set
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- Back
- 3rd side (hint)
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what is considered under weight and what is considered over weight for mother?
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less than 100 more than 200
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what is considered malpresentation?
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not vertex
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how many pounds is ok to gain during pregnancy
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25-35
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with oligiohydraminos how many ml do you see? how many pockets do you see? what do you see on strip?
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500mL
5-7cm pockets variable decels |
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babies usually stay in place usually after what weeks?
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37
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biophysical profile is out of how many points
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10
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what trimester has the most accurate ultrasound?
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first
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how can the cervical length be assessed besides vaginal exam
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ultrasound
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what is an ectopic pregnancy?
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outside of the uterus usually the fallopian tubes
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what is nuchal translucency and what does it mean
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fluid in the neck; chromosome problems
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what does the doppler shift assess?
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forward movement of blood through the umbilical artery
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what are the 2 high risk pregnancies indicated r/t doppler ultrasound
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PIH
IUGR |
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what does the color doppler do
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assess blood flow in the umbilical vein and two arteries
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what is AFP and does it cross into maternal circulation
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protein in fetal plasma excreted into amniotic fluid by way of fetal urine. crosses into maternal circulation
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MSAFP is what
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maternal serum AFP
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what is AFAFP
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amniotic fluid AFP
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how many weeks is serum or amniotic fluid drawn?
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16-18 weeks
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what could an elevated AFP indicate?
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-open neural tube(spina bifida, anencephaly)
-abdominal wall defect -fetal demise -multifetal gestation -incorrect dates |
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what could a low AFP indicate?
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-chromosomal abnormalilites (down syndrome
-incorrect dates |
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what does anencephaly mean
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part of the brain didn't grow
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who do you draw the AFP from mom or baby?
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mom
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why is the AFP drawn?
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to assess level of AFP
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is an AFP a screening or diagnostic test?
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screening
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if AFP is abnormal the client is sent to a perinatologist for UTZ to determine what?
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if dates are correct, multifetal pregnancy, fetal demise
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what are the 2 diagnostic tests
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chorionic villus sampling
amniocentesis |
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what is a triple marker screening test for?
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screening for neural tube defect
down syndrome tisomy T21 trisomy 18 trisomy 13 |
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what are the 3 test for hormones
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AFP (decreased w t21)
Human Corionic gonadotropin (increased w t21) estriol (decreased w t21) |
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what is a quadruple marker screen
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same as hormones + inhibit a (produced by placenta)
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what does CVS show?
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shows genetic makeup of baby
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what are the three things needed before giving a CVS
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genetic counseling
risk and benefits informed concent |
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what weeks is a CVS used for
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10-12 weeks
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what 3 tests are used before CVS
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gonorrhea
chlamydia GBS |
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what are the 2 approaches that can be used for CVS
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transcervical
transabdominal |
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with the TC what is the approach
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lithotomy
vag/cervix prep antiseptic aseptic tech UTZ guidance small cath inserted into cervix..sample of chorionic villus aspirated into syringe |
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with the TA what is the approach
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supine
UTZ to determine best location small needle into placenta chorionic villus is aspirated |
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what are the advantages of CVS
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earlier than amnio
abnormal results can choose abortion |
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what are the 2 risk ass with CVS
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bleeding
fetal loss |
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how much sooner do the results come with CVS w amnio
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2-3 hr
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at what weeks is an amnio done?
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15--20 weeks
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early amnio before 14 weeks has increased risk for what two things?
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foot deformities
inadequate fluid |
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why is an early amnio risky
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not enough fluid
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amnio is offered to woman at what age
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35 years
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midtrimester amnio detects what 4 things
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-chromosomal abn
-fetal condition with woman sensitized to Rh positive blood -intrauterine infection -amniotic fluid AFP |
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third trimester amnio tests for lung maturity what are the 2 tests
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lecithin/sphingomyelin ratio2:1
phosphatidylglycerol present |
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what do erythroblastosis cause
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destruction of rbis
fetal anemia jaundiced(path) |
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what is hydrous fetalis
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edematous with heart failure
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amnio is done for what reason
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UTZ to determine fetus
placenta largest pocket of fluid supine w wedge |
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spinal needle inserted into amniotic sac how much is aspirated
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20ml
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no sex or exercise for how long after amnio
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1-2 days
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educate client to call about what
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vag bleed
leaking of fluid fever uterine contractions |
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what are the advantages of amnio
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safe
minimal pain dx fetal abnormalities rh sensitization fetal lung materity |
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when is an amnio done
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performed at 15-20 weeks
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what are the disadvantages
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cells need 3-7 days to grow
termination may be hard at 18-20 weeks less than 1% risk of preg loss at 15-20 2-5% risk at 11-13 weeks |
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what is a cordocentesis
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aspiration of fetal blood from the UC
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what is the indication for percutaneous umbilical cord sampling (cordocentesis)
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rh disease
dx of abnormal blood clotting acid base status of fetus used to deliver bld/drugs to fetus |
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with PUBS, what is used to guid needle insertion
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UTZ
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where is the needle inserted in for PUBS
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umbilical vessel where cord meets placenta
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what vein is usually used
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umbilical vein bc it is larger than arteries and blood sample can be taken
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bleeding from cord it watched with what
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UTZ
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how long after PUBS is fetal monitoring indicated
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hour
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after PUBS delivery team must be prepared for what
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emergency C/S
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what is the most common complication
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fetal bradycardia
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what are the risks for PUBS
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uncontrolled bleeding
hematoma laceration of cord thrombosis PTL PPROM |
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for antepartum fetal surveillance what are the 4 methods
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NST
CST BPP fetal movement |
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what is the purpose of a NST
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determine fetal well being by FHR and FM
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what is a reassuring sign on NST
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accelerations w/o FM (indicates adequate oxygenation and healthy CNS)
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how long does it take and where is wedge placed
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20-60 min placed under hip w head elevated
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what is a reassuring and reactive interpretation of NST
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2 FHR accels15 beats above baseline x15 seconds in 20 min
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what is a non reassuring nonreactive interpretation of NST
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less than 2 access 15 beats x 15 seconds in 20 min
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26-28 weeks what do you expect to see on NST
what about 30-32 weeks |
-10x10 accels
-15x15 accels |
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what is a FAS used to determine
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nonreactive NST findings or shorten time of NST in 3rd trimester
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a reactive result of FAS means what
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reactive results
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FAS is applied to maternal abdomen over fetal head for how long and when it is repeated (intervals)
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up to 3 sec
repeat x3 1-5 min intervals |
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FAS is used after what week
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32 weeks-fetus reacts to noise with body movement, normal response access
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when is a CST used
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if NST and FAS did not cause reactive NST
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CST shows response of what
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fetus to uterine contractions
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when is a CST performed
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37 weeks
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the fetus with adequate oxygen reserve tolerates stress from UCs and strip remains what
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reactive
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CST is contraindicated
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PTL
placenta previa PPROM prior classical cesarean (they would tear) |
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breast self stimulation does what two things
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produces oxytocin which starts UC
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oxytocin increases every how long until what happens
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every 15-20 min until 3 UC in 10 min
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what is a negative CST
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reassuring strip no late decels
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what is a positive CST
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fetus not tolerating stress from UC's non reassuring strip. late decals w 50% of UCs
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what is equivocal CST
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intermittent late decels, variable decels, hyperstimulation w decels
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Unsatisfactory CST would show what
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less than 3 UCs in 10 min
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with a negative CST 99% reassurance of uteroplacental unit will support life for how long
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1 week
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with a positive CST what does that mean
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birth by cesarean healthy newborn
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a BPP assesses what
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FHR on NST
FM fetal breathing fetal muscle tone AFI |
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of a BPP what level is ok and what level requires further eval
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8/10 ok 6/10 further eval
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with hypoxia what does it show 1, 2, 3
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lose FHR reactivity first
fetal breathing second fetal tone last |
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what does loss of fetal tone mean
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acidosis
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what does chronic hypoxia do
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fetus shunts blood to vital organs; brain and heart
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with a decreased AFI what is happening and what is a normal AFI
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blood being shunted away from kidneys and lungs
normalL10-20cm |
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oligohydramnios is what
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less than 5 cm of fluid
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with polyhydramnios what do you worry about
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cord prolapse
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a well oxygenated fetus moves ___ what about a compromised
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frequently
less frequently |
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with a maternal assessment of FM what is done
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fetal kick counts after 28-30 weeks
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how do you do th assessment
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count FM for 30 min x 3 daily or daily for 1 hr
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a healthy fetus moves over how many times in an hr
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10
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if no fetal movement or decreased by 50% what should she do
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drink something with sugar and ice count again
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what are the drugs that can affect movement
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methadone
heroin cocain alcohol tobacco |
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how many calories does a newborn need
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100-110kcal daily
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how many calories does breast milk/formula contain
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20kcal/oz
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what are the important nutrients a newborn needs
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carbs
proteins fats vitamins/minerals |
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breastmilk for how long?
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6 months then solid
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breast milk is composed of what 3 things
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colostrum, transitional milk, mature milk
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colostrum comes in when, what does it provide
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1st week
high in protein, fat-soluble vitamins, low carbs immunoglobulins (passive immunity) |
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transitional milk comes in when what does it provide
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3-4 days
immunoglobulins and proteins decrease, lactose, fat and calories increase |
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when does mature milk come in what does it provide
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after 2 weeks
proteins, carbs, fats, vitamins, enzymes |
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breast milk has more water when?
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in summer less in winter
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what are the 4 breast feeding positions
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football, cradle, side laying, latch on
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sucking stimulates what two things and why
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release of oxytocin for milk let down and prolactin to increase milk production
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what does latch stand for
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latch
audible swallows type nipple comfort hold |
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how does the L get rated
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0 no latch
1 repeated attemps 2 grasps breast |
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how does the A get rated
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0 none
1 few 2 spontaneous swallows |
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how does the T get rated
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0 inverted
1 flat 2 everted |
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how does the C get rated
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0 very sore
1 little sore 2 soft nontender |
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how does the H get rated
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0 full assist
1 min assist 2 no asist |
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how often should baby be fed and how long
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20 min ea breast 2-3 hours around clock
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what are the conditions are contraindicated with breast feeding
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active tb
hiv drugs chemo galactosemia |
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what type of hepatitis can breastfeed..and what must happen first
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b must have IgG hep B
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what are the 2 breast problems that may prevent breast feeding
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engorgement and nipple pain
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when should babies be weaned from breast feeding and how
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1 year and stop feeding one feeding at a time
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with breast milk storage how long can it be in refrigerator, freezer, deep freezer
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ref-72 hr
free-1 mo deep f-3-4 mo |
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what happens if milk is frozen
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leukocytes are destroyed
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what gets preserved
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immunoglobins
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how do you warm breast milk
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warm with warm water, no microwave
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what are the benifits of breast feeding (infant)
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less allergies
prevent infections decreased diabetes/sids |
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what are the benifits of breast feeding (mom)
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uterine involution
rest reduced stress no cost less cancer osteoporosis rheumatoid arthritis |
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what are the two types of formulas
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ready to use
concentrated powedered |
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how often do you bottle feed
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3-4 hr
1/2-1 oz first 1-2 days 2-3 oz by end of first week |
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what are the 3 ways to care after discharge
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home visits to high risk infant
outpatient visists telephone counceling |
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what are the 8 immunizations for baby
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hep b
dtp hib polio mmr pneumoccoccal influenza hep a |
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when is immediate help necessary
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breathing difficulties
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what are 2 risk factors for sids
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male and cold weather
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