Lowdermilk And Perry Final Review - Nur313 (3)

Front 1

Fetal Heart Rate (FHR)

Back 1

beats per minute of the fetal heart. Normal range is 110-160 beats per minute.

Front 2

Baseline fetal heart rate

Back 2

average rate during a 10 minute segment that excludes periodic or episodic changes, periods of marked variability, and segments of the baseline that differs more than 25 bpm.

Front 3

Variability

Back 3

irregular fluctuations in the baseline FHR of two cycles per minute or greater.

Front 4

Accelerations

Back 4

visually apparent abrupt increase in FHR above the baseline rate.

Front 5

Early Decelerations

Back 5

visually apparent gradual decrease in FHR and return to baseline in response to FETAL HEAD COMPRESSION. Onset coincides with beginning of contraction with recovery at the end of a contraction.

Front 6

Late Decelerations

Back 6

Visually apparent gradual decrease in FHR and return to baseline caused by UTEROPLACENTAL INSUFFICIENCY. Characterized by Late onset (middle of contraction) and Late recovery (during relaxation).
Nursing Care includes change position, administer oxygen, stop pitocin.

Front 7

Variable Decelerations

Back 7

visual abrupt decrease in FHR below the baseline, caused by UMBILICAL CORD COMPRESSION. Characterized by sudden drops and rapid returns with variable time relationship to contractions.
Nursing care includes change position, amnioinfusion to loosen cord, etc.

Front 8

Induction Methods

Back 8

Pitocin, Cervadil, Prepadil, Prostaglandin gel, ROM, sex, spicy foods, etc.

Front 9

C-Section...why?

Back 9

Cephalopelvic Disproportion (CPD), fetal distress, chorioamnitis, infection, placenta previa, eclampsia, HELLP syndrome, abruptio placentae.

Front 10

BUBBLE HE

Back 10

B: breast
U: uterus
B: bladder
B: bowels
L: lochia
E: episiotomy
H: Homan's sign
E: emotional status

Front 11

Episiotomy

Back 11

incision made in the perineum to enlarge the vaginal outlet.
2 types: mediolateral and midline.
1st-4th degree lacerations.

Front 12

Lochia rubra

Back 12

Red, distinctly blood tinged vaginal flow that follows birth and lasts 2-4 days.

Front 13

Lochia serosa

Back 13

Serous, pinkish brown, watery vaginal discharge that follows lochia rubra until about the 10th day after birth.

Front 14

Lochia alba

Back 14

Thin, yellowish to white vaginal discharge that follows lochia serosa on about the tenth day after birth and that may last from 2-6weeks postpartum

Front 15

Hemorrhage, main cause.

Back 15

Uterine atony: relaxation of the uterus.

Front 16

Baby Blues

Back 16

Occurs in up to 70% of women PP. Mild depression where functioning of the individual is not impaired.

Front 17

Postpartum Depression

Back 17

More serious depression that can eventually incapacitate them to the point of being unable to care for themselves or their babies.

Front 18

Postpartum Psychosis

Back 18

Syndrome characterized by depression, delusions, and thoughts by the mother of harming either the infant or herself.

Front 19

Apgar Score

Back 19

rapid assessment of the need for resuscitation based on five signs that indicate the physiologic state of the neonate:
1. Heart Rate
2. Respiratory Rate
3. Muscle tone
4. Reflex irritability
5. Color

Front 20

Normal B/P range: Neonate

Back 20

60-80 sytolic
40-45 diastolic

Front 21

Normal Resp range: Neonate

Back 21

30-60 breaths per minute

Front 22

Heart Rate range: Neonate

Back 22

100-160 beats per minute. (Low end of range is for resting infant. Active infant should range from 120-160)

Front 23

Newborn Hemoglobin range

Back 23

14-24 g/dL

Front 24

Newborn Hematocrit range

Back 24

44-64%

Front 25

Newborn RBC count

Back 25

4,800,000-7,100,000/mm3

Front 26

Newborn Platelet count range

Back 26

150,000-300,000/mm3

Front 27

Newborn WBC count

Back 27

9,000-30,000/mm3

Front 28

Ductus Venosus

Back 28

a blood vessel carrying oxygenated blood between the umbilical vein and the IVC, bypassing the liver.

Front 29

Ductus Arteriosus

Back 29

anatomic shunt between the pulmonary artery and arch of the aorta.

Front 30

Foramen Ovale

Back 30

Septal opening between the atria of the fetal heart.

Front 31

Thermoregulation

Back 31

maintenance of balance between heat loss and heat production.

Front 32

Cold stress

Back 32

imposes metabolic and phsilogic demans on all infants, regardless of gestational age and condition. Resp rate increases causes pulmonary vasoconstriction and decreased o2 uptake by the lungs. Also causes peripheral vasoconstrition leading to decreased 02 uptake by the tissues resulting in metabolic acidosis.

Front 33

Caput succedaneum

Back 33

generalized, easily identifiable edematous area of the scalp, most commonly found on the occiput.
DOES CROSS SUTURE LINES.

Front 34

Cephalohematoma

Back 34

collection of blood between a skull bone and its periosteum.
DOES NOT CROSS SUTURE LINES.

Front 35

Lactogenesis

Back 35

After delievery, a percipitate decrease in estrogen and progesterone levels trigger the release of prolactin in anterior pituitary gland. Prolacting stimulates milk production in lactating mothers.
FIG 27-3

Front 36

Role of oxcytocin in Labor and Postpartum

Back 36

1. Contracts the uterus during birth
2. Contracts the uterus postpartum to control bleeding and promote uterine involution.
3. Sucking stimulus of infant on mothers breast stimulates the hypothalamus, which secretes oxytocin from the posterior pituitary, signaling milk let down.
FIG 27-3

Front 37

Preterm Birth

Back 37

birth occuring before 37 but after 20 weeks gestation.

Front 38

Magnesium Sulfate

Back 38

CNS depressant; relaxes smooth muscles including the uterus. Stops preterm labor.
Antidote: calcium gluconate

Front 39

Beta-adrenergic agonists

Back 39

Relax smooth muscles, inhibiting uterine activity and causing bronchodilation.
Ritodrine (Yutopar) and Terbutaline

Front 40

Calcium Channel Blockers

Back 40

Relax smooth muscles including the uterus by blocking calcium entry.
Nifedipine (Procardia)

Front 41

Prostaglandin Synthetase Inhibitors (NSAIDS)

Back 41

Relaxes uterine smooth muscles by inhibiting prostaglandins
Indomethacin (Indocin)

Front 42

PROM

Back 42

Premature Rupture of Membranes. Rupture of amniotic sac and leakage of fluid beginning at least 1 hour before the onset of labor at any gest. age.
DO NOT DO A VAG EXAM, this can introduce bacteria into the vagina, increasing risk of infection.

Front 43

Prolapsed Umbilical cord

Back 43

the cord lies below the presenting part of the fetus. Pressure on the cord may be relieved by the examiner putting a sterile gloved hand into the vagina and holding the presenting part off the cord. The mother is then assisted in a modified Sims, Trendelenburg, or knee-chest position.