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65 Cards in this Set
- Front
- Back
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client with severe preeclampsia is receiving IV magnesium sulfate. What nursing interventions are appropriate?
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monitor VS q 30-60 min
notify the physician if RR<12 Keep ca++ gluconate on hand (antidote for mag sulfate) monitor DTR q hour monitor cardiac and renal fx UO must be >30 cc/hr b/c mag sulfate is eliminated through kidneys |
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Magnesium Sulfate
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is a CNS depressant and anti-convulsant
used to prevent & control seizures in preeclamptic & eclamptic clients and treat preterm labor |
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what should you check before administering repeat parenteral dose of mag sulfate
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check for patellar reflex (indicator of CNS depression).
RR must be >16 |
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suppressed patellar reflex may be a sign of ________
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impending respiratory arrest (s/t CNS depression)
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in-vitro fertilization is used in women with __________
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nonpatent, diseased, or missing fallopian tubes,
Or infertility of unknown cause |
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How does in-vitro fertilization work?
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ova & sperm are collected and allowed to incubate
fertilized ovum is transferred into woman's uterus woman carries pregnancy throughout gestation and gives birth |
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platypelloid pelvis has a ____________ shape
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flat
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gynecoid pelvis has a __________ shape
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normal pelvis
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anthropoid pelvis has a _______ shape
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oval
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android pelvis has a ________ shape
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heart
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primary reason why pregnant teens are at risk of nutritional deficiency b/c
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teens experience major growth spurt
pregnancy adds to these needs |
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Hegar's sign
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at about 6th week of pregnancy, lower uterine segment becomes soft & thin
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6th day postpartum, the fundus is located ________
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halfway b/w symphysis pubis & umbilicus
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how do you assess brachial DTR
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support client's arm and ask client to let the arm go totally limp while its being held
place thumb over tendon strike thumb with the small end of a reflex hammer normal response: slight flexion of forearm |
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Folic acid is important during pregnancy b/c it is needed for
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healthy cell growth and repair
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how much folic acid is needed by pregnant women
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at least 4 servings of folic-acid rich foods per day
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foods high in folic acid
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dark, green leafy vegetables
legumes whole grain yeast glandular meats |
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clinical manifestations of vaginal infection with Candida albicans
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pain, itching and a thick, white vaginal discharge
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clinical manifestations of UTI
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proteinuria, hematuria, edema, HTN, costovertebral angle pain
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when can you use Naagele's rule to predict delivery date
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need to have regular 28-day menstrual cycle
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Naagele's rule
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1st day of LMP + 7 days
subtract 3 months add 1 year |
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supine hypotension syndrome in late pregnancy is caused by
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compression of IVC & aorta by the fetus
turn client to a side-lying position |
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biophysical profile assesses __________
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FHR, fetal breathing movements, gross fetal movements, fetal tone and amniotic fluid volume
(0-2 points for each) |
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a score of ______ is considered normal on a biophysical profile
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8 or more
10 is perfect |
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biophysical profile is used to assess
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amniotic fluid volume and fetal activity
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best source of Ca++ is
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dairy products
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lactose intolerant women can get Ca++ from
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dark, green, leafy vegetables, broccoli, legumes, nuts and dried fruits
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Is spinach a good source of Calcium ?
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yes
but it also contains oxalates that decrease Ca++ availability |
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foods containing _______ increase the absorption of oral iron supplements
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ascorbic acid (Vit. C)
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Iron supplements should not be taken with ________
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milk or dairy products
coffee/ tea |
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inevitable abortion
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termination of pregnancy that cannot be prevented
moderate-to-severe bleeding with mild cramping and cervical dilation is noted |
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incomplete abortion
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heavy bleeding, severe cramping, cervical dilation and passage of large clots
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threatened abortion
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slight-to-moderate bleeding, intermittent cramping without dilation of cervix.
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septic abortion
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bleeding with odor, cervical dilation and fever, cramping may or maynot be present
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maternal infections like ________ are causes of spontaneous abortion
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syphilis, toxoplasmosis and rubella
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Main concern for clients with possible ectopic pregnancy
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hypovolemic shock and controlling pain
monitor VS (esp. pulse) |
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priority assessments for clients with preeclampsia
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monitor weight
check for edema |
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b-HCG is ____________ than expected in clients with ectopic pregnancy
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lower
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absence of b-HCG would mean client is _______
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not pregnant
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high levels of b-HCG indicate _______ pregnancy
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molar
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Risk factors for developing gestational diabetes include _________
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obesity (>198 lbs)
chronic HTN family hx of diabetes previous birth of large infant (> 4000 g) gestational diabetes in prior pregnancy |
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Glucose crosses the placenta but _______ does not.
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insulin
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why do maternal blood glucose levels increase in the 2nd half of pregnancy?
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high fetal demands of glucose
insulin resistance caused by hormonal changes |
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diabetic pregnant client needs _______ insulin during 2nd half of pregnancy
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increased
(d/t diabetogenic effect of pregnancy) |
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what is gestational trophoblastic disease (hydatidiform mole)
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a group of several diseases -- all involve abnormal growth of cells inside a woman's uterus.
unlike cervical or endometrial cancer, GTD doesn't develop from uterus cells. These rare, once fatal, but now highly curable tumors start in the tissue that begins to develop immediately after conception |
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most common S/S of gestational trophoblastic disease
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elevated b-HCG levels
vaginal bleeding larger than normal uterus for gestational age failure to detect FHR even with sensitive instruments excessive N/V early development of PIH |
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HCG can be detected in blood as early as ________ days after conception or ________ days after LMP
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6 days after conception
or 20 days after LMP |
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between ______ and ____ weeks of pregnancy, maternal pulse rate increases slowly, upto 10-15 bpm, which lasts until term
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14 and 20
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During pregnancy CO and blood volume ______
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increases
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BP _______ in the 1st half of pregnancy and returns to baseline in the 2nd half of pregnancy
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decreases
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strategies for decreasing morning nausea
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eat crackers before arising
eat smaller, more frequent meals decrease fat content consume adequate fluids in b/w meals but not with meals |
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normal amniotic fluid is
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pale and straw colored
may contain flecks of vernix should have watery consistency should not have odor |
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amber-colored amniotic fluid suggests presence of _________
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bilirubin
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greenish amniotic fluid suggests presence of ______
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meconium
suggests fetal distress |
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priority intervention for home care nurse visiting client with mild preeclampsia is
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to monitor fetal movement
ask client to keep a record of fetal movements bed-rest with BRP is advised check urine for protein |
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prenatal client with history of heart disease should avoid ________
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exposure to infections
e.g. avoid visitors with active infections |
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how would you perform the Heimlich maneuver on a woman with advanced stage of pregnancy
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place the woman on her back
place a wedge (pillow or rolled blanket) under the right abdominal flank & hip to displace the uterus to left side of abdomen |
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fallopian tubes transport a mature _________ for final maturation and fertilization
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oocyte
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Estrogen is produced in __________ during pregnancy
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ovarian follicles, corpus luteum, adrenal cortex and placenta
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progesterone is produced in ___________ during pregnancy
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corpus luteum, adrenal glands & placenta
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FSH and LH are secreted by the ________ when stimulated by GRH from the hypothalamus
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anterior pituitary gland
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Main purpose of placenta is to
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provide an exchange of nutrients and waste products b/w mother and fetus
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Main purpose of the amniotic fluid is to
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cushion and protect the fetus
maintain fetus body temperature |
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Can nutrients, drugs, antibodies and viruses pass through the placenta?
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yes
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umbilicus has _____ arteries and ____ veins
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2 arteries and one vein
arteries carry deoxygenated blood (and waste products) pumped from fetus's heart vein carries oxygenated blood and provide oxygen and nutrients to the fetus |
