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59 Cards in this Set
- Front
- Back
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What is the number 1 characteristic of placenta previa?
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Painless vaginal bleeding (70%)
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Abruption Placentae?
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Bleeding from the placental site may separate the membranes and flow out through the vagina, or it may remain concealed (retroplacental hemorrhage)
Abdominal pain, uterine tenderness and a hypertonic uterus is often present |
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5 components of the APGAR
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Heart Rate
Respiration Muscle Tone Reflexes Color |
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Mongolian Spots
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Blue patched, more typical in dark skin babies, commonly found on buttocks
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Acrocyanosis
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Bluish color to extremities before fully effecting blood profusion
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Modes of heat loss in the newborn
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Conduction
Convection Radiation Evaporation |
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Why is Vitamin K given to newborns?
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Coagulation stimulant
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What is primary concern for infants recieveing phototherapy?
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Dehydration
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Circumcision care
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Make sure infant has voided after
Vaseline the gauze Not remove exudate |
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Glucose requirements in pregnancy?
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Gradually increase from 18-24 weeks until 36 weeks after which they level off
Inuslin resistance increases as well as up to threefold increase in demand: 2nd, 3rd tri |
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Diabetes in pregnancy risk to mother?
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Hydamnios
Polyhydramnios |
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Classical S & S of mastitis?
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Unilateral and develops well after flow of milk is established
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Other S & S of mastitis?
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Chills, fever, malaise, local breast tenderness, swelling, redness, axillary adenopathy
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Generally accepted criteria for a reactive NST ?
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Two or more accelerations of 15 beats/minute over baseline FHR lasting 15 seconds in a 20 minute period
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Basis for non-stress test
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Normal fetus produces characteristic FHR patterns in response to fetal movements
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NST in the healthy fetus with an intact central nervous system
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90% of gross fetal body movements are associated with FHR accelerations
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Purpose of contraction stress test?
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Identify the fetus in jeopardy who is stable at rest, but shows evidence of compromise with stress (contractions)
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What are you looking for with CST
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Late decel
Contractions prduces decreased profusion, which leads to fetal hypoxia |
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Negative CST
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No late decels
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Positive CST
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• If REPETITIVE LATE DECELERATIONS are noted (3 consecutive contractions), the findings are positive
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Biophysical profile
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Score variables : All scored 0 (abnormal) or 2 (normal)
Fetal breathing movements Limb/body movements Fetal tone/posture Amniotic fluid volume Non-stress test (NST) Maximum score 10/10 |
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Low-levels of MSAFP, unconjugated estirol, and amniotic fluid
hCG levels elevated |
Down's syndrome
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High levels of MSAFP
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Nerual tube defects
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Ectopic
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A pregnancy in which the fertilized ovum is implanted outside of the uterine cavity
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Complete mole
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Fertilization of egg whose nucleus is lost or inactivated
Sperm duplicates itself No fetus, placenta, amniotic fluid, membranes |
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Partial mole
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Two sperm fertilize a normal ovum
Usually fetal parts |
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Concerns for molar pregnancies
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Induction of labor is NOT recommended due to the increased risk of embolism from trophoblastic tissue
Follow-up serum bHCG must be done for 1 year; a rising hCG and enlarging uterus may indicate choriocarcinoma |
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What are the post-partum hemorrhage meds?
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Oxytocin (pitocin)
Methergine Prostaglandin (Hemabate, Prostin 15m) |
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Pitocin
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Stimulates uterine contraction
Treat PPH 10-40units / L in LR or NS |
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Methergine
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Stimulates uterine contraction
Contraindications: hypertension, cardiac (do not give if > 140/90 .2mg IV or IM 2mg PO |
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Hemabate
Prostin 15m |
Stimulates uterine contraction
Contraindication: Asthma, hypersensitivity .25mg IM |
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Other measures for PPH
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Crystalloid solutions or other blood prducts to restore volume
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Superficial venous thrombosis
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Most common form of PP thrombophlebitis; it is characterized by pain and tenderness in the lower extremity
NSAIDs, elevation, rest, heat TED |
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Deep vein thrombosis
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Unilateral leg pain, calf tenderness, and swelling, may have Homan's
Heparin (5-7 days), Coumidin 3mos, rest, elevation |
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Pulmonary embolism
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Dyspnea and tachypnea, chest pain, elevated temp, tachycardia, doom
Continuous IV Heparin until symptoms resolved, followed by subcutaneous Heparin of Coumadin therapy for 6 months |
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Appendicitics in pregnancy
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Uterus pushes appendix upwards so pain manifests in different area
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Magnesium sulfate
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Prophylaxis against seizures and antihypertensive agents are given if DBP > 100-110 (preeclampsia)
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Why cant you give an ecclamptic women who is hemorrhaging methergine?
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Because it icreases BP
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HELLP syndrome
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Laboratory diagnostic variant of severe preeclampsia involves hepatic dysfunction, characterized by :
Hemolysis (H) Elevated liver enzymes (EL) Low platelets (LP) |
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DIC definition?
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Disseminated intravascular coagulation
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DIC characteristics
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Pathologic form of clotting that is diffuse and consumes large amounts of clotting factors
Caused by: Abrupt placentae Retained dead fetus Infection Preeclampsis |
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How do you treat DIC
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Treat the underlying cause
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When do you use Methotrexate?
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Unruptured ectopic pregnancies
Blocks folic acid in fetal cells so that they cannot divide |
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Antenatal steroid use?
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IM injections to accelerate fetal lung maturity
Decrease rates of intraventricular hemorrhage in preterm infants |
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Dystocia?
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Long, difficult, or abnormal labor
Primary cause of C-section Bandl's ring |
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Bandl's ring
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A pathologic retraction ring that forms between the upper and lower uterine segments and is associated with prolonged ROM, protracted labor, and increased risk of uterine rupture
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Precipitous labor def?
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Labor that lasts less than 3 hours from the onset of contractions to the time of birth
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Amniotic fluid embolism
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Occurs when amniotic fluid containing particles of debris (vernix, hair, skin cells or meconium) enters the maternal circulation and obstructs pulmonary vessels, causing respiratory distress and circulatory collapse
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Possible complications of CS
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Maternal : aspiration, pulmonary embolism, hemorrhage, thrombophlebitis, wound infection, would dehiscence, UTI, injury to bowel or bladder, anesthesia related complications
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Anticipatory grief
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Occurs before the loss happens
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Early PPH (acute / primary)
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Occurs within 24 hours of the birth
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Late PPH (secondary / delayed)
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After 24 hours following birth, but within 6 weeks
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Respiratory Distress Syndrome
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Lung disorder caused by a lack of surfactant, which leads to progressive atelectasis
Prematurity Admin surfactant |
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Postmaturity
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Greater than 42 weeks gestation regardless of weight
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Complications of postmaturity
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Increased mortality rate
Meconium aspiration Persistent fetal circulation (PFC) |
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Toxoplasmosis
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Pregnant women cannot handle cat litter boxes
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What environmental factors may contribute to development of cleft palate?
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Radiation
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Myelomeningocele
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Type of spina bifida, spinal canal does not close properly
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Interventions for Myelomeningocele
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Protect sac – make sure it does not rupture!
Avoid any pressure on sac Keep infant on stomach or side |
