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