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275 Cards in this Set
- Front
- Back
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How long does a new egg live?
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24 hours
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How long does sperm live?
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72 hours
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How long is it before the egg implants after ferilization?
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7 - 10 days
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What produces HCG?
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Chorionic vili turns into the placenta which produces the HCG
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What produces progesterone?
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placenta and corpus luteum
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2 arteries and 1 vein consist in the what?
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umbilical cord
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what is the umbilical cord protected by
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wharton's jelly
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What is amniotic fluid for? Name 4.
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thermoregulation
prevention(cushion) fetal movement source of PO fluid and excretion |
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What week gestation are the organs fully developed?
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8 weeks
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What are risk factors in pregnancy?
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substance abuse
malnourishment ages <16 and >40 lower socioeconomic factor |
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what are subjective signs of pregnancy
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nausea and vomiting
fatigue increased breast size |
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What are positive signs of pregnancy?
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Goodell's sign
HCG levels Braxton-Hicks contractions |
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What is the normal weight gain for pregnancy?
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25 - 35 lbs
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what are things you would call the doctor for if you were pregnant?
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bleeding with abdominal pain
headaches vomiting blurred vision swelling of the hands and feet |
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what is checked with the baby rating scale?
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reflexes
respirations heart rate color muscle tone |
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what is the nomal respiratory rate for infants
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40 - 60
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when the rate of the infants metabolism is equal to the oxygen consumption
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thermo neutral zone
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what is lost 4 x's faster than adults in an infant
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heat
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why should you do a rectal temperature in an infant first
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to check for imperforate anus
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what hormone produces milk
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prolactin
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what helps in coagulation?
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vitamin K
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What stiumlates the let down of milk?
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oxytocin
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What retards involution?
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multiple fetus, enlarged bladder, grandipara, anesthesia
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what helps involution?
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breastfeeding, ambulation, and uncomplicated delivery
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where is the fundus usually located?
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it is firm and located midline
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what percentage of women experience post partum depression?
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70%
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what are some symptoms of post partum depression?
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crying, anorexia, not getting along with significant others
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what causes thrombophlebitis?
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increased clotting factors
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what are some causes of post partum hemorrhage
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increased PIH, infection
placental fragments, malnutrition, anesthesia |
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what happens RH and invades RH- mother?
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Mother stimulates antibodies
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what prevents RH antibodies?
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Rhogam
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CMV passes through what?
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placenta and cervix
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what is the number one sign of premature rupture of membranes
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infection
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what are other signs of premature rupture of membranes other than infection?
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malpresentation and prolapsed cord
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what are signs of abruptio placentae
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rigid abdomen, acute pain, tender uterus, and bleeding
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what causes early decelerations?
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head compression
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how is a variable deceleration indicated on a fetal heart monitor
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sharp drop off
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what may cause a variable deceleration?
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cord compression
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what is a late deceleration?
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starts at the middle of a contraction and ends after the contraction is over
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what is a cause of late deceleration?
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utero placental deficiency
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how can you help a mother in labor for pain in-invasive?
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change position, focal point, cool cloths, massage or back rub?
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how many weeks gestation is considered pre-term labor?
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20-37 weeks
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what are signs of pre-term labor?
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cervical dilitation with contractions and effacement
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what are risks for Small gestational age?
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smokers
PIH - preeclampsia Diabetes heart disease |
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what is the number 1 problem with pre-term babies
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RDS - respiratory distress syndrome
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what are signs of RDS - respiratory distress syndrome?
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cyanosis, tacypnea, retractions, grunting, nasal flaring
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what is one thing you can do to help prevent respiratory distress syndrome in an infant?
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keep them warm.
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what is the main cause for ectopic pregnancy
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PID
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What are signs of PIH?
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edema, increased blood pressure and proteinuria
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What interventions can you do to help with PIH?
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lay on side, 24 hour UA, mag sulfate, strict I&O's
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how much formula can a baby hold?
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1-2 oz or 30-60ml of formula
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what vessel does oxygenated blood come from first in fetal circulation?
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inferior vena cava
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what percentage of people have the risk of inheriting autosomal inheritance?
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25%
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PDA is caused by what?
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hypoxia
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what signs are for a reassuring fetal heart rate
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accelerations and variability
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what is the first sign of an infant getting sick?
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poor eating
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after a cerclage, why would a woman go into the hospital?
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if her water breaks or if she is having contractions
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what is the number one symptom from an epidural?
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hypotension
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what is the antedote for mag sulfate?
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calcium glutenate
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what should you check when administering mag sulfate?
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deep tendon reflexes
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what needs to be checked after a mole is removed?
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choriocarcinoma
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what is the most common malpresentation?
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occiput posterior
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Identify three interventions to teach the mother how to relileve engorgement.
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apply warm compresses or take warm shower; hand pump to relieve pressure; advil or anti-inflammatory
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Identify two signs and symptoms of a post-partum uterine infection.
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odorous discharge
low grade fever malaise anorexia |
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list three causes of postpartum hemorrhage.
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lacerations, retained placental fragments, uterine rupture, coagulation disorders
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list two s/s or a vaginal hematoma?
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rectal pressure, perineal pain, difficulty voiding,
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By 5 minutes, the infant is completely pink, heart rate 140, respiratory rate 40, moving actively and looking around. Arrange the following caretaking activities in order of priority a) use erythromycin ointment for eye prophylaxis b) be sure tha the identification procdess is completed c) intiate parent-infant acquaintance by wrapping the baby in warm blankets and placing in mother's arms. d)perform a complete physical and gestational age assessment
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b
a c d |
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Prior to the birth, to prevent heat loss the nurse should prepare the environment by:
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pre warm the radiant heater;
warm towels and blankets; have a hat available for infant |
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name two conditions that precede formation of vitamin K in the newborn infant
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have the baby eat first
there should be bacteria in the colon |
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Is a dark bluish splotch at a base of an infant spine normal or a problem
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normal
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If a bluish color continues in hand and foot at 18 hours of life normal or a problem?
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problem
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if the infant regurgitates 10ml after 8am feeding, is the normal or a problem?
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normal
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If the infant's temperature is 99 degrees F at 7am, is this normal or a problem?
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normal
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is a nasal flare and slight intercostal retractions normal or a problem in an infant?
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problem
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if the parietal bones overlap 0.25 cm after birth, is this normal or a problem?
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normal
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if the hematocrit is 37% and hemoglobin 12g in an infant, is this a problem or is it normal?
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problem
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if the skin has red spots that blanch on pressure (infant) normal or a problem
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normal
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describe two requirements before newborn circumcision is done
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consent form;
NPO prior to circumcision; make sure infant has had vitamin K |
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describe three observations that indicate circumcision is healing well
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no bleeding or foul smelling drainage; no s/s of infections; infant is voiding without difficulty
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all of the following are symptoms of Abruptio Placentae except:
a. one sided pain b. tender uterus c. bleeding d. rigid abdomen |
a
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name the identifying symptom of an ectopic pregnancy
a. vaginal bleeding b. sharp one-sided pain c. HCG levels rising more slowly d. fainting/dizziness |
b
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what is the number 1 complication of PROM
a. infection b. decrease fetal movement c. prolapsed cord d. malpresentation |
a
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what is the identifying criterios of choriocarcinoma follwoing a hydatidiform mole
a. abnormal chest x-ray b. anemia c. elevated HCG levels d. elevated estrogen levels |
c
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how does a RH(-) women potentially develop RH(+) antibodies?
a. delivering a RH(+) baby b. having an abortion c. Receiving RH+ blood d. having an infection with Gram (-) bacteria |
a
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what is the probably cause of variable decelerations
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severe fetal hypoxia
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what is the probable cause of bradycardia in the infant
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umbilical cord compression
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what is the probably cause of decreased variability
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mild fetal hypoxia with PH normal
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what is the probable cause of early decelerations
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fetal head compression
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what is the probably cause of late decelerations
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uteroplacental insufficiency
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what is the probable cause of tachycardia over 180 beats/min
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maternal fever
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after pitocin infusion started, contractions become hypertonic
a. early decelerations b. late decelerations c. variable decelerations d. mod decrease of variability |
b
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partial cord prolapse after membranes have ruptured
a. early decelerations b. late decelerations c. variable decelerations d. mod decrease of variability |
c
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the mother has been supine in bed
a. early decelerations b. late decelerations c. variable decelerations d. mod decrease of variability |
d
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what is the probable cause of bradycardia in a fetus?
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severe fetal hypoxia
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what is the probable cause of late decelerations in a fetus?
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utero placental insufficiency
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what is the probably cause of accelerations in a fetus?
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reassuring fetal pattern
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what is the probable cause of decreased variability
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infant sleeping
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what is the probably cause of variable decelerations
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umbilical cord compression
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what is the probable cause of increased variability in a fetus?
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increased movements and medications
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identify 2 of the diagnosing criteria of PIH/Preeclampsia?
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high blood pressure >140/90
edema in face & hands protein in urine |
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identify 3 symptoms of preeclampsia / PIH
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dizziness
blurred vision headache (chronic) edema in face, feet and hands decreased urine output |
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list 3 interventions for a client hospitalized with preeclampsia/PIH
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lay pt on side
monitor BP administer BP meds deep tendon reflexes liver function tests weigh daily |
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what is the only way to cure PIH/Preeclamsia/Eclampsia?
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birth of the infant
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what is the diagnosing criteria of Eclampsia
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seizures
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what is the premature separation of a normally implanted placenta from the uterine wall?
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abruptio placentae
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what is the cause of abruptio placentae
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it is unknown
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what are possible causes of abruptio placentae
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substance abuse, decrease flow to placenta, htn, maternal trauma, smoking, fibroids, older age, short umbilical cord, high parity
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what are signs of central abruptio placentae
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blood is trapped in the middle with no pain
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what are signs of marginal abruptio placentae
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vaginal bleeding with pain
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what are symptoms of complete abruptio placentae
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massive vaginal bleeding with severe pain
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what are s/s of abruptio placentae
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rigid abdomen, tender uterus, acute pain, bleeding
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complications due to severity of bleeding and time between separation and birth are:
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shock
hemorrhage hypovolemia infant death |
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are fibrinogen levels and platelet counts in abruptio placentae increased or decreased
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decreased
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sickle cell anemia
- if only one parent is a carrier, can the infant get it? |
no
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how long does a normal rbc last?
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120 days
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how long does a rbc in sickle cell anemia last
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5 - 20 days
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what does sickle cell anemia's sickle shaped rbc's cause?
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stasis of blood
hypoxia ischemia in joints & extremities severe abdominal pain |
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how is sickle cell anemia treated?
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hydration
transfusions recombinant erythropoeitin that stimulates RBC growth |
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if the placenta implants in the lower uterine segment, it is called
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placentae privia
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types of placenta previa are
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marginal, partial and complete
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what does placenta previa do?
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covers the internal os of the cervix where the baby cannot get out
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what are s/s of placenta previa?
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painless bleeding
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how is placenta previa diagnosed?
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with an ultrasound
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when is treatment started with placenta previa?
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when bleeding begins
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if less than 37 weeks gestation with placenta previa - what should be done?
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delay birth to allow fetus to mature
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if more than 37 weeks gestation with placenta previa - what should be done?
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deliver the baby
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main problems of placenta previa are:
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bleeding causes hypoxia to infant;
each bleeding episode is more; c-section will be needed because the baby cannot get out |
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what are interventions for placenta previa?
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bedrest; monitor blood loss; fetal heart tones; no vaginal exams; maternal vital signs; cbc, ua & RH factor, IV fluids; Administer Betamethasone to help baby's lungs develop
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What percentage of blood volume increase in the changes of pregnancy?
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45%
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what does the level of Hct do in physiological changes of pregnancy
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drops
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what does the level of iron do in the physiological changes or pregnancy
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drops - more iron is needed
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what happens to platelet and coagulation factors do in physiological changes of pregnancy?
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increases
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does the thrombus formation of physiological changes in pregnancy increase or decrease
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increase
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what happens to the heart rate of the mother when she is pregnant?
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increases 15 - 20 beats
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during the 2nd trimester, blood pressure increases or decreases and what hormone causes it?
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decreases and relaxin causes it
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when a pregnant woman is lying down in supine position what happens to her blood pressure?
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drops
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due to 45% of blood pressure what are symptoms in pregnancy?
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varicose veins, hemorrhoids, and dependent edema
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what are some respiratory problems during pregnancy?
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dyspnea and chronic nasal stuffiness
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what causes chronic nasal stuffiness in pregnancy
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increase of blood
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what hormones cause bladder infections in pregnancy
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relaxin
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heartburn and constipation are caused by what hormone during pregnancy
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relaxin
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what hormone causes N/V in pregnancy
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HCG
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progressive lordosis in pregnancy is caused by what hormone
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relaxin
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insulin production is increased during pregnancy which causes what
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increase in hunger
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what are interventions to help with n/v in pregnancy
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vitamin B6, decrease spicy foods, avoid odors, eat ice, and eat small meals
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what are interventions to helps with heartburn
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avoid caffeine, cigarettes, and use no sodium based antacids
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what are interventions to help prevent constipation
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increase fluids, fiber and exercise
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what are interventions to help with backaches
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exercise, and use the pelvic tilt exercise
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what are interventions to help with hemorrhoids and varicose veins
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wear support hose, elevate hips and legs
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what intervention helps with cramps in pregnancy
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massage
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what are some hormones in pregnancy
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estrogen, progesterone, FSH, LH, HCG, Relaxin, Prolactin
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What is progesterone presented by?
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placenta and corpus luteum
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what is estrogen presented by?
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ovaries
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what hormone prepares breasts for lactation?
|
progesterone and prolactin helps with breast feeding
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when the fetus is stressed, what happens to its heart rate?
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it increases
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blood flow for the fetal circulation?
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placenta, ductus venosus, inferior vena cava, rt atrium, foramen ovale, left atrium, ductus arteriosus
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what is the care of an incompetent cervix?
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CERCLAGE
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what can cause incompetent cervix?
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repetitive 2nd trimester losses, previuos preterm births, short labors, elective abortions, cervical manipulation,
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warning signs of incompetent cervix
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lower back pain
pelvic pressure changes in vaginal discharge |
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how can you manage incompetent cervix(s)
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bedrest
avoid heavy lifting no coitus |
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after 37 weeks gestation can the cerclage be removed?
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yes
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if a c-section is going to be performed, what should be done with the cerclage?
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left to avoid repeating procedure in future pregnancies
|
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when are women usually diagnosed with aids when pregnant?
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when the child becomes ill
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ACV, elective C-section, and avoid breastfeeding can prevent what?
|
the transmission to HIV to infants
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if a patient has AIDS and is asymptomatic and become pregnant, will the disease process accelerate?
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no
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how is Aids transmitted?
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blood, body fluids, transplacentally, and through breast milk
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What can HIV cause in pregnancies?
|
PROM, Fetal death, Preterm birth, low birth weight
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How long can the mothers' HIV antibodies remain in the infant?
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18 months
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Median diagnosis of an infant with HIV is how old?
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9 months
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what are s/s of HIV in infants?
|
failure to thrive
recurrent infections neurological abnormalities encephalopathy interstitial lymphocytic pneumonia |
|
|
what are danger signals of pregnancy/
|
sharp 1 sided pain
diffuse abdominal pain |
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what are signs of approaching labor?
|
braxton hicks contractions
blood show increased pelvic pressure lightening |
|
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what are specific instructions of the patient planning on breast feeding
|
do not use soap on the nipples, to wear a supportive bra, don't stimulate nipples or it will generate oxytocin
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what is the Coomb's test for?
|
to measure the number of RH positive antiboides in the mother's blood.
|
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what is a negative Coomb's test indicate
|
the mother needs Rhogam
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what is a positive Coomb's test indicate
|
the mother does not need Rhogam
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List common discomforts of pregnancy
|
breast tenderness
n/v shortness of breath |
|
|
Meiosis means
|
new cells are created
|
|
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Mitosis means
|
cell division
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|
Hydatiform Mole looks like what
|
a cluster of grapes - placenta becomes swollen and fluid filled
|
|
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what age does hydatiform moles happen in?
|
women over 40
|
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paternal genes are responsible for extra embryonic membranes are indicative of what?
|
hydatiform moles
|
|
|
Complete H-Mole - check for
|
choriocarcinoma
|
|
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complete H-mole - normal sperm fertilizes what type of egg?
|
anuclear (no chromosones)
|
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Partial H-mole consists of a normal ovum fertilized by how many sperm
|
2
|
|
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what type of H-mole can a fetus exist?
|
partial
|
|
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what kind of H-mole invades the myometrium?
|
invasive mole
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what are clinical signs of H-moles?
|
vaginal bleeding, brown to bright red;
enlarged uterus greater than weeks pregnant; no fetal heart tones |
|
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other clinical signs of H-moles?
|
PIH before 24 weeks
anemia hyperemsis - due to increased HCG elevated HCT |
|
|
Bilirubin levels of 17-20 suggest what with the fetus?
|
will not survive 10-14 days longer without intervention
|
|
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Intrauterine transfusion can increase 80-90% of survival rate in what type of infants
|
infants with bilirubin
|
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What are some advantages of epidural during labor?
|
can be awake
muscle tone can be sustained for birth near complete pain relief |
|
|
what are some disadvantages of epidurals during labor?
|
incomplete relief
toxic reactions |
|
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Epidural clients' need what bolus before administrations?
|
1000 cc of fluid
|
|
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what is the most common side effect of epidurals?
|
hypotension - this is why they administer the fluids
|
|
|
what are side effects of epidurals
|
hypotension, n/v, bradycardia, respiratory depresseion, loss of consciousness, cardiac arrest, nerve damage
|
|
|
morphine epidurals provide pain relief for how long?
|
up to 24 hours
|
|
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can narcotics be received after morphine epidurals?
|
shouldn't be
|
|
|
most common side effect of morphine epidural
|
itching
|
|
|
spinals are usually used for what type of birth?
|
c-section
|
|
|
what are nursing care procedures for regional anesthesia
|
vital signs ever 5 minutes then 15 minutes, turn every hour, assess bladder, assess body position, monitor levels of effects
|
|
|
when a mother receives general anesthesia, how long does it take to deliver the baby
|
2 minutes
|
|
|
Complications of c-section consist of?
|
UTI
Hemorrhage Uterine Infection Wound infection |
|
|
Transverse Pfannenstiel benefits are:
|
less blood loss
easier to repair less likely to rupture no adherence to bowel can't extend |
|
|
veritical c-sections are for:
|
emergencies
|
|
|
Vaginal births after c-section may cause
|
prolapsed cord
fetal distress placenta previa |
|
|
Early signs of labor are:
|
lightening
braxton-hicks contractions increased pelvic pressure bloody show |
|
|
Fetal monitoring is done with a:
|
TOCO
|
|
|
How is a fetal heart rate monitored?
|
Scalp electrode
|
|
|
How can uterine contractions be measured acurately?
|
intrauterine pressure catheter
|
|
|
Normal FHR is?
|
120-160
|
|
|
Bradycardia is indicated by
|
<120
|
|
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Tachycardia is indicated by
|
>160
|
|
|
Fetal tachycardia can be caused by:
|
maternal fever, dehydrations, infection, anemia, medications
|
|
|
bradycardia can be caused by
|
medications, severe hypoxia
|
|
|
Increases of greater than 25 beat variability can be caused by:
|
hypoxia, movement or medications
|
|
|
Accelerations which are increases from the baseline are indicative by how many beats and for how long
|
15 beats for more than 15 seconds
|
|
|
a non-stress test should indicate what in a healthy fetus
|
heart rate should go up every time the baby moves
|
|
|
does early decelerations respond to oxygen?
|
no
|
|
|
Interventions for Late decelerations are
|
position change
increase iv fluids apply oxygen call dr if not correctable deliver baby |
|
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Severe Variable decelerations are indicated by what drop in BPM in how long
|
<70 bpm and >60 seconds
|
|
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Prolonged decelerations are for how many bpm and for how long
|
30bpm for 10 minutes
|
|
|
fetal scalp stimulation does what
|
increases heart rate 15 beats for 15 seconds in a normal fetus
|
|
|
What do you mark on the tracing record?
|
vaginal exams
ROM maternal VS Scalp Electrode placement Medications Emesis, Hiccups, Coughing Blood draws Scalp stimulation Pushing Epidural Anesthesia |
|
|
Occiput posterior is the most common what?
|
malpresentation
|
|
|
CPD - cephalopelvic disproportion
|
fetus is too large
abnormal fetal position |
|
|
cpd may cause
|
skull fractures
intracranial hemorrhage damage to soft tissue |
|
|
what is indications of CPD?
|
prolonged labor
dilatation slow engagement is slow |
|
|
Prolonged labor is common in what type of women/
|
nulliparas
|
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preciptious delivery is how long?
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less than 3 hours
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What are maternal implications of preciptious delivery?
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risk of uterine rupture
ineffective coping lacerations of cervix, etc. postpartum hemorrhage |
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what are fetal
implications of preciptious delivery? |
fetal distress
cerebral trauma |
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What is a prolapsed cord?
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when the umbilical cord comes out before the baby
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what interventions are necessary during a prolapsed cord?
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bedrest until engagement
monitor FHR Knee Chest, o2, trendelenberg immediate surgery |
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prostaglandins are used to do what?
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ripen cervix and induce labor
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Toxoplasmosis is from what?
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raw meat, and feces of cats
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Toxoplasmosis s/s
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asymptomatic
malaise rash |
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If someone is diagnosed with toxoplasmosis, what is recommended if diagnosed before 20 weeks gestation?
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abortion because baby will die soon after delivery
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Surviving infants of toxoplasmosis s/s
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blind
deaf severely retarded |
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How can a pregnant woman prevent toxoplasmosis
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wear gloves when gardening
dont' change cat litter eat well cooked meat |
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Rubella diagnosed in 1st trimester - what is recommended
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abortionj
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symptoms of rubella in mother?
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asymptomatic or rash
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what can happen to an infant born from a mother with rubella?
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mentally retarded
heart defects cerebral palsy the baby should be isolated |
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CMV - cytomeglovirus
mother s/s |
asymptomatic
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What type of delivery is indicated for cytomeglovirus
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c-section
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s/s of CMV - cytomeglovirus in infants
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no fontanels
mentally retarded maybe no damage |
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herpes type 2 - s/s
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lesions on genitals
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transmission of Herpes type 2 virus to baby is?
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with rupture of membranes, usually transplacentally is rare
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what risk is concurrent with Herpes Type 2 virus
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spontaneous abortions
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Vaginal delivery with active herpes of infants will contact disease - what will happen
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70% of babies will die
83% of survivors will have brain damage |
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a baby born with herpes - s/s
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lesions
seizures poor feedings fever jaundice |
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what type of birth should happen with a mother with herpes
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c-section
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Babies with Group B Strep s/s
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severe respiratory distress syndrome
early assessment and intervention essential for survival |
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Gestational diabetes probable causes
|
pre-existing disease
stress of pregnancy altered metabolism due to hormone level changes |
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screening for gestational diabetes happens when?
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24 - 28 weeks
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Complications to mother with DM?
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Hydramnios
Ketoacidosis Retinopathy |
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Complications to infant with mother with DM?
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Large infant
IUGR RDS Hyperbilirubinia Polycythemia |
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Nursing intervention for DM mothers?
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diet and exercise
meals evenly distributed 22-27 lbs weight gain avoid concentrated sweets |
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Normal newborn - what to do immediately after birth
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dry, wear gloves until first bath, skin to skin contact or radiant warmer, coomb's test with cord blood, stimulation
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Apgar scores - assess at 1 min and at 5 min. 1 min scores predicts survival what predicts neurologic abnormalities at 1 year
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5 minute abgar scores
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what medications are used on the newborn at birth?
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erythromycin in eyes
vitamin k |
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fertilization occurs when
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one sperm penetrates the ovum
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how many sperm live in one ejaculation
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20-60 million
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how long do sperm live
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2 - 3 days
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gestation age is determined by first day of last period - how is the due date calculated?
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-3months + 7 days
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What is the lochia
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what is sloughed off after birth - takes approximately 3 weeks
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Postpartum depression happens when and can last how long?
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shortly after birth and up to a year
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Colostrum is what?
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yellow fat soluble food for baby first from breasts
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What are s/s of engorgement?
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swelling
tenderness warmth shiny throbbing pain fever |
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Treatment for engorgement
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warm shower
feed baby - don't limit time massage breast express milk cold compresses after feeding tyleno or advil |
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Mastitis s/s
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tender area
warm firm red |
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endometritis s/s
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foul smelling lochia
temp spike uterine tenderness tachycardia |
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S/S of PP hemorrhage
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pooling of blood
large clots soaked pads <hour restlessness, anxiety, thirst |
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treatment for PP hemorrhage
|
VS
IV vluids O2 Massage Utereus Evaluate bleeding |
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S/S of vaginal hematomas
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Perineal pain
Rectal pressure difficulty voiding |
