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39 Cards in this Set
- Front
- Back
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Postpartum Epidual Morphine
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Pain relief associated with c-sec
- episiotomies - 3rd or 4th Lacerations - injected in the epidural throug space throug a catheter; pain relief for 24hrs - side effects: respiratory depression, n/v, itching, urinary retention. All of which can be managed with naloxone (if itching can be tolerated, naloxone should be avoided, especially since it counteracts the pain relief). |
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Methylergonovine Maleate (Methergine)
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- Stimulates the smooth muscle of the uterus
- it is used postpartally to stimulate the uterus to contract in order to decrease blood loss by clamping off uterine blood vessels and to promote the involution process - drug has a vasoconstrictive effect on all blood vessels, esp large ateries - rapid onset action - dose may be repeated every 2-4 hours - should never be used duing pregnacy or in labor - assess fundal height; lochia, bp, ergot toxicity (n/v, headache, muscle pain, cold or numbing fingers/toes, chest pain, general weakness,) - DO NOT SMOKE DURING ADMINISTRATION (nicotine from cigarettes leads to constricted vessles and may lead to hypertension) and sign of toxicity. |
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Signs of bladder distention in Postpartal women
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- as soon as 1-2 hrs after childbirth
- due to PP diuresis - palpate the bladder - encourage to void - assist by: letting the mother hear running water by turning water on in the sind or tub, running warm sink and having her place on hand in the water or her feet in a basin of warm water. |
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Puerperium
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postpartal period, where the woman adjusts, physically and psychologically, continues up to six weeks
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Involution
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rapid reduction in size and the return of the uterus to a nonpregnant state
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fundus
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top portion of the uterus, situated in the midline midway between the symphis pubis and the umbilicus
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boggy uterus (uterine atony)
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As blood collects and forms clots with the uterus, the fundus rises, firm contraction are interupted causing this.
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Lochia
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debris remaining after birth throug the discharge, classified according to its appearance and contents.
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Lochia rubra
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dark red; it occurs for the 1st 2 -3 dys adn contains. epithelial cells, erythrocytes, leukocytes, shreds of decidua and occasionally fetal meconium, lanugo, and vernix.
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Lochia serosa
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pinkish color; 3- 10 dys, contains serous exudates, cervical mucus, and other contents similiar to lochia rubra.
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Lochia alba
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creamy white, yellowish discharge persist for addl. two weeks, contains, fat, cholesterol crystals, etc...
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anovulation
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occurs when the woman does not release a ripened egg during her menstrual cycle - due to increase levels of prolactin, which is secreted by the anterior pituitary gland.
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diastasis recti abdominis
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a seperation of the abdominal muscle.
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afterpains
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common in multiparas that in primiparas and are caused by intermittent uterine contractions.
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Maternal role attainment
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process by which a woman learn mothering behavior and become comfortable identity as a mother
- anticipatory stage: occurs during pregancy; looks to role modes;s - formal stage child is born; still influence by the guidance of others; acts as others expects her to act - personal stage she is comfortable with the notion of herself as mother |
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postpartum blues
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transient period of depression that occurs during the first few days of the puerperium in 70% of all postpartal women
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en face position
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direct face to face and eye to eye contact
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Acquaintance phase
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new mother applies herself to the task of getting toknow her baby
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Mutal regulation
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mother and infant seek to deal with the issue of the degree of control to be exerted by each partner in their relationship. A balance is sought between the needs of the mother and the needs of the infant. During the phase negative feelings are likely to surface or intensify
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Reciprocity
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When mutual regulation arrives at the point where both mother an dinfant primarity enjory each other's company. An interactional cycle that occurs simultaneiously between mother and infant
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Hepatitis B Vaccine
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a prophylactic treatment against all substypes of hep. B
- can be transmitted across the placenta, abut most neborns are infected during birth - given IM into the anterolateral thigh within 12hrs, 1 month and at 6 month of age - low grade fever may be expectd as a side effect- 99.8... etc. - will not prevent infection during its incubation period - have epinephrine availabel to treat possible allergic reactions - consider delaying the firs dose if baby is preterm <1000g, until term |
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Erthromycin Ophthalmic Ointment
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- prophylactic treatment of ophthamia neoatorum, which is caused by the bacteria neiseria gonorrhoeae.
- required by law - also effective against chlamydial infections - inserted along the lower conjunctival surface of each eye, starting at the inner canthus - instilled only once - side effects of edemal and ability to focus and inflammation usually disappear in 48hrs - wipe away excess after 1 min - |
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Vita K - Phytonadione (AquaMEPHYTON)
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prophlylaxis and treatment hemorrhagic disease of the newborn. it promotes liver formation of the clotting factors II, VII, IX and X
- IM is given in the vastus lateralis thigh muscle - one time only - in the birthing area or 1 hour of birth - if mom received anticoagulants during pregnancy an addl. dose may be ordered by the physician and is given 6-8 hours after the first injection - observe for bleeding (usually occurs on the 2nd or 3rd day) - may be seen as ecchymoses or bleeding from umbilical cord, surgical sites, nost, or GI. - observe to jaundice and kernicterus in preterms - protect drug from light - GIVE VITAMIN K BEFORE CIRCUMCISION PROCEDURE |
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Functional Residual capacity (FRC)
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the air left in the lungs at the end of a normal expiration
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alveolar surface tension
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the contracting force beteen the moist surfaces of the alveoli.
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surfactant
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is a mixture of surface-active phospholipid (lecithin and sphingomyelin) which are critical for alveolar stability.
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neonatal transition
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the first few hours fo life in which the newborn stabilized respiratory and circulatory functions.
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Cardiopulmonary adaptation
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the onset of respiration stimulates changes in the cardiovascular system that are necessary for sucessful transition to extrauterine life.
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Hbf
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fetal hemoglobin
- greater affinity to O2 |
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Periodic breathing
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breathing pattern is characterized by pauses lasting 5-15 seconds
- has no prognostic significance - |
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Obtaining BP on newborn
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using teh doppler technique or a 1 to 2 inch cuff and a stethoscope over the brachial artery
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active acquired immunity
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the pregnant woman forms atibodies in response to illness or immunization
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Passisve acquired immunity
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When IgG antibodies are transferred to the fetus in utero and transfered during the 3rd trimester, preterm are more susceptible to infection
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IgA
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Is found in colostrum, the forerunner of breast milk.
- begin to produce secretory IgA in their intestinal mucosa about 4 weeks after birth |
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IgM
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Most or all of it is produced by teh fetus beginnign at 10 to 15 weeks' gestation.
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Tylenol No. 3
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300mg acetaminiphen and 30 mg codeine
- mild to moderate pain - secreted in breast milk - |
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Percocet
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325mg acetaminophen adn 5mg oxycodone
- moderate to moderately severe pain - use in aspirin sensitive women - SE: hypogycemia...etc - with c-sec mothers who have depressed cough reflex. teach to cough and deep breathe - monitor bowel sounds, and bowel elimination - drug is secreted in breast milk - |
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Rubella Virus Vaccine, live
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Meruvax2
- single dose - Sub Q in outer aspect of the upper arm - stimulate active immunity against rubellsa virus - determine if woman is sensitive to neomycin - immunosuppressed - has had blood transfusions (not to be give within 3 months) - given at discharge - AVOID PREGNANCY FOR MONTHS following vaccination - you may want to discuss contraception - |
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RhoGAM (Rh immune globulin specific for D antigen)
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Mother must be RH negative
- prevention of sensitization to the RH factor in RH negative women and to prevent hemolytic disease in the newborn in subsequent pregnancies - given IM within 72 hours of birth - Antepartal 28wks IM |
