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57 Cards in this Set
- Front
- Back
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Gestational hypertension/Pregnancy induced hypertension |
blood pressure greater than 140/90 -lay mom on left side -monitor B/P throughout pregnancy -goes away after delivery -can cause abruption (placenta coming off uterine wall) |
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Preclampsia AKA toxemia (Affects from hypertension) S&S |
-Protein in urine(24hr urine test for total protein) -elevated liver enzymes |
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Preclampsia Med |
Magnesium sulfate IV 2-4g bolus |
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Eclampsia |
-seizures -hypertension induced |
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Magnesium Sulfate Side Effects |
-trembling -tachycardia(tell pt this is normal) -flushed hot flashed (tell pt this is normal) Reflex will go away in magnesium toxicity |
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Magnesium sulfate N.I |
-do hourly checks Assess for: -Vision changes -Headache -Resp. -Breath sounds -Gerd/Stomach upset -Output (not enough kidney perfusion) -Reflex/Clonus -Edema -B/P |
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Clonus |
Relax leg and foot dorsiflex of it beats back + for Clonus |
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Tx for Preclampsia and Eclampsia |
Delivery: -depending on the severity will determine if it goes away |
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Dystocia |
Anything causing ineffection labor or difficult labor |
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Should dystocia |
-head comes out -McRoberts Maneuvers(knees by ears) -Supra pubic pressure (pressure to push shoulder out) -Corkscrew Maneuvers (physician only):will grab shoulder and try to rotate the baby out -Posterior Arm delivered 1st -if these do not work push back in and do emergency C-section |
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Most common broken bone |
Clavicle |
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Prolapsed Cord |
Cord hanging out of cervix -increase risk for prolapsed cord with a breech baby -keep pressure on head and perform c-section -if at station -3 or -4 and water breaks may result in prolapsed cord |
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Terms of Pregnancy |
37-42 weeks is term 35-36 Late preterm Less then 35 preterm more than 42 weeks post dates |
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What to Worry about in Late Pre-term |
-Lung maturity -Feeding Suck/Swallow reflex not coordinated |
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Pre-Term Labor |
Contractions, ROM, that are causing dilation - |
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How to Tx Pre-Term labor |
-Brethine/terbutaline -SUBCUT 0.25mg can be given in repeated doses -Procardia (PO) (extended release (longterm) -Give Procardia and Brethine at same time Magnesium sulfate given after all other meds fail |
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Nitrazine Positive Test |
Goes on litmus paper that changes color; It turns bright blue or dark blue for positive, tests PH (blood will interfere) -can have false positive with vaginal bleeding -Tests ROM |
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Fern Test |
Take slide and collect fluid. Looks like a fern if amniotic fluid is present |
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Rupture of Uterus |
Previous C-section or surgery to uterus increases risk for ROU S&S -severe abdominal pain |
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Acreta |
-placenta grows into wall of uterus |
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Placenta Previa |
Complete- total growth over cervis (will bleed during dilation) Partial: Covers half the cervix Marginal: Just touches cervix can sometimes deliver vaginally Lowlying: does not touch cervix |
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Precautions before C-section |
Need to know if placenta is anterior or posterior for a C-sec, so its not cut into |
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Abruptio Placentae |
Premature separatation of placenta from the fetal wall before fetus is deliverer |
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Abtuptio Placentae S&S |
-Dark,Red, painful,vaginal bleeding -Uterine rigidity(hard and will stay hard) |
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Uterine Inversion |
-Uterine turns completely or partially inside out usually during or after delivery of the placenta -Dont give potocin so uterus doesnt clamp down -can push uterus back in |
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Amniotic Fluid Embolism |
Escape of amniotic fluid into maternal circulation. debris containing amniotic fluid deposits in pulmonary arterioles, usually fatal to mother |
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Amniotic Fluid Embolism S&S |
-Respiratory distress(SOB) -chest pain -cyanosis -seizures -H.F -pulmonary edema -fetal bradycardia -distress |
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Supine Hypotensive Syndrome (Vena Cava Syndrome) |
-occurs when venous return to heart is impaired by weight of uterus -Results in partial occlusion of vena cava and descending aorta -dont want mom on back turn on left side or sit up |
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Supine Hypotensive Syndrome (Vena Cava Syndrome) S&S |
-Hypotension -light headed -fetal decellerations -bradycardia |
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Uterine Resuscitation |
-Turn off putocin -Turn to Left Side -Turn on 02 (facemask) -IV bolus (fluid) |
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Involution: (Physiological Maternal Changes ) |
-Rapid decrease in size of uterus as it returns to pre-pregnant state, -fundal height decreases one fingerbreadth 1cm per day |
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When to Admin RhoGam |
72hrs after and 28 weeks gestational period |
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Kangaroo Care |
-Skin to skin helps baby regulate temp & Regulate respirations
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Breast-Feeding |
-Put baby to breast ASAP baby and moher in stable condition -remain with mother during feeding until she feels secure with baby and procedure |
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Assess Latch |
-Latch achieved by infant -Audible Swallowing -Type of Nipple -Comfort of mother -Help given to mother during nursing Always ask if they are Breast feeding |
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Hematoma |
-Localized collection of blood into tissues of reproduction tract after delivery -make sure its not growing -want it soft -usually in perineum or labia |
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Hemorrhage |
Vaginal Bleeding more than 500ml C-Section more than 1000 -EBL(estimated blood loss) -first 24 hours early hemorrhage -after first 24 hours late hemorrhage |
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Mastitis |
Inflammation of breast as a result of infection usually occuring in breastfeeding mothers 2-3 weeks after delivery -can still breastfeed -very painful -caused by not emptying breast |
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Mastitis S&S |
Hot/Red Breasts Temp Pain |
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Pre-Term Newborn (less than 37 weeks) |
Primary concern: -Lung Maturity -Feeding corrdination -Cold and stress (need to keep baby covered) |
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Post-Term Newborn (after 42 weeks) |
Concerns: -Hypoglycermia -increased risk for meconium aspirations(can stain them green- BM inside womb) -Dry, pealy, skin because of decrease in verix |
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Respiratory Distress Syndrome (RDS) |
Serious lung disorder caused by immaturity and inability to produce surfactant resulting in hypoxia and acidosis |
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Respiratory Distress Syndrome S&S |
-Tachypnea -Flaring Nares -Expiratory grunting -Retractions -Decreased Breath sounds -Apnea -Pallor and cyanosis -Hypothermia -Poor Muscle Tone |
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Respiratory Distress Syndrome Tx |
Endotracheal-Tube put the surfactant through tube |
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Meconium Aspiration Syndrome |
Aspiration can occur in utero or with first breath -Meconium gets into lungs suction immediately after head is delivered |
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Hyperbilirubinemia/ Jandice |
Caused by dying RBC's not being able to be processed Tx: Phototherapy -can cause brain damage if not Tx'd |
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Addicted Newborn Neonatal Abstance syndrome (NAS) |
S&S -Vomiting -Sweating -Excessive suckling -Sneezing alot (3-4x in a row) -Watery stool -Hypertonicity(very stiff) |
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(NAS) Scoring |
-Adding up all the symptoms -scoring done every 4 hours -NAS score will increase having more symptoms |
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Fetal Alcohol Syndrome |
Thin Lips, Tight features, Flat Forehead,Dont have above lip indent, Causes facial deformities and will be developmentally delayed there is no safe amount of alcohol consumption |
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Hypoglycemia |
Abnormal low level of serum glucose lower than 30mg/DL in first 72 hours or lower than 45mg/DL after first 3 days of life S&S tachypnea,hypothermia,twitching,tremors,unstable temp,cyanosis |
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Medication to Give to Newborn |
-Erythromycin in eye to prevent infection -Hep B Vaccine,series of 3 shots 1 week after birth -Vit K: helps for blood clotting |
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Simian Crease |
Downs Marker |
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Body Measurements |
Length 45-55cm Weight:2500-4300 Head Circumference: 33-35.5cm Chest circumference:30-33cm Fontanels should be flat and soft approx. 3-6cm |
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Physical Exam |
Eyes-crossed secondary to weak extraocular muscles Ears-Pinna on or above line drawn from canthus of eye Nose-Obligatory nose breathing Mouth-Epstein's pearls possibly present on hard palate Neck-Trachea midline Chest-Circular appearance with diaphragmatic respirations |
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Vocab |
Lanvgo-fine soft hair milia-Baby acne Nevi-stork bites birth marks ,red |
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Bathing a Baby |
Wait till cord falls off keep cord clean and dry |
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Reflexes |
Sucking and Rooting-touching cheek and head turning Palmar/Plantar grasp-Fingers and toes curl Moro-allow head and trunk to fall back Startle-loud noise Pull to sit-head falls forward Babinski-toes flare outward when ball of foot is touched after 1 yr of age this indicates neurological deficit |
