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68 Cards in this Set
- Front
- Back
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what is birth rate?
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number of live births per 1,000 live births
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what is the death rate?
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number of deaths of 1,000 live births
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what is perinatal period?
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20 wks gestation to 28 days
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what does fetus kidney produce urine?
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12 wks
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when is vernix present?
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28 wks
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when is lanugo present?
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16 wks
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when does fetus expel meconium in utero?
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about 13 wks
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what are some warning signs in pregnancy? (9)
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1. vaginal bleeding
2. swelling 3. severe ha 4. blurring 5. ab pain 6. persistent vomitting 7. chills/fever 8. dysuria 9. water break |
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assessment, where would fundus be at 12 wks, 20 wks?
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12 wk=pelvis
20=imbilicus |
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how to assess diagonal conjugate?
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symphysis to sacrum (needs to be at lease 11.5 cm)
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how to assess a-p diameter? needs to be how long?
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"gun" 9.5-11.5
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blood building foods? (4 classes)
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1. dark leafy
2. wheat/whole grain 3. nuts 4. dark meats |
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what is the nursing care for first phase? LATENT
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1. encourage ambulation if not bleeding or ROM
2. give fluids/ice chips 3. oral care if vomit |
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what is nursing care for active phase? (8)
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1. palpate contraction q15-30 min
2. encourage voiding (because vaginal discharge and bloody show increase) 3. assess vs q1h for low risk adn q30 min for hi risk 4. assess FHR q30 min (low risk) and q15mi (hi risk) 5. assess cervix 6. change chux 7. comfort measures (pillows/side lying) 8. clean perineum |
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nursing care for transition phase? (3)
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1. vs q30 min for mom and baby for low risk
2. instruct to breathe thru nose and relax between contractions 3. encouraging panting |
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what is the nursing care for 2nd stage?
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1. ice pack
2. encouragement |
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what is the nursing care for 3rd stage? (7)
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1. Put baby in trendelenburg and suction
2. dry head then body 3. apgar 4. physical assessment 5. newborn identification 6. intiation of attachment also 7. delivery of placenta w/ or w/o pitocin |
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nursing care of fourth stage? (3)
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1. palpate uterus q15min
2. changing chux/shower 3. check vs, lochia, episiotomy |
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BP and P should ___ immediately PP?
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decrease
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how often to assess FHR in active and transition phases?
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q15 min
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asess FHR how often in 2nd stage?
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q5-10min
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explain how early decels look?
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inversely looks like contractions...SO with contraction, FHR goes down minimally WITHIN normal range
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late decels indicate ____ and appear ___ in the contraction. IT is ___ range?
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uteroplacental insufficiency
late normal |
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sharp drops and returns may indicate what kind of fetal heart?
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variable decels d/t cord compression (usu within normal range
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variable decels are ___in FHR is ___ bpm or more with a duration of ___ seconds?
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decrease, 15bpm, 15 seconds
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where does engagement begin at?
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station 0
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what is the cardinal mechanism in fetus? acronym
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EVERY
DAMN FOOL IN ROSTERDAM EATS ROTTEN EGG ROLLS EVERY |
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WHAT IS THE most important factor in involution?
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exfoliation b/c it does not leave a fibrous scar
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what retards involution? (6)
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think FROG PAD
1. full bladder 2. retain fragments 3. overdistention 4. grandmultiparity 5. prolonged labor 6. difficult labor |
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explain the taking in phase? (3)
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1. passive and dependent
2. need rest and food 3. talks about l&d experience |
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preoccupation of babies to fathers is termed?
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engrossment
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explain taking hold phase? (3)
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1. wants to be independent
2. concern for bodily function 3. need health teaching GOOD TIME TO TEACH |
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explain letting go phase? (2)
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1. separate themselves from past and present
2. redefine roles |
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explain the four roles of attainment?
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1. anticipatory=looks to role models
2. formal=acts like how she thinks she SHOULD act (after birth 3. informal=makes own decision 4. personal=is comfortable with being a mom |
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three ways to facilitate attachment?
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1. freq contact
2. freq feeding 3. en face |
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how is the dads interaction different from the mom?
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dad= holds the fingers, uses facial expressions, increases stimuli
mom=holding, cuddling |
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how is breastfeeding jaundice and breast milk jaundice differ?
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breastfeeding jaundice occur in the first few days and is due to poor feeding ways
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what to teach if mother has breastfeeding jaundice?
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1. encourage freq breastfeeding q2-3hr
2. avoid supplementation 3. acces lactation consultant |
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what to teach the mother who gave her baby breast milk jaundice?
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may need to stop breastfeeding until other causes of jaundice are ruled out. By one day of not feeding breastmilk, bilirubin levels should drop
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what are some complications of version? (7)
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1. cord compression
2. hemorrhage 3. placental abruption 4. cord tear 5. fetus entangled 6. fetal death 7. emergency c/s |
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wht are the contraindications for pitocin induction? (9)
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1. previa/abruptio
2. prolapsed cord 3. fetal demise/nonreassuring 4. previous classical incision 5. pelvic abnormality/cancer 6. genital herpes 7. more than one c-section 8. transverse lie 9. any abdominal incision |
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what is the goal for pitocin induction?
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to achieve 3 contraction with duration of 40-60 seconds in 10 minutes with good uterine relaxa between contractions
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what are the effects of pitocin on fetus? (3)
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1. hyperbilirubin
2. trauma 3. hypoxia with hypotension of mom |
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when should you perform a c-section?
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1. placenta previa/abruption
2. cpd 3. active herpes 4. umbilical prolapse 5. dystocia FTP 6. nonreassuring status 7. malignant tumors |
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what are r/f for puerperal infections? (10)
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1. c-section
2. Prolonged ROM 3. prolonged labor 4. unhealthy 5. intra (whatevers) 6. trauma 7. chorioamniotis 8. forceps 9. manual removal of placentae 10. DM |
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infx that involves the connective tissues of broad ligaments is?
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pelvic cellulitis
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what is the leading cause of maternal death?
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hemorrhage
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what is pp hemorrhage? (2 ways)
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1. more than 1000cc
2. decrease in hct 10% |
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what are r/f for PP hemorrhage? (8)
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1. prlonged third stage
2. preeclampsia 3. episio/lacteration 4. pitocin 5. aresa of descent 6. general anesthesia 7. chorioamniits 8. overdistention of uterus |
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all pregnant woman are screened for GDM at what gestation?
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24-28 wks
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what is a complication of missed abortion?
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DIC
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product of ectopic pregn (what is the largest if using methotrexate?)
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3.5cm
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how much lbs can a PP client expect to lose immediately pp?
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10-12lbs from amnio/baby and another 5 lbs from diuressis
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an infant has mottling, whare some possible causes? (4)
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1. chill
2. prolonged apnea 3. sepsis 4. hypothyroidism |
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red spots that are prominent when she cries? what do you tell the parents?
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these are telangiectactic nevi which will dissappear
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you see red spots on face that does not blanch, what do you suspect and what do you tell the parents?
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nevus flammeus
think "never" fade |
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type 1 alveolar cells for gas exchange develops at how many wk gestation?
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24-28
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when would you not halt PTL?
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1. cervical dilation of more than 8 cm
2. severe preeclampsi 3. chorioamnitis 4. hemorrhage 5. fetal death |
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how does a woman blood volume and pulse change in pregnancy?
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blood volume increase by 45% and P increase by 10-15 bpm
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what is the level of WBC for pregnant women?
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15,000-20,000
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what is the avg latent phase for nullip and multip?
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nullip: 8.6
multip: 5.3 |
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what is the cervical dilation rate for nullip and multip?
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1.2 for nullip
1.5 for multip |
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how long is 2nd stage for nullip and multip
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nullip: 2 hours
multip: 15-30 min |
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how is the mother's bp and pulse in 4th stage
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bp decrease and pulse increase
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in nullip what is the cervical dilation rate transition on?
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1 cm/hr= nullip
2cm/hr=multip |
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what is perinatal mortality rate?
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the sum of deaths of fetus and newborn occuring between 20wks and 28 days per 1,000 live births
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engrossment is bonding or attachment?
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bonding
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how to facilitate attachment? (8)
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1. meet maternal needs
2. have her talk about L&D 3. support system 4. allow parents to inspect baby 5. cuddling/interacting with baby 6. early freq feedings 7. learn engagment cues/disengagement cues 8. adapt to temperament of baby |
