Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
MATERNITY 3
| Question | Answer |
|---|---|
| What are the risk factors of PPH? | multiple gestations, polyhydraminios, macrosomic fetus, multifetal gestation |
| How is PPH diagnosed? | blood loss and a change in hematocrit by 10% |
| What is the blood loss for a vaginal birth to be considered PPH? | loss of >500 mL of blood |
| What is the blood loss for a cesarean birth to be considered PPH? | loss of >1000 mL of blood |
| What are the S/S of PPH? | Hypotonia of the uterus, uterine atony, deviated to the right, uncontrolled bleeding, saturated perineal pads, constant trickling from the vagina, and blood clots bigger than a quarter |
| What are the nursing considerations of PPH? | FIRMLY MASSAGE THE FUNDUS, assist in emptying the bladder, administer O2 if needed through a non-rebreather. |
| What is the treatment for PPH? | **if the medications & nursing interventions are not effective--> uterine tamponade, uterine artery ligation, hysterectomy |
| What are the risk factors of mastitis? | inadequate emptying of the breast, frequent engorgement, sudden slowing/stoppage of breastfeeding, and sore/cracked nipples |
| What are the S/S of mastitis? | reddened, hot area in one breast, one-sided tenderness, fever, one-sided pain to the axillary region |
| What is the patient education for mastitis? | discourage/stop use of underwire bras, FREQUENT/CONTINUED breastfeeding on affected side, encourage pumping and direct feeds to empty affected side, warm compresses, and rest as much as possible |
| What type of issue is Abruptio Placenta? | detachment issue |
| what type of issue is placenta previa? | attachment issue |
| What color blood would you see in abruptio placenta? | DARK red blood |
| What color blood would you see in Placenta Previa? | BRIGHT red blood |
| What will the patient experience in Abruptio Placenta? | PAINFUL bleeding, abdominal pain, uterine tenderness |
| What will the patient experience in Placenta Previa? | PAINLESS bleeding and nontender uterus |
| When do we assess APGAR? | one minute and 5 minutes after birth |
| What characteristics would receive 0 points on APGAR? | Absent activity, no pulse, floppy to stimulation, blue/pale all over, no breathing |
| What characteristics would receive 1 point on APGAR? | flexed arms and legs, pulse less than 100, minimal response to stimuli, pink body accompanied by acrocyanosis, slow and irregular respirations |
| What characteristics would receive 2 points on APGAR? | Active, pulse greater than 100, prompt response to stimuli, pink color, and vigorous cry |
| What are the interventions for an APGAR score of 7-10? | no interventions, baby doing well, just needs post-delivery care |
| what are the interventions of an APGAR score of 4-6? | some resuscitation assistance required, stimulate the baby, rub the baby's back |
| What are the interventions of an APGAR score of 0-3? | Needs full resuscitation |
| What are the risk factors of uterine rupture? | Vaginal birth after cesarean, previous cesarean birth, uterine surgery/trauma, uterine tachysystole FIRST FOUR RESULT IN A SCARRED UTERUS |
| how is uterine rupture diagnosed? | Typically diagnosed through the symptoms and vital signs, ultrasound |
| What are the S/S of uterine rupture? | Abnormal FHR, variable DECELS, bradycardia, abdominal pain, uterine tenderness, hypovolemic shock IF hemorrhage occurs |
| What is one way women can prevent uterine rupture? | Women who had a previous cesarean birth are instructed NOT TO ATTEMPT a vaginal birth |
| What is the treatment for uterine rupture? | Immediate cesarean birth (THIS IS AN OBSTETRIC EMERGENCY), D/C oxytocin if due to uterine tachysystole, possible blood transfusion, laparotomy or hysterectomy |
| What is the complication for MOM from a uterine rupture? | hemorrhage |
| What is the complication for BABY from a uterine rupture? | hypoxia |
| What are risk factors for labor dystocia? THE 6 P's | Powers-->ineffective uterine contractions, Passageway--> altered pelvic structure, Passenger--> macrosomia or abnormal position, Psych--> maternal fatigue, Placenta, Position |
| What are the S/S of labor dystocia? | not progressing through labor, poor progression in dilation, effacement, and fetal station |
| What are the complications of labor dystocia? | shoulder dystocia (OBSTETRIC EMERGENCY) |
| What is the treatment for labor dystocia? | for shoulder dystocia--> mcroberts maneuver, maternal changes in position Other--> amniotomy, assisted birth |
| What is precipitous labor? | Labor that lasts less than three hours from the onset of contractions to the delivery of the baby |
| What are the risk factors of precipitous labor? | oxytocin admin., uterine tachysystole, placental abruption, and cocaine use |
| What are the S/S of precipitous labor? | anxiety that they won't make it to the hospital in time, disbelief that they are progressing so quickly |
| What are the nursing considerations of precipitous labor? | monitor the patients vital signs, I+O, admin of IV fluids, and D/C oxytocin |
| What are the complications of precipitous labor for MOM? | tearing/lacerations, uterine rupture, PPH |
| What are the complications of precipitous labor for BABY? | shoulder dystocia, hypoxia, intracranial trauma |
| What are the risk factors of a molar pregnancy? | History of molar pregnancy, really young or old, nutritional deficiencies |
| How to diagnose molar pregnancy? | transvaginal ultrasound, serum hCG levels |
| What are the S/S of molar pregnancy? | early signs are ASYMPTOMATIC, later signs consist of vaginal bleeding, excessive N/V, anemia, abdominal cramping, preeclampsia |
| What is the treatment for molar pregnancy? | Most molar pregnancies will abort spontaneously. Suction cutterage |
| What is the patient education for molar pregnancy? | follow up care-->frequency physical exams, pelvic exams, and weekly monitoring of hCG levels Educate to wait 3-6 months before conceiving again |
| What are the risk factors for ectopic pregnancy? | tubal infections/damage, history of ectopic pregnancy, tubal surgery, smoking |
| How is ectopic pregnancy diagnosed? | pregnancy test to confirm pregnancy and ultrasound |
| What are the S/S of ectopic pregnancy? | unilateral dull abdominal pain, delayed menses, and spotting |
| what are the S/S of a RUPTURED ectopic pregnancy? | signs of shock, shoulder pain |
| what is the MEDICATION treatment for ectopic treatment? | methotrexate--> halts/destroys cells growth |
| What is the SURGICAL treatment for ectopic treatment? | commonly done if rupture has occured-->salpingectomy and or salpingostomy |
| What are the risk factors of hyperemesis gravidarum? | molar pregnancies, hyperthyroid diseases, multiple gestations, diabetes, GI disorders |
| How is hyperemesis gravidarum diagnosed? | Based on symptoms, may test urine for ketones |
| what are the S/S of hyperemesis gravidarum? | severe & persistent vomiting, weight loss, DEHYDRATION, dry mucous membranes, electrolyte imbalances, increased HR and decreased BP |
| what are the nursing considerations for hyperemesis gravidarum? | fluid and electrolyte replacement |
| What is the patient education for hyperemesis gravidarum? | eat small, frequent meals. Separate liquids from solids. High protein snacks. Consume drinks/foods with ginger. Consume foods high in vitamin B6 |
| What happens during the normal labor process VS cervical insufficiency? | Normal labor process-->the cervix dilates & effaces in preparation for birth. In cervical insufficiency-->this process happens early |
| What are the risk factors of cervical insufficiency? | cervical trauma, history of cervical surgery, collagen disorder, uterine anomalies |
| How is cervical insufficiency diagnosed? | a vaginal ultrasound to measure the cervical length |
| What are the S/S of cervical insufficiency? | Early pregnancy-->painless dilation of the cervix Later in pregnancy-->mild discomfort, spotting |
| What is the treatment of cervical insufficiency? | cervical cerclage |
| What is a cervical cerclage? | A suture that is put around the cervix to constrict the internal os. Can be done prophylactically or as a rescue procedure. Removed around 36-38 weeks |
| What is the patient education post op of a cervical cerclage? | bed rest for a few days, avoid sexual intercourse, REPORT signs of preterm labor, ROM, or infection |
| What are the complications of cervical insufficiency? | preterm birth or pregnancy loss |
| What are the post-delivery newborn medications? | Erythromycin ophthalmic ointment, Vitamin K, and Hep B vaccine |
| What is the purpose of administering erythromycin ophthalmic ointment? | given as a prophylaxis for ophthalmia neonatorum |
| What is the purpose of administering Vitamin K? | A newborn's gut is sterile, meaning they do not have any intestinal flora that produces vitamin K until 7 days after birth. Vitamin K is ESSENTIAL for blood clotting. Given to prevent hemorrhage and bleeding |
| What are 5 reflexes seen in a newborn? | Babinski, rooting, moro, tonic neck, palmar, and plantar |
| What is the babinski reflex? | When the bottom of the foot is stroked from the heel upward, the big toe dorisflexes and the other toes spread out |
| When does the babinski reflex disappear? | after 1 year of age |
| What is the rooting reflex? | When the baby's mouth is stroked, the baby will turn its head and open the mouth. This helps the baby find the food source when feeding. |
| When should the rooting reflex disappear? | after 3-4 months, can last up to a year |
| What is the moro reflex? | Can be triggered by a sudden loud noise or unexpected movement. The infant will extend the arms with palms up and then move the arms back to the body |
| When should the moro reflex disappear? | after 6 months |
| What is the tonic neck reflex? | When an infant is lying on its back and quickly turns its head to one side. The leg and arm on that side will EXTEND, while the leg and arm on the opposite side will FLEX |
| When should the tonic neck reflex disappear? | after 3-4 months |
| What is the palmar grasp? | When a finger is touching the inside of the infant's palm, the hand will close |
| When should the palmar grasp disappear? | should lessen around 3-4 months |
| What is the plantar grasp? | When a finger is placed or touching under the toes, the toes will curl |
| When should the plantar grasp disappear? | should lessen around 8 months |
| What are the 4 types of heat loss? | evaporation, conduction, convection, and radiation |
| How is heat lost during evaporation? How is prevented? | Body heat lost due to moisture on skin to cooler air; dry infant immediately after birth |
| How is heat lost during convection? How is prevented? | Body heat lost to cooler air; keep bed away from open windows |
| How is heat lost during conduction? How is it prevented? | Body heat lost to a cooler surface in direct contact; warm stethoscope & other instruments before use |
| How is heat lost during radiation? How is it prevented? | Body heat lost to a cooler object nearby; Keeping infant away from any drafts |
| What is the patient education on breast care? | keep nipples CLEAN AND DRY by changing nursing pads often. Use soft, supportive bra 24/7. Hand expression to reduce engorgement & encourage production |
| What are the nursing considerations for breast care? | Monitor for S/S of MASTITIS, diet and hydration, I+O for baby. Lactation consultant. Ibuprofen & anti-inflammatory drugs for fever and aching with engorgement. ASSESS for cracking/impaired skin integrity--> can increase risk for infection |
| What are the risk factors for abruptio placenta? | MATERNAL HYPERTENSION, cocaine use, preeclampsia, blunt trauma, smoking, twin gestation |
| How is abruptio placenta diagnosed? | Ultrasound to rule out placenta previa, often diagnosed with symptoms |
| What are the S/S of abruptio placenta? | DARK RED vaginal bleeding, abdominal pain & rigidity, uterine tenderness, contractions, extended fundal height, disseminated intravascular coagulation |
| What are the nursing considerations for abruptio placenta? | Pelvic rest (no vaginal exams or intercourse), insert an indwelling catheter, fluid & blood replacement, prepare for birth if the woman has active bleeding or if mom or baby is in danger, assess UO |
| What are the complications of abruptio placenta for the MOM? | HEMORRHAGE/SHOCK, hypofibrinogenemia, thrombocytopenia |
| What are the complications of abruptio placenta for the BABY? | intrauterine growth restriction and preterm birth |
| What is the pathology of prolapsed umbilical cord? | When the umbilical cord is BELOW the presenting part; OBSTETRIC EMERGENCY |
| What are the risk factors of a prolapsed umbilical cord? | Long umbilical cord, malpresentation, unengaged presenting part |
| How is prolapsed umbilical cord diagnosed? | Visually seen from the naked eye, palpation, fetal heart monitor (will show bradycardia) |
| What are the S/S of prolapsed umbilical cord? | cord is seen by the naked eye from the vagina, cord is felt coming out of the vagina, women may feel the cord after ROM, variable DECELS |
| What is the treatment for a prolapsed umbilical cord? | Modified sims or trendelenburg position, the HCP will put their hand into the vagina and hold the presenting part off the umbilical cord, oxygen, IV fluids, if the cord is out of the vagina, wrap a sterile towel with normal saline around the cord |
| What should you NOT do with a prolapsed umbilical cord as the NURSE? | do NOT attempt to put the cord back in |
| What are the complications for prolapsed umbilical cord for the BABY? | hypoxia or stillbirth |
| What is the normal range of BP in a newborn? | Systolic is 60-80; diastolic 40-50 |
| What is the normal range for HR in a newborn? | 110-160 |
| What is the normal RR for a newborn? | 30-60 |
| What is the normal temperature range for a newborn? | 97.7-99.5; most commonly taken axillary |
| What are the signs of Respiratory Distress? | Stridor, wheezing, nasal flaring, chest retractions, persistent crackles after birth |
| What is NEC? | Acute inflammatory disease in the GI tract. It can cause necrosis & perforations of the bowels |
| What are risk factors of NEC? | Premature birth, enteral feeding, hypoxia, bacteria |
| How is NEC diagnosed? | radiography and labs |
| What are complications of NEC? | perforation, shock, infection/sepsis, death |
| What are S/S of NEC? | GI symptoms-->distention & tenderness, abnormal gastric residual, bloody stools, and poor feedings |
| What is the treatment of NEC? | Discontinue all tube feedings, possible surgical resections, administer TPN and Antibiotics |
| What is brown fat and how is it metabolized? | Pockets of extra-vascular fat with more nerves and more power to warm the body. Strong metabolism of lipids to keep the baby WARM |
| When is meconium normally passed in a newborn? | The first 24-48 hours of life |
| What are the risk factors for NAS? | mothers who use opiods during pregnancy |
| What are the S/S of NAS? | HIGH PITCHED CRY, EXCESSIVE/FREQUENT YAWNING, SEIZURES, sweating, irritability, GI upset |
| What is the treatment of NAS? | opioid therapy (morphine, methadone), IV fluids |
| What are the nursing considerations for NAS? | swaddle the newborn, decrease stimuli--> keep the room quiet and dim, give the newborn a pacifier, seizure precautions for the newborn, gavage feedings, high calorie formula, frequent feedings |
| What are the risk factors for hypoglycemia in newborns? | pregnant mothers with DM, preterm infants, large for gestational age |
| How is hypoglycemia diagnosed in newborns? | serum glucose test |
| What are the S/S of hypoglycemia? *may be asymptomatic or symptomatic* | jitteriness, irritability, hypotonia, tachypnea, apnea, temp instability, and seizures |
| What is the treatment of hypoglycemia? | IV glucose, IV dextrose, oral feedings |
| What are the nursing considerations with hypoglycemia? | prevention--> identify newborns that are at risk continue to monitor blood glucose with a heel stick |
| What is the timeline of pathological jaundice? | happens within the first 24 hours of life |
| What is the timeline of physiological jaundice? | happens AFTER 24 hours of age |
| What are the causes of pathological jaundice? | HEMOLYTIC DISEASE--> RH/ ABO incompatibility, premature infants, failure to pass meconium, sepsis |
| What are the causes of physiological jaundice? | immature liver, increased RBCs, vacuum assisted birth |
| what is the treatment of pathological jaundice? | phototherapy |
| what is the treatment of physiological jaundice? | typically there is no treatment there is no treatment or complications; it will resolve on its own |
| What is the complication of pathological jaundice? | kernicterus-->untreated hyperbilirubinemia can cause brain damage |
| What are the risk factors of MAS? | post-term infants, hypoxia-induce peristalsis, umbilical cord compression |
| How is MAS diagnosed? | meconium stained amniotic fluid, Chest XR |
| What are the S/S of MAS? | amniotic fluid will appear green, respiratory distress after birth--> can obstruct the large airways |
| What is the treatment of MAS? | suction the newborn's nose or mouth as needed, possible intubation or ventilation, administration of surfactant |
| What are the complications of MAS? | chemical pneumonitis |
| What are abnormal findings of lochia? | HEMORRHAGE-->soaking pad in less than an hour, clots larger than the size of a plum INFECTION-->foul odor, green/yellow purulent discharge, fever |
| Describe Rubra Lochia. | TIMING--> birth to 4 days DESCRIPTION-->bright or dark red; small clots |
| Describe Serosa Lochia. | TIMING-->4-10 days DESCRIPTION--> pinkish/brown; less or no clotting |
| Describe Alba Lochia. | TIMING--> 10-28 days DESCRIPTION--> whitish/yellow; little to no blood or blood clots |
| What are the nursing considerations for perineal care? | Ice packs, Sitz baths-->BLOT DRY AFTER, peri bottle, local anesthetics-->witch hazel/pain relief spray, position a mother on her SIDE to reduce pressure and assess perineum, MONITOR lacerations & episiotomy sutures-->REEDA |
| What is the patient education for perineal care? | cleanse, wipe, & apply peri-pads/ice packs, hand hygiene before & after care, cleanse with mild soap and water at least once daily, change pad with each void/bowel movement. Educate on signs of an infection-->can occur at any time during healing process |
Created by:
mkozej001
Popular Nursing sets