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NPN 201

Final Study Guide Maternal/Newborn

QuestionAnswer
90% of all births at home in what era? Early 1900's
Early 1900's top 3 causes of death for mom 1. hemorrhage 2. Infection 3. Pregnancy induced Hypertension
Early 1900's top 3 causes of death for baby 1. Prematurity 2. Dehydration 3. Contagious disease
Fetal Mortality Rate The number of fetal deaths of 20 weeks or more gestation for every 1000 live births
Maternal Mortality Rate The number if maternal deaths per 100,000 live births
Current 3 top causes of death in mom 1. Embolism 2. Hemmorhage 3. Pregnancy induced hypertension
Current 3 top causes of death in baby 1. Congenital or chromosomal defects 2. Prematurity and low birth weight 3. SIDS -Sudden infant death syndrome
90% of births done in hospitals in what era? 1960's-1980's
Testes (aka gonads) Responsible for Production of sperm and production of male sex hormone (Testosterone)
sperm male sex cell
Ovum(1) Ova (2 or more) the female sex cell
zygote fertilized ovum
Testes essential reproductive organ of the male
bulbourethral cowper's gland
external genital of the male scrotum
seminiforous tubules continually forming sperm from puberty until death of the man
Sperm cells may join with the ova, the female sex cell, to form a new human
One of the testes function is to secrete male hormone testosterone that developes male secondary sex characteristics
Vas deferens continuation of ducts that start in epididymis
Corpus spongiosum erectile
Cowper's gland also known as bulbourethral
epididymis narrow tube that lies along the top and behind the testes
prostate gland donut shaped gland beneath the bladder
ejaculatory duct continuation of vas deferens
semen mixture of sperm and secretions of accessory glands
seminal vesicles contributes 60% of the seminal fluid volume
prepuce removed during circumcision
bartholin accessory female sex gland
ova sex cells of female
clitoris Female erectile tissue located at the junction of the labia
labia minora 2 small folds of skin located inside the labia majora
The ovaries are the gonads of the female
ovaries have two main functions production of female sex cell and to secrete sex hormones
meiosis specialized type of cell division that occurs during sexual reproduction
estrogen and progesterone the two female sex hormones secreted by the ovaries
estrogen is the sex hormone that causes the development and maintenance of the female secondary sex characteristics
progesterone acts with estrogen to help initiate the menstrual cycle
entranceway of the sperm vagina
fingerlike projection called fimbriae uterine tubes
consists of body, fundus, and cervix uterus
Bartholin's gland secretes lubricating fluid
breasts primarily fat tissue
alveoli grapelike clusters of milk secreting cells
lactiferous ducts Drains milk in to nipple
areola colored area around the nipple
mons pubis skin covered fat pad over the symphysis pubis
labia majora 2 large folds of skin
AWHONN Association of Women's Health Obstetrics and Neonatal Nursing
Info about the AWHONN Formed in 1969; Goal to improve the health of women and newborns. Responsible for Car seat laws/usage
Viable Age of Preterm Baby? 24 Weeks gestation
Morbidity Prevelence of a specific disease or disorder in the population at a specific period of time.
#1 Cause of child mortality Accidents 5 and younger = Poisoning 5 and older = other types of accidents
Where is morbidity data collected from? ERs, doctor's visits etc.
Risk Factors for Infant mortality Late prenatal care; Low birth weight; Congenital anomolies; SIDS; Respiratory Distress Syndrome
SIDS Sudden Infant Death Syndrome - No explainable cause of infant death under 1 year of age. Lie baby on back to sleep
Respiratory Distress Syndrome At birth , surfactant in the lungs decrease, causing collapse of the alveoli. Surfactant in injected via ET tube into the lungs at 1 hour of age and again at 15 hours. If child makes if first 96 hours they have reasonable chance of survival
Risk factors for maternal mortality Lack of prenatal care; Smoking; Alcohol/Drug use; Teenage pregnancy; Poor nutrition (Folic Acid and Prenantal Vitamins are essential)
Folic Acid Prevents Neural tube defects
Main goal of the reproductive system? To reproduce
Sexual Developement begins At conception
Sex of child is determined when? At conception
Chromosomes--Females Carry which two? XX (the only choice)
Chromosomes-- Males carry which two? XY (will be either X or Y)
Who determines sex of baby? The male... "If there's a Y, it's a guy"
Oogenesis Development of matured female ovum
About how many ova reaches maturity out of 2 million? 400... During childhhod - majority of degeneration of ova occurs. 400,000 remain at puberty.. Only 400 ever mature enough to be fertilized. 1 ovum is released each menstrual cycle.
LPNs CANNOT Intibate
Chromosomes We get 2 pair of 23 = 46 chromosomes - First 22 sets are identical = Autosomes. 23rd set determines our sex.
Puberty - Repro - Female Occurs about age 14
Puberty - Repro - Males Occurs about age 12
Menstrual Cycle Average length of cycle is 28 days any significant deviation is associated with infertility. Average blood loss is 25-60ml
Ovarian Cycle Hormones FSH and LH stimulate changes in ovaries. Respectively, each hormone has most control over it's phase
Follicular Day 1 to day 14. Due to increased FSH levels, follicle developes, matures and produces Estrogen- It grows fills and bursts open. Pituitary senses Estrogen and releases LH
Luteal Day 14- Day 28 - When Follicle bursts with estrogen, pituitary senses this and releases Leutinizing Hormone. This is what causes Ovulation. LH Drops and turns into corpus luteum which secretes progesterone.
Corpus Luteum After LH drops, corpus luteum secretes progesterone. If no fetilization takes place, corpus luteum degenerates, estrogen and progesterone falls off and cycle starts again.
Uterine Cycle Occurs at the same time as Ovarian Cycle
Menstrual Phase Day 1-5; Onset of menses due to low estrogen levels.
Proliferative Day 5-14; Estrogen begins to rise- Endometrium lining regenerating.Cervical mucus is thin and alkaline-favorable to fertilization. Ends with ovulation
Secretory Phase Esteogen remains high. Progesterone is being secreted by corpus luteum. Uterus is being prepared for pregnancy. If no pregnancy occurs, estrogen and progesterone fall off. (As in Ovarian Cycle)
Ischemic Phase Day 27 - Day 28- Estrogen and progesterone have fallen off.. Uterine lining become Ischemic (Sloughs off) and meses begins. New Cycle starts.
Reproductive Issues: Breast Disorders Breast Self exams should be done a week after your period
Fibrocystic Breast Disease Coomon in women 30-50 due to estrogen changes; caffiene worsens. paniful and tender. Oral contraceptive lessen s/s. Disappear over time
Fibroadenoma Freely moveable rounded masses. Well defined borderd. Common in young women and in the upper outer quadrant of the breast. Usually goes away but can be surgically removed
Breast Cancer 2ns Leading cause of cancer deaths in women. Risk Factors: over 50 and family history. S/S Small painless lump, immoveable, breast dimpling. Treatments depends on stage 1(small)-4(mastisized)
Tamoxifen Tamoxifen (Soltamox) blocks the actions of estrogen and is used to treat and prevent some types of breast cancer.
Uterine Disorders: Fibroids Non-Malignant- Very commn- Surgical removal, Causes heavy menstual flow, uterine pressure
Endometrial Cancer Malignant- Common in women 50-70. Risks: Obesity, Early menarch/Late menopause. Trt, Hystorectomy/salpingoophorectomy(removal of uterus and both ovaries)
Cervical Dyplasia Abnormal Cells in cervix; Dysplastic cells can turn into cervical cancer. Treatment is conization
Endometriosis Endometrial tissue grows outside uterine cavity, endometrial tissue sloughs off and causes bleeding in abdominal cavity.
Cervical Cancer Caused by HPV - Gardisil can prevent
Ovarian Cysts Fluid filled sac in ovary- can rupture causing severe pain usually goes away on it's own
Ovarian Cancer The most lethal reproductive cancer. 50% only have a 5 year survival rate. A cancer of old age (over 50) It is assymptomatic into already mastisized to other body systems. Trt, hystorectomy
Polycystic ovanrian syndrome (PCOS) Numerous follicular cysts (not fluid filled). Increase in LH, Estrogen and andromgen levels and decrease in FSH levels. Treat with hormone therapy and laparoscopic surgery
Cystocele Bladder prolapse- Bladder prolapses into vaginal cavity - Usually due to damage of ligaments during childbirth - Trt A & P repair, bladder tack colporraphy
Rectocele Rectal prolapse - Rectal wall prolapses into vaginal cavity - Usually due to damage during childbirth or chronic constipation - Trt A & P repair, colporraphy
Uternine Prolapse Uterus prolapses into vaginal cavity - S/S Heavy dragging sensation in pelvis. Trt A & P repair, surgery Pessares device inserted into vagina that supports pelvic structures
Testicular Cancer Most common in men 15-35. 90% cure rate if caught early. Encourage male self exams. Treatment, orchiectomy (remove one testical and spermatic cord). Tends to be unilateral
Erectile Dysfunction Inability to acheive or maintain an erection that allows for satifying sexual intercourse. Common in men over 65, men on antidepressant, HTN meds, Diabetes, Prostate issues. Trt, doc can order PSA (Prostate specific antigen) To check for prostate cancer
Prostate Disorders All disorders affect urine stream. General Terms: DRE(Digital Erectile exam)TURP (Transurethral resection of the prostate)
BPH Benign Prostate Hyperplasia Most common in men over 50. Testosterone is converted to DHT ( dihydrotestosterone).In BPH there is too much DT and Estrogen
Prostate Cancer Leading Cancer in men over age 40- If diagnosed early has 100% cure rate!
Contraception Prevention of pregnancy
Fertility Awareness Calendar method- Belief that ovulation occurs on the same day each month - NOT reliable
Spermacides Use with barrier. Destroys or decreases motility of sperm. Creams, foam, gels etc
Barrier Method Condomas, diaphragms cervical cap. Prevents sperm from entering cervix
IUD T-shaped copper device in place for up to 5 years.
Hormonal Contraceptive Combination of estrogen, progestin. Pills patch, depo provera (IM)
Surgical Sterilization Considered permanent but it is possible to have reversed
Vasectomy Cut and tie vas deferens. Must follow up for sperm count
Tubal Ligation Cut and tie fallopian tubes
Infertility Inability to acheive pregnancy after 1 or more years of unprotected sex. Infertility can be caused by unstreated STD's that have cause PID (pelvic inflammatory disease)
Artificial Insemination Sperm in collected, stored and concentrated (for high sperm count) then inserted into vagina or egg is removed, fertilization done in lab and inserted into the uterus.
Hormone Therapy Stimulates ovulation which results in more than one egg being released.
Invitro Fertilization They take several fertilized eggs and implant them into the uterus in hopes that one woll implant.
Fertilization Uniting of 2 sex cells in the fallopian tubes. They then must travel to the uterus and implant for a normal pregnancy to occur. Sperm can live 72 hrs inside female. The ova is fertile for 12-24 hrs.
Placenta Shiny side = maternal side; Whiter shiney side= fetal side. Functions; Transports nutrients to baby; produces HCG, relaxen, fatty acids, glycogen and cholesterol for fetal use. Also protects and cusions fetus
Umbilical Cord 2 arteries,1 vein. Transports blood nutrients to fetus
3-layer germ will become embryo- Description of layers. Ectoderm (outside) -skin cells, NS, eyelenses; glands: Mesoderm(middle)-Muscles bones circulatory sys.: Endoderm (inner)- Respiratory system, bladder, liver and pancreas
Fetal developement: Pre-embryonic Stage Fertilization day 14
Fetal developement: Embryonic Stage Weeks 3-8 - All body systems are formed. 3rd week 3 layer germ formed will become embryo.
Fetal developement: Fetal Stage Weeks 9-birth - Body systems mature and begine to function
Fetal Circulation Begins at 4 weeks gestation - The umbilical vein carries oxygenated blood from placenta to fetus. The 2 arteries carry deoxygenated blood to the placenta.
Central Nervous System Present by the 6th week gestation but will not mature for 7-10 years
Respiratory System Lung structure mature by 23rd week but not able to function outside of uterus. Wks 20- 23 surfactant is produced
Surfactant Decreases surface tension inside alveoli and allows lungs to expand. Permits survival outside of uterus. At about 35 weeks gestation, surfactant has fully matured the lungs.
Gastrointestinal Forms in 4th week. Contain amniotic fluid which baby swallows. Contains protein, glucose, lanugo, and vernix. Meconium comprised of amniotic fluid, bile and epithilial cells. it should stay in bowel until after delivery. If not, could cause aspiration.
Reproductive External genitalia formed and visible by 12th week
Antepartal Diagnostic Testing Antepartal= Period before birth .. Tests done to check on fetal well-being HCG and Estriols are normally produced in pregnancy
Ultrasound / @18 weeks to check for spinal deformaties - No danger to baby - used 40 years
Triple Marker(Optional testing) 90% of women who have poor Triple Marker results will have a normal baby. AKA: MSAS or MSAFS: Blood draw to check for fetoprotein. Abnormally high/low can suggest problems. Done @16-20 weeks. Checks for neural Tube defects such as Spina Bifida, and Ancephaly (Failure of Brain to grow normally), Trisomy 18 and Down's Syndrome
Trisomy 18 Abnormally Low levels of fetoprotein, HCG and Estriols- The most severe birth defect possible. Numerous issues with all systems. Usually spontaneously aborted by the body
Downs Syndrome Low alpha protein, estroils and high HGC.
Amniocentesis
Non-stress test
Biophysical Profile
Fetal Breathing
Fetal Movement
Fetal Tone
Amniotic Fluid Volume
Fetal Heart Rate
Fetal Heart Monitoring
Health promotion prior to conception
Male
Female
Pregnancy
Ectopic Pregnancy
Categories of Drugs
Indications of Pregnancy
Presumptive
Probable
Hegars Signs
Goodell’s Sign
Chadwicks Sign
Positive
Teratogens
Antineoplastics
Tetracyclines
Radiation
Dilantin
Varicella
Rubella
STDs
Gonnorrhea
Syphallis
Group B Strep
Maternal Changes
Reproductive
Uterus
Cervix
Vagina
Breast
Cardiovascular
Respiratory
astrointestinal
Musculoskeletal
Endocrine
Anterior Pituitary
Posterior Pituitary
Hematologic
Prenatal Care
Initial Visit
Health History
Risk Factors
Physical Exam
Labs
TPALM
EDD
Teaching
Prenatal Schedules
Discomforts During Pregnancy
Meds Usable
Interventions
Fainting
Urinary Frequency
Nausea Vomiting
Hyperemesis Gravidarium
Increased Vaginal Discharge
Shortness of Breath
Heartburn
Backaches
Round Ligament Leg pain
Constipation
Hemmoroids
Trouble Sleeping
Nutrition Weight
Nutrients
Protein
Iron
Calcium
Folic Acid
Danger Signs in Pregnancy
High Risk Factors
Biophysical
Psychosocial
Sociodemographic
Environmental
Complications with Bleeding
Spontaneous Abortion
Ectopic Pregnancy
Placenta Previa
Marginal
Partial
Complete / Total
Abruptio Placentae
Marginal Central Complete
Hyperemesis Gravidarium
Caria Conditions
Congestive Heart Failure
Gestational Diabetes
Hyperpertensive Disorders
Gestational Hypertension
Chronic Hypertension
Pre-Eclampsia
Mild
Severe
Eclampsia
HELLP Syndrome
Hemolytic Disorders
Blood Types
ABO Incompatibility
Infections
TORCH
Tests To assess Maternal Well-being
Maternal Hemoglobin
Indirect Coombs Test
One Hour Glucose screen
Vaginal Culture
Types of Abortions / Miscarriages
Labor and Delivery
Lightening
Braxton Hicks contractions
Cervical Changes
Bloody Show
Rupture of Membranes
Nesting
When to go to the Hospital
Pain Management
Non-pharmacological
Lamaze
Effleurage
Guided Imagery
Pharmacological
Narcotics
Demerol
Regional Blocks
Epidural
Components of Labor and Delivery
5 P’s
Passageway
Pzssenger
Power
Position
Psyche
Process of labor
1st stage
Latent
Active
Transition
Amniotomy
2nd Stage
Episiotomy
3rd Stage
Shultz
Duncan
4th Stage
Cardinal Movements
Engagement
Descent
Flexion
Internal Rotation
Extension
Restitution
External Rotation
Expulsion
Nursing care of laboring mom
Assess
Data collection
External fetal monitoring
1st Step - Baseline heartrate
Baseline variability
Short term variability
long term variability
2nd Variation FHR
Reassuring
Nonreassuring
Danger Signs
Nursing DX/Goals/Intrapartum
Interventions
Nurses Functionsa time of delivery
Prepares
positions
cleans peri area
gets apgar
thermoregulation
cardiorespiration
meds to baby
vit k
ileotycin
Triple Dye
Assisted delivery
induction
augmentation
forceps
vacuum extraction
c-sections
incisions
labopr dystocia
nursing care
observce for hemmorage
iobserve for shock
fundud
lochia
pca pump
Newborn care(Initial)
Airway ! Prioity
Respiratory Distress
APGAR
Thermoregulation
Heat loss
Evaporation
Conduction
Convection
Radiation
Vital Signs
Respirations
Heartrate
Blood Pressure
Metabolic Adaptioin
Complete Assessment
Skin
Normal Variations
Acrocyanosis
Vernic Caseosa
Lanugo
Jaudice
Psyiologic Jaundice
Patholigic Jaundice
Mongolian Spots
Birthmarks
Talengioectactic Nevi
Stork bite
Nevi Flammeous
Port Wine Stain
Millia
Erythmea Toxicum
Newborn Rash
Head
Fontanels
Anterior
Posterior
Normal Variatioins Molding
Caput Succeedum
Cephalahematome
Eyes
Nose
Ears
Low Set ears
Mouth
Cleft Lip
Cleft Palate
Heart Sounds
Murmurs
Lung Sounds
Apnea
Abdomen
Umbilical
Meconium
Genitourinary
Genitalia
Female - Labia
Male - Scrotum
Pneudomenstrution
Smegma
Epistadius
Hypospadius
Anus
Extremeties
Simian’s Crease
Overall posture
Ortholani’s Maneuvers
Primitive Reflexes
Palmar
Plantar
Sucking
Rooting
Moro
Stepping/Walking
babinskis
Tonic Neck
Determining Gestational Age
New Ballard Score
Neuromuscular
Physical Maturity
Nurses Duties
Parent Teaching
Bathing
Labs/Medds
Hearing Screen
Nutrition
Preventing infections
Protection
Screening
PKU
Cyctic Fibrosis
Sickle ell Anemia
Circumcision
Gomco
Plastibell
Mogen
Discharge Teaching
Nutrition
Breastfeeding
Advantages to Breastfeeding
Disadvantages to Breastfeeding
Bottle Feeding
Advantages to Bottle Feeding
Disadvantages To Bottle Feeding
Latching
Formula Types
Stool Differences
PostPartum Period
Physiological Changes
Retrogressive
Psychological Changes
Progressive
Lactation
Uterus
Fundal Height
Fundal Consistency
Lactation
Involution
Lochia
Lochia Rubra
Lochia Serosa
Lochia Alba
Afterpains
Ovaries
Vagina
Breast
Cardiovascular
DVT
Gastrointestinal
Musculoskeletal
Urianry
Lacerations
Wt loss
Physiological
Taking in
Taking Hold
Attachment and Bonding
Postpartum Blues
Postpartum Assessment
Vital Signs
Heart Lungs
Focused
Breast
Uterus
Amount of lochia
Description of lochia
Bladder
Bowel Sounds
Pain
Labs
Bonding
C-Section Aftercare
Lung Sounds
Fetal Circulation: Ductus Arteriosis Diverts blood from the pulmonary artery to the aorta
Fetal Circulation: Foramen Ovale A hole that connects the rt and left atria, diverts blood from rt and left atrium to keep blood from going to the lungs
Fetal Circulation: Ductus Venosus A branch from umbilical vein diverts blood away from the liver
Fetal Circulation: General info Once infant takes 1st breath, circulation changes: Within 30 min-24 hours fetal circulation structures will close off and become ligaments
Amniocentesis @15-18 weeks, checks for abnormalities and blood incompatability
Non-stress test AKA Fetal monitoring. 40 minute test to check fetal movement and heart rate.
Reactive Non-Stress Test Reactive = good. 2 episodes of increased hr in 20 minutes by 15 beats per minutes for 15 seconds each time.
Non-reactive Non stress test Non-reactive = bad. Criteria not met for reactiveIf no increase of 15 bpm for 15 sec, Nurse notifies MD
Biophysical Profile Ultrasound and non-stress tests assess 5 variables - 1. Fetal Oxygenation 2. Movement 3. Tone 4. Amniotice fluid Vol. 5. Fetal Feart Rate
Fetal Heart Rate monitoring Done at mostly all prenatal visits. Heart rate can be heard @10 wks by using doppler on mom's abdomen.
Health promotion prior to conception (Male) Smoking decreases sperm motility - Stop exposure to chemicals etc. 3-4 months before conception
Health promotion prior to conception (Female) Eat low fat, high fiber diet, exercise, Prenatal Vitamins. Folic Acid prevents birth defects
Pregnancy Divided into 3 Trimesters = 9 months. 40 weeks gestational period
Ectopic Pregnancy When zygote does not implant in the uterus 95% of the time it is in a fallopian tube. If caught, must remove fetus and tube. If not caught, can cause maternal bleeding and death
Categories of Drugs Drugs are classified into 5 categories. Cat A Safe for mother to take while pregnant. B,C,D, presumed unsafe but not tested. Cat. X, Teratogenic to fetus.
Indications of Pregnancy-Presumptive Subjective Data - N/V, Fatigue, Frequent Urination, Quickening (fluttering), Cerical color changes, Breast and skin changes.
Indications of Pregnancy-Probable Objective Data - Abdominal enlargement, Cervical softening, Ballottment, Braxton Hicks, Palpation of fetal outline, Positive pregnancy Test. Hegar's, Goodel's and Chadwick's signs.
Indications of Pregnancy-Positive Diagnostic Signs of pregnancy - Auscultation of Fetal heart sounds, Fetal movement felt by examiner, visualization of fetus / Ultrasound etc
Hegars Signs Probable - Lower segment of uterus is soft,
Goodell’s Sign Probable - Softening of the cervix
Chadwicks Sign Probable - Bluish, purple discoloration of the cervix & vagina
Teratogens Agents that are known or believed to cause fetal harm and/or defects
Antineoplastics Cancer Drugs
Tetracyclines Antibiotic - Stains teeth and causes bone malformaties
Radiation Associated with congenital malformations and retardations. We do not know what constitutes a "high" amount
Dilantin Cleft Palate
Varicella Scarring of fetal skin and Limbs that are not completely developed.
Rubella Deafness, Cataracts and cardiac defects
Gonnorrhea,Syphallis,Herpes,Chlamydia,Group B Strep Blindness - Why we use Erythromycin ointment
Maternal Changes-Uterus Non pregnant weighs 2oz.& hold10ml of fluid. End of Pregnancy weighs 2lbs. & hold 5L of fluid.
Maternal Changes- Uterus location by week 12 wk in Abdominal Cav.; 16th wk. halfway between sympesis pubis&umbilicus; 20 wks, reached level of umbilicus, 24 wks. fundus enlarges 1cm per week (+ or -) 2cm
Maternal Changes-Cervix Very thick sticky mucus plugs opening to cervical os (mucus plug) Keeps microbes out. Expelling = Bloody show
Maternal Changes-Vagina copious secretions produced
Maternal Changes-Breast Swell due to estrogen, veins visible, straie (Stretch marks) Areola darkens
Maternal Changes-Cardiovascular Pulse increases 10-15 bpm,Cardiac output increases by 50%, Prone to Suppine Hypotensive syndrome (turn on left side to releive)
Maternal Changes-Respiratory Shortness of breath. by 12 wks, uterus pushes diaphragm upwards. 02 Demand increased,
Maternal Changes-Gastrointestinal N/V Very common, Constipation common, Heartburn
Maternal Changes-Musculoskeletal Lordosis, waddling, backache, pelvis feels "loose". Muscle cramps due to nutrient depletion.
Maternal Changes-Endocrine Pituitary gland inlarges by 135% due to producing hormones that are not usually produced. Gestational Diabetes,
Maternal Changes-Anterior Pituitary Begins to produce prolactin = Lactation
Maternal Changes-Posterior Pituitary Produces Oxytocin = Milk let down and uterine contractions
Maternal Changes-Hematologic Blood volume increases by 40-45% above normal. RBCs do not increase but the plasma volume does this is called hemodilution , anemia (Iron given) Venousstasis and hypercoagulation to protect from excessive bleeding during delivery.
Prenatal Care Initial Visit Health History Recognize Risk Factors Physical Exam, Labs drawn, EDD, Patient teaching. don't brush after vomiting 1 hour, Predisposition to gingivitis, no hot baths
GTPALM G- Gravida (no. Pregnancies),"T"Term (no. of term preg. 37-42wks), "P"para (no. of del. after 24 wks gest.) "A"Abortion (no. of abortions (any type) before 24 wks gest.)"L" Living (no. of currently living children)"M" multiples (no. of multiple births)
Due Date Estimation - Naegeles's Rule 1st day of last mentrual period, subtract 3 months, add 7 days.
Prenatal Schedules q4wks for 28 weeks, then q 2 weeks from week 29 - 36, then weekly from week 37-delivery.
Meds Usable Tylenol, Rolaids, Sudafed
Nutrients Needs 300 extra calories daily during pregnancy
Danger Signs in Pregnancy Fever, severe vomiting, unreleived headache,blurred vision ro spots, pain in epigastric region, sudden st gain or edema in face or hands, vaginal bleeding, painful urination, any fluid from vagina, decrease in fetal movement.
High Risk Factors (R/F) Anything that puts mom or baby's health at risk.
Biophysical R/F Abnormalities, genetics, poor nutrition, mother's health
Psychosocial R/F smoking, alcohol, drug use
Sociodemographic R/F Low income, poor nutrition, lack of prenatal care, marital status
Environmental R/F Air quality, pesticides, radiation, stress
Spontaneous Abortion Any loss of pregnancy before the 20th week
Placenta Previa - Blastocyte implants low in uterus, grows near, partially or over the cervical opening.
Placenta Previa Concern Later in pregnancy, cervix dilates and effaces, placenta tears away from endometrium. If this happens, will have to deliver or mom and baby die.
Placenta Previa - Partial Placenta near cervical opening but doesn't cover
Placenta Previa - Marginal Placenta covers part of the cervical opening
Placenta Previa- Complete/Total Placenta totally covers cervical opening
Abruptio Placentae Premature seperation of the placenta.
Abruptio Placentae - Marginal Edge of placenta seperates = Bright red bleeding
Abruptio Placentae - Central Center of placenta seperates. blood gets trapped between placenta and uterus. No bleeding but painful
Abruptio Placentae-Complete Entire placenta seperates. Profuse bleeding, very painful. uterus is firm and boardlike. Deliver ASAP
Hyperemesis Gravidarium Excessive Vomiting -
Congestive Heart Failure Commonn in pregnancy - Cardiac output increases by 50%. S/S Edema, Crackles/Rails lung sounds, dyspnea on exertion, cough, no energy, heart murmur
Gestational Diabetes Only occurs during pregnancy - Did not have before
Gestational Hypertension Transient - will go away, BP 140/90 or higher
Chronic Hypertension HTN that was present before pregnancy and lasts beyond past 12 weeks of delivery
Pre-Eclampsia Mild: usually no complaints, Severe:
Mild BP 30 sys. & 14 dias. over norm. Decreased urine output, proteinuria, marked edema hands and face, wt gain 1 lb per week, Hyper deep tendon reflexes, 1+ protein
Severe BP 160/110 or greater, Headache, vision changes, 2+ protein, Generalized edema all over,Wt gain 2+ lbs per week urine < 500ml/24hrs. Give Mag Sulfate
Magnesium Sulfate- MgS04 Magnesium Sulfate Therapeutic Range 4-8 mg/dl. Keep calcium gluconate or calcium carbonate at the bedside (Antedote).Mon. for deep tendon reflexes.
Eclampsia Caused by severe preeclampsia. Grand mal seizures, possible coma,
HELLP Syndrome Hemolysis, Elevated liver enzymes, Low platelet count -- When BP is elevated blood vessells are damaged, If blood can't get through, RBCs breakup. Platelets < 100,000
Blood Types A B AB O
ABO Incompatibility If mom is negative and baby is positive.
TORCH -T Toxoplasmosis -Infection caused by a protozoan-Eating raw, uncooked meat, cat littler, steam deli meats
TORCH -O Other - Hep B, Syphillis, Varicella,
TORCH -R Rubella German measles- Deafness most common impairment
TORCH -C Cytomegalovirus - Type of herpes.
TORCH -H Herpes Simplex Virus Cold sores, genital herpes
Maternal Hemoglobin Checked at 1st prenatal and again at 7 months to assess for anemia which could cause hypoxia in baby
Indirect Coombs Test Done at 28 weeks if mom is RH negative to see if she has been sensitized
One Hour Glucose screen
Vaginal Culture
Types of Abortions / Miscarriages
Labor and Delivery
Lightening
Braxton Hicks contractions
Cervical Changes
Bloody Show
Rupture of Membranes
Nesting
When to go to the Hospital
Pain Management
Non-pharmacological
Lamaze
Effleurage
Guided Imagery
Pharmacological
Narcotics
Demerol
Regional Blocks
Epidural
Components of Labor and Delivery
5 P’s
Passageway
Passenger
Power
Position
Psyche
Process of labor
1st stage
Latent
Active
Transition
Amniotomy
2nd Stage
Episiotomy
3rd Stage
Shultz
Duncan
4th Stage
Cardinal Movements
Engagement
Descent
Flexion
Internal Rotation
Extension
Restitution
External Rotation
Expulsion
Nursing care of laboring mom
Assess
Data collection
External fetal monitoring
1st Step - Baseline heartrate
Baseline variability
Short term variability
long term variability
2nd Variation FHR
Reassuring
Nonreassuring
Danger Signs
Nursing DX/Goals/Intrapartum
Interventions
Nurses Functionsa time of delivery
Prepares
positions
cleans peri area
gets apgar
thermoregulation
cardiorespiration
meds to baby
vit k
ileotycin
Triple Dye
Assisted delivery
induction
augmentation
forceps
vacuum extraction
c-sections
incisions
labopr dystocia
nursing care
observce for hemmorage
iobserve for shock
fundus
lochia
pca pump
Newborn care(Initial)
Airway 1 Priority
Respiratory Distress
APGAR
Thermoregulation
Heat loss
Evaporation
Conduction
Convection
Radiation
Vital Signs
Respirations
Heartrate
Blood Pressure
Metabolic Adaptioin
Complete Assessment
Skin
Normal Variations
Acrocyanosis
Vernic Caseosa
Lanugo
Jaudice
Psyiologic Jaundice
Patholigic Jaundice
Mongolian Spots
Birthmarks
Talengioectactic Nevi Stork bite
Nevi Flammeous Port Wine Stain
Millia
rythmea Toxicum Newborn Rash like mosquito bites
Head
Fontanels
Anterior
Posterior
Normal Variatioins Molding
Caput Succeedum
Cephalahematome
Eyes
Nose
Ears
Low Set ears
Mouth
Cleft Lip
Cleft Palate
Heart Sounds
Murmurs
Lung Sounds
Apnea
Abdomen
Umbilical
Meconium
Genitourinary
Genitalia
Female - Labia
Male - Scrotum
Pneudomenstrution
Smegma
Epistadius
Hypospadius
Anus
Extremeties
Simian’s Crease
Overall posture
Ortholani’s Maneuvers
Primitive Reflexes
Palmar
Plantar
Sucking
Rooting
Moro
Stepping/Walking
babinskis
Tonic Neck
Determining Gestational Age
New Ballard Score
Neuromuscular
Physical Maturity
Nurses Duties
Parent Teaching
Bathing
Labs/Meds
Hearing Screen
Nutrition
Preventing infections
Protection
Screening
PKU
Cyctic Fibrosis
Sickle ell Anemia
Circumcision
Gomco
Plastibell
Mogen
Discharge Teaching
Nutrition
Breastfeeding
Adv
Disadvantages
Bottle
Adv
Disadvantages
Latching
Formula
Stool Differences
PostPartum Period
Physiological Changes
Retrogressive
Psychological Changes
Progressive
Lactation
Uterus
Fundal Height
Fundal Consistency
Lactation
Involution
Lochia
Rubra
Serosa
Alba
Afterpains
Ovaries
Vagina
Breast
Cardiovascular
DVT
Gastrointestinal
Musculoskeletal
Urianry
Lacerations
Wt loss
Physiological
Taking in
Taking Hold
Attachment and Bonding
Postpartum Blues
Postpartum Assessment
Vital Signs
Heart Lungs
Focused
Breast
Uterus
Amount of lochia
Description of lochia
Bladder
Bowel Sounds
Pain
Labs
Bonding
C-Section Aftercare
Lung Sounds
Respiratory Depression
IV
Dressing
Bowel Sounds
Urinary output
Thrombosis Formation
Ambulation
Passing Gas
Diagnosis
Interventions
Teaching
Postpartum complications
hemorrage
Early
late
Lacerations
Infection
Edometritis
Mastitis
Venous Thrombolism
Diseminated Vascular Coagulation DIC
P/P/ Depression
P/P Psychosis
Methergine
Hemabate
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