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NPN 201
Final Study Guide Maternal/Newborn
| Question | Answer |
|---|---|
| 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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