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68WM6 P2 maternal 2

Maternal chapter 27

Abruptio Placentae Premature separation of a normally implanted placenta.
Antiphospholipid Antibodies Autoimmune antibodies that are directed against phospholipids in cell membranes. It is associated with recurrent spontaneous abortions, fetal loss, and severe preeclampsia
Bicornuate Uterus Malformed uterus having two horns.
Cerclage Encircling the cervix with suture to prevent recurrent spontaneous abortion caused by early cervical dilation.
Dilation and Curettage (D&C) Stretching the cervical os to permit suctioning or scraping of the walls of uterus. This is performed in abortion, to obtain samples of uterine lining tissue for laboratory examination, and during postpartum to remove retained fragments of placenta.
Dilation and Evacuation (D&E) Wide cervical dilation followed by mechanical destruction and removal of fetal parts from the uterus. After complete removal of the fetus, a vacuum curet is used to remove the placenta and remaining products of conception.
Afterpains Cramping pain after childbirth caused by alternate relaxation and contraction of uterine muscles.
Atony Absence or lack of usual muscle tone.
Catabolism Destructive process that converts living cells into simpler compounds; process involved in involution of the uterus after childbirth.
Decidua Name applied to the endometrium during pregnancy. All except the deepest layer is shed after childbirth.
Diastasis Recti Separation of the longitudinal muscles of the abdomen (rectus abdominis) during pregnancy.
Dyspareunia Difficuld or painful coitus in women.
Engorgement Swelling of the breasts resulting from increased blood flow, edema, and presence of milk.
Episiotomy Sugical incision of the perineum to enlarge the vaginal opening.
Fundus Part of the uterus that is farthest from the cervix, above the openings of the fallopian tubes.
Involution Restrogressive changes that return the reproductive organs, particularly the uterus, to their non-pregnant size and condition.
Kegal Exercises Alternate contracting and relaxing of the pelvic muscles. These movements strengthen the pubococcygeal muscle, which surrounds the urinary meatus and vagina.
Lactation Secretion of milk from the breasts; also describes the period of breastfeeding.
Lochia Alba White or cream-colored vaginal discharge that follows lochia serosa. Occurs when the amount of blood is decreased and the number of leukocytes is increased.
Lochia Rubra Rededish vaginal discharge that occurs immediately after childbirth; composed mostly of blood.
Lochia Serosa Pink or brown-tinged vaginal discharge that follows lochia rubra and preceds lochia alba; composed largely of serous exudate, blood, and leukocytes.
Milk-Ejection Reflex Release of milk from the alveoli into the ducts; also known as the letdown reflex.
Oxytocin Posterior pituitary gland hormone that stimulates uterine contractions and the milk-ejection reflex. Also prepared synthetically.
Prolactin Anterior pituitary homone that promotes growth of breast tissue and stimulates production of milk.
Peurperium Period from the end of childbirth until involution of the reproductive organs is complete; approximately 6 weeks.
REEDA Acronym for redness, ecchymosis, edema, discharge, and approximation; useful for assessing wound healing or the presence of inflammation or infection.
Subinvolution Delayed return of the uterus to its non-pregnant size and consistency.
Acrocyanosis Peripheral cyanosis; the blue discoloration of the hands and feet in most infants at birth that may persist for 7-10 days.
Autolysis Self-dissolution of self-digestion in tissues or cells by enzymes in the cells.
Circumcision Surgical procedure in which a part of the foreskin is removed, leaving the glans penis uncovered.
Colostrum Breast fluid that may be excreted from the seconde trimester of pregnancy onward ut is most evident in the first 2-3 days after birth and before the onset of true lactation. Thin yellowish fluid is rich in proteins and calories,
Cryptorchidism Failure of testes to descend into te scrotum.
Diaphoresis The secretion of sweat, especially the profuse secretion of sweat.
Diuresis Secretion and passage of large amounts of urine.
Fontanelle Broad area or soft spot consisting of a strong bond of connective tissue between an infant's cranial bones.
Gynecomastia Development of abnormally large mammary glands in a male that sometimes may secrete mil. When observed in the newborn, it is in response to maternal hormones; may be noted in either sex of the newborn.
Harlequin Sign Rare color change of nopathologic significance occurring between the longitudinal halves of the newborn's body; when te infant is placed on one side, the dependent half is noticeably pinker than the superior half.
Homans' Sign Early sign of thrombophlebitis of the deep beins of the calf in which there are complaints of pain when the leg is in extension and the foot is dorsiflexed.
Lanugo Downy, fine hair characteristic of the fetus between 20 weeks and birth; most noticeable over the shoulders, forehead, and cheeks, but found on nearly all parts of the body except palms of hands and soles of feet.
Latch-On Attachment of the infant to the breast for feeding.
Meconium First stools of the infant; viscid, dark greenish brown, almost black; sterile; odorless.
Parent-Child Attachment (Bonding) Initial phase in a relationship characterized by strong attraction and a desire to interact.
Polydactyly Excessive number of digits (finger or toes).
Pseudomenstruation Discharge of blood-tinged mucus from the vagina of the newborn, which occurs in response to maternal hormones.
Syndactyly Malformation of digits, commonly seen as a fusion of two or more toes to form one structure.
Vernix Caseosa Protective, gray-white fatty substance of cheesy consistency covering the fetal skin at birth.
A woman has delivered her fist baby, vaginally after 6 hours of labor. She had an uneventful pregnancy and is in good health. She is transferred from the recovery room to the postpartum unit. Routine care of the postpartum patient includes all except: Massaging the fundus firmly every 15 minutes.
The nurse is performing a routine postpartum assessment. Before measuring the height of th epatient's fundus, the nurse should: Ask the patient to empty her bladder.
The nurse finds brigt red bleeding on a patient's peripad. The stain is about 6 inches long. What is the correct discription of the character and amount of lochia? Lochia rubra, moderate.
The nurse is teaching breast care for the lactating woman. It should include all of the following except: Washing breasts and nipples with soap and water before each feeding.
A woman asks the nurse how she will know her baby is getting enough milk. The nurse's response is based on her knowledge that a good determinant is the baby: has 6-10 wet diapers per day.
In evaluating maternal adjustment, which behacior would lead the nurse to believe that the patient is still in the taking-in phase? she: spends the majority of her time talking about her delivery experience.
A baby boy is 1 hour old. He weighs 7 pounds, 3 ounces; is 21 inches long; has irregular respirations of 42 breaths/min with adequate chest movement, a heart rate of 145 bpm, and temp of 35.6 C, axillary; and is acrocyanotic. What is an appropriate goal? Temperature will stabilize at 36.5-37 degrees celcius.
When teaching parents how to bathe their baby, which point should the nurse stress? Do not immerse the baby in water until after the umbilical cord has fallen off.
The nurse teaches parents about care of the umbilical cord. What is not a part of this care? Keeping the cord moist to promote healing.
A baby has a Gomco circumcision. What instruction would the nurse give his parents for care of the circumcised penis? Cover the glans wit a petroleum gauze dressing.
On examing a woman who gave birth 5 hourse previously, the nurse finds that the woman has saturated a perineal pad within 15 minutes. The nurse's first action is to: Palpate the woman's fundus.
A woman gave birth 48 hours ago to a healthy baby girl. She has decided to bottle feed. During the assessment, the nurse notices that both breasts are swollen, warm, and tender on palpation. The patient should be advised that this is best treated by: Applying ice to the breasts for comfort.
A first-time mother is to be discharged from the hospital tomorrow with her baby girl. Which behavior indicates a need for further intervention by the nurse before she can be discharged? The woman: Leaves the baby on her bed while she takes a shower.
The nurse observes several interaction between a postpartum woman and her new son. Which behavior if exhibited by this woman, would the nurse identify as maladaptive regarding parent-infant attachment? Seldom makes eye contact with her son.
The nurse can help a father in his transition to parenthood by: Pointing out that the infant turned to his voice.
When performing a postpartum assessment, the nurse should: Assist the patient into a lateral position with upper leg flexed forward to facilitate examination of her perineum.
The nurse helps change a newborn's diaper after the baby's first bowel movement. The mother expresses concern since there is a large amount of sticky, darkgreen-almost black-stool. Mom asks the nurse if something is wrong. The nurse's best response is to: Explain that this typos of stool is called meconium and is expected for the first few bowel movements of all newborns.
Refers to the processs whereby an infant's behacior and characteristics acall forth a corresponding set of maternal behaviors and characteristics. Bonding.
Refers tot he face-to-face position in which a parent's and infant's faqces are approximately 20 cm apart and on the same plane or level. Enface.
Phase of postpartum admustment characterized by a woman's need to review her labor and birth experiences with the nurse who cared for her while she was in labor.Other behaviors exhibeted include reliance on others to help meet needs and excietement. Taking-in.
Term applied to a parent's absorption, preoccupation, and interest in his or her infant; the term typically is used to describe the father's intense involvement with his newborn. Engrossment.
Milia Small white spots usually seen on the nose and chin of a newborn.
Newborn Rash (eythema toxicum neonatorum) An elevated, hivelike rash that may result in small while vesicles on the newborn.
Telangiectatic Nevi (stork bites) Flat pink or red marks often seen on the eyelids, nose, or nape of the neck on a newborn. Become more vivid when the infant cries.
Mongolian Spots Areas of increased pigmentation on the newborn, most common on the lumbar dorsal area. May appear bluish black.
Nevus Flammeus (port-wine stain) A reddish purple discoloration often seen on the face of a newborn.
Strawberry birhtmarks (nevus vasculosus) Capillary hemangiomas.
BUBBLE-HE Assessment for the postpartum patient. Breast, Uterus, Bladder, Bowel, Lochia, Episiotomy, Homans' Sign, and Emotional Status.
Peurperal Phases Taking-in phase, taking-hold phase, letting-go phase.
Taking-In Phase Mother is focused primarily on her own need for fluid, food, and sleep. May recount the details of her labor and delivery many times. Attemps to piece together all the details of the birth. Helps the mother realize pregancy is over.
Taking-Hold Phase Mother becomes more independent, exhibits concern about managing her own body functions and care. May compare her infant to others. Often called the "teachable, rechable, referable moment".
Letting-Go Phase Time of relingquishment for the mother and often father also. They must relinquich the infant of their fantasies and accept the real infant, also their previous lifestyle if it is their first kid.
Lochia is characterized by: It's appearance and contents; IE color, amount, odor, and presence of clots.
Lochia volume Heavy is saturating a pad every 2 hours, moderate is less than a 6" stain, light is less than a 4" stain, scant is less than a 2" stain, and excessive is saturation of a peripad within 15 minutes.
Episiotomy comfort measures: Ice pack, topical medications(dermoplast, epifoam, tucks pads), sitz bath, dry heat, oral analgesics.
Rho(D) Immune Globulin (Rho Gam) Given to a RH-negative mother who has a RH-positive infant within 72 hours of birth.
Postpartum Danger Signs Passive reactions either verbal or nonverbal, hostile reactions, disappointment over the sex of the baby, lack of eye contact, and non-supportive interaction between parents.
Give an oxytocic medication such as Pitocin or Methergine if: The fundus is not firm and massaging and breast feeding does not increase the muscle tone (boggy uterus).
Created by: djv