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nur 124 exam 2

type one diabetes no insulin, age 20 and below
type two insufficient insulin receptors,have insulin, age 40 and up
fetal risks of diabetes spontaneous abortion,stil birth, lethal congenital malformation, shoulder dystocia, birth injuries, dont produce surfactant
maternal risks of diabetes preeclampsia, progression of retinopathy, infections. obstructed labor
best time to excersise after meals BS is rising
infant BG should be above 50
after birth baby still produces in excess of insulin to take care of in excess of glucose that has now stopped resulting in decreasing glucose after birth
breast feeding decreases glucose in mom
28 wks estrogen, progesteron and HCl decrease insulin productionto allow more glucose for baby. Allows mom to have more energy for growing fetus
failure to progress bad contractions, bad passage
hypotonic dysfunction contractions too weak from extended uterus, analgesia, anesthesia, bad pelvis
a pregnancy that ends before 20 wks and 500g wt, no surgical/medical intervention spontaneous abortion
slight spotting, cramping, no passage of tissue, no dialation threatened abortion
open cervical os, heavey bleeding, severe cramping, expulsion of fetus, retain placenta incomplete abortion
expulsion all fetal tissue, cervix closed, light bleeding/cramping complete abortion
tx for both incomplete/complete dilation curettage. D n C
fetus died with conception products retained missed abortion, tx medica/sirgocal termination
fertilized ovan attaches outside of uterus ectopic preg, tx surgical removal, methotrexate for absorption of preg
ectopic preg causes inf, scaring of falopian tubes causing more ectopic pregsz
eggs nucleus is deactivated, sperms nucleus replicates. resembles a unch of grapes hydatidiform mole, tx pass on own or suction curettage. seem preg w hcg levels
placenta implanted in lower section of uterus placenta previa
premature separation of placenta placenta abruption
signs of placental previa bleeding aftter 20wks, vs normal, tx ultrasound for placental placement, no vag exam, <36wks no activity monitor, at term c-section
risk factors for placental abruption maternal hypertension, cocaine,
signs of placental abruption bleeding, ab pain, contraction hypertonis, abn FHR increases, maternal hypovolemia/shock inc HR, dec BP, tx: amild prior 36wks=observation, if bad birth now
cure for gestational hypertension birth
vasospasm that impeedes blood vlow to all the organs and increses BP. preeclampsia
signs of preeclampsia bp > 140/90 on 2 separate takings > 2hr apart, proteinuria 2 takings 6hr apart
used to prevent convulsions caused by pre and eclampsia. decreases neuromusclur irritability. dec contractions for preterm labor magnesium sulfate
anecdote for magnesium sulfate calcium glutenate
therapuetic level of magnesium sulfate 4-8, always ngo through IV pump
produced by breakdown of red blood cells bilirubin, toxic to body
unconjucted indirect bilirubin is released , not water soluable, liver changes it to conjucted direct by conjugation now can be excreted.
excess unconjucted indirect bilirubin absorbed subQ tissue causing yellowing jaundice
staining of tissues of brain causing permant damage kernicterus
jaundice occuring p 24hr stopping in 7 days or 48hr p birth for 9 days physiological jaundice, unconj bill<= 12,direct bil <= 1.5,
jaundice more likely to cause brain damage, shows before 24hr and lasts for 7-10 days pathologioc
tx for jaundice feeding, phototherapy, eye protection, hydration, no lotions, check temp
TORCH toxoplasmosis, other, rubella, cytomeglovirus, herpes
virus in mom from cat feces, uncooked meat, causes swollen glands fatigue, muscle pains toxoplasmosis
virus in fetus/nb toxoplasmosis abortion, asymptomatic at birth, neurologic damage years later
TORCH "other" HIV, hepatitis B, gonorrhea, parvovirus B19, syphilis, varicella
HIV mom=decrease immune, nb=asymptomatic at birth
Hepatits B mom=v, ab pain, jaundice, fever, rash, painful jts; nb=HBiG at birth, hepatitis B vac at birth and scheduled
parvovirus B19 older children 5th desease, during preg inf results in miscarriage, hydrops, internal uterine growth retardation, anemia
moms w HIV cannot breat feed, keep membranes intact, c-sec, will give med during labor to prevent transmission
group B strep causes neonatal sepsis, vag/rectal culture at 34-36wks, penicillian drug choice
rubella droplet contact, nasopharyngeal secreation, immune=1:8>, live MMR vac give w/i 15 mins of draw up subq, DO NOT GET PREG W/I 28 DAYS.
rubella mom=rash, fever, malaise, nb=worse in 1st tri, deafness, cataracts, heart defects, retardation
cytomeglovirus form of herpes, in urine, saliva, vaginal secretions, semen, breast milk, feces, common in daycares, use good hand hygene
cytomeglovirus effects mom=asymptomatic, cold symptoms, no tx, nb=most asymptomatic, deafness, blindness, seizures, retardation, some symptoms dont show for years
herpes mom=vesicles/shallow ulcers, crust over in genital areas, if active during labor=c-sec, tx=acyclovir during preg, nb=mortality rate w/o antiviral 25%
aspiration of amniotic fluid to test lung maturity 2/3 tri amniocentesis, good lungs= 1:2, need consent
inj used to decrease contractions tribulitine, breatherine
maternal serum triple/quad screen test for downs, neural tube defects, trisomy 18, AFP, 16-18 wks gest
NST nonstress test 32 wks gest, for adequate oxygenation of fetus, for non movement, prior still borns, baby not growing, Need 15 beats above base x 15 sec and have 2 of those in 20-30 min time period. want it to be "reactive"
CST contraction stress test after 34 wks, IV pitocin/nipplen stim; reg=good no decelerations w or wo contractions, pos=bad decelerations w contractions. need to deliver soon, c-sec, baby cant tolerate contractions
biophysical profile BPP NST=2(reactive), ultrasound 2pts for each..fetal movements, FHR, fetal resp, amniotic fluid index (AFI) 8-10=normal, <6 need to deliver
dep-provera inj progesterone q 11-13wks, doesnt effect lactation, lose bone density, delays fertility 18th after quitting, take w vit D, hair loss
essure implants into fallopian tube results in scarring 99% effective
implanon preogestin continous release, rod in place x3yrs, irregular bleeding, reversible
ortho evra patch, chnage q wkx3wks, 1wk patch free,
nuvaring releases med continously, insert sun p menes remove in 3wks, ring free 1wk, vag irritation
oral contraceptives synthetice estrogen, progesterone, supresses ovulation, protects against ovarion/endometral cancer, decreases effectiveness of antiterburculosous drugs, anticonvulsants, antifungals, anti HIV
intrauterine contraceptives, mirena inplace all times, long erm low cost, reversible, can b expelled wo knowledge, increases pid,
chemical birth control barriers spermicidal and foam
hormonal barriers OCPs, inj, transdermal, vaginal,
mechanical barriers condum, IUD, diaphragm, cervical cap, sponge
clamydia yellow dc, painful urination tx: both partners
gonorrhea bacterial gr- diplococcus, direct contact w inf mucosa, vag dc, dysuria, tx: cephalosporins
trichomonas vag inf by protozoa, yellow-green dc, itching, strawberry cervix tx: flagyl, no ETOH
syphilis painless shankers, any tissue, treponema pallidum spirochette, contact, penicillian
HSV1 oral, sunlight triggers them
HSV2 genital
postpartum hemorrhage vag-500ml, c-sec 1000ml
causes of hemorhage uterine atony,trama, placental fragments, terus not returning to normal size
assessment of hemorhage check fundus, void, remove clots, bleeding, vitaql signs,
hemorrhage drugs
methergine contraomdocated in hypertension
carboprost (HEMABATE) prostoglandin used in extreme cases
cytotec now used more than methergine
inf of hte uterine lining metritis
perineal or if c-sec could ber incisional wound inf
caused by staph aureus or e coli, spread by moms hands staff or babys mouth mastitis
LAS inflammation at the site with drainage. Pain at site. foul smelling urine. inflamed berasts
GAS temp 100.4 or higher, WBC above 20,000. aching and flu like symptoms
PGAS states feels unable to cope
transient. doesnt seriously afffect mothes ability to give care tgo nbor herself postpartum blues
difficulty taking care of herself or nb. irritability postpartum depression
very serios, delusional, manic, poor judgemenmt postpartum psychosis
obstruction of airway causing pneumonitis meconium aspiration
lack of surfactant production resp distresstransient tachypnea, babys resp symptom get worse
failure to progress contraction probs, passage prob
coordinated, but wek infreqeunt and brief contractions hypotonic dysfunction from overextended uterus, analgesia
artificial rupture of the amniotic sac amniotomy-probs prolapse cord, inf
increase effecticveness of contractions that are already present augumentation
contractions are not present. causing contractions to occur inductions
head is born, anterior shoulder cannot pass under pubic arch shoulder dystocia
rapid acting insulin onset: wi 15 min, peak: 2-3hr, dur: 3-4hr
short acting insulin onset: 30 min, peak: 3-4hr, dur: 6-8hr
intermediat acting onset: 2-4hr, peak: 4-12hr, dur: 12-24hr
long acting onset: 3-4, peak: 14-24, dur: 24-36hr
best time to excersie is after meals, BS is rising
1hr glucose test >140
3hr glucose test >100
maintain BG level at 110
Created by: vstein