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VSNG1230 Test 2

Blueprint for OB Test 2

QuestionAnswer
Common signs and symptoms of iron-deficiency anemia in the pregnant woman are tachycardia, tachypnea, dyspnea, pale skin, low BP, heart murmur, headache, fatigue, weakness, and diszziness. Pica, and pagophagia are also associated with SEVERE iron-deficiency anemia.
Anemia during pregnancy is indicated by hemoglobin levels less than 10 g/dL
Nursing care for iron-deficiency anemia during pregnancy Counseling, Vitamin C enhances and folate, Iron supplements predispose to constipation, support and teaching, adequate fluid intake and rest are important.
Treatment for iron-deficiency anemia during pregnancy diet rich in iron and folate in addition to iron and folate supplementation. Folate increases the effectiveness of Iron therapy. Rarely is a blood transfusion needed.
What medication cannot be continued during pregnancy? Coumadin
C-Section during genital warts Should be done anytime, not just during outbreaks. Baby is always at risk for getting it transmitted.
Treatment of Asthma during pregnancy Mgmt of acute exacerbation, inhalers used for treatment, labor and birth mgmt, will have to alter med management
Why would you alter asthm med mgmt during pregnancy? Some cross the placental barrier
Nursing care for asthma during pregnancy Teaching is a major role, smokking cessation and control of the environment
Because the pregnant woman has increased iron requirements, she is particularly vulnerable to iron-deficiency anemia
Pregnant women with a poorly controlled asthma experience a higher incidence of preeclampsia-eclampsia, hemorrhage, premature labor, respiratory failure, and death.
If asthma is well controlled throughout pregnancy, perinatal outcomes are similar to those of the general population.
epilepsy is a group of neurologic disorders that involve a long-term tendency to have recurrent unprovoked seizures
Treatment for epilepsy during pregnancy current recommendations are for the woman to remain on the drug that most effectively controls her seizures (typically does not cross barrier)
Nursing care of status epilepticus during pregnancy teach importance of carefully following her treatment regimen, eating a diet high in folic acid and of taking folic acid supplements, provide emotional support during prenatal testing for fetal anomalies.
Toxoplasmosis is acquired from litter boxes
TORCH stands for Toxoplasmosis, Other infections (Hep B, Syphilis, Varicella, Herpes Zoster), Rubella, Cytomegalovirus, Herpes Simplex Virus
Chlamydia Most common STI in the US, untreated increases the risk of contracting HIV/AIds
The major risk to the pregnancy during seizure results from blunt trauma. Trauma can lead to miscarriage, premature rupture of membranes, and placental abruption.
This is highly recommended for the woman with epilepsy wishing to become pregnant preconception care
The physician may try to wean the woman from the AED because they are typically the cause of these fetal defects clept lip and palate and cardiac, urinary tract, and neural tube defects comprise the majority of malformations
The physician advises the woman to wait at least how long after seizures are under control before trying to become pregnant 6 months
AEDs increase the risk for neural tube defects so she should receive a high dose of folate supplementation in the 1-3 months preceding and throughout pregnancy
Status epilepticus is an emergency complication of epilepsy whereby seizure activity continues for 5-30 minutes or more after treatment is initiated or when three or more seizures occur without full recovery between seizures.
Blood work for seizures includes glucose, electrolytes, CBC, AED levels, and blood and urine tox screens.
The physician starts 2 iv lines post-status epilepticus to allow for iv admin of benzos such as diazepam or lorazepam
Advice for the epileptic pregnant woman Eat a diet high in folic acid. Also plenty of rest and sleep and to exercise regularly.
Sleep on what side during pregnancy? Left
Assessment for TORCH History: flulike symptoms, fatigue, cat exposure, genital lesions, rash, exposure to sick children.
Assessment for TORCH Physical Exam: lymphadenopathy, headache, malaise, jaundice, NV, low-grade temp, rash, ulcerated and painful lesions of the genitals
Assessment for TORCH Psychosocial: Fear, anxiety, apprehension
Diagnostics for TORCH Serologic Tests: TORCH screen, CBC< HBsAg and HBeAg, Liver function tests; Cultures: CMV, HSV; Pap smear; Serial ultrasounds (monitor for IUGR and other defects throughout preg)
Interventions for TORCH Instruct woman regarding specifics of the infection, transmission, and meds and med mgmt; Reinforce importance of hand washing; encourage questions; suggest a multidisciplinary conference with family members; encourage breast feeding
S/S of Toxoplasmosis: chorioretinitis, intracranial calcification, and hydrocephalus in the newborn
toxoplasmosis is difficult to diagnose because it rarely produces symptoms in the woman. It is particularly harmful if the fetus contracts the parasite between 10 and 24 weeks of pregnancy
Treatment of Toxoplasmosis spiramycin, pyrimethamine, and sulfadiazine.
The woman with toxoplasmosis also takes folinic acid to prevent bone marrow suppression.
Perinatologist Treats mother and baby during and after pregnancy
neonatologist treats only the baby after it's been born
Selected risk factors for Gestational Diabetes Mellitus History of a large-for-gestational age infant, history of GDM, previous unexplained fetal demise, advanced maternal age (>35years), Family history of Type 2 diabetes or GDM, Obesity (>200lb), Non-caucasian ethnicity, FBG >140, RBG >200
The woman with Type 1 DM Fetal surveillance, Diet, Exercise (with approval), Insulin therapy
The woman with GDM Fetal Surveillance, Sometimes insulin, exericise, diet.
It is important to monitor fetal growth because macrosomia occurs more commonly in women with Gestational DM. Conversely, for the woman with longstanding DM or vascular disease, the fetus may be growth restricted.
Nursing Process Implementation for the pregnant wioman with DM Monitor mgmt of therapeutic regimen, Monitor for and prevent infection, Monitor fetal status
Gonorrhea Second in prevalence, Resistant to antibiotics, Can leave the woman infertile or susceptible to ectopic pregnancy because of scarring in the reproductive tract.
Human papillomavirus Most common viral STI in the US, Has a tendency to increase in size during pregnancy, Neonatal HPV infection can result in life threatening laryngeal papillomas. Causes Cervical Cancer
Trichomoniasis Associated with adverse pregnancy outcomes, infections diseases, White milky discharge from Males - female has funky crotch stink.
HIV/AIds Very important for the practitioner to know the pregnant womans HIV status
2 main goals of treatment for the pregnant woman with HIV Prevent progression of the disease in the woman, Prevent perinatal transmission of the virus to the fetus.
Transmission of HIV to the baby can occur during birth or during breast feeding
Treatment of women with IPV routine screening of all women is the key to assisting those who are ready to report abuse and receive help; interventions for the victim of IPv are directed toward safety assessment and planning.
Be careful to only respond to the IPV victim only with supportive statements
Adolescent pregnancy issues many pregnant teens seek late prenatal care, may be fearful of disclosing pregnancy
Treatment for teen pregnancy prevention. advocacy. help them develop a support network.
Nursing care for teen pregnancy Care for developmental needs, adequate nutrition is essential, care for emotional and psychological needs, Be knowledgeable about community resources
Pregnancy Later in life nursing care approach with an open mind, may feel they have "too much" med info and feel overwhelmed, good skin care.
Hyperemesis Gravidarum Disorder of early pregnancy characterized by severe nausea and vomiting, results in weightloss, nutritional deficiencies, and or electrolyte and acid/base imbalalce
Hyperemesis Gravidarum most often appears between 8 and 12 weeks and usually resolves by week 20
Exact cause of Hyperemesis gravidarum is unclear
Risk of hyperemesis is increased with multiple gestations, molar pregnancy, history of hyperemesis gravidarum, stress and psycho factors can contribute
Molar Pregnancy mimics pregnancy. Is not actual pregnancy. Best indicator of hyperemesis gravidarum.
Created by: christinego