Maternity123
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| What is a triple screen? When is it administered? | (AFP- Alpha-fetoprotein); HGC; and unconjugated estriol levels- over age 35 at the 15th week of pregnancy
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| Why do we do a triple screen? | drawn on blood serum; detect open spinal cord or chromosomal defect may occur. if positive in 16th week- amniocentesis will be scheduled
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| What are the three complications most likely to occur over age 40? | Pre-term or post-term birth; PIH, or cesearean as a woman's circulatory system is not what it used to be; not as elastic
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| Name some reasons women over 40 develop PIH? | possibly r/t blood vessel inelasticity or bc hypertension occurs more in nulliparas than multiparas.
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| Name the best intervention for women with PIH? | Rest for a good portion of the day.
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| Women over 40 lose elasticity and cervical dilation may not occur as spontaneously as for younger women. What is a good method to determine if this is occuring? | Graph/Chart labor progress and encourage a woman to verbalize her feelings about labor progression to allow for reassurance and to prompt any necessary interventions.
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| Besides cervial dilation, what else are we looking for complications with in terms of elasticity and labor complications? Interventions? | loss of elasticity for the uterus and resulting higher risk for postpartum hemorrhage and perineal-anal tears. Close observation and assessment of lochial flow.
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| What areas of planning do you need to consider when working with phys/cogn. challenged moms-to-be? | transportation, pregnancy counseling, support persons, health, work, recreation and self esteem
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| What do we need to especially consider when a develop. challen. woman wants to conceive? | Urge her to come for preconceptual care- need to evaluate meds for safe pregnancy
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| What is a major concern of phys. or cogn. challenged pregnant women? What are we assessing? | Safety. Assess emergency contact persons, suppliers of transportation, mobility, elimination, and autonomic responses as well as meds.
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| In terms of mobility and the disabled women in wheelchairs- what do we need to make sure they do and why? | press with their hands against the armrests and lift their buttocks up off the wheelchair seat for 5 seconds/hr to prevent pressure ulcer formation on the buttocks and posterior thighs.
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| to prevent limitations on the venous return from the lower extremities for wheelchair bound pregs what can we have them do? | for at least 1 hr morning and afternoon decrease the sharp bend at the knees. this will promote venous return and help prevent varicosities and thrombi formation- adjust the footrests
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| In terms of self esteem, what do we want disabled pregs to feel with changes to their mobility? | her reduction in independence allows for a safe pregnancy as she is preventing potential falls
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| Why is elimination a concern for disabled pregs? | If mobility is a challenge, they may not use the bathroom as much or consume appropriate volumes of liquids. Encourage a high fluid intake and frequent voiding to prevent UTIs. Also consider those who catherize themselves.
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| Define autonomic reflexia. | An exaggerated autonomic response to stimuli in women with a high spinal cord injury (cervical or high thoracic)caused either distended bladder, + uterine size, contractios or breastfeeding.
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| What are symptoms of autonomic reflexia? | without upper motor neuron control: severe hypertension (300/160mmHG), throbbing headache, skin flushing, profuse sweating above level of spinal lesion, nausea, bradycardia can occur also.
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| Why do we have to act immediately if we notice s/s of autonomic reflexia? | immediately protect against cva or intraocular damage- eleveate her head to reduce cerebral pressure and locate the irritating stimulus. may need antihypertensive
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| If a disabled woman cannot be examined in a lithotomy position, what position can you put her in. | dorsal recumbent
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| If a woman in a wheelchair relies on a support person for a hot meal cooked on a stove, what do you need to consider? | How to inform her of nutritious foods that can be prepared cold.
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| What are special considerations for women in labor who are disabled? | can they feel the contractions? (if not palpate the abdomen continually for initial signs) can they push? (if not, cesarean or forceps birth) they may have to deliver in a sims or dorsal recumbent position.
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| In labor, what are two risks with ruptured membranes? | intrauterine infection and prolapse of the umbilical cord. after 24 hours after the rupture and labor has not started, induced labor will be initiated to help reduce these risks
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| What are four integrated concepts for a successful labor: | passage, passenger, powers, psychological outlook
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| What is another name for the anterior fontanelle? | the bregma
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| What is a vertex? | the space between the two fontanelles
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