Term
| What is the basic function of the foramen ovale, ductus venosus, and ductus arteriosus? |
|
Definition
| to bypass the fetal liver newand lungs |
|
|
Term
| When do alveolar ducts appear? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| When does surfactant begin to be produced? |
|
Definition
|
|
Term
| When does surfactant production peak? |
|
Definition
|
|
Term
| when does fetal breathing begin? |
|
Definition
|
|
Term
| why is fbm (fetal breathing mvmt)necessary? |
|
Definition
-develops chest wall muscles and diaphragm
-helps regulate lung fluid volume and growth |
|
|
Term
| what two radical changes must happen for infant breathing to occur? |
|
Definition
-pulmonary ventilation must be established by lung expansion
-increase in pulmonary circulation |
|
|
Term
| Why does the ductus venosus close? |
|
Definition
| pressure changes with cord clamp |
|
|
Term
| What organ is perfused when the ductus venosus closes? |
|
Definition
|
|
Term
| the fetal lungs are filled with |
|
Definition
|
|
Term
| what happens to the chest during birth? |
|
Definition
|
|
Term
| what happens when the chest is compressed? |
|
Definition
| increased intra thoracic pressure |
|
|
Term
| what happens to the chest after birth? |
|
Definition
-chest wall recoils
-negative intrathoracic pressure
-fluid replaced with air |
|
|
Term
| what happens to the intrathoracic pressure when a newborn exhales and cries? |
|
Definition
-positive pressure is created
-air is distributed throughout alveoli
-fluid is absorbed by capillaries/lymphatic system |
|
|
Term
| what happens to intrathoracic pressure when a newborn inhales? |
|
Definition
-pressure is negative
-lung fluid moves from alveoli to alveolar membranes to interstitial tissue |
|
|
Term
| when pulmonary vascular resistance decreases and pulmonary blood flow increases |
|
Definition
| more interstitial fluid is absorbed in the bloodstream |
|
|
Term
|
Definition
| cessation of placental flow |
|
|
Term
| cord clamping causes what chemical changes? |
|
Definition
-increased Pco2
-decreased pH
-decreased Po2
-transitory apnea! |
|
|
Term
| what causes the 'initial gasp'? |
|
Definition
| transitory apnea stimulates chemoreceptors that trigger the brain's resp center |
|
|
Term
| what happens to baby's temp after birth? |
|
Definition
| decreases, causes chilling |
|
|
Term
|
Definition
| skin nerve endings, responds with rhythmic respirations |
|
|
Term
| what does detachment of the placenta do to the systemic pressure? |
|
Definition
|
|
Term
| what causes closure of the foramen ovale and the ductus arteriosus? |
|
Definition
| lungs fill with air, pulmonary pressure goes down |
|
|
Term
| closure of the foramen ovale is caused by |
|
Definition
| changes in atrial pressure |
|
|
Term
| lungs filling with air causes increased |
|
Definition
left atrial pressure
-b/c pulmonary blood flow increases
-increased pulmonary blood return to L atrium |
|
|
Term
| why does R atrial pressure decrease? |
|
Definition
-decreased pulmonary vascular resistance
-decreased umbilical venous return |
|
|
Term
| what happens when L atrial pressure is greater than R atrial pressure? |
|
Definition
|
|
Term
| how does the closure of the ductus arteriosus happen? |
|
Definition
-increased systemic vascular pressure reverses blood flow through ductus arteriosus
-blood flows from aorta into pulmonary artery |
|
|
Term
| how dose ductus venosus close? |
|
Definition
-unknown
-related to mechanical pressure changes |
|
|
Term
| normal newborn heart rate |
|
Definition
-120 to 160 bpm
-listen to apical pulse for 1 min
-as high as 180 at birth |
|
|
Term
| a murmur may indicate that |
|
Definition
| ductus arteriosus or foramen ovale did not completely close |
|
|
Term
| Heart rate and respiratory rate are increased during/right after |
|
Definition
|
|
Term
|
Definition
-right after birth 60-70
-2 hours after birth 30-60 |
|
|
Term
|
Definition
| pauses lasting 5-15 seconds |
|
|
Term
| is it abnormal for a baby to stop breathing for more than 20 seconds? |
|
Definition
|
|
Term
| true or false: newborns have less SQ fats than adults |
|
Definition
|
|
Term
| true or false: Blood vessels are closer to the skin in infants |
|
Definition
| true, blood is more influenced by temp changes |
|
|
Term
| what does the infants flexed posture have to do with thermal regulation? |
|
Definition
| decreases SA exposed to the environment, decreases heat loss |
|
|
Term
| true or false: newborns have increased basal metabolic rate |
|
Definition
|
|
Term
| is shivering common in newborns? |
|
Definition
|
|
Term
|
Definition
| non shivering thermogenesis |
|
|
Term
| what does NST use to provide heat? |
|
Definition
| BAT, brown adipose tissue |
|
|
Term
|
Definition
| 26-30 weeks, increases until term |
|
|
Term
| why does brown fat provide heat? |
|
Definition
-quickly metabolized
-causes heat to be transferred to periphery |
|
|
Term
| what is the primary source of heat in the hypothermic newborn? |
|
Definition
|
|
Term
| where on the body is the brown fat? |
|
Definition
|
|
Term
| when RBC's are destroyed where is the iron content stored? |
|
Definition
|
|
Term
| if the mother had adequate iron intake, how long will the infant have enough iron? |
|
Definition
|
|
Term
| what is the main source of energy for the first 4-5 hours of life? |
|
Definition
|
|
Term
|
Definition
| byproduct of hemoglobin break down |
|
|
Term
|
Definition
-fat soluble
-CANNOT be excreted
-CAN be toxic |
|
|
Term
|
Definition
-non toxic
-excreted through the GI system |
|
|
Term
| true or false: infants have a lot of RBC's |
|
Definition
|
|
Term
| what happens when RBC's are destroyed |
|
Definition
|
|
Term
| what does bilirubin normally do? |
|
Definition
| goes to the liver to bind to glycogen |
|
|
Term
| why can a baby get jaundice? |
|
Definition
| liver is too immature and there will be too much bili for the baby to handle and it will become jaundiced |
|
|
Term
|
Definition
-yellow skin
-temporary inability of the body to eliminate bilirubin |
|
|
Term
| what are the 2 types of jaundice? |
|
Definition
|
|
Term
| when does bilirubin peak? |
|
Definition
| peaks on days 3-5 for term infants |
|
|
Term
| when does physiologic jaundice appear? |
|
Definition
|
|
Term
| 6 factors related to physiologic jaundice |
|
Definition
-large amts of bili delivered to liver
-defective uptake of bili from plasma
-defective conjugation of the bili
-defect in bili excretion
-inadequate hepatic circulation
-increased re absorption of bili from the small intestine |
|
|
Term
| why is maintaining temp important to during physiologic jaundice? |
|
Definition
-cold stress causes acidosis
-this causes decreased serum albumin binding sites |
|
|
Term
| why is it important to monitor stool during physiologic jaundice? |
|
Definition
| if not pooping, no bili excretion and can be reabsorbed |
|
|
Term
| why is important to encourage early feedings during physiologic jaundice? |
|
Definition
-promotes elimination, bacterial colonization
-gives calories and protein for hepatic binding |
|
|
Term
|
Definition
|
|
Term
| what is the primary cause of pathologic jaundice? |
|
Definition
|
|
Term
| what happens is a mom is rh neg and her baby is rh pos? |
|
Definition
-blood mixes
-moms RBC's treat the baby's RBC's as intruders
-can attack baby's RBC's or future pregnancy |
|
|
Term
| what happens is baby's RBC's are attacked? |
|
Definition
-they will be destroyed
-baby makes more
-will become anemic bc they can only make immature RBC's |
|
|
Term
|
Definition
| can only prevent the RBC attacks |
|
|
Term
|
Definition
if potential mixing of mom's blood and fetal blood
-miscarriage
-unusual bleeding
-abd trauma
-28 weeks |
|
|
Term
| When does rhogam need to be given postpartum? |
|
Definition
| 72 hours pp, if mom is rh neg and baby is rh pos |
|
|
Term
|
Definition
-mother is type O, baby is A or B
-incompatibility can occur if moms serum antibodies interact with antigen on fetus' RBC's
-mom can build up A or B titers which can lead to hemolysis of newborn RBC's |
|
|
Term
| what is a direct coombs test? |
|
Definition
| measures if there are antibody-coated RBC’s in baby |
|
|
Term
| what does a positive direct coombs test indicate? |
|
Definition
| increased risk for jaundice, BAD |
|
|
Term
| how does phototherapy treat jaundice? |
|
Definition
| Light makes the bilirubin water soluble so body can excrete it |
|
|
Term
| phototherapy nursing implications |
|
Definition
-cover eyes
-cover genitals
-reposition q2h
-monitor temp
-feed q2-3 hrs if BF, q 3 if bottlefed |
|
|
Term
| GI adaptations after birth |
|
Definition
-difficulty digesting starches the first few mos
-digestion slow first few mos
-cardiac sphincter immature
-calorie intake low day 5-10
-expect some weight loss
-2-10 stool per day is normal |
|
|
Term
|
Definition
|
|
Term
|
Definition
| urine containing urine crystals |
|
|
Term
| true or false: newborns have a low GFR |
|
Definition
| true, means that are unable to dispose of water rapidly |
|
|
Term
| when do most newborns void? |
|
Definition
|
|
Term
| how many voids should a newborn have on day 1-2? |
|
Definition
|
|
Term
| After the first two days, how many voids do you see within 24 hours? |
|
Definition
|
|
Term
| is pseudo menstruation normal? |
|
Definition
|
|
Term
| how developed is the baby's immune system at birth? |
|
Definition
| not fully developed bc of relatively sterile womb |
|
|
Term
| what influences a newborns behavior? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| what does meconium look like? |
|
Definition
|
|
Term
| rhogam is only given to women with |
|
Definition
|
|
Term
| what is an indirect coombs? |
|
Definition
-checks MOM for antibodies
-if NO antibodies, give rhogam
-28 weeks is when mixing occurs |
|
|
Term
| bilirubin is toxic to the baby's |
|
Definition
|
|
Term
| for the first 24 hours, bili level is crucial, what level indicates tx is needed? |
|
Definition
|
|
Term
| What level of bili is toxic to the baby's brain? |
|
Definition
|
|
Term
| spit up, throw up, and regurg can indicate |
|
Definition
|
|
Term
|
Definition
| checks BABY's blood for antibodies |
|
|
Term
| when does pseudo menstruation occur? |
|
Definition
|
|
Term
| what can indicate infxn in a baby? |
|
Definition
|
|
Term
| what lab value indicates infxn? |
|
Definition
| increased igM indicates intrauterine ifxn in mom |
|
|
Term
| what does TORCH stand for? |
|
Definition
toxoplasmosis
rubella
cytomegalovirus
herpes
-what baby can get from mom during delivery? |
|
|
Term
| brick dust usually appears in |
|
Definition
|
|
Term
| what may affect a baby's ability to self quiet? |
|
Definition
| drug dependency makes them unable to self quiet |
|
|
Term
| true or false: babies can habituate to certain stimuli |
|
Definition
|
|
Term
| true or false: baby cannot distinguish between sweet and sour |
|
Definition
|
|
Term
| true or false: baby can distinguish his own mothers colostrum |
|
Definition
|
|
Term
|
Definition
| birth-30 min pp, at most 2 hours |
|
|
Term
| period of inactivity to sleep phase |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| what should occur during the transition? |
|
Definition
-maintain patent airway/stable VS
-maintain neutral thermal environment
-prevent vit k deficiency bleeding
-prevent eye infxn
-assess for nn distress
-initiate feeding
-facilitate parent/newborn attachment |
|
|
Term
| how do you facilitate attachment? |
|
Definition
| give the baby to the mother |
|
|
Term
| how can the nurse maintain the airway? |
|
Definition
-ABC's
-drying/stimulation
-apgar scores
-cord logistics
-VS q 30 min x 2hrs or stable
-prevent heat loss |
|
|
Term
| what does pp admission involve? |
|
Definition
-review prenatal/L&D
-document newborn condition
-antepartum/L&D records
-basic measurements incl gest age assessment |
|
|
Term
| why do babies need to recieve vitamin k? |
|
Definition
| baby's gut is sterile and therefore unable to create vitamin k, which is needed to clot |
|
|
Term
| when should vitamin k be given? |
|
Definition
| within the first couple hours pp |
|
|
Term
|
Definition
| .5-1.0 mg given IM in the vastus lateralis |
|
|
Term
|
Definition
| pain, edema, allergic rxn possible |
|
|
Term
| nursing care associated with vitamin k admin |
|
Definition
-protect from light
-monitor for SE
-give BEFORE circumcision |
|
|
Term
| is it ok to massage the injection site with alcohol after vit k is given? |
|
Definition
|
|
Term
| when does a baby have enough flora to produce vit k? |
|
Definition
|
|
Term
| why is erythromycin given? |
|
Definition
| to prevent eye infxn caused by neisseria gonorrhoeae |
|
|
Term
|
Definition
| .5-1 cm long ribbon strand, inner canthus along lower conjuctival surface |
|
|
Term
| nursing care associated with erythromycin admin |
|
Definition
-wash hands
-DO NOT irrigate eye after its given
-observe for side effects |
|
|
Term
| signs of neonatal distress |
|
Definition
-increased resp rate
-difficult resps
-chest retractions
-nasal flaring
-grunting
-grimacing
-excessive mucous
-cyanosis
-abd distention |
|
|
Term
| more signs of nn distress |
|
Definition
-vomiting of bile stained material
-absence of mec within 24 hrs of birth
-absence of urin elimination within 24 hrs
-jaundice within 24 hours
-temp instability
-jittery or glucose less than 40 mg% |
|
|
Term
| using the bulb syringe too often can cause |
|
Definition
|
|
Term
| when should the initial feed be attempted? |
|
Definition
| during 1st period of reactivity |
|
|
Term
| when should first bottle feeding occur? |
|
Definition
|
|
Term
|
Definition
-smacking/licking lips
-opening/closing mouth
-sucking
-rooting
-fussy
-trying to position for nursing
-fidgety/squirming
-moving head frantically from side to side
-CRYING-late sign |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| nursing interventions for newborn with acute pain |
|
Definition
| swaddle, sucrose as ordered, soothing touch/voice, interventions to a minimum |
|
|
Term
| nursing interventions for a newborn with hypothermia? |
|
Definition
-kangaroo care
-radian warmer
-swaddle
-hat |
|
|
Term
| nursing interventions for aspiration risk or ineffective clearance |
|
Definition
-bulb suction
-position change
-suction |
|
|
Term
|
Definition
| tracheal esophageal fistula, enclosure of esophagus food goes down trachea, need surgery! |
|
|
Term
| What is the ballard scale? |
|
Definition
-determines true gestational age
-within 24 hours of life |
|
|
Term
|
Definition
|
|
Term
| few creases or in top 3rd = |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| white heads, sebaceous glands |
|
|
Term
| what is erythema toxicum? |
|
Definition
|
|
Term
| when does the anterior fontanelle close? |
|
Definition
|
|
Term
| what should we assess fontanelles for? |
|
Definition
| bulging or sinking (dehydrated) |
|
|
Term
| when does the posterior fontanelle close? |
|
Definition
|
|
Term
|
Definition
-blood between cranial bone and membrane
-doesn't cross suture line
-disappears after 2-3 weeks
-could take months |
|
|
Term
|
Definition
-crosses suture lines
-water, swelling of the scalp
-reabsorb within 12 hours or a few days after birth |
|
|
Term
| what is a baby at risk for after circumcision? |
|
Definition
-hemorrhage
-urethral damage- problems urinating
-infxn |
|
|
Term
| what should you monitor the baby for during circumcision? |
|
Definition
-cold stress
-hypoglycemia |
|
|
Term
| nursing care associated with circumcision |
|
Definition
-vaseline on gauze w diaper change
-do not put diaper too tight or too loose
-assess for infxn (pus, swelling, no urination)
-give analgesics if desired |
|
|
Term
|
Definition
|
|
Term
| which babies are at risk for hypoglycemia? |
|
Definition
-LGA's, SGA's, IUGR's
-being cold |
|
|
Term
|
Definition
| tremors, lethargy, irritability |
|
|
Term
| how to prevent hypoglycemia in a baby |
|
Definition
|
|
Term
| how to control pain during a heel stick |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
-amino acid disorder that lacks ability to break down certain proteins
-causes increased phenylalanine in blood
-can lead to mental retardation
-if pos, baby should avoid phenylalanine for rest of life |
|
|
Term
| what should be done if a hearing test is abnormal? |
|
Definition
-redo
-if abnormal again, see ENT |
|
|
Term
|
Definition
| turn neck to one side, that side remains flat (limbs), other side flexed (limbs) |
|
|
Term
|
Definition
| stroke one side of lips in corner, baby will turn head to that side and open mouth |
|
|
Term
|
Definition
| startle reflex, sudden stimuli causes baby to lift up both arms |
|
|
Term
|
Definition
| stimulation of the outside (lateral side) of the sole of the foot, then flexion |
|
|
Term
|
Definition
| natural tendency to suck anything |
|
|
Term
|
Definition
| put finger in baby's hand, baby will grasp it |
|
|
Term
| how does breast feeding lower pp blood loss? |
|
Definition
| b/c it increases oxytocin (which causes uterine contraction) |
|
|
Term
| what are some other benefits for mom from BF? |
|
Definition
-saves money
-hormones released reduce stress
-increased weight loss
-decreased risk for breast/ovarian cancer |
|
|
Term
|
Definition
-better GI function
-infxn protection
-less chance for ear, resp infxns
-less chance for wheezing
-reduced risk of obesity, CVD, autoimmune disorders,and DM |
|
|
Term
| What populations of women absolutely cannot BF? |
|
Definition
-women with HIV
-maternal drug use
-galactosemia (glucose-like problem) |
|
|
Term
| potential BF contraindications |
|
Definition
-pain
-leaking
-embarassment
-stress, causes decreased milk production
-unequal feeding responsibilities (unless pumping)
-diet restrictions (foods that make them sick)
-limited FP options (progesterone only)
-vaginal dryness bc decreased estrogen/progesterone
-medications |
|
|
Term
|
Definition
-estrogen, breast ducts proliferate
-progesterone, develop lobules/alveoli
-prolactin levels rise, prog blocks them
-after birth prog drops, milk production |
|
|
Term
| if there is no breast stimulation, when do prolactin levels fall? |
|
Definition
|
|
Term
|
Definition
-first 24-72 hours
-immune factors
-laxative
-bilirubin |
|
|
Term
|
Definition
-2 days is early
-usually 3rd-5th day |
|
|
Term
|
Definition
-more fat
-changes in response to baby's growth |
|
|
Term
| true or false: total number of feeds more important than interval |
|
Definition
|
|
Term
| true or false: as baby gets older it provides less active cues that its hungry |
|
Definition
| false, it provides MORE active cues |
|
|
Term
| what does LATCH stand for? |
|
Definition
-breastfeeding assessment tool
L-latch
A-audible swallowing
T-type of nipple
C-comfort (breast/nipple)
H-hold (positioning) |
|
|
Term
|
Definition
-upper and lower lips touching
-sunken cheeks
-clicking sounds (broken suction)
-tongue not visible below nipple when lower lip is pulled down
-creased nipple following feed |
|
|
Term
|
Definition
-cool compress
-frequent feedings
-massages
-frequent warm showers
-OTC meds |
|
|
Term
| how many feedings should happen in 24 hours? |
|
Definition
|
|
Term
|
Definition
-swallowing sound
-8 feeds/24 hrs
-breasts soften after feeding
-no. of wet diapers increases daily till 4th or 5th day
-6-8 wet diapers per day by 5th day
-stool begin to lighten by 3rd day
-yellow stools by day 5 |
|
|
Term
| pre conceptual folic acid recommendation |
|
Definition
|
|
Term
| what happens to uterine mass during pregnancy? |
|
Definition
| increases due to cell hypertrophy |
|
|
Term
| what causes the increase in normal vaginal discharge during pregnancy? |
|
Definition
| estrogen stimulates glandular tissue in the cervix |
|
|
Term
| how do the ovaries manage the endometrium until the placenta takes over? |
|
Definition
| secrete HcG to maintain the corpus luteum which secretes progesterone to maintain endometrium |
|
|
Term
| what happens to the vagina during pregnancy? |
|
Definition
-hyperplasia of epithelium
-hypertrophy
-increased vascularity
-thickened mucosa
-increased/acidic secretions |
|
|
Term
| what are some breast changes that occur during pregnancy? |
|
Definition
-increased sensitivity
-increased vascularity
-estrogen/prog cause hypertrophy and hyperplasia for lactation
-striae
-colostrum (as early as 12 wks) |
|
|
Term
| is pulmonary function impaired during pregnancy? |
|
Definition
|
|
Term
| why might a pregnancy woman feel SOB? |
|
Definition
| during 3rd trimester, uterus pushes against diaphragm/lungs |
|
|
Term
| how does the4 growing uterus displace the heart? |
|
Definition
|
|
Term
| what happens to cardiac output during pregnancy? |
|
Definition
-increases 30-50% by 30 wks
-works harder, more effective, increased blood volume |
|
|
Term
| why might pulse increase 10-15 bpm from the baseline during pregnancy? |
|
Definition
| due to increased blood volume |
|
|
Term
| what happens to systemic and pulmonary vascular resistance during pregnancy? |
|
Definition
|
|
Term
| increased blood volume during pregnancy is secondary to |
|
Definition
| increased plasma and RBC mass |
|
|
Term
| what is physiologic anemia? |
|
Definition
-due to increase in plasma & RBC mass
-30-34 wks peak |
|
|
Term
| what does a decrease in systemic vascular resistance cause? |
|
Definition
|
|
Term
| why does cardiac output increase during pregnancy? |
|
Definition
| mom's and baby's oxygen demands increase |
|
|
Term
| what is supine hypotensive syndrome? |
|
Definition
| uterus compresses vena cava, decreased blood flow back to the heart causing hypotension |
|
|
Term
| is systolic mumur common in pregnant women? |
|
Definition
|
|
Term
| when is BP the lowest during pregnancy? |
|
Definition
|
|
Term
| when does BP begin to increase during pregnancy? |
|
Definition
| 3rd trimester, normal by term |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| why is pregnancy a hypercoagulable state? |
|
Definition
| b/c some clotting factors are increased during pregnancy |
|
|
Term
| why are pregnant women at risk for venous thrombosis? |
|
Definition
-venous stasis
-hypercoagulable state |
|
|
Term
| how does pregnancy effect BMR? |
|
Definition
| increases 20-25% bc of increased work load |
|
|
Term
| is water retention normal during pregnancy? |
|
Definition
|
|
Term
| why is the pancreas stressed during pregnancy? |
|
Definition
| bc of increased insulin needs, deficiency =gest. diabetes |
|
|
Term
| why might one notice thyroid size increase during pregnancy? |
|
Definition
| hyperplasia and increased vascularity cause increased thyroid size |
|
|
Term
| why is the pituitary gland enlarged during pregnancy? |
|
Definition
-anterior pituitary causes 10x rise in prolactin
-posterior pituitary produces oxytocin |
|
|
Term
| common GI changes during pregnancy |
|
Definition
-slow motility
-displaced intestines
-decreased cardiac sphincter tone
-slow gastric emptying
-slow gallbladder emptying |
|
|
Term
| what problem could slowed gastric emptying cause? |
|
Definition
|
|
Term
| would eating small frequent meals be beneficial to the pregnant woman? |
|
Definition
|
|
Term
| what are accupressure wristbands? |
|
Definition
| help relieve nausea early on in pregnancy |
|
|
Term
| when should iron and prenatal vitamins be temporarily stopped? |
|
Definition
| if the woman is experiencing nausea |
|
|
Term
| what vitamin can help with nausea? |
|
Definition
|
|
Term
| what foods can help with nausea? |
|
Definition
-carbonated drinks
-complex carbs
-low fat, high protein |
|
|
Term
| cutting back on what type of food can help decrease pytalism in pregnancy? |
|
Definition
|
|
Term
| what happens to the bladder during the first trimester? |
|
Definition
| it is crowded by the uterus |
|
|
Term
| what happens to the bladder during the 3rd trimester? |
|
Definition
| presenting part crowds the bladder |
|
|
Term
| why is there an increased risk for renal/urinary infection during pregnancy? |
|
Definition
-pressure on the bladder causing impaired flow
-fetus & progesterone causes dilated kidneys and ureters which causes URINARY STASIS |
|
|
Term
| what are some renal/urinary changes during pregnancy? |
|
Definition
-muscle tone relaxation
-ureters elongate causing prolonged time for urine to reach bladder = urine stasis
-urine stasis = increased risk for UTI |
|
|
Term
|
Definition
| face during pregnancy, darkened skin on forehead, nose, and cheeks |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| blotches over palms, due to increased estrogen |
|
|
Term
| how does posture change during pregnancy? |
|
Definition
| lordosis increases throughout pregnancy |
|
|
Term
| what is round ligament pain? |
|
Definition
| a short stabbing sensation in the abdomen |
|
|
Term
| why should on hip be elevated when lying down? |
|
Definition
| to prevent vena cava compression |
|
|
Term
|
Definition
nagele's rule
LMP minus 3 mos plus 7 days |
|
|
Term
| when to use ultrasound to determine gestational age |
|
Definition
-hx of irregular cycles
-recent contraceptive use
-breastfeeding women
-recent loss/abortion
-client whose exam is way different than expected LMP |
|
|
Term
| what is level 2 ultra sound? |
|
Definition
| A Level 2 Ultrasound is a more detailed ultrasound than the standard ultrasound |
|
|
Term
|
Definition
| 9 months, 40 weeks, 280 days |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
gravida
parity (birth > 20 wks)
term (> 37 wks)
preterm
abort
living child |
|
|
Term
| routine labs for pregnant women |
|
Definition
-CBC w/pltlts
-U/A w/culture
-rh type/antibody screen
-rubella status
-hep b status
-HIV
-syphillis
-pap smear
-GC/CT |
|
|
Term
| labs to test pregnant women for infxn |
|
Definition
-TB
-toxoplasmosis
-hep c antibodies
-varicella
-BV (bacterial vaginosis)
-HIV |
|
|
Term
| labs to test for heritable disorders |
|
Definition
-ashkenazi jew panel
-cys fib
-hgb electrophoresis (evaluates diff types of hgb) |
|
|
Term
| if HIV status is unknown at birth, can the newborn be tested? |
|
Definition
-unless mom refuses
-rapid HIV test |
|
|
Term
| danger signs in pregnancy to be reported by client |
|
Definition
-sudden gush of fluid from vagina
-vaginal bleeding
-abd pain
-temp of 101 and chills
-dizziness
-blurry/double vision/seeing spots
-swelling of hands/feet
-persistent vomiting
-decreased urine output |
|
|
Term
| what should be reviewed at every ap visit? |
|
Definition
-nutrition, exercise, weight gain
-how to contact provider
-danger signs
-OTC
-normal pregnancy changes |
|
|
Term
| objective data gathered at AP visit |
|
Definition
-urine dip for protein and glucose
-weight
-FHT
-fundal height |
|
|
Term
| when is down syndrome screen done? |
|
Definition
-1st trimester
-11-14 wks
-elective |
|
|
Term
| when is an ultra sound done to look at fetal anatomy? |
|
Definition
|
|
Term
| when is a triple screen done? |
|
Definition
-2nd trimester
-14-20 wks
-elective |
|
|
Term
| what are the 28 week labs? |
|
Definition
-done in 3rd trimester
-repeat cbc w/platelets
-repeat syphillis
-gestational diabetes screen |
|
|
Term
| When is GBBS testing done? |
|
Definition
|
|
Term
| what can GBBS do to a baby? |
|
Definition
-cause septic shock
-die or cerebral palsy |
|
|
Term
|
Definition
-hx of baby with GBBS
-hx of her having GBBS |
|
|
Term
|
Definition
early- birth-48 hrs
late- a week or 2 after birth |
|
|
Term
| if a woman is positive for GBBS, when and how is she treated? |
|
Definition
-during labor
-2 IV doses of ampicillin |
|
|
Term
| what types of vaccines cannot be given during pregnancy? |
|
Definition
|
|
Term
| what indicates special assessments are needed? |
|
Definition
-AMA (>35)
-decreased fetal mvmt
-abd trauma
-high risk med condition
-IUGR/macrosomia |
|
|
Term
| what are specialized assessments? |
|
Definition
|
|
Term
|
Definition
-optional
-look at baby's neck to see if abnormal, 1st trimester |
|
|
Term
| fetal movement is the most accurate way to determine |
|
Definition
|
|
Term
| 1st trimester weight gain |
|
Definition
|
|
Term
| 2nd trimester weight gain |
|
Definition
|
|
Term
| 3rd trimester weight gain |
|
Definition
|
|
Term
| recommended pregnant caloric intake |
|
Definition
| 300 cals above pre-preg cals |
|
|
Term
| recommended caloric intake for lactating mothers |
|
Definition
| 500 cals above pre-preg cal intake |
|
|
Term
| why is calcium needed during pregnancy? |
|
Definition
| helps mineralize fetal bones and teeth |
|
|
Term
| how much calcium is needed during pregnancy? |
|
Definition
-1300mg if less than 19
-1000mg if over 19 |
|
|
Term
| why is folic necessary during pregnancy? |
|
Definition
| decreases neural tube defects |
|
|
Term
| how much folic acid should be taken during pregnancy? |
|
Definition
|
|
Term
| why is iron necessary during pregnancy? |
|
Definition
-fetal & placental growth
-increases maternal blood volume |
|
|
Term
| how much iron should pregnant women take? |
|
Definition
| need additional 30-60 mg per day |
|
|
Term
|
Definition
-mercury
-salmonella
-listeria |
|
|
Term
| inadequate intake of iron can contribute to |
|
Definition
|
|
Term
| inadequate calcium can contribute to |
|
Definition
|
|
Term
| when are fetal kick counts usually done? |
|
Definition
|
|
Term
|
Definition
low risk 36 wks
high risk 34 wks |
|
|
Term
| what do accelerations during an NST imply? |
|
Definition
|
|
Term
| are decelerations during an NST ok? |
|
Definition
| NO, decelerations of a min or more are very bad! |
|
|
Term
| instead of using 15x15 count, what is used for less than 32 wks? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| molar pregnancy is indicated by |
|
Definition
| 4x the normal beta HCG levels |
|
|
Term
| are molar pregnancies viable? |
|
Definition
|
|
Term
| how can molar pregnancies become dangerous? |
|
Definition
| can become choriocarcinoma |
|
|
Term
| after molar pregnancy, can a woman get pregnant again? |
|
Definition
| not for a year, monitor HCG for 1 year, chest x ray every month |
|
|
Term
| how is pregnancy confirmed? |
|
Definition
|
|
Term
| how are the contractions caused during a CST? |
|
Definition
-pitocin (more control)
-nipple stimulation |
|
|
Term
| during a CST, how many contractions happen? |
|
Definition
| 3 contractions in a 10 min window |
|
|
Term
| what does a positive CST indicate? |
|
Definition
| bad because late decelerations tell us fetus won't be able handle labor |
|
|
Term
| if there is a positive CST and a baby is over 32 weeks, what happens next? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| see accelerations, no deccelerations |
|
|
Term
| since CST is rarely done, what is done instead? |
|
Definition
| biophysical profile (BPP) |
|
|
Term
|
Definition
-HR
-muscle tone
-breathing
-movement
-amniotic fluid |
|
|
Term
|
Definition
-decreased fetal mvmt.
-nonreactive NST
-IUGR
-SGA
-PTL
-preeclampsia
-gest. diabetes
-premature ROM |
|
|
Term
|
Definition
|
|
Term
|
Definition
-amniotic fluid index
-pocket of fluid, measure it |
|
|
Term
|
Definition
| maternal serum alpha fetoprotein |
|
|
Term
| what does the quad screen screen for? |
|
Definition
-NTD's
-trisomy 18
-trisomy 21 |
|
|
Term
| when is the quad screen done? |
|
Definition
-15-22 wks
-most accurate @ 15-16 wks |
|
|
Term
| what is amniocentesis used for? |
|
Definition
| detection of genetic, metabolic, DNA abnormalities & lung maturity (3rd tri) |
|
|
Term
| who is offered amniocentesis? |
|
Definition
|
|
Term
| when is amniocentesis done? |
|
Definition
-1st tri
-early as possible (need fluid build up) |
|
|
Term
| chronic villus sampling (CVS) is done to detect |
|
Definition
| genetic, metabolic, DNA abnormalities |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| which is available earlier, CVS or amnio? |
|
Definition
|
|
Term
|
Definition
-limb reduction
-miscarriage (causes her to go into labor)
-bleeding
-infxn
-injury to fetus |
|
|
Term
|
Definition
-FFN
-cervical length & os |
|
|
Term
| what does positive FFN indicate? |
|
Definition
| indicates PTL within 2 weeks |
|
|
Term
| what does a good L/S ratio and a positive PG indicate? |
|
Definition
|
|
Term
| when are lungs usually mature? |
|
Definition
|
|
Term
|
Definition
-have pt empty bladder
-if not, poor visualization |
|
|
