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NCLEX information review: Maternity

Terms in this set (42)

What is the name of the hormone that induces amenorrhea?
Progesterone
What are presumptive signs of pregnancy?
Amenorrhea
N/V
Urinary frequency
Breast tenderness
What are probable signs of pregnancy?
Positive pregnancy test
Goodell's sign (softening of cervix, 2nd mo)
Chadwick's sign (bluish color of vagina mucosa and cervix, 4th wk)
Hegar's sign (softening of lower uterine segment, 2nd/3rd mo)
Uterine enlargement
Braxton Hicks
Linea nigra
Facial chloasma
Abdomen striae
Darkening of areola
What are positive signs of pregnancy?
Fetal heartbeat
Doppler 10-12 wks
Fetoscope 17-20 wks
Fetal movement
US
What is gravidity?
Number of times a woman has been pregnant
What is parity?
Number of pregnancies in which the fetus reaches 20 weeks
What is viability?
Capacity to live outside the uterus
24 wks
What is TPAL?
T- # of term deliveries (after 37 weeks)
P- # of preterm deliveries (After 20 weeks, but before 37 weeks)
A- # of pregnancies ending in abortion (before 20 weeks)
L- # of currently living children
What is a spontaneous abortion?
Miscarriage
Bleeding
Cramping
Backache
hCG levels drop with imminent miscarriage
Usually occur before 20 wks
What is Naegele's rule?
The rule estimates the expected date of delivery (EDD). LMP date + 7 days + 9 months = estimated date of delivery (older version + 1 year, - 3 months, + 7 days)
What are nutritional requirements in the 1st trimester?
Well-balanced diet
Increase protein 60g/day
What is expected weight gain in the 1st trimester?
1-4 lbs
What are danger signs of pregnancy?
Sudden gush of vaginal fluid
Bleeding
Persistent vomiting
Severe HA
Abdominal pain
Increased temp
Edema
No fetal movement
What are common discomforts in the 1st trimester?
Constipation
Ankle edema
N/V
Breast tenderness
Urinary frequency
Tender gums
Fatigue
Heartburn
Increased vaginal secretions
Nasal congestion
Varicose veins
Hemorrhoids
Backache
Leg cramps
What is smoking during pregnancy associated with?
Small for gestational age
Low birth weight
Cleft lip/palate
Risk for placental abruption doubles
How often should a pregnant pt visit PCP the first 28 wks?
Once a month
How often should a pregnant pt visit PCP wks 28-36?
Every 2 wks
How often should a pregnant pt visit PCP after 36 wks?
Weekly
What should a pt do prior to an US?
Drink water
What are nutritional requirements for the 2nd trimester?
Add 300 calories/day
What is expected weight gain in the 2nd trimester?
1 lb/wk
What is considered a term pregnancy?
37-40 wks
What is expected weight gain in 3rd trimester?
1 lb/wk
What is pre-eclampsia?
Develops after 20 wks
Increased BP
Proteinuria
Edema
2 or more lbs weight gain in a wk
Can have seizure --> eclampsia
Tx with Magnesium sulfate
What is magnesium sulfate?
Acts as anticonvulsant
Sedative
Vasodilates
How do you determine fetal position/presentation?
Leopold maneuver
Void prior
Between contractions
What are signs of labor?
Lightening ("dropping" of fetus into pelvis)
Engagement
Fetal stations
Increase in levels of activity (Nesting)
Ripening of the cervix (softening)
Uterine contractions
Bloody show
Diarrhea
Rupture of membranes
What is a non-stress test (NST)?
2 or more accelerations of 15 bpm with or without fetal movement
Each acceleration should last for 15 secs
Recorded for 20 mins
Want a reactive result
What is a biophysical profile (BPP)?
Commonly done in 3rd trimester
Measures 5 parameters by US (2 pts each)
HR, muscle tone, movement, breathing, amount of amniotic fluid around baby
Observed for 30 mins
What is a contraction stress test (oxytocin challenge test)?
For high risk pregnancies
Determines if baby can deal with stress of contraction
Want a negative result
Usually not done before 28 wks
Results only good for 1 wk
What is an early deceleration?
Benign
Caused by fetal head compression
What is a late deceleration?
Bad
Caused by utter-placental insufficiency
What is a variable deceleration?
Bad
Caused by umbilical cord compression
What is true labor?
Contractions are regular and increasing and are not relieved by change in position. In fact, activity makes pain worse. Discomfort in back radiates around to abdomen.
What is false labor?
Irregular contractions
Discomfort in abdomen
Decreased with activity change
What is done for preterm labor?
Goal is to stop labor
Treat any existing vaginal infections or UTIs
Hydrate mom
Bedrest
May be given
Magnesium sulfate
Betamethasone
Terbutaline
Indomethacin
Nifedipine
What is epidural anesthesia?
Position: Lie on left side, legs flexed, prop over bedside table
Give stage 1 at 3-4 cm
Usually no HA
Major complication is hypotension
IVF
Put pt in semi-Fowlers
Check UOP
What are nursing considerations for oxytocin?
1:1 nursing
Alert for complications
Hypertonic labor
Fetal distress
Uterine rupture
Want contractions q2-3 mins lasting 60 sec
Discontinue if
Too often contractions
Too long contractions
Fetal distress
Piggybacked into mainline
What is a normal postpartum assessment?
VS
Temp: May increase to 100.4*F
BP: stable
HR: 50-70 for 6-10 days post
Breasts: Soft for 2-3 days then engorgement
Abdomen: Soft/loose
GI: Hunger
Uterus: Want fundus to be firm
Lochia
Rubra: 3-4 days
Serosa: 4-10 days
Alba: 10-28 days
UOP
What is breast care for breastfeeding mothers?
Cleanse with warm water after each feeding
Let air dry
Support bra
Ointment for sores
Express colostrum and let dry
Breast pads
Increase calorie intake by 500 calories/day
Increase fluid intake
What is breast care for non-breastfeeding mothers?
Ice packs
Breast binders
Chilled cabbage leaves
No stimulation
What are postpartum complications?
Infection (within 10 days after birth)
Hemorrhage (early-first 24hrs, late-24hrs-6wks)
Uterine atony
Lacerations
Retained fragments and forceps delivery
Mastitis (2-4 wks)
Fever/chills
Swollen, hard, tender breasts
Malaise
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