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DA Maternity And Newborn Assessment
Terms in this set (69)
What is ferning and when is it used?
Ferning is looking at the mucous under a microscope. It looks like a fern. It looks this way during ovulation and during the rupture of membranes.
How does basal body temperature predict ovulation?
Basal body temperature increases 1 degree 24-36 hours after ovulation.
With oral contraceptives (estrogen and progesterone based) what is the major risks associated with them?
Estrogen based stops what?
They are at a higher risk for DVT or PE and can increase BP.
Estrogen based will stop breastfeeding.
Danger signs with oral contraceptives...
Severe Leg Pain.
Advantages of the Depo-Provera shot?
It is good to use with anticonvulsants.
Plan B is most effective when?
Within 72 hours of intercourse.
A vaginal diaphragm is used with what? How long can it be left in?
You must use it with spermicidal jelly.
It can be left in for a max of 24 hours inside.
What kind of lubricant should be used with condoms?
Only a water-based lubricant.
Two types of Long-Acting Reversible Contraception?
1. Intrauterine Devices (IUD)
2. Nexplanon (Arm Implant)
How to ensure that a vasectomy worked?
Wait three months and have sperm levels checked.
How many vessels should the umbilical cord have?
One vein and two arteries (AVA)
What does a history of a thyroid disease place the expecting mother at risk for?
It increases their risk for a miscarriage.
What is GTPAL?
Term (37-42 weeks)
Preterm (<37 weeks)
What is Nagele's rule?
Add 9 months and 7 days to the first day of the last menstrual period.
If they have nasal congestion during pregnancy, which drops should they use and what should they avoid?
They should use a saline nose drops and avoid Afrin.
Pica during pregnancy can be caused from what?
During pregnancy they should avoid taking _____ because it increases their risk for bleeding. Instead they should use what?
During pregnancy they should avoid taking ASA because it increases their risk for bleeding. Instead they should use tylenol and ibuprofen.
What should the pregnant woman do for leg cramps?
They should be encouraged to dorsiflex their foot. Toes to their nose.
Symphysis Pubis at 12 weeks
At Umbilicus at 20 weeks
Xyphoid Process at 36 weeks
Lightening occurs when?
What are Braxton Hicks Contractions?
Lightening occurs 2-4 weeks before labor.
Braxton Hicks Contractions are irregular contractions.
When should follow up visits be scheduled for pregnancy?
Every 4 weeks until 28 weeks.
Every 2 weeks 28-36 weeks.
Weekly after 36 weeks.
Normal weight gain during pregnancy...
Quickening is typically felt when?
What indicates a positive fetal stress test?
Increase in FHR of 15 beats per minute for 15 seconds. They should have 2 accelerations in 20 minutes.
What does a biophysical profile (BPP) indicate?
Assessment for fetal intrauterine risk.
What should the L/S ratio be?
What does it determine is developed?
If they are underdeveloped, what should you do?
It should be 2:1
It determines lung development.
If they are underdeveloped, you can administer betamethasone
Acronym for cardinal movements of labor...
Vertex vs. Breech Presentation?
Vertex is head down
Breech is head up
If the membranes rupture, what does this indicate?
That the birth will happen.
Latent phase frequency and duration of contractions...
Frequency: Up to every 5 minutes
Duration 30-45 seconds
Active phase frequency and duration of contractions...
Frequency: Every 3-5 minutes
Duration 45-60 seconds
Oxytocin is used for what?
For stimulation or augmentation of labor.
Always give it with a NS solution.
Transition stage frequency and duration of contractions...
Frequency: 2 minutes
Duration 60-90 seconds
When you give an epidural, what should you be prepared for?
Get ready for hypotension because their blood pressure can drop.
You should only push when?
When they are fully dilated.
VEAL CHOP (acronym for FHR interpretation)
V - Variable
E - Early decelerations
A - Accelerations
L - Late decelerations
C - Cord Compression (Variable)
H - Head Compression (Early Decelerations)
O - Okay! (Accelerations)
P - Placental insufficiency (Late Decelerations)
The placenta should be delivered _____-_____ minutes after delivery.
5-30 minutes after delivery.
Up to how long after delivery can the woman still hemorrhage?
How long does the color last:
Up to one month after pregnancy.
How long does the color last:
Rubra = 1-3 days
Serosa = 3-10 days
Alba = 11-21 days
What should be taught for comfort after birth?
Ice to the perineum for the first 24 hours, and then sitz baths afterward.
The post-partum blues are normal for up to how long?
Up to two weeks.
Normal respiratory rate for a newborn?
If RR is above 60 you do what?
Normal respiratory rate is 30-60.
If it is higher than 60 you hold feeds to decrease the risk of aspiration.
Physiologic vs. Pathologic Jaundice...
Physiologic is after the first 24 hours and can be normal.
Pathologic is within the first 24 hours after birth and can be a sign of Rh incompatibility.
Cephalohematoma vs. Caput Succedaneum...
Cephalohematoma doesn't cross suture lines.
How soon after birth should a newborn pee and poop?
Within the first 24 hours.
When do you give Rhogam?
If an Rh negative mother gives birth to an Rh positive baby. You give it to the mom.
How to tell if a baby is being feed enough/hydrated enough?
If they are having 6-10 wet diapers per day.
Symptoms of an ectopic pregnancy?
They will have vaginal bleeding with lower abdominal pain and tenderness on exam.
Symptoms of Placenta Previa?
What should be avoided?
Painless bright red vaginal bleeding.
They should avoid vaginal exams because it can cause hemorrhage or abruption.
Symptoms of Abruptio Placentae?
Continuous pain at site of abruption and a board-like abdomen.
Pre-eclampsia vs. Eclampsia...
Pre-eclampsia is hypertension after 20 weeks with proteinuria.
Eclampsia is the same as pre-eclampsia with the presence of seizures.
Mild vs. Severe Pre-eclampsia...
Mild is a BP > 140/90
Severe is a BP > 160/110
What HTN med is contraindicated in pregnancy?
ACE inhibitors and ARB's.
What is magnesium sulfate used for?
To depress CNS and decrease neurological irritability.
MgSO4 toxicity symptoms... (3)
Antidote for magnesium sulfate?
1. RR < 12
2. DTR absent
3. Urinary output declines.
Antidote is calcium gluconate.
What is HELLP syndrome?
If it develops what must be done?
It is Hemolysis, Elevated Liver Enzymes, and Low Platelets.
If it develops, preparations for a vaginal or caesarian delivery must be done.
What are insulin needs during each trimester?
Insulin needs decrease in the first trimester.
Insulin needs double to quadruple in the second and third trimester.
What should the nurse look for in the newborn birthed from a gestational diabetic?
Hypoglycemia because glucose crosses the placenta but insulin does not.
Signs and symptoms of fetal distress in womb? (3)
1. Prolonged bradycardia
2. Recurrent late decelerations
3. Passage of meconium
Actions you should implement for a cord compromise/cord prolapse... (5)
1. Elevate presenting part
2. Call for help
3. Start O2
4. Knee chest position
5. Deliver that baby
What is indicative of a hemorrhage in a postpartum woman?
> 500 mL in 24 hours.
Where should the height of the fundus be after delivery? How quickly should it return to normal?
The height of the fundus after delivery should be at the umbilicus.
It should go down one finger breadth each day afterwards.
Oxytocin is only for an _____ or _____ uterus. If the fundus if firm, oxytocin wont be helpful. Consider a _____ instead.
Oxytocin is only for an atonic or boggy uterus. If the fundus if firm, oxytocin wont be helpful. Consider a laceration instead.
Methergine is given for what?
It can cause _____.
Given for uterine atony.
Can cause hypotension.
Grams to pounds to kg...
1000 grams = 2.2 pounds = 1 kg
If the mother is HIV positive, what will the doctor do for the mother and for the baby following delivery?
They will both be given antiretrovirals to decrease the viral load.
Breastfeeding with HIV/AIDS is contraindicated.
If the mother has active genital herpes lesions in pregnancy what will happen?
They will do a C-Section to prevent transmission to the newborn.
How should mammograms be done?
Baseline at 40
Every 1-2 years 40-50
Yearly after 50.
Should be done sooner if there is a family history
High risk factors for pregnancy?
1. <16 or >35
2. History of cardiac or renal disease
3. History of preterm labor/births
5. Substance abuse/smoking
With late decelerations what does it mean?
If you have late decelerations with oxytocin infusion what should you do?
It means that there is placental insufficiency.
If you are giving oxytocin and you have late decelerations, you STOP.
Turn mother on side
Prolapse assessment and call physician.
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