Chadwick's sign -- is it a presumptive, probable, or positive sign of pregnancy? Hegar's sign -- is it a presumptive, probable, or positive sign of pregnancy?
Goodwell's sign -- is it a presumptive, probable, or positive sign of pregnancy? fetal heart tones -- is it a presumptive, probable, or positive sign of pregnancy? positive pregnancy test (peeing on the stick) - is it a presumptive, probable, or positive sign of pregnancy? braxton-hicks contractions -- is it a presumptive, probable, or positive sign of pregnancy? fetal outline felt by examiner -- is it a presumptive, probable, or positive sign of pregnancy? quickening -- is it a presumptive, probable, or positive sign of pregnancy? linea nigra -- is it a presumptive, probable, or positive sign of pregnancy? darkened areola -- is it a presumptive, probable, or positive sign of pregnancy? striae gravidarum -- is it a presumptive, probable, or positive sign of pregnancy? chloasma -- is it a presumptive, probable, or positive sign of pregnancy? amenorrhea -- is it a presumptive, probable, or positive sign of pregnancy? What's the McDonald method of calculating gestational age? what is gravidity? What's parity?
probable probable probable positive
presumptive presumptive presumptive presumptive presumptive presumptive gestational age is approx. equal to the fundal height measured from the symphysis pubis # of pregnancies # of pregnancies in which the fetus/fetuses reach viability (at least 20 weeks or 500g) regardless of whether the fetus is born alive or not. G = gravidity T = term births (38 wks or more) P = preterm births (20-17 wks) A = abortions/miscarriages (before 20 wks) L = living kids 35-50% False. WBC count increases by 10,000/mm^3
blood volume increases by how much during pregnancy? T/F. WBC count decreases during pregnancy.
does maternal pulse rate increase or decrease during pregnancy? how much does the cervix dilate during the latent phase of the 1st stage of labor? how much does the cervix dilate during the active phase of the 1st stage of labor? how frequent are contractions during the active phase and how long do they last? how frequent are contractions during the transition phase and how long do they last? what begins and ends the 3rd stage of labor? oxytocin given for induction of labor is always given by which route? what's the most common adverse effect of prostaglandin E2 (PGE2)? What is prostaglandin E2 given for? how do you position the pt after inserting a PGE2 suppository? what is laminaria and what is it used for? the most noninvasive way to attempt to induce labor is: how often should you observe for S&S of bleeding in an infant who has just undergone a circumscision? T/F. Do not remove the small amount of yellow exudate from the circumscision site the day after the procedure.
increase from 0 to 4 cm. from 4 to 8 cm 2-3 min apart, lasting 60 secs each 1.5 to 2 min apart, lasting 60-90 secs each time begins with birth of baby, ends with expulsion of placenta
IV Piggyback hypertonic uterine contractions to soften and dilate the cervix for induction of labor have pt lie flat to prevent leakage laminaria is a brown algae (kelp) that is used as a mechanical cervical dilator for induction of labor. nipple stimulation -- to trigger the release of endogenous oxytocin
every 15-30 minutes for the first 2 hours
True. Yellow exudate the day after is expected. To avoid bleeding, do not remove it.
False. T/F. You can give the infant a tub bath No tub baths until 2 weeks post-surgery when the circumscision site 2 days after circumscision. is completely healed. T/F. You should remove the plastibell False. from the infant's penis in 5 days after Wait for it to fall off on its own in 5-8 days. circumscision. meconium: Describe the infant's first stool. - thick, tar-like - greenish-black Describe breast-milk stool: mustard yellow, soft/mushy, and sometimes sweet-smelling Describe formula stool: yellow, formed, and pasty what is the daily caloric need of an 100-120 cal/kg/day infant? what lecithin:sphingomyelin (L:S) ratio 2:1 normally
indicates fetal lung maturity? (3:1 for diabetic client) the presence of what in the amniotic fluid is associated with respiratory distress? what does high levels of Alphafetoprotein (AFP) in the amniotic fluid indicate? what does low levels of Alphafetoprotein (AFP) in the amniotic fluid indicate? what is the normal fetal HR range? T/F. Variability of fetal HR is normal. what is considered normal acceleration of fetal HR? what do late decelerations in fetal HR indicate? phosphatidylglycerol (PG)
neural tube defects Down syndrome or gestational trophoblastic disease (hydatidiform mole) 110-160 bpm True. 15 beats for 15 secs, 2-3 times in a 20 min frame uteroplacental insufficiency and fetal anoxia - pregnancy induced HTN - diabetes - overstimulation by oxytocin
3 top risk factors (+ 3 more) for late decelerations:
others include: - post-term pregnancy - drug abuse - placenta previa or abruptio placentae - have pt lie on left side to take pressure off inferior vena cava Other possible interventions: - administer O2 - administer IV fluids - stop oxytocin influsion cord compression
What do you do if pt is having late decels?
what are variable decelerations associated with? what do early decelerations indicate? T/F. lack of variability of fetal HR is a bad sign. T/F. No interventions are needed for early accelerations. What is hyperemesis gravidarum? What do you look for in the urinalysis of a pt suffering from hyperemesis
fetal head compression True. True. No interventions are needed if labor is progressing normally. excessive nausea and vomiting r/t high hCG lvls that is prolonged past 12 weeks of gestation and results in 5% weight loss from prepregnancy weight, dehydration, F&E imbalance, etc. - ketones and acetones - increased specific gravity
gravidarum? T = Toxoplasmosis O = Others (Hep B, syphilis, herpes zoster) R = Rubella C = Cytomegalovirus H = Herpes & HIV False. Rubella vaccines should NEVER be given in pregnancy. placenta previa = painless bleeding placenta abruptio = painful 40-50 lb weight gain is normal
what does TORCH stand for?
T/F. All pregnant women should get vaccinated for Rubella. Main difference between placenta abruptio and placenta previa: how much weight gain is expected for a twin pregnancy? T/F. A multiple gestational pregnancy puts the mother more at risk for preterm labor.
True. - shortness of breath - chest pain - pulmonary edema - maternal tachycardia - hyperglycemia - hypokalemia - BP - UO - reflexes - respirations 1. infuse IV tocolytic (hydration and medication stops preterm labor) 2. administer betamethisone (to develop fetal lungs in case of early delivery) 3. apply fetal monitor (to monitor contractions and fetal HR) 4. bedrest teaching - trendelenburg - knee-chest - side-lying with hips elevated <100 1 8-10 need for further stimulation such as back rub and oxygen pink body with blue extremities
6 side effects of tocolytics:
things to monitor for when on mag sulfate: Pt's having preterm labor. Place in order of priority: - apply fetal monitor - infuse prescribed IV tocolytic - administer betamethisone - pt teaching regarding bed rest what positions can you place your pt who has a cord prolapse? what HR receives a score of 1 according to Apgar? what score is given for a facial grimacing according to Apgar? what total Apgar score range is considered good? what does an Apgar score of 5-7 indicate? what's acrocyanosis?
what pH is amniotic fluid? and what color would the nitrazine paper turn into? what's the normal temperature for a newborn? what's considered excessive vaginal bleeding in the immediate postpartum period? How big are normal blood clots that are passed out one day after delivery? how long does lochia rubra last? what is lochia serosa and how long does it last? what is lochia alba and how long does it last? T/F. Heavy perspiration is expected for the first few days after delivery. After delivery, how long does the pt's WBC count remain elevated for? when does normal renal function return post-delivery? a female pt should have get pregnant for how many months after a rubella vaccine? T/F. mother's milk does not contain any iron. how many days after conception will hCG levels be detected in the blood T/F. You should apply fundal pressure on the mother for fetal shoulder dystocia. Normal bilirubin levels for the 1st 3 post-delivery days: what should you encourage to help the newborn rid of bilirubin? T/F. to help ease contraction pain, the pt's partner should apply intermittent pressure on the pt's lower back. T/F. IUD's are recommended for women who have given birth previously
pH 6.5-7.5 bluish-greenish, dark blue 97.7-99.5 degrees F or 36.5-37.5 degrees C >500ml for vaginal delivery >1000ml for c-section delivery
no bigger than 1cm 2-3 days post-delivery pink-brownish watery discharge lasting from 3-10 days post-delivery
yellowish white discharge lasting from 10-17 days post-delivery but can persist for 6 wks True. 10-12 days (return to normal in around 2 weeks) by 6 weeks
stay clear for 3 months False. Iron from mother's milk is better absorbed than iron from formula. 6-11 days post-conception False. Apply suprapubic pressure to help delivery the baby. day 1: 6 mg/dl or less day 2: 8 mg/dl or less day 3: 12 mg/dl or less encourage feeding, which results in more elimination of bilirubin False. constant pressure should be applied. True.
rather than for women who have never given birth. IUD's can maintain effectiveness for how many years? how are Nubain (Nalbuphine) and Stadol (Butorphanol) different from Fentanyl and Morphine? T/F. You should apply heat packs on your breasts for mastitis. What's precipitate labor? what does Kleihauer-Betke test do? When can chorionic villus sampling be performed? when can the sex of the fetus be determined? At which gestational age are all body organs formed? When does the fetal heart begin the beat? when can you hear it using a Doppler? when can you hear it with a fetoscope? vernix caseoa develops when? brown fat present at what gestational age? Fetus gains ability to hear at what gestational age? what's the ductus arteriosus?
up to 10 years Stadol and Nubain do not cause respiratory depression, so they can be on standing order. False. You should apply ice. labor that occurs really fast, lasting 3 hours or less from onset of contractions. ensures blood obtained for percutaneous umbilical blood sampling (PUBS) is from the fetus 10-12 weeks gestation at 12 weeks (3 months) 8 weeks (2 months) - begins to beat at 4 weeks (1 mo.) - hear it w/ a Doppler at 8-12 weeks (2-3 mo.) - hear it w/ a fetoscope at 20 weeks (5 mo.) at 20 weeks (5 months) 28 weeks (7 months) 24 weeks (6 months) duct that connects the pulmonary artery with the aorta allowing blood to bypass the lungs
what's the foramen ovale? What's the ductus venosus? what serves as the respiratory organ for the developing fetus? T/F. the umbilical vein carries oxygenated blood. T/F. Always have the pt sign a consent form before performing an ultrasound or any other procedure. T/F. Have the pt void before performing an ultrasound.
intra-atrial opening that shunts blood from the R to L atria shunts blood from the umbilical vein to the inferior vena cava allowing most of the blood to bypass the liver the placenta True. It carries oxygenated blood and nutrients from the placenta (maternal supply) to the fetus False. Pts do not need to sign a consent prior to an US. False. Pts should drink lots of fluids and fill the bladder to stabilize the uterus
Define fetal lie: Define: fetal attitude: define fetal presentation:
define fetal position: external cephalic version is usually done at how many weeks? RhoGAM is administered at how many weeks of gestation?
for an US. relationship of the mom's spine to the fetal spine. (transverse or parallel/longitudinal) relationship of fetal body parts to one another. (flexion or extension) the part of the fetus that enters the pelvic inlet first. (occiput, mentum, scapula, or sacrum) Relationship of the presenting part in reference to its directional position as it relates to one of the 4 maternal pelvic quadrants. (labeled with 3 letters: R/L, O/S/M/Sc, A/P/T) after 37 weeks gestation 28 weeks gestation determines maternal readiness for labor by evaluating: - cervical dilation - effacement - cervical consistency (firm, medium, soft) - cervical position (posterior, midposition, or anterior) - presenting part station - score of 9 or more for nulliparas - score of 5 or more for multiparas 120 mg 1g (1000mg)
What's a Bishop score?? and what are the 5 factors?
What Bishop scores indicate readiness? a lactating women should consume how much vitamin C per day? a lactating women should consume how much calcium daily? T/F. Iron needs for lactating women are about the same as non-lactating women. a positive contraction stress test indicates a need for what other test? combined oral contraceptive use can is contraindicated if you have what 3 problems? what happens to hCG levels in women with hydatidiform moles?
biophysical profile - headaches - liver problems - gall bladder problems increased hCG levels, and faster than usual uterine growth - never been pregnant - over age 40 - infertile - menstrual irregularities - family hx of breast, bowel, or endometrial cancer - have first kid at young age - oral contraceptives - have given multiple births
what increases your chances of getting ovarian cancer?
what decreases chances of getting ovarian cancer?
T/F. You should clean the entire cord with alcohol several times daily. what is done to relieve hydramnios? T/F. a split S2 is common in newborns during the first few hours of life. when should a primigravida expect to feel quickening? how about a multigravida? what kind of labor (true or false) contractions start in the back and radiates to the abdomen? what kind is usually felt in the abdomen only? what is Hegar's sign and when can you assess for it? when can fetal outline be palpated? when is ballottement elicited? T/F. Maternal oliguria is often associated with epidural anesthesia. What is an adverse effect of epidural anesthesia on fetal heart rate? is amniotic fluid acidic or alkaline? T/F. Maternal feelings of inadequacy is normal 3-7 days postpartum and does not necessarily indicate postpartum depression. what's the priority intervention for a mother in active phase? what is the neonate's capacity for feeding during the 1st 24 hrs and how often should you feed? what 2 factors increase the chances of having afterpains postpartum? T/F. A yellowish hue to the skin of a 1-hr old neonate is abnormal.
- primigravid: 20-22 weeks - multigravida: 18-20 weeks
- True labor is felt in the back and radiates to the abdomen - False labor is usually felt in the abdomen only
- softening of the uterine isthmus - between 6-8 weeks after 24 weeks after 4-5 months False.
brady and decreased variability alkaline
review short-pant form of breathing (it may reduce need for pain meds)
40-60ml every 2-4 hours - multiparity. (decreased uterine muscle tone leads to alternating relaxation and contraction during uterine involution) - breastfeeding. (from oxytocin release, which stimulates the uterus to contract and thus enhances involution) True. It's too soon for the neonate to be exhibiting jaundice.
T/F. neonates are obligate nose breathers. a well fed neonate should wet how many diapers in a day? what drug is given to prevent fetal transmission of group B strep? how long does it take for the neonate's penis to heal after a circumcision? how do you prevent retinopathy of prematurity in an infant receiving oxygen via ventilator? the action of mag sulfate occurs at which site? can a pregnant pt take castor oil for constipation? what are two conditions that would place a pregnant woman at risk for DIC? what happens to hCG levels in the postpartum period? what drug is usually prescribed for morning sickness? Why is Compazine and Tigan not prescribed for morning sickness? why is Methergine given postpartum in some cases? can oxytocin cause decreased or increased blood pressure in postpartum pts? T/F. amniocentesis can determine the sex of the fetus. can amniocentesis be used to determine fetal lung maturity?
True. they have no ability to breath through their mouths 10-12 wet diapers penicillin G potassium I.V.
monitor PaO2 levels and keep O2 concentration from going above normal limits. neuro-muscular junctions (does not act on CNS) no. it can lead to premature contractions - placenta abruptio - intrauterine fetal death disappears within the first 8-24 hours after delivery in lactating and nonlactating pts. Emetrol (a phosphorated carbohydrate solution) they can cause congenital anomalies and should not be used during pregnancy to prevent or treat postpartum hemorrhage from uterine atony or subinvolution
increased blood pressure
True. yes but only during the last trimester
T/F. Amniocentesis is used to diagnose polyhydramnios. what are the 3 cardinal signs of an ectopic pregnancy? T/F. Terbutaline can cause bradycardia.
False. ultrasounds are used to diagnose polyhydramnios, but an amniocentesis can be used to relieve it. - abdominal pain - vaginal bleeding - a positive pregnancy test False. It can lead to tachycardia
a hydatidiform molar pregnancy increases the risk for what condition? therefore what needs to be monitored and for how long? what info regarding birth control should you teach a pt who just got treated for a hydatidiform molar pregnancy? when can a women try to get pregnant again after a hydatidiform molar pregnancy? T/F. The risk of recurrence of a hydatidiform mole is high. what should you teach/ for a pregnant pt who's getting gestational diabetes? T/F. hyperemesis gravidarum is a neurologic disorder. are prone to what common complication during pregnancy? what serious adverse effect is associated with oxytocin (Pitocin) administration during labor? distinguish between the primigravida and multigravida cervical dilation: Neonatal heart rates lower than how many beats/minute necessitate chest compressions and ventilatory support? when should oxytocin be discontinued during labor? what 4 things are commonly included in early childbirth (1st trimester) educational classes? approximately where is the fundal height at 20 week gestation? the uterus deviates to which side in early pregnancy? Adverse reactions to Oxytocin in the mother such as hypertension and fluid overload are due to what effects of drug?
- increases risk for choriocarcinoma - hCG levels needs to be monitored monthly for 1-2 years
client should be counseled to use a reliable method of birth control for at least 1 year
after 1 year if hCG levels remain low False. risk of recurrence is low Teach her about diet. The client's blood glucose level should be controlled initially by diet and exercise, rather than insulin False. The cause of hyperemesis gravidarum isn't known iron def. anemia tetanic contractions (high risk for fetal hypoxia) Primigravidas will efface and then dilate, while multigravidas will efface and dilate at the same time
if under 60 bpm
Oxytocin should be discontinued when contractions occur less than 2 minutes apart or last longer than 90 seconds. - warning signs of complications - the anatomy and physiology of pregnancy - nutrition - fetal development at the umbilicus. right side. (so many women experience RLQ pain/pulling)
due to its antidiuretic effects
when does the plantar grasp reflex disappear?
by 9 months - nonstress test - fetal tone - fetal breathing - fetal motion - quantity of amniotic fluid
what are the 5 components of a biophysical profile?
For the 1-hour glucose tolerance test, a result of greater than or equal to what number of mg/dl indicates the need for further testing? A postpartum woman should be suspected of psychosis if she exhibits what? T/F. Postpartum psychosis is considered a medical emergency. T/F. Postpartum psychosis is not associated with a past history of a psych disorder and tx. when does postpartum psychosis start?
manic-depressive behaviors (delusions or hallucinations)
True. Because suicide and infanticide are common. False.
around 4 weeks postpartum.