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Flashcards

Final 303

Kate Caldwell N303 English 161 cards

Cards in this deck (161)

  1. 1What is considered the "neonate" period?First 28 days of life
  2. 2In a newborn, what stimulates the first breath?Low O2 and high CO2
  3. 3Why is vaginal breath better than C/S when considering the "trap doors"?Allows expulsion of amniotic fluids from the lungs, leading to better closing of the trap doors
  4. 4What is the max period of apnea in a newborn?15 seconds
  5. 5What is a newborn RR?30-60
  6. 6What is a retraction?Sunken in chest
  7. 7What is a newborn HR?120-160
  8. 8Why are transient murmurs normal in a newbie?Because the ducuts arteriosis is still open (bypasses the lungs)
  9. 9What should the newborns temp be?36.5-37.5 C or 97.7-99.7 F
  10. 10What is conduction?Transfer of heat between 2 direct objects (skin to skin, warm blanket to skin)
  11. 11What is convection?Hot or cold airflow
  12. 12What is evaporation?Heat loss when liquid vaporizes...baby bath!
  13. 13What is radiation?Heat loss to cooler surface NOT in direct contact...air conditioner
  14. 14What are s/s of cold stress in an infant?High pitched cry, mottled skin, lethargic, hypotonic, hypoglycemic, jaundice
  15. 15What are s/s of a hypoglycemic newbie?Jittery, low temp, poor muscle tone and suckling, tachypnea
  16. 16What infants are at risk for hypoglycemia?Preemies, Posties, IUGR, Macrosomia, Cold Stress
  17. 17What should newbies BS be?40-80. If less than 40, feed more often
  18. 18Whats unique about baby RBCs?BIG, but there are few of them (anemia of infancy)
  19. 19What is needed to produce vitamin K?bacteria in the gut (babies don't get this til 4-6 days after birth!)
  20. 20What is the normal weight loss of an infant?5-10% of birth weight within first 2 days
  21. 21What color is transitional stool?Greenish/brownish
  22. 22What color is milk stool?Yellow/mustard/chunky
  23. 23Which bilirubin causes jaundice?Unconjugated---its not broken down and builds up
  24. 24Bilirubin is produced by the breakdown of what cells?RBCs
  25. 25Which jaundice is normal?Physiologic
  26. 26When does physiologic jaundice occur?NOT in first 24 hours, usually day 2 or 3
  27. 27When does nonphysiologic/pathological jaundice occur?Within first 24 hours
  28. 28What is infant intake for first 2 days of life?40-60 ml/kg (0.5-1 oz/pound)
  29. 29What is infant output in first 2 days?1-2 voids daily
  30. 30What is intake for infant after first two days of life?100-150 ml/kg (1.5-2 oz/pound)
  31. 31What is output after first 2 days?6 voids by 4th day
  32. 32What are the 3 periods of activity in an infant?First period of reactivity (first 30 minutes after birth), Period of decreased responsiveness (sleep), Second period of reactivity (somewhere in hours 2-8 post birth)
  33. 33When are APGARs done?Minute 1 and 5
  34. 34What 5 categories does the APGAR look at?Color, pulse, grimace/irritability, respiratory effort, activity/tone
  35. 35What is the order for suctioning immediately post delivery?Suction mouth first, then nose (if you suction nose first, leads to inspiration, which leads to aspiration of mucous)
  36. 36What is defined as low birth weight?<2500 grams
  37. 37What is defined as low birth weight?<2500 grams
  38. 38What is Caput Succedaneum?Edema over the occipital region due to prolonged pushing; it crosses suture lines (bilateral)
  39. 39What is cephalahematoma?Accumulation of blood under periosterum due to trauma (vaccum!!!). Does NOT cross suture lines and is usually one sided
  40. 40What do sunken fontanelles mean?Dehydration
  41. 41What do wide spaced fontanelles mean?Fluid in the brain
  42. 42What does crepitus over clavicles mean?They broken bra
  43. 43What is the rooting reflex?Infants turn face toward stimulus and making sucking motion
  44. 44How many calories are in most breast milk and formula?20 calories/ounce
  45. 45What are benefits of breastmilk to baby?More easily digested (more frequent poops!), contains immunoglobulins and antioxidants, decreases risk of infection, diabetes, and obesity
  46. 46What are benefits of breastfeeding for mom?Decreased PP bleeding, rapid uterine involution, early return to pre-pregnancy weight, and reduced risk of ovarian and breast cancer
  47. 47What stimulates milk production and what stimulates "let down"?Milk production is stimulated by PROLACTIN (suckling causes more to be produced), "Let Down" is stimulated by OXYTOCIN (also stimulated by baby's cry!)
  48. 48What is foremilk/hindmilk?Foremilk quenches THIRST, and is released in first 10-15 minutes of BF. Hindmilk quenches HUNGER, and is released at about 15 minutes...richer in fat and lactose
  49. 49How often are infants fed?q2-3h
  50. 50When breastfeeding, how many extra calories does mom need?500 extra from pre-pregnancy, or additional 200 to pregnancy diet
  51. 51What is nipple confusion?Baby likes bottle nipple better than moms! Establish breast nipple before introducing bottle
  52. 52Can Hep B moms breastfeed?Yes, as long as nipples aren't cracked or bleeding
  53. 53What are risks of GDM?Macrosomia, shoulder dystocia, polyhydraminos, preterm birth and labor
  54. 54When are women screed for GDM?24-26 weeks
  55. 55How are women screened for GDM?1 hour GTT. Give 50-75 grams of sugary drink
  56. 56What is the normal BS range after a GTT?<135. If its greater than this, need to do a 3 hour fasting test. If get 2 or more abnormals here, you have GDM
  57. 57What are s/s of hypoglycemia?Tremors, sweating, cold skin, disorientation, headache, hunger
  58. 58What are s/s of hyperglycemia?Fatigue, hot skin, dry mouth, thirst, fruity breath
  59. 59What is the GBS screen done?At 36 weeks
  60. 60To have milkd preeclampsia, what must the BP be?Rise of 30+ systolic AND 15+ diastolic over baseline. OR >140/90
  61. 61For a diagnosis of mild preeclampsia, what must protein in urine be?Greater than +1
  62. 62What are symptoms of severe preeclampsia?ALL of same for mild plus TWO or the following: BP of 160/110 on two occasions, Proteinuria of +3 or +4, generalized edema in hands and face
  63. 63What distinguishes Eclampsia from Preeclapmsia?Seizures
  64. 64What is the cure for preeclampsia?Delivery
  65. 65What classifies HELLP syndrome?Similar to severe preeclampsia, but with hemolysis, elevated liver enzymes, and low platelets
  66. 66What is unique about HELLP moms BP?Can be normal
  67. 67How do we treat HELLP?Administer Mag Sulfate
  68. 68Which two drugs increase lung maturity?Betamethasone and Decadron
  69. 69Which drug decreases risk of seizures?Mag Sulfate
  70. 70What is mag sulfate dosage?4-6 grams loading dose. Then 1-2 grams/hour maintenance dose
  71. 71When giving mag sulfate, what should you be sure to assess q2h?Deep tendon reflexes (if they are decreases or absent, STOP mag)
  72. 72When should you hold/stop mag sulfate?If respirations are less than 12, urine output is less than 30 ml/hr, or there is an absence of DTRs
  73. 73What is mag sulfates antidote?Calcium Glutonate
  74. 74How long after delivery can seizures occur?48 hours post
  75. 75Can mag sulfate be given IM?Yeap. 5 mg per butt cheek
  76. 76When do most miscarriages occur?Weeks 8-13
  77. 77What are s/s of threatened miscarriage?Spotting with NO cervical change. Treat with bedrest and no sex for 2 weeks
  78. 78What are s/s of inevitable/incomplete miscarriage?Moderate to heavy bleeding with DILATED CERVIX. Treat with hospitalization and grief counseling. Will need to D+C cervix to scrape out "products of conception"
  79. 79What is a complete miscarriage?All products of conception come out, and cervix is closed. No need for D+C
  80. 80How is an incompetent cervix treated?McDonald Suture: Cerclage stich on uterus opening until term
  81. 81What is a ruptured ectopic pregnancy usually confused with?Appendicitis
  82. 82What are risk factors for ectopic pregnancies?Scarring (PID), IUD as birth control
  83. 83What are s/s of hydatidiform mole?vaginal bleeding in first trimester, uterus larger than expected
  84. 84If mom has mole, what needs to be tested for 1 year?HcG levels: she can't get pregger for a year!
  85. 85Where is the placenta located in placenta previa?in the lower segment of the uterus. It may be blocking the cervical os!
  86. 86What are s/s of placenta previa?Painless, bright red bleeding, usually in the 3rd trimester
  87. 87What are risk factors for placenta previa?previous scarring/surgery, or fibroid tumors (placentas love scars!)
  88. 88When does abruptio placentae usually occur?late 3rd trimester or during labor
  89. 89What is abroptio placentae assocaited with?HTN, high gravidity, abdominal trauma, cocaine and cigarette use
  90. 90What are s/s of abruptio placentae?vaginal bleeding, abdominal/back pain, ridig (board-like) abdomen, FHR decels
  91. 91When is RhoGAM given?28 weeks and within 72 hours postpartum
  92. 92When is preterm labor?Between 20 and 37 weeks gestation
  93. 93What are symptoms of preterm labor?Greater than 5 contractions per hour WITH cervical change
  94. 94Which population has a double risk of PTL?African Americans
  95. 95What meds are given if mom is in PTL?Tocolytics: Mag sulfate to relax smooth muscle, Betamethasone/Decadron to grow lungs, and Brethine/Tribuatline to slow contractions
  96. 96What is the biggest reason for premature rupture of membranes?Infection, specifically Chorioamnionitis
  97. 97What is unique about amniotic fluid associated with chorioamnionitis?It smelllllls
  98. 98What is an amniotomy?assisted rupture of membranes
  99. 99What needs to be assessed before and after AROM?FHR 20 minutes before and immedately after to assess for prolapsed cord or cord compression
  100. 100If meconium is found in amniotic fluid, what should be done?Amnioinfusion
  101. 101Whats the difference between augmented and induced labor?Augmented labor helps it along, whereas induced labor is initiated labor
  102. 102What does Bishop's Score assess?Cervical ripeness
  103. 103What are 3 cervical ripeners?Prostoglandin gel, Cervidil, and Cytotec
  104. 104What cervical ripener is also found in semen?Prostoglandins
  105. 105What classifies hypertonic contractions?Lasts 90-120 seconds
  106. 106When can a VBAC not be done?If mom had c/s with CLASSICAL incision
  107. 107What is precipitate BIRTH?No trained attendant is present
  108. 108What two situations call for amnioinfusion?Meconium stained amniotic fluid of deep variable decels
  109. 109When would you NOT use amnioinfusion?If mom has increased intra-uterine resting tone
  110. 110What can be a major complication of shoulder dystocia?Brachial plexus damage resulting in Erb's Palsy
  111. 111What is the turtle sign?When babies head retracts back into mom. Is is a sign of shoulder dystocia
  112. 112What 3 manuevers are performed during shoulder dystocia?McRoberts (mom pulls knees to ears), Suprapubic pressure (nurse pushes on moms abdomen to push shoulders out), Corkscrew (MD twists baby as coming out)
  113. 113What is a prolapsed cord?Cord lies below presenting part of fetus
  114. 114How do you treat prolapsed cord?Emergency c/s. Push head back in on way to OR and make sure it is OFF the cord
  115. 115What may cause a uterine inversion?Provider pulling cord and placenta before its ready to come out
  116. 116Whats another name for anaphylactoid syndrome?Amniotic Embolism
  117. 117What are the 3 most common PP complications?Infection, bleeding, psychological
  118. 118What is a tell-tale sign of PP infection?Foul smelling lochia
  119. 119What is the biggest contributing factor to PP hemorrhage?uterine atony
  120. 120What 3 things can cause uterine atony?Overdistension of uterus (LGA), mag sulfate, or general anesthesia
  121. 121If uterus is boggy PP, what do you do?massage the fundusssss
  122. 122If there is bleeding and the fundus is firm, what can be assumed?Vaginal bleeding
  123. 123If there is bleeding associated with intense perineal pain, what can be assumed?Hematoma
  124. 124What 3 meds treat PP hemorrhage?PITT, Methergine, Hemobate
  125. 125Who can't receive methergine?HTN or preeclampsia
  126. 126Who can't use Hemobate?Asthmatics
  127. 127What side effect is associated with all 3 anti-hemorrhagics?GI upset
  128. 128when do baby blues occur?Day 3-10 PP and only last a week or two
  129. 129When does PP depression occur?Week 4-6 PP and lasts weeks to months
  130. 130If an infant is septic, what happens to their temp?Instability, may be high or LOW
  131. 131What antibiotic treats GBS?Penicillin
  132. 132What are s/s of withdrawal baby?Irritable, runny nose, sneezing, always awake
  133. 133When does physiologic jaundice occur?Day 2-3
  134. 134When does pathological jaundice occur?within first 24 hours
  135. 135Which jaundice is "normal"?Physiological
  136. 136What causes transient tachypnea?Delay of fetal lung fluid absorption. Common in c/s babies or babies of diabetic moms
  137. 137How do we treat IRDS?Give baby artifical surfactant: Survanta
  138. 138If a baby has hypoxia, what is usually the cause?a patent ductus arteriosis: will have bounding pulses, tachy, sweating, cyanosis, murmur
  139. 139How do we measure infant I+O?Weigh diapers
  140. 140Which SGA baby is better?Asymmetric because its head sparing and occurs later in pregnancy
  141. 141Which STD is the most common in women?Chlamydia, followed by Gonorrhea
  142. 142What are s/s of chalymida and gonorrhea?Often asymptomatic, but may have purulent drainage or UTI pain and RED eyes (gonorrhea)
  143. 143How is syphillis treated?30 days of antibiotics and sexual abstinence during treatment
  144. 144What three things does PID put you at risk for?ectopic pregnancy, infertility, and placenta previa
  145. 145Whats another name for HPV?Genital warts
  146. 146Whos at highest risk for HPV?Prenant women, because they are immunosuppressed from steroids
  147. 147What does a LEEP biopsy do?Removes HPV genital warts
  148. 148Which cancer is HPV associated with?Cervical cancer
  149. 149How do HIV moms deliver?Usually c/s, but can be vaginal. Don't breastfeed
  150. 150What commonly causes bacterial vaginosis?Too much anti-bacterial soap! Causes smelly discharge odor
  151. 151Which two STDS do condoms NOT protect against?Herpes and HPV
  152. 152What is a downside to diaphragms?Must be refitted for them periodically, especially after pregnancy or change in weight
  153. 153Which two hormones do most pills contain?Estrogen and Progesterone
  154. 154Which homrone is in the mini pill?Only progesterone
  155. 155Who shouldn't use the pill?Uncontrolled HTN, history of DVT, or smoker over age of 35
  156. 156How soon does the morning after pill need to be taken?Within 72 hours
  157. 157What hormone is in the Depo shot?Progesterone
  158. 158How long should depot shots be used?Given q3months for less than two years due to increased risk for depression and bone loss
  159. 159What do IUDs (Mirena) put you at risk for?PID
  160. 160What two hormones are in Nuva Ring?Estrogen and Progesterone
  161. 161For permanent sterilization, what two things are done?TIE and SNIP

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N303 Flashcards on Final 303, created by Kate Caldwell on 23/08/2013.
Created by
Kate Caldwell · Aug 2013
Updated
Feb 16, 2018
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