Exam 2

How do we want the baby to present in the body to know that they will be going into labor?

0 station

How many days does postpartum blues typically resolve within?

10-14 days

How much total volume of bleeding comes from the lochia?

225 mL

Which blood glucose level is common within the first hours of life?

40

If the mother is not breastfeeding, how many weeks after giving birth will she begin her period?

6-10 weeks

What does APGAR assess for?

Appearance, Pulse, Grimace, Activity (muscle tone), & Respiration. Each of these is scored on a scale of 0-2 with a total of 10 being the best

What is the diagnostic criteria for preeclampsia?

BP over 140/90 after 20 weeks of gestation and proteinuria

After labor, where do we want the uterus to be? Above or below the umbilicus? Is that considered plus or minus?

Below the umbilicus and considered minus

For the baby's first feeding, what is encouraged for the first interaction with mom? If this method is not wanted, then what is the other option?

Breastfeeding & if this does not work by hour 5 they can try bottlefeeding

Which type of fontanelle can indicate increased intracranial pressure? Which type can indicate dehydration?

Bulging fontanelle - ICP Depressed/sunken - dehydration

Patients who have stillbirths or retain their fetuses are at high risk for what?

DIC

What is the mother at increased risk for if spent extended period of time pushing?

Damage to the peroneal nerve resulting in drop foot (palsy)

___________ is commonly known as " soft spots."

Fontanelles

What does HELLP in HELLP syndrome stand for?

Hemolysis, Elevated Liver enzymes, & Low platelets

What is the meaning of cervical ripening?

Inducing labor

Which complication is seen in all types of ROM?

Infection of amniotic membranes

What is Abruptio Placentae/ Placental abruption? What symptoms will we see in this condition?

Premature detachment/separation of the normal placenta from the uterus. Dark red bleeding, Extended fundus, Tender uterus, Abdominal pain, Concealed bleeding, Hard abdomen, Experience DIC, Distressed baby

What is the difference between Braxton hick's contractions and real labor contractions?

Real labor contractions happen at the top of the uterus & change of the cervix. Braxton hick's contractions does not change the cervix & has pain in the sides & groin.

What does premature rupture of membrane mean?

Rupture of amniotic membrane before onset of labor.

What 5 conditions are at risk for DIC?

Sepsis, Pregnancy, cancer, burns, & trauma

What two monitors can be used to assess for contractions during labor? Which monitor is more accurate?

Toco and IUPC. The internal is more accurate because it can tell us the strength, duration, and contraction frequency.

What is placenta previa? What symptoms will we see in this condition?

abnormal attachment of the placenta in the uterus near or over the cervical opening. Painless bright red bleeding, Relaxed soft uterus, Episodes of bleeding, Visible bleeding, Abnormal fetal position

How many months do we want mothers do breastfeed?

at least 6 months

For premonitory signs of labor, how would lightening be described?

baby drops into the pelvis, which increases pelvis pressure, leg cramps, & venous stasis.

Which medication do we give in preterm labor that helps with the baby's lung development?

betamethasone

For postpartum depression, why do women need to be seen quickly?

can evolve into psychotic behaviors

What is the main clinical manifestation that tells us a miscarriage has occurred?

changes in fetal movement/heart rate

In which two locations do we assess capillary refill in a newborn?

chest & forehead

What is the primary force of labor? What are the three phases of it?

contraction & three phases are frequency, duration, & intensity.

Due to newborns being obligate nose-breathers, what are they at risk for?

cyanosis

In our lab levels, will we see our platelets and fibrinogen decrease or increase?

decrease

Why is magnesium sulfate given?

decrease threshold to have a seizure & lowers bp

What is the difference between a dime size clot & fist size clot?

dime size clot is considered normal and seen postpartum. Fist size clots are concerning that can lead to postpartum hemorrhage

The doctor will take it out for a vacuum extraction if this occurs.

discontinue if more than three "pop-offs" occur

What is the underlying cause of DIC?

due to a secondary condition

Why is vaginal delivery preferred over a c-section for the baby?

during vaginal delivery the compression the baby goes through allows fluid to be squeezed out of the lungs

What is the key feature that tells us it is postpartum blues?

episodic tearfulness

Death of a fetus after 20 weeks of gestation can be called what two things?

fetal demise or stillbirth

What two things related to the fetus do we need to monitor for it the mother has eclampsia?

fetal hypoxia & placenta abruption

Which three patients are misoprostol contraindicated in?

had a surgical incision, vaginal birth after c-section, and too many contractions.

What type of cry are we going to hear from infants who are born with fetal alcohol syndrome?

high pitch cry

What is the diagnostic criteria for chronic hypertension?

history of hypertension that is seen before 20 weeks of gestation & continues to the 42nd day postpartum

What is the mother at increased risk for if spent extended period of time in stirrups?

increased risk of thrombophlebitis

What are the three medications can we give to stop preterm labor?

indomethacin & nifedipine & mag sulfate

There is no _________ in breastmilk, so at 6 months they need to introduce this supplement if they are going to continue breastfeeding.

iron

Which supplement is needed for the mother after birth?

iron due to all the blood loss

If there is CVA tenderness present postpartum, what can this indicate?

kidney infection

Since most complications in a c-section are due to prolonged bed rest, what do we want patients to do?

leg exercises every 2 hours

If the mom who abuses heroin has overdosed, what can the baby be at high risk for?

meconium aspiration

What does artificial rupture of membrane mean?

midwife or doctor ruptures the membrane

What does it mean when the fetus is floating if we were to do a ballottement exam?

moving freely above the pelvic inlet and we can push the head away

In DIC, all body systems are involved & require careful, ________ __________.

ongoing assessment.

What is happening in the first stage of labor?

onset of true labor where the patient starts dilating

What does heroin put the mom at high risk for when they are pregnant?

overdose/death

What three areas does the mother get her immediate weight loss from postpartum?

placenta, baby, & amniotic fluid

What are the clinical manifestations of cocaine abuse for a pregnant mother?

placental abruption, fetal demise, cardiovascular/CNS effects, & Nasal/sinus diseases

How do we massage the fundus? Do we want the fundus to be firm or boggy?

placing one hand on the belly button & the other by the symphysis pubis and we want it to be firm

Which complication is the biggest issue seen in AROM?

prolapsed cord

What symptoms are related to mastitis?

redness, tenderness, swelling, & fever

What does preterm premature rupture of membrane mean?

rupture of membrane before 37 weeks

To be eclamptic, you must have had a ________.

seizure

If mom is diagnosed with postpartum psychosis, what is the first thing we need to do?

separate mom and baby because she cannot be trusted alone with baby

What does a wandering baseline mean for a fetus?

serious issue and an unsteady pattern

Where does pain present in HELLP syndrome?

severe pain in the RUQ, neck & shoulder

How is their belly going to feel postpartum? What is a word usually use to describe it?

soft, doughy texture jelly-belly

_________ are the spaces between the cranial bones.

sutures

What causes effacement in true labor?

the thinning of the cervix

Which substance is the number one risk for SIDs in newborns?

tobacco

If clotting is the major issue, how will we treat this? What is the patient at risk of if we use this treatment?

use heparin in low doses due to high risk for bleeding

What does variability refer to in fetal heart rate? What happens when we have reduced variability?

variability in FHR is the fluctuations in the heart rate. Reduce variability is the best single predictor for determining fetal compromise, which can be risks of acidosis or hypoxia.

Which supplement is recommended for mothers to give their babies if they are breastfeeding?

vitamin d

Within how many hours after their Foley is removed do we want them to void?

within 6 hours

If the mother is breastfeeding, does this reduce the change of pregnancy?

yes, but there is still a risk

What does VEAL CHOP stand for related to FHR pattern and cause?

Variable deceleration Cord compression Early deceleration Head compression Acceleration Okay! Late Deceleration Placental Insufficiency