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OB NURSING
Flashcard Deck
Study
What consequence can administering high levels of oxygen to a premature neonate cause?
It can cause blindness as a result of retrolental fibroplasia.
What are the characteristics of true labor?
True labor produces regular rhythmic contractions, abdominal discomfort, progressive descent of the fetus, bloody show, and progressive effacement and dilation of the cervix.
How can a mother break the suction of her breastfeeding infant?
The nurse should teach her to insert a finger at the corner of the infant's mouth.
What is amniotomy?
Amniotomy is the artificial rupture of the amniotic membranes.
What is the average weight gain during pregnancy?
Weight gain averages 25 to 30 lb (11 to 13.5 kg) during pregnancy.
What effect does rubella have on the fetus during the first trimester?
Rubella has a teratogenic effect, producing abnormalities in up to 40% of cases without interrupting the pregnancy.
How can immunity to rubella be measured?
Immunity to rubella can be measured by a hemagglutination inhibition test (rubella titer), with a titer greater than 1:8 indicating immunity.
What does the term "floating" mean in relation to fetal descent during labor?
Floating means the presenting part isn't engaged in the pelvic inlet but is freely movable and ballotable above the pelvic inlet.
What does the term "engagement" mean in relation to fetal descent during labor?
Engagement occurs when the largest diameter of the presenting part has passed through the pelvic inlet.
What does fetal station indicate?
Fetal station indicates the location of the presenting part in relation to the ischial spine, described as 1, 2, 3, 4, or 5 to indicate the number of centimeters above or below the ischial spine (station 5 is at the pelvic inlet, station 0 is at the level of the ischial spine).
What position provides the greatest degree of comfort during the first stage of labor?
The sidelying position usually provides the greatest degree of comfort during the first stage of labor.
What does an Apgar score of 7 to 10 indicate?
An Apgar score of 7 to 10 indicates no immediate distress.
What should be done if the umbilical cord can't be loosened and slipped from around the neonate's neck during delivery?
It should be clamped with two clamps and cut between the clamps.
What does an Apgar score of 4 to 6 indicate?
An Apgar score of 4 to 6 indicates moderate distress.
What does an Apgar score of 0 to 3 indicate?
An Apgar score of 0 to 3 indicates severe distress.
Clamping and Cutting the Umbilical Cord
Around the neonate's neck, it should be clamped with two clamps and cut between the clamps.
Apgar Score Interpretation
An Apgar score of 7 to 10 indicates no immediate distress, 4 to 6 indicates moderate distress, and 0 to 3 indicates severe distress.
Moro Reflex Elicitation
To elicit Moro reflex, the nurse holds the neonate in both hands and suddenly but gently drops the neonate's head backward.
Normal Moro Reflex
Normally, the neonate abducts and extends all extremities bilaterally and symmetrically, forms a C shape with the thumb and forefinger, and first adducts and then flexes the extremities.
Pregnancy-induced Hypertension (Preeclampsia)
Pregnancy-induced hypertension (preeclampsia) is an increase in blood pressure of 30/15 mm Hg over baseline or blood pressure of 140/95 mm Hg on two occasions at least 6 hours apart, accompanied by edema and albuminuria after 20 weeks gestation.
Goodell's Sign
Goodell's sign is softening of the cervix.
Positive Signs of Pregnancy
Positive signs of pregnancy include ultrasound evidence, fetal heart tones, and fetal movement felt by the examiner, not usually present until 4 months gestation.
Quickening
Quickening, a presumptive sign of pregnancy, occurs between 16 and 19 weeks gestation.
Vaginal Bleeding during Pregnancy
Any vaginal bleeding during pregnancy should be considered a complication until proven otherwise.
Cows' Milk in Infants
Cows' milk shouldn't be given to infants younger than age 1 because it has a low linoleic acid content and its protein is difficult for infants to digest.
Ovulation during Pregnancy
Ovulation ceases during pregnancy.
Naegele's Rule for Estimating Delivery Date
To estimate the date of delivery using Naegele's rule, the nurse counts backward 3 months from the first day of the last menstrual period and then adds 7 days to this date (3-7-1).
Fundus Location at 12 Weeks Gestation
At 12 weeks gestation, the fundus should be at the top of the symphysis pubis.
Jaundice Examination in Neonates
If jaundice is suspected in a neonate, the nurse should examine the infant under natural window light. If natural light is unavailable, the nurse should examine the infant under a white light.
Three Phases of Uterine Contraction
The three phases of a uterine contraction are increment, acme, and decrement.
Untitled Flashcards
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Intensity of labor contraction
Assessed by the indentability of the uterine wall at the contractions peak. Graded as mild, moderate, or strong.
Gynecoid pelvis
Most ideal for delivery. Other types include platypelloid, anthropoid, and android.
Safe level of alcohol intake for pregnant women
There is no safe level of alcohol intake for pregnant women.
Chloasma
The mask of pregnancy, pigmentatio n of a circumscribed area of skin usually over the bridge of the nose and cheeks that occurs in some pregnant women.
Frequency of uterine contractions
Measured in minutes, is the time from the beginning of one contraction to the beginning of the next.
Vitamin K administration to neonates
Administered to prevent hemorrhagic disorders because a neonate's intestine can't synthesize vitamin K.
Criteria for internal fetal monitoring
Cervix must be dilated at least 2 cm, amniotic membranes must be ruptured, and the fetus's presenting part must be at station 1 or lower for internal fetal monitoring.
Fetal alcohol syndrome symptoms
Present in the first 24 hours after birth and may include lethargy, seizures, poor sucking reflex, abdominal distention, and respiratory difficulty.
Variability in fetal heart rate
Any change in FHR from its normal rate of 120 to 160 beats per minute.
Acceleration in fetal heart rate
Increased FHR.
Deceleration in fetal heart rate
Decreased FHR.
Symptoms of heroin withdrawal in neonates
May begin several hours to 4 days after birth.
Symptoms of methadone withdrawal in neonates
May begin 7 days to several weeks after birth.
Cardinal signs of narcotic withdrawal in neonates
Coarse flapping tremors, sleepiness, restlessness, prolonged persistent high-pitched cry, and irritability.
Treatment for neonates addicted to narcotics
Chlorpromazine (Thorazine) is used to treat neonates who are addicted to narcotics.
Care for neonates experiencing narcotic withdrawal
Provide a dark, quiet environment for a neonate who is experiencing narcotic withdrawal.
Signs of respiratory distress in premature neonates
Nostril flaring, substernal retractions, and inspiratory grunting.
Respiratory distress syndrome in premature infants
Develops due to a lack of surfactant in the pulmonary alveoli of premature infants.
Positioning of infants for sleep
Infants should be placed on their back to sleep to reduce the risk of Sudden Infant Death Syndrome (SIDS).
Signs of respiratory distress in a premature neonate
Nostril flaring, substernal retractions, inspiratory grunting
Cause of respiratory distress syndrome in premature infants
Lack of surfactant in pulmonary alveoli
Safe sleeping position for infants
On the back (back to sleep)
Contributions of male sperm and female ovum to chromosomes
Male sperm: X or Y chromosome, Female ovum: X chromosome
Percentage of water in a neonate's body
78-80%
Position for nasotracheal suctioning in an infant
Neck slightly hyperextended in a sniffing position, chin up, head tilted back slightly
Organogenesis
Occurs during days 14-56 of gestation in the first trimester of pregnancy
Tying off the neonate's umbilical cord after birth
1-2.5 cm from the abdominal wall with a cotton cord, plastic clamp, or rubber band
Gravida
Number of pregnancies a woman has had regardless of outcome
Para
Number of pregnancies that reached viability, regardless of whether the fetus was delivered alive or stillborn
Viability of a fetus
At 20 weeks gestation
Untitled Flashcards
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Fundal height at 36 weeks gestation
At 36 weeks gestation, the fundus is at the lower border of the rib cage.
Fourth stage of labor
Postpartum stabilization lasts up to 4 hours after the placenta is delivered. This time is needed to stabilize the mother's physical and emotional state after the stress of childbirth.
Fundus is at the level of umbilicus
At 20 weeks gestation
Premature neonate
One born before the end of the 37th week of gestation.
Pregnancy-induced hypertension
A leading cause of maternal death in the United States.
Habitual aborter
A woman who has had three or more consecutive spontaneous abortions.
Threatened abortion
Occurs when bleeding is present without cervical dilation.
Complete abortion
Occurs when all products of conception are expelled.
Hydramnios (Polyhydramnios)
Excessive amniotic fluid, more than 2000 ml in the third trimester.
Factors affecting breastfeeding mother's milk supply
Stress, dehydration, and fatigue may reduce a breastfeeding mother's milk supply.
Transition phase of the first stage of labor
Cervix is dilated 8 to 10 cm, and contractions usually occur 2 to 3 minutes apart and last for 60 seconds.
Nonstress test - Reactive
Considered reactive if two or more fetal heart rate accelerations of 15 beats/minute above baseline occur in 20 minutes.
Nonstress test - Nonreactive
Considered nonreactive if fewer than two fetal heart rate accelerations of at least 15 beats/minute occur in 20 minutes.
Recommended water intake for pregnant women
Pregnant women should drink at least eight 8 oz glasses (about 2000 ml) of water daily.
Reasons for performing a nonstress test
Assess fetal well-being in a pregnant patient with a prolonged pregnancy (42 weeks or more), diabetes, a history of poor pregnancy outcomes, or pregnancy-induced hypertension.
Low-birth-weight neonate
Weighs 2500 g (5 lb 8 oz) or less at birth.
Breastfeeding - Emptying both breasts
When both breasts are used for breastfeeding, the infant usually doesn't empty the second breast. Therefore, the second breast should be used first at the next feeding.
Umbilical cord care
Clean the umbilical area with a cotton ball saturated with alcohol after every diaper change to prevent infection and promote drying.
Very low-birth-weight neonate
Weighs 1500 g (3 lb 5 oz) or less at birth.
Teenage mothers and low-birth-weight neonates
Teenage mothers are more likely to have low-birth-weight neonates because they seek prenatal care late in the pregnancy.
Umbilical cord care
Clean the umbilical area with a cotton ball saturated with alcohol after every diaper change to prevent infection and promote drying.
Teenage mothers and low birthweight neonates
Teenage mothers are more likely to have low birthweight neonates because they seek prenatal care late in pregnancy as a result of denial and are more likely than older mothers to have nutritional deficiencies.
Implantation in the uterus
Occurs 6 to 10 days after ovum fertilization.
Linea nigra
A dark line that extends from the umbilicus to the mons pubis. It commonly appears during pregnancy and disappears after pregnancy.
Cutis marmorata
Mottling or purple discoloration of the skin. It's a transient vasomotor response that occurs primarily in the arms and legs of infants who are exposed to cold.
Placenta previa
Abnormally low implantation of the placenta so that it encroaches on or covers the cervical os. In complete (total) placenta previa, the placenta completely covers the cervical os. In partial (incomplete or marginal) placenta previa, the placenta covers only a portion of the cervical os.
Abruptio placentae
Premature separation of a normally implanted placenta. It may be partial or complete and usually causes abdominal pain, vaginal bleeding, and a boardlike abdomen.
Preeclampsia symptoms
The classic triad of symptoms of preeclampsia are hypertension, edema, and proteinuria. Additional symptoms of severe preeclampsia include hyperreflexia, cerebral and vision disturbances, and epigastric pain.
Ortolani's sign
An audible click or palpable jerk that occurs with thigh abduction. It confirms congenital hip dislocation in a neonate.
First immunization for a neonate
The hepatitis B vaccine, which is administered in the nursery shortly after birth.
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