Term
|
Definition
| alleviate symptoms without a cure |
|
|
Term
| What are the two categories of pain? |
|
Definition
| nociceptive and neuropathic |
|
|
Term
| Describe nociceptive pain |
|
Definition
| caused by damage to somatic or visceral tissues |
|
|
Term
|
Definition
| superficial (arising from skin, mucous membranes), sharp, burning, prickly or deep (bone or CT) |
|
|
Term
|
Definition
| responds to inflammation, stretching and ischemia; intense cramping pain |
|
|
Term
| Describe neuropathic pain |
|
Definition
| burning, shooting, stabbing, sharp or electric shock like pain |
|
|
Term
| Acute pain control eventually leads to what? |
|
Definition
|
|
Term
|
Definition
| greater than 3 months; waxes and wanes; pain is controlled but does not go away |
|
|
Term
| What are the 7 elements of a pain assessment? |
|
Definition
| patter, location, intensity, quality, associated symptoms, management strategies, patient's beliefs |
|
|
Term
| Describe a multimodal approach to pain |
|
Definition
| use of two or more different meds to control pain |
|
|
Term
| What is the most common side effect of a narcotic analgesic? |
|
Definition
|
|
Term
|
Definition
| have analgesic ceiling; no physical dependence; available OTC (asprin, tylenol, motrin, aleve) |
|
|
Term
| What are 4 types of opioids? |
|
Definition
| morphine, codeine, demerol, dilaudid |
|
|
Term
| Describe the side effects of opioids |
|
Definition
| constipation, n/v, sedation, respiratory depression and pruritis |
|
|
Term
| What substance rapidly reverses the effects of opioids? |
|
Definition
|
|
Term
| Corticosteroids should not be given with what? |
|
Definition
|
|
Term
| What do corticosteroids treat? |
|
Definition
|
|
Term
| antidepressants may be good for what kind of pain? |
|
Definition
|
|
Term
| Describe scheduling in med administration |
|
Definition
| focus in on prevention and control of pain once pain has become severe |
|
|
Term
| Describe the titration of medication |
|
Definition
| does adjustment based on adequacy of analgesic effect vs side effects produced; goals is to use smallest dose to give effective pain control with fewest side effects |
|
|
Term
| What are the 5 Ps of labor and birth? |
|
Definition
| Passenger, passageway, powers (uterine contractions), position of mother, psychological response of mother |
|
|
Term
|
Definition
|
|
Term
| Describe the anterior fontanel |
|
Definition
| largest, diamond shaped, closes by 18 months |
|
|
Term
| Describe the posterior fontanel |
|
Definition
| triangular shaped, closes 6-8 weeks after birth |
|
|
Term
| Describe fetal presentation |
|
Definition
| part of the fetus that enters the pelvic inlet first and leads through the birth canal |
|
|
Term
|
Definition
| relationship of long axis of fetus to the long axis of mother |
|
|
Term
ID fetal lie position:
fetal spine is parallel to maternal spine |
|
Definition
|
|
Term
ID fetal lie position:
fetal spine is at right angle to maternal spine |
|
Definition
|
|
Term
ID fetal lie position:
fetal spine is at an angle to maternal spine |
|
Definition
| oblique; likely to convert to longitudinal or transverse during labor |
|
|
Term
|
Definition
| relationship of feta body parts to each other; normal is flexion |
|
|
Term
|
Definition
| relationship of presenting part to one of the 4 quadrants of the maternal pelvis |
|
|
Term
| Describe the nomenclature of fetal position |
|
Definition
| Location of presenting part R or L of maternal pelvis; presenting part of fetus (occiput, sacrum, mentum, scapula); presenting part in relation to Anterior, posterior or transverse maternal pelvis; LOA most common |
|
|
Term
|
Definition
| misplacement of the placenta; requires c-section |
|
|
Term
| Define station in childbirth |
|
Definition
| relationship of presenting part to imaginary line between ischial spines of maternal pelvis |
|
|
Term
|
Definition
| when the largest diameter of the presenting part reaches the maternal pelvic brim |
|
|
Term
ID aspect of maternal pelvis:
formed by upper margins of pubic bone, sacrum and sacral promontory |
|
Definition
|
|
Term
ID aspect of maternal pelvis:
formed by symphysis pubis, ischium and portion of ileum, sacrum and coccyx |
|
Definition
|
|
Term
ID aspect of maternal pelvis:
formed by pubic arch, ischial tuberosities and tip of coccyx |
|
Definition
|
|
Term
|
Definition
| thinning and shortening of cervical canal from 0-100 |
|
|
Term
|
Definition
| progressive cervical change; cervix must be effacing AND dilating |
|
|
Term
| In primagravidas, effacement occurs ____ |
|
Definition
|
|
Term
| In multigravidas effacement ____ |
|
Definition
| and dilation progress together |
|
|
Term
|
Definition
| responsible for effacement and dilation of cervix and descent of fetus; involuntary contractions at points in upper uterine segment; followed by short rest periods |
|
|
Term
| Describe secondary powers |
|
Definition
| bearing down efforts that aid in expulsion of fetus; pushing occurs when woman feels the urge |
|
|
Term
| Define "laboring her down" |
|
Definition
| moving the woman so gravity can assist with birth |
|
|
Term
| Pushing before the mom is ready can lead to what? |
|
Definition
|
|
Term
| The mother pushing on the side can change the baby between what two positions? |
|
Definition
|
|
Term
| Describe lightening in labor |
|
Definition
| feeling like the baby has dropped; easier for mom to breath but puts more pressure on bladder |
|
|
Term
| When will the mucus plug be expelled? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| What are 3 signs associated with labor? |
|
Definition
| 1-3 pound weight loss; diarrhea, and nausea |
|
|
Term
| What are the 3 phases of labor stage 1? |
|
Definition
| early (0-3cm), active (4-7cm), transition (8-10) |
|
|
Term
| Women ask for pain meds at what point in labor? |
|
Definition
|
|
Term
| What are the behavioral characteristics of stage 1 transition phase? |
|
Definition
| yelling, irritability, n/v |
|
|
Term
| In what stage of labor does pushing happen? |
|
Definition
|
|
Term
| What are the complications of an episiotomy? |
|
Definition
| increases risk of tearing to rectum and leg |
|
|
Term
| What are 3 signs of placental separation? |
|
Definition
| lengthening of umbilical cord, gush of blood, globular appearance of abdomen |
|
|
Term
| What is a cleansing breath? |
|
Definition
| deep breath in through nose and out to mouth |
|
|
Term
| What is the most common cause of labor? |
|
Definition
| uterine stretch (distention) |
|
|
Term
| What are 2 reasons engagement in labor may not occur? |
|
Definition
| baby is too big; baby is transverse or breech |
|
|
Term
| What is the normal FHR range? |
|
Definition
|
|
Term
| FHR normally accelerates with what? |
|
Definition
| fetal movement, vaginal exam, and abdominal palpation |
|
|
Term
| FHR deccerlates with what? |
|
Definition
| fetal head compression, compression of umbilical cord, and uteroplacental insufficiency |
|
|
Term
| What are the CDV changes of the mother in labor? |
|
Definition
| increased CO, increased BP, increased WBC 14-16k |
|
|
Term
| Describe maternal GI changes in labor |
|
Definition
| slowed GI motility, increased possibility of n/v and diarrhea |
|
|
Term
| Describe the neurological changes a mother goes through in labor |
|
Definition
| changes as stages progress: euphoria, seriousness, amnesia,elation |
|
|
Term
| Describe gate control theory in regards to labor pain |
|
Definition
| massaging thighs and abdomen to simulate normal somatosensory reactions and distract from the pain |
|
|
Term
| When in labor is analgesia given and why? |
|
Definition
| during a contraction; perfusion to baby is less |
|
|
Term
| What area does a pudendal effect? |
|
Definition
| numbs perineum (nerve of ischial spine) |
|
|
Term
| Describe the function of an intrathecal |
|
Definition
| regional anesthesia, lasts 12 hrs, morphine derivative |
|
|
Term
|
Definition
| electronic fetal monitoring |
|
|
Term
| What are the two categories of FHM patterns? |
|
Definition
| reassuring and non-reassuring |
|
|
Term
| Describe IA in fetal monitoring |
|
Definition
| intermittent auscultation |
|
|
Term
| What are two types of external fetal monitoring and their placement sites? |
|
Definition
| FHR (ultrasound transducer) lower fetal back, Uterine contractions (tocotransducer) placed on fundus |
|
|
Term
| What is the form of invasive internal monitoring? |
|
Definition
|
|
Term
| What two things are required for internal fetal monitoring? |
|
Definition
|
|
Term
|
Definition
| intrauterine pressure catheter |
|
|
Term
| What is the normal range for Montevideo units? |
|
Definition
| mVus; 150-250 for 10 mins |
|
|
Term
| What can cause reduced fetal oxygen supply? |
|
Definition
| maternal hypertension or hypotension (hemorrhage or analgesia), hypovolemia from hemrrhage |
|
|
Term
| Describe the 4 levels of FHR variability |
|
Definition
| absent; minimal (< or = 5bpm); moderate (6-25); marked (>25) |
|
|
Term
| What are the two categories of changes in baseline FHR? |
|
Definition
| periodic (with contractions) and episodic (without contractions) |
|
|
Term
| What is the criteria for FHR accelerations? |
|
Definition
| must be 15 or> over baseline and last 15 secs or more |
|
|
Term
| Describe early decelerations |
|
Definition
| gradual decrease and increase return to baseline and occurring with uterine contractions |
|
|
Term
| Describe variable decelerations |
|
Definition
| visual abrupt decrease in FHR below baseline; U V or W shape; caused by umbilical cord compression |
|
|
Term
| What 4 things can the nurse do to rectify variable decelerations? |
|
Definition
| change mom's position, assess for cord prolapse, alter pushing technique, discontinue oxycotin |
|
|
Term
| Describe late decelerations |
|
Definition
| gradual decrease after contraction has started and continues once it is over; uteroplacental insufficiency |
|
|
Term
| What is the cause of poop stained amniotic fluid? |
|
Definition
| baby defecated out of stress |
|
|
Term
|
Definition
| spontaneous, artificial, premature |
|
|
Term
| What 4 things do you need to assess about the patient's contractions? |
|
Definition
| onset, frequency, duration, and intensity |
|
|
Term
| What is the function of a med that is a labor augmentor? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| How long is the post partum period? |
|
Definition
|
|
Term
| What are the 3 stages of Rubin's Stages of Maternal Attachment? |
|
Definition
| taking in, taking hold, and letting go |
|
|
Term
| What is the nurse's action when patient has boggy uterus with heavy lochia? |
|
Definition
|
|
Term
| What is the nurse's action when you find the uterus firm and lochia flow? |
|
Definition
| notify health care provider immediately; possible lacerations hematoma or retained placental fragments |
|
|
Term
| Describe proper care of episiotomy site post op |
|
Definition
| use cold water, then warm for healing; shower, not bath; sitz baths |
|
|
Term
| Describe the two types of mastitis |
|
Definition
congestive: improper emptying of breasts while feeding causing obstruction of ducts
Infectious: result of damage to breast from improper latch |
|
|
Term
| How long after delivery should women void? |
|
Definition
|
|
Term
| What is the #1 reason for a boggy uterus? |
|
Definition
|
|
Term
| What are the signs of maternal attachment? |
|
Definition
| eye contact, feeding, being attentive to baby, calling baby by its name |
|
|
Term
| Describe the feeding and elimination patterns of newborns |
|
Definition
formula: 3-4 hrs
Breastfeed: 2-3 hrs
6-8 wet diapers; 2-3 poops per day |
|
|
Term
| What 3 time periods are common for discontinuation of breastfeeding and why? |
|
Definition
| 6 hrs (baby is asleep), 6 wks (mom goes back to work), 6 months (baby get teeth) |
|
|
Term
| What are the 5 S's of comforting a crying baby? |
|
Definition
| Swaddle, sway/swing, shush (resembles mom's heart in utero), side lying, sucking |
|
|
Term
| How often should you bathe newborns? |
|
Definition
|
|
Term
| How long is the neonatal period? |
|
Definition
|
|
Term
| Describe the first period of reactivity for a newborn |
|
Definition
| first 30 mins of life, HR 160-180, alert, best time to breastfeed |
|
|
Term
| Describe the second period of reactivity |
|
Definition
| 4-8 hrs after birth, periods of tachycardia and tachypnea, increased muscle tone, meconium passed |
|
|
Term
| What is the most critical and immediate adjustment for newborns to life? |
|
Definition
| establishment of respirations |
|
|
Term
| What is the normal infant RR? |
|
Definition
|
|
Term
| What is the normal HR for a newborn? |
|
Definition
| 110-160; decrease below 100 if sleeping, increase above 180 if crying |
|
|
Term
| Non shivering thermogenesis is accomplished by _____ |
|
Definition
| brown fat; secondarily by increased metabolic activity |
|
|
Term
|
Definition
| unique response organ for cold adaptation in new borns; reserves rapidly depleted with cold stress |
|
|
Term
ID aspect of heat loss:
loss of heat due to cooler air currents |
|
Definition
| convection; prevented by placing baby away from air ducts or doors |
|
|
Term
ID aspect of heat loss:
transfer of heat not in direct contact with the baby |
|
Definition
| radiation; walls are cold |
|
|
Term
ID aspect of heat loss:
loss of heat when water is vaporized |
|
Definition
| evaporation; dry baby when born |
|
|
Term
ID method of heat loss:
transfer of heat to cooler surfaces by direct skin contact |
|
Definition
|
|
Term
| How many kcal per day does a newborn require for growth? |
|
Definition
| 120; initial weight loss of 5-10% is normal |
|
|
Term
| What is given to the newborn for their coag difficulties? |
|
Definition
| Given Vit K IM to stimulate synthesis of prothrombin |
|
|
Term
| When does physiologic jaundice occur in newborns? |
|
Definition
| After first 24 hrs of life |
|
|
Term
| ____ high in ____ provides some passive immunity for breastfed infants |
|
Definition
|
|
Term
| When is a baby considered pre-term? |
|
Definition
|
|
Term
| What should the Gl level of a newborn be? |
|
Definition
|
|
Term
| T/F: BPH predispose men to cancer of prostate gland |
|
Definition
|
|
Term
|
Definition
| result of decrease testosterone in proportion to estrogen leading to gland growth |
|
|
Term
| Describe the clinical symptoms of BPH |
|
Definition
| obstructive:difficulty initiating voiding, decrease in flow force; irritative: urinary frequency, urgency, dysuria |
|
|
Term
| What are the 3 goals of collaborative care for BPH? |
|
Definition
| restore bladder draining, relieve patient' symptoms, prevent/treat complications |
|
|
Term
| Describe the conservative treatment for BPH |
|
Definition
| decrease caffeine, alcohol, spicy food, evening fluid intake; set up timed voiding schedule |
|
|
Term
|
Definition
| Transurethral Resection of Prostate; removal of prostatic tissue through cytoscope under anethesia; most effective treatment for BPH |
|
|
Term
| What is the most common cancer among men and what racial group is effected the most? |
|
Definition
|
|
Term
| What is the primary area of metastasis in prostate cancer? |
|
Definition
|
|
Term
| Growth of prostate cancer is highly dependent on what? |
|
Definition
|
|
Term
|
Definition
| dilation of veins that drain testes; may be associated with infertility from increased heat(corrected by ligation) |
|
|
Term
| Describe testicular cancer |
|
Definition
| rare; mostly occurs in whites 15-34; non tender firm scrotal mass and scrotal swelling |
|
|
Term
| PMS is related to the ___ phase of the menstrual cycle |
|
Definition
|
|
Term
ID:
long intervals between menses; >35 days |
|
Definition
|
|
Term
DI:
excessive/prolonged menstrual bleeding |
|
Definition
|
|
Term
ID:
irregular bleeding or bleeding between periods |
|
Definition
|
|
Term
| Menopause is diagnosed by a decrease in ___ and an increase in____ |
|
Definition
|
|
Term
| Describe HRT for menopausal women |
|
Definition
| estrogen if no uterus; estrogen and progesterone for women with uterus, if estrogen only, promotes endometrial cancer |
|
|
Term
| What is the primary cause of female infertility? |
|
Definition
|
|
Term
|
Definition
| presence of abnormal endometrial tissue in sites outside endometrial cavity |
|
|
Term
| What are 4 benign ovarian cysts? |
|
Definition
| dermoid, follicular, corpus luteum, polycystic ovary syndrome |
|
|
Term
ID cyst type:
originate from germ cells that contain fat, hair and teeth |
|
Definition
|
|
Term
ID cyst:
asymptomatic, shrink over menstrual cycles, mature grafian follicle issue in young women |
|
Definition
|
|
Term
ID cyst:
occur after ovulation; pain, tenderness over ovary, delayed menses, disappear without treatment |
|
Definition
| corpus luteum cysts; prevented by birth control |
|
|
Term
| Describe polycystic ovary syndrome |
|
Definition
| occurs most often in <30; cause of infertility; commonly seen with obesity and hirutism; can lead to CDV and type 2 diabetes |
|
|
Term
| What are the clinical manifestations of ovarian cysts? |
|
Definition
| often asymptomatic unless large; constipation, menstrual irregularities, urinary frequency, full feeling in abs/pelvis |
|
|
Term
| When is surgery for cysts required? |
|
Definition
| >8cm that don't shrink or are solid |
|
|
Term
|
Definition
| uterine fibroids (smooth muscle tumors); nodular, enlarged uterus, increased pelvic pressure |
|
|
Term
|
Definition
| benign lesion of cervix/endometrium in reproductive years; most common>40; bleeding with sex, removed surgically |
|
|
Term
ID female cancer:
rare; more common >60; highly associated with HPV; possible itching burning pain |
|
Definition
|
|
Term
| What is the most common site of vulvar cancer? |
|
Definition
|
|
