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Nursing 334
OB
227
Nursing
Pre-School
09/30/2011

Additional Nursing Flashcards

 


 

Cards

Term
decidua
Definition

endometrium of uterus that grows thicker and vascular to support pregnancy

 

-deciduas basalis: directly under embryo

-deciduas capsulari: surrounds embryonic sac

Term
chorion
Definition

outer membrane of the embryo

chorionic villi-"fingers" of connective tissue that contain fetal capillaries at core

-extend into the endometrium

-instrumental in production of placental hormones such as hCG, hPL 9human placental lactogen), estrogen and progesterone

-forms the fetal portion of the placenta

Term

what makes up the umbilical cord?

 

Definition

made from the amnion and chorion (inner and outer fetal membranes)

-one vein:oxygenated blood from the placental villi to the fetus

-two arteries:carry deoxygenated blood from the fetus back to the placental villi

-filled with Wharton's jelly: protects vessels and prevents compression

Term

how often is amniotic fluid being made?

and what is it made by?

pupose?

Definition

constantly being made, by the amniotic membrane.

cushions embryo, controls temp, permit symmetric growth and development, prevent adherence of fetus to the amnion and allow freedom of movement, and cushions cord.

Term

normal amount of amniotic fluid?

to much?

to little?

Definition

800-1200mL

Hydramnios: too much fluid (more than 2000mL), unknown cause.

Oligohydramnios: too little fluid (less than 400mL) cause by a disturbance in kidney function.

Term
placental circulation is established when?
Definition
3rd week of pregnancy.
Term
how many lobes in the placenta and what are they called?
Definition
15-20 separate lobes called cotyledons
Term
is there a direct exchange of blood between the embryo and the mother during pregnancy?
Definition
No, exchange is through selective osmosis.
Term
name the two sides of the placenta
Definition

maternal portion (outside) consists of deciduas basalis and its circulation, surface appears red and flesh-like.

fetal portion (inside) consists of the chorionic villi and their circulation, covered by the amnion, appears shiny and gray.

Term
Placental osmosis
Definition
very effective, allows almost all substances to cross from the mother to the fetus.
Term
purpose of hCG
Definition
Human Chorionic Gonadotropin, maintains production of estrogen and progesterone from the corpus luteum
Term
purpose of estrogen
Definition
develops mammary glands for lactation and stimulates uterine growth.
Term
purpose of progesterone
Definition
maintains the endometrial lining of the uterus
Term
hPL purpose?
Definition
Human Placental Lactogen, promotes mammary gland growth and regulates maternal glucose, protein and fat levels (for adequate fetal nutrition)
Term
specialized structures in the fetus shunt blood flow away from the non-functioning _____ to supply important organs of the body, especially the _____.
Definition
Lungs, Brain
Term
fetus at 4 wks?
Definition
4-6mm, brain formed from anterior neural tube, limb buds seen, heart beats, GI system begins.
Term
fetus at 6 weeks?
Definition
12mm, primitive skeletal shape, chambers in the heart, respiratory system begins, ear formation begins.
Term
fetus at 12 weeks?
Definition
8cm, ossification of skeleton begins, liver produces red cells, palate complete in mouth, skin pink, thyroid hormone present, insulin present in pancreas
Term
fetus at 16 weeks?
Definition
13.5 cm, teeth begin to form, meconium begins to collect in intestines, kidneys assume shape, hair present on scalp.
Term
fetus at 20 weeks?
Definition
19cm, myelination of spinal cord begins, suck and swallow begins, lanuga covers body, vernix begins to protect the body.
Term
fetus at 24 weeks?
Definition
23cm, respiration and surfactant production begins, brain appears mature.
Term
fetus at 28 weeks?
Definition
27cm, nervous system begins regulation of some functions, adipose tissue accumulates; nails, eyebrows, and eyelids are present; eyes are open.
Term
fetus at 36 weeks?
Definition
35cm, earlobes soft with little cartilage, few sole creases.
Term
fetus at 40 weeks?
Definition
40 cm, adequate surfactant, vernix in skin folds and lanugo on shoulders, earlobes firm, sex apparent.  weight about 3,000 to 3,600 g (6lb,10oz to 7lb,15oz).  Varies in defferent ethnic groups.  Skin has a smooth, polished look.  hair on head is course and about 1 inch long.  Body and extremities are plump.
Term
peak fertility is approximately how many days before ovulation, until how many days after?
Definition
5, 3
Term
infertility
Definition

lack of conception despite unprotected sexual intercourse for at least 12 months.

 

 

Term
Fertility Awareness Based Methods?
Definition

Basal body temp- every morning upon awakening record body temp for 3-4 months

Ovulation method- assess the cervical mucus changes.  follicular phase mucus is thick, white, sticky and not safe for sperm.  during ovulation it is clear, watery and stretchable (spinnbarkheit. egg white appearanc)

Calendar rhythm- record menstral cycle for 6 months, assume that ovulation occurs 14 days before the start of the next menstrual period

Symptothermal method- recording various indicators of fertility like:cycle length; frequency and timing of coitus; cervical mucus changes; secondary signs of ovulation such as increased libido, abdominal bloating, mittelschmerz; and changes in BBT.

Standard days method-for women with regular cycles

Lactational amenorrhea- high levels of prolactin released during breastfeeding should prevent ovulation.

Term

pharmacological agents for endometriosis r/t infertility

 

Definition

Danazol (Danocrine)

Oral contraceptives

Ovulation-induction agents (clomid)

Seraphene

Human Menopausal Gonadotropin (HMG)

Bromocriptine (Parlodel)

Term

Clomiphene Citrate: anovulatory fertility agent

Definition

Drug action: stimulates release of FSH and LH

Side effects: hot flashes, breast discomfort, headache and insomnia

route and dose: PO, 50-200 mg/day from cycle 3-7

Term

problems with karyotypes?

 

Definition

trisomies, monosomies, mosaicism.

 

example:trisomy 21 (down syndrome), trisomy 18, trisomy 13, defects in sex chromosomes like Turner syndrome in girls, X. or Klinefelter's syndrom in boys, XXY.

Term
Mendelian Inheritance?
Definition

single gene inheritance.

 

 

Term
Phenotype?
Definition
outward appearance
Term
Genotype?
Definition
Genetic composition
Term

if a gene is autosomal dominant there is a ____% chance of passing the trait?

if autosomal recessive, ___% chance of affecing the child, and ___% chance the child will be a carrier?

Definition

50%

25%

50%

Term
X Linked Recessive
Definition

no male to male transmission

50% chance carrier mom passes to son who will be affected.

50% chance carrier mom passess to daughters who become carriers.

dad cannot pass to son, but all daughters will be carriers.

Term
X Linked Dominant
Definition

extremely rare

Fragile X syndrome

no male to male transmission

heterozygous females may be affected

affected fathers will ahve affected daughters, but no affected sons.

Term

ultrasound is best when?

used for what?

Definition

18-20 weeks

detect head and craniospinal defects, GI malformations, renal malformations, skeletal malformations, and fetal nuchal translucency

Term
when to perform amniocentesis?
Definition
15-20 weeks
Term
maternal serum screening for genetic disorders
Definition

AFP (alpha-fetoprotein) done at 15-22 weeks of pregnancy.

 

detects 85-90% neural tube defects & 80% Downs syndrome

Term
anatomic and physiologic changes in women during pregnancy?
Definition

reproductive: amenorrhea

uterus: increased blood flow (1/6 of total maternal blood volume), Braxton Hicks, increase weight, strength, elasticity, and vascularity, increased amounts of estrogen and growing fetus.

cervix: increased estrogen levels, Goodell's sign (softening), Chadwick's sign (blue color), mucorrhea (increased discharge), hyperplasia, formation of mucous plug seals endocervical canal

Term
when is colostrum produced?
Definition
third trimester
Term
during pregnancy blood volume increases how much?
Definition
30-50%
Term
hemodilution is called?
Definition

pseudoanemia

Hgb <11, Hematocrit <30%

Term
BP in 2nd trimester _____, then returns to normal baseline.
Definition
decreases
Term
during pregnancy venous pressure in the legs increases causing what?
Definition
edema, varicosities, hemorrhoids
Term
supine hypotension syndrome
Definition
woman lies on back, uterus causes vena cava compression, orthostatic hypotension
Term

cardiac output during pregnancy?

HR?

Definition

increases 30-50%

increases 15-20%

Term
increases levels of progesterone causes what to happen in the lungs?
Definition

increased volume of air.

decreased airway resistance

increased anteroposterior diameter

thoracic breathing occurs as uterus enlarges

Term

incraesed levels of progesterone effects the GI system how?

 

Definition

delayed gastric emptying

decreased peristalsis

N/V, increased saliva, smoothe muscle relaxation causes peristalsis to slow, desplacement of intestines and stomach which causes heartburn, bloating, and constipation

Term
incraesed levels of blood volume effects the GU system how?
Definition

renal tubular reabsortion increases

increased GFR and reanl plasma flow, frequency, nocturia

UTI's are common (can cause PTL, pre term labor)

Term
skin and hair during pregnancy
Definition
increased skin pigmentation caused by increased estrogen and progesterone
Term

musculoskeletal during pregnancy

 

Definition
relaxation of joints caused by increased est. and prog.
Term
metabolism during pregnancy
Definition
increased due to growing fetus and its support system
Term
weight during pregnancy
Definition

recommended 25-35 lbs

if overweight, recommended gain is 15-25 lbs.

if underweight, gain weight as needed to reach ideal weight plus 25-35 lbs.

Term
endocrine system during pregnancy
Definition

increased thyroid/BMR (basal metabolic rate)

pancreas: increased insulin

Term
during pregnancy, pH increases.  this can cause what?
Definition
increased chance of vaginal yeast infectons
Term
increased skin pigmentation can cause what?
Definition
chloasma (mask of pregnancy), linea nigra (ewe)
Term
Subjective (presumptive) changes
Definition

amenorrhea

nausea and vomiting

fatigue

urinary frequency

breast changes

quickening

Term
objective (probable) changes
Definition

Goodell's and Chadwick's sign

Hegar's (softening of the uterine tissue between the body of the uterus and the cervix) and McDonald's sign (flexability of the uterus at the junction between the cervix and body of uterus)

Enlargement of the abdomen

Braxton Hicks contractions

Uterine souffle (soft blowing sound auscultated in uterus)

Skin pigmentation changes

Pregnancy tests

Term
diagnostic (positive) changes
Definition

Fetal heartbeat

Fetal movement

Visualization of the fetus

 

Term
Urine pregnancy tests
Definition

Hemagglutination-inhibition test

Latex agglutination test

or detect hCG during early pregnancy

(the first two are done on first early morning urine specimen)

positive within 10-14 days after the first missed period

Term

Serum tests for pregnancy

 

Definition

Beta subunit radioimmunoassay:positive a few days after presumed implantation

Immunoradiometric assay (IRMA): takes 30 min to perform

Enzyme-linked immunosorbent assay (ELISA): detects hCG levels as early as 7-9 days after ovulation and conception, 5 days before the first missed period

Fluoroimmunoassay (FIA): takes about 2-3 hours to perform

Term
Mothers emotional and psychological changes during each trimester?
Definition

1st: disbelief and ambivalence (love/hate)

2nd: quickening, helps mother to view fetus as separate from herself

3rd: anxiety about labor and birth; nesting occurs(bursts of energy)

Term
Rubin's four tasks?
Definition

1 ensuring safe passage through pregnancy, labor, and birth

2 seeking acceptance of this child by others

3 seeking commitment and acceptance of herself as mother to infant; attatchment formed

4 learning to give oneself on behalf of one's child

Term
fathers emotions during each trimester?
Definition

1st may feel left out, disbelief, may be confused by his partner's mood changes, might resent the attention she receives

2nd begins to decide which behaviors of own father he wants to imitate or discard

3rd anxiety about labor and birth

Term

complications of pregnancy

 

Definition

vaginal bleeding, with or without discomfort

rupture of membranes

swelling of the fingers, puffiness of the face or around the eyes

continuous, pounding headache

visual disturbances (blurred vision, dimness, spots)

persistent or severe abdominal pain

chills or fever

painful urination

persistent vomiting

changes in frequency or strength of fetal movements

Term

Danger signs in pregnancy?

C A B S

Definition

C-chills and fever/cerebral disturbances

A-abdominal pain

B-blurred vision/bleeding/BP

S-swelling/sudden escape of fluid

Term
Nullipara
Definition
woman who has had no births at more than 20 wks
Term
Primipara
Definition
woman who has had one birth at more than 20 weeks gestation
Term
multipara
Definition
woman who has had two or more births at more than 20 weeks gestation
Term
multigravida
Definition
woman in second or any subsequent pregnancies
Term
primigravida
Definition
in first pregnancy
Term
nulligravida
Definition
no pregnancies, duh
Term
Gravida
Definition
any pregnancy, including present
Term
Para
Definition

birth after 20 weeks gestation

(before is abortion)

 

 

Term
regarding Para, twins are considered how many births?
Definition
1
Term
Para is broken down into what categories?
Definition

T P A L

T-#of term infants born (37 wks +)

P-# of preterm infants (>20 <37 wks)

A-# of pregnancies ending in SAB/TAB

L-# of currently living children

Term

susie smart is pregnant.  she has four sons at home: twins born in 1996 at 34 weeks, then singletons born in 1998, and 2001.  She had 1 miscarriage in 2000.  what is her gravida/para?

vs her GTPAL?

Definition

G=5

P=3

 

G=5

T=2

P=2

A=1

L=4

Term
recomended weekly weight gain 1st trimester
Definition
3.5-5 lbs
Term
recomended weight gain during 2nd and 3rd trimester?
Definition

1 lb/week

 

or 12 lbs/trimester

Term
dieting during pregnancy can result in what?
Definition
maternal ketosis of course
Term

maternal nutrition

 

increase caloric intake by how much/day?

 

protein increase?

Definition

about 300 calories/day additonal for a total of 2500/daily

 

up to 60g/day

Term
Folic Acid helps prevent what?
Definition
neural tube defects
Term
important minerals for pregnant women?
Definition
calcium, phosphorus, iodine, iron, fluoride, sodium, zinc
Term
water each day?
Definition
8-10 glasses
Term

Morning sickness caused by?

 

fixed or curved by?

Definition

high levels of hCG, est., and/or prog. levels

lowered maternal blood sugar

lack of vitamin B6

diminished gastric motility

affects 50% of pregnant women

 

not waiting longer than 12 hrs between meals

eat small frequent meals

snack at bedtime and delay eating in AM

Call MD if not eating more than 24hrs

Term

PICA can lead to?

apparently common enough to mention. crazy toilet paper, dirt eaters.

Definition
iron deficiency
Term
which artificial sweetener is best/safest to use?
Definition
Splenda
Term
adolescents need more ___, ___, and ___ than adult pregnant women.
Definition
iron, calcium, folic acid
Term
involution
Definition
rapid reduction in size of uterus and return to prepregnant state.
Term
uterus is at what level within 6-12 hrs after delivery?
Definition
umbilicus
Term
how far does the uterus decend each day after delivery?
Definition
one finger width or 1cm
Term
uterus rids itself of debris remaining after birth through discharge called?
Definition
lochia
Term
Lochia changes, in desending order:
Definition

bright red at birth

Rubra- dark red

Serosa- pink

Alba- white

Clear

Term
if the fundus arises and becomes boggy, what is it called, and caused from?
Definition
called uterine atony, caused by blood collection and the formation of clots.
Term
what type of mother would be expected to have more painful afterpains from delivery?
Definition
Multiparas, because of the repeated stretching of the uterine muscles.
Term
uterine contractions are know as?
Definition
after pains
Term
which type of mother would have a uterus that remained contracted after giving birth?
Definition
Primaparas
Term
after pains are stronger during breastfeeding due to what?
Definition
release of oxytocin
Term

menstruation returns when, after birth, in the nonlactating mother?

ovulation returns when?

Definition

6-10 weeks

 

6 months

 

return of ovulation and menstruation in breastfeeding mother is prolonged related to length of breastfeeding continues

Term

after delivery, spontaneous BM may not occur till?

 

Definition
2-3 days after delivery
Term
after birth, intestines may be sluggish due to?
Definition

lingering effects of prog. and decreased muscle tone.

 

elimination will return to normal within one week.

Term
uterus not at midline?
Definition

bladder distention

 

if bladder is in center, and uterus is in center, why is it pushed to the SIDE?  whatever!

Term
hematuria in 2nd or 3rd week after delivery may indicate?
Definition
UTI
Term
Taking In
Definition

1-2 days after delivery.

mother is passive and somewhat dependent as she sorts reality from fantasy in birth experience.

food and sleep are major needs.

Term
Taking Hold
Definition

2-3 days after delivery.

mother ready to resume control over her life.

she is focused on baby and may need reassurance.

Term
four stages to maternal role attainment
Definition

anticipatory stage- during pregnancy

formal stage- when baby is born

informal stage

personal stage

Term

transient period of depression occurs when?

what may the mother experience?

Definition

first few days after delivery

 

mother may experience tearfulness, anorexia, difficulty sleeping, feeling of letdown

 

usually resolves within 10-14 days

Term
three phases of maternal attachment behavior
Definition

acquaintance phase- fingertip exploration, en face position, responds verbally to sounds of infant

phase of mutual regulation- adjustment between needs of mother and needs of infant

reciprocity- mutually gratifying interaction among mother, infant, and father

Term
what is it called when the father has a "sense of absorption", preoccupation with infant, and strong interest in infant?
Definition
Engrossment
Term
Postpartum risk factors?
Definition

preeclampsia

diabetes

cardiac disease

cesarean birth

overdistention of uterus

abruptio placentae or placenta previa

precipitous labor

prolonged labor

difficult birth

extended period of time in stirrups at birth

retained placenta

Term
temp elevations post partum should only last for how long?
Definition
24 hrs
Term
BUBBLE HEER
Definition

Breast

Uterus

Bladder

Bowel

Lochia

Episiotomy

Homan's Sign

Edema

Emotional

Rhogam

Term

Bubble heer

 

Breast

Definition
assess for and prevent mastitis.  teach how to cleanse breasts and nipples.  support with breastfeeding.
Term

Bubble heer

 

Uterus

Definition
fundus should be firm in the midline.  immediately after deliver, the top of the fundus is several finger breadths above the umbilicus.  the fundus then descends into the pelvis approximately one finger breadth per day.  massage the fundus if it is boggy.
Term

Bubble heer

 

Bladder

Definition
observe for bladder distention, it may displace the uterus.  diuresis occurs during the first two postpartal days.  evaluate for UTI.
Term

Bubble heer

 

Bowel

Definition
stool softeners or laxatives may be necessary.  by the second or third day post delivery, normal bowel movements should occur.
Term

Bubble heer

 

Lochia

Definition
should not have a foul odor.  Rubra (dark red first three days), serosa (pinkish, serosanguinous 3-10 days), and alba (creamy or yellowish after 10th day and may last a week or two)
Term

Bubble heer

 

Episiotomy

Definition
observe for infection or healing
Term

Bubble heer

 

Homan's sign

Definition
observe for thrombophlebitis
Term

Bubble heer

 

Edema

Definition
assess for s/s of preeclampsia
Term

Bubble heer

 

Emotional

Definition
support is a must
Term

Bubble heer

 

Rhogam

Definition
is a blood product administered at 28 weeks and within 72 hrs after deliver
Term
REEDA
Definition

Redness

Edema

Ecchymosis (bruising basically)

Discharge/Drainage

Approximation

Term

Lochia volume assessment.

4 different assessment amounts.

Definition

in order from least to most

-Scant

-Light

-Moderate

-Heavy

-OMG (just kidding for this one of course)

Term

when is a vaginal birth mother discharged?

cesarean birth?

Definition

48 hrs

96 hrs

 

include physical exam, discharge teaching, rubella vaccine, and Rhogam

Term
Name some maternal nursing diagnoses
Definition

Constipation related to fear of tearing stitches or pain.

Acute pain related to perineal edema or epsiotomy from birth.

Impaired skin/tissue integrity related to tearing/shearing forces or surgical intervention.

Impaired urinary elimination.

Risk for infection.

Term
Lochia is rubra for how long?
Definition
2-3 days after birth
Term
Lochia is serosa for how long?
Definition
3-10 days after pregnancy
Term
Lochia is alba for how long?
Definition
11-14 days, may last up to 3-6 weeks after birth.
Term
Monitor VS and CV status how often after birth?
Definition
every 15 minutes for the first hour after birth, and every 30 minutes for the next hour, then hourly for approximately 2 more hours, then every 4 hours or more frequently if there is bogginess, position out of midline, or heavy lochia flow.
Term
how often is the uterus assessed in postpartum?
Definition
every 8 hrs starting from 24 hrs postpartum to discharge.
Term
Normal BP limits postpartum?
Definition
no more than 30 mmHg systolic or 15 mmHg diastolic over baseline
Term
relief of perineal discomfort?
Definition

ice packs

topical agents

perineal care

Term
Relief of hemorrhoidal discomfort?
Definition

sitz bath

topical anesthetic ointments-dermaplast

rectal suppositories

witch hazel pads

Term
what is a good position to put a woman in for the relief of afterpains?
Definition
prone position
Term
what can you do to suppress lactation of the nonbreastfeeding mother
Definition

-wear supportive bra within 6 hrs after birth for 5-7 days.  only remove when showering.

-begin after birth: ice packs applied over axillary area of each breast for 20 min. 4xdaily.

-avoid stimulation of the breasts

-avoid heat on breasts, face away from the shower water.

Term
activity of the mother after birth?
Definition

gradually increase activities and ambulation after birth.

avoid heavy lifting, excessive stair climbing, and strenuous activity.

delay returning to work until after 6 weeks postpartum examination.

resume all activities by 4-5 weeks when lockia flow stops.

Term
when can sexual activity resume?
Definition
after the episiotomy has healed and lochia has stopped.
Term
sexual arousal can stimulate what in the breastfeeding mother?
Definition
milk leakage
Term
can certain contraceptives interfere with breastfeeding?
Definition

yes, mothers should be given acvailable options.

(whatever those are)

Term
things to check for in a pt who had a cesarean?
Definition
breasts, location and firmness of fundus, lochia, incision site, foley catheter-placement, color, and amount, BS-present all quadrants, and pain (may have PCA)
Term
if a pt has a cesarean, and received general anesthesia, abdominal distention my cause discomfort.  what do you do in this case?
Definition
position client on left side, include exercises, early ambulation, avoid carbonated beverages, may need enema and/or stool softener.  encourage turn, cough, deep breath every 2 hrs while awake until she is ambulating.
Term
administer analgesics when after birth?
Definition

within 24-72 hours

 

allows her to become more mobile and active

Term
performing a newborn examination at the mothers bedside does what?
Definition
provides excellent opportunity to teach the new mother about her baby.  adolescent mothers need positive feedback.
Term
preparation for discharge should begin when?
Definition
when the expectant mother enters birthing unit
Term
basic infant care that parents should be educated on before discharge?
Definition

when to anticipate cord will fall off

information about tub baths and immunizations

feeding and handling infant

safety concerns

Term
signs of postpartum complications:
Definition
sudden, persistent, or spiking fever.  change in the character of the lochia-foul smell, return to bright red bleeding, excessive amount, passage of large clots.  Evidence of mastitis, such as breast tenderness, reddened areas, malaise.  Evidence of thrombophlebitis, such as calf pain, tenderness, redness.  Evidence of urinary tract infection, such as urgency, frequency, burning on urination.  Continued severe or incapacitatin postpartum depression.
Term
during pregnancy protein should increase to what?
Definition
60g/day
Term
foods to curve nausea and vomiting?
Definition
crackers, pretzels, sourballs (candy)
Term
cravings are caused by what
Definition
associated with an increased need of carbohydrates or particular vitamins
Term
iron deficiency can cause?
Definition

PICA

 

internet- actually any vitamin or mineral deficiency can cause this, but most commonly it is iron.  often a person will crave/eat the things that contain the vitamin they are lacking.

Term
what vitamins are commonly inadequate in adolecent mothers?
Definition
iron, folic acid and calcium
Term
what is phenylketonuria?
Definition
low phenylalanine diet between preconception and breastfeeding
Term

pregnant mothers can eat up to how much fish?

what element are we being cautious of?

what types of fish have high levels of this?

 

Definition

12oz/wk

mercury

swordfish, tilefish, and mackerel

Term
a microorganism that can be found in refrigerated and ready to eat foods as unpasteurized milk, dairy products, meat, poultry, and seafood?
Definition
listeria monocytogenes
Term
foods that contain calcium?
Definition
milk, cheese, pudding, soy milk, raisins, broccoli, green leafy vegies, salmon, almonds
Term
can eat dairy and egg products
Definition
lacto-ovovegetarians
Term
can eat dairy but no eggs
Definition
lactovegetarians
Term
no foods from animal sources
Definition
vegans
Term
most vegans need additional supplementation of what vitamins?
Definition
B12, D, iron, zinc and calcium
Term
main source of energy as well as fiber?
Definition
carbohydrates
Term
magnesium helps what?
Definition
cellular metabolism
Term
iron helps what?
Definition
prevent maternal anemia, maintains fetal and infant stores of iron.
Term
calcium and phosphorus helps what?
Definition
promotes mineralization of fetal bones and teeth
Term
iodine helps what?
Definition
promotes fetal thyroid gland function
Term
sodium helps what?
Definition
regulates fluid balance and metabolism in the mother
Term
zinc helps what?
Definition
promotes growth of fetus and sufficient lactation.
Term
folic acid helps what?
Definition
prevent neural tube defects in the fetus
Term

how many calorie increase in second and third trimester?

during lactation?

Definition

300kcal/day

200kcal/day

Term
vitamin B12 needs increases how much during pregnancy?
Definition
2.4-2.6 mcg/day
Term

which food groups are we concerned with?

how much of each should mothers eat/day?

Definition

grains, vegetables, fruits, milk, meat/beans

 

grains 6oz/day, vegetables 2 1/2cups/day, fruits 2cups/day, milk 3cups/day, meat and beans 5 1/2oz/day.

 

use fats oils and sweets sparingly

Term
what factors should we assess in pregnant adolescents?
Definition
low prepregnant weight and anemia, low weight gain during pregnancy and eating disorders, young age at menarche, unhealthy lifestyle: smoking, alcohol, and illicit drug use, excessive prepregnant weight, chronic disease.
Term
formula feeding mothers can lose how much weight after birth?
Definition
1-2 lbs/wk is acceptable
Term
factors that retard uterine involution?
Definition
prolonged labor, anesthesia, difficult birth, grandmultiparity, full bladder, incomplete expulsion of placenta or membranes, infection, overdistention of uterus.
Term
risk for thromboembolism lasts how long after birth?
Definition
6 weeks
Term
postpartum chills and diaphoresis is normal after birth if?
Definition
afebrile
Term
taking in?
Definition
1-2 days after delivery, mother is passive and somewhat dependent as she sorts reality from fantasy in birth experience.  food and sleep are major needs.
Term
taking hold?
Definition
2-3 days after delivery, mother ready to resume control over her life, she is focused on baby and may need reassurance.
Term
what is the purpose of postpartal home care?
Definition
expand upon and reinforce information, interact with the family in a more relaxed setting, family has control of the setting, and opportunity to assess home safety.
Term
home visit physical assessment of the newborn should include what?
Definition
VS, assessment of systems, infants behavioral state, paren-infant interaction, presence of jaundice, condition of the umbilical cord and circumcision, reflexes and activity, hydration, nutritional status and feeding history, elimination of urine and stool, slee-wake cycles, weight, and ensure that the screening exams have been completed.
Term
a prevention of SIDS when infant is sleeping?
Definition

place infant on back?

"Back to Sleep"

Term
encourage parents to hold their infant how?
Definition
upright
Term
results from violent shaking?
Definition
SBS, shaken baby syndrome.  causes swelling, bleeding, amy sustain permanent damage or death.
Term
foods high in iron?
Definition
green leafy vegies, cashews, red meat, dairy, tofu, prunes
Term
foods high in thiamine?
Definition
raw sunflower seeds, yellow fin tuna, black beans, peas, corn
Term
foods high in magnesium?
Definition
squash, watermelon, sesame seeds, soy beans, brazil nuts, almonds, cashews
Term
foods high in folic acid?
Definition
green leafy vegies, oranges, asparigus, kedney beans, grains
Term
Colic?
Definition
persistent, unexplained, inconsolable crying. or gas.  can start 2-3 weeks of age continue until 4-6 months of age.  can continue for several hours each day.  often in evening.
Term
Colicy babies are at risk for?
Definition
abuse
Term
Colic interventions?
Definition
dietary modifications in infant or breastfeeding mother.  pharmacologic agents like simethicone.  vibration, carrying.  no definitive treatment.
Term
purpose of newborn screenings?
Definition
to detect disorders: galactosemia, phenylketonuria (PKU), sickle cell anemia, mental retardation, physical handicaps and/or cause of death.
Term
name a couple of the minimal criteria for early discharge of an infant:
Definition
uncomplicated antepartum, intrapartum and postpartum courses, vaginal delivery, singleton without complications, newborn completed at least two successful feedings, newborn has urinated and passed at least one spontaneous stool, physical exams show no abnormalities, family or other support person, etc.
Term
breastfeeding difficulties
Definition
insufficient milk, sore nipples, flat nipples, plugged ducts, mastitis
Term
how can you help prevent cracking and fissures of the breastfeeding nipples?
Definition
air drying. 
Term
perinatal loss?
Definition
death of the fetus/child from conception-age 28 days
Term
IUFD
Definition
Intrauterine fetal death
Term
stillbirth or fetal demise?
Definition
death after 20 wks gestation
Term
fetal deaths after 20 wks gestation occurs how much in the US?
Definition
6.2:1000, or 60% of all perinatal deaths
Term
perinatal mortality rate?
Definition
late fetal deaths, over 28 weeks gestation, plus first  days.  
Term
perinatal loss causes?
Definition
physiologic maladaptations such as asphyxia, congenital malformations.  pregnancy complications such as preclampsia, diabetes, placental problems, thyroid disorders, infections, multiple gestations, lower education attainment, advanced maternal age, obesity, intrauterine growth restriction (IUGR)
Term
prolonged retention of a dead fetus can cause?
Definition
DIC disseminated intravascular coagulation, infection-endometritis, sepsis
Term
tests to determine cause of fetal loss?
Definition
fetal blood tests and xrays, autopsy or  MRI, placental studies, chromosomal studies
Term
Bereavement
Definition
suffered the event of loss
Term
grief
Definition
reaction to the loss
Term
mourning
Definition
process of incorporating experience into one's life
Term
perinatal loss also referred to as?
Definition
"Silent Loss"
Term

the caring theory

 

5 attributes of caregiver?

Definition

Knowing

Being with

Doing for

Enabling

Maintaining belief

Term
3 options for disposition of the dead baby?
Definition

traditional burial via funeral home

cremation at funeral home

hospital disposition

Term
about what portion of teenage pregnancies are terminated?
Definition

one friggin third! thats 1/3rd!!!

 

 

Term
which teens have higher adolescent birth rates?
Definition
african american and hispanic teens
Term
psychosocial tasks of the adolescent?
Definition
developing an identity, gaining autonomy and independence, developing intamacy in a relationship, developing comfort with ones own sexuality, and developing a sense of acheivment.
Term

adolescent developmental stages

 

early?

middle?

late?

 

 

Definition

early(14 and under)-confomity to peer group

middle(15-17)-seeks independence, turns increasingly to peer groups

late(18-19)-understands and accepts consiquences for behavior

Term
impact of pregnancy on developmental tasks?
Definition
cannot live up to parents expectations, negative identity, peer pressure engages antisocial behavior, sexual activity may be a way to develop intimacy, engage in sexual activity for wrong reasons, poor school performance may occur.
Term
contributing factor to adolescent pregnancy
Definition
early onset of puberty, first sexual experience at an early age, lack of information about contraception, inability to access contraceptives easily, in some cultures there is less stigma, lack of adult supervision, repeat pregnancy risk is higher if the teen lives with the sexual partner, or phychosocial factors.
Term
physical risks for teen pregnancy
Definition

 

¨Preterm labor

 

¨Low birth weight infant

 

¨Cephalopelvic disproportion (CPD)

 

¨Iron deficiency anemia

 

¨Preeclampsia-Eclampsia

Sexually transmitted infections (STIs)

Term
adolescents are more likely to get pregnant again within how long?
Definition
2 years
Term
what % of fathers to adolescent pregnant mothers are NOT teens?
Definition
50%
Term
major nursing goal for adolescents is primary prevention which includes what?
Definition

active outreach activities

health education and sex education

counseling

family planning services

promotion of abstinence or regular use of effective birth control

focus on reducing specific sexual risk taking behaviors

Term
¨Nursing care in the area of secondary prevention includes assessment, diagnosis, planning and intervention and evaluation. what is the goal?
Definition
¨A goal is for early entry of the pregnant adolescent into the healthcare system is crucial, delayed prenatal care increase risk of poor outcome.
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