HESI Maternity Nursing Flashcards

Terms Definitions
Goodells Sign
Softening of the Cervix - at 8 weeks
Chadwicks Sign
Bluing of the Cervix - as early as 4 weeks
Braxton-Hicks Contractions
May appear at 12 weeks
Weight Gain 1st Trimester
2.5 - 4 pounds
Increased risk of UTI
Teach - increased fluids, wipe from front to back, voiding before and after intercourse.
Fundal height reaches umbilicus at the ________week.
Quickening occurs at week _____.
Fetus can breath, swallow and regulate temp at______ weeks
Fundus reaches the xiphoid at ______ weeks.
L/S (lecithin / shingomyelin) ratio should be ____ at ____wks.
2 to 1 at 38 weeks
Term births
Pre - term births
Living children
Dead before 20 weeks = abortion
= number of deliveries. added after 20 weeks
Nagele Rul
Count back 3 months from the FIRST day of the last normal menstrual period and add 7 days.
How much does blood volume increase?
Approx 1500 ml
1000 ml = plasma
500 ml= RBC
begins wk 10, peaks at 32
Hgb Values during pregnancy
Hct values during pregnancy
Rubella antibody screen
>1:10 = immunity
Wt Gain 1st Tri
3.5-5 recommended
2-4 average
Wt Gain After 1st Tri
0.9 lb per week
>2 lb per week weight gain, think...
Fetal HR
110-160 beats per min
Client should come to Hospital when contractions are...
Regularly 5 minutes apart
Nutrional Addions
Increase Calories by 300 / day
Increase Protien by 30 g / day
Increase Iron by 30 mg /day
Folic acid should be 800-1000 mcg
The goal is to produce contractions that occur every 2 to 3 minutes, duration of 60-70 seconds.
FHR greater than 160 beats per minute duration of 10 minutes or longer.
Early sign of fetal hypoxemia
Tachycardia associated with late decelerations an absent or minimal variability.
Maternal serum AFP is used in pregnancy as a screening tool for neural tube defects. High levels of AFP after 15 weeks of gestation and a NTD. Gestational age is an important factor in determining normals.
Alpha-fetoprotein and down syndrome
Down syndrome is associated with lower than normal alpha-fetoprotein.
Terbutaline sulfate
Works by relaxing uterine smooth muscles and slowing contractions.
Terbutaline side effects
May cause tachycardia, increase cardiac output, restlessness, headache, and a feeling of nervousness.
Magnesium sulfate
Most commonly used tocolytic agent.
Adverse reaction of magnesium sulfate
Respiratory rate less than 12. Absent DTRs, severe hypotension, extreme muscle weakness and urine output less than 30 ml/hr
Ovulation occurs 14 days before the first day of the menstrual period.
Blood pressure over ________, is a concern for preeclampsia.
Blood pressure exceeding 140/90 or increase by 15 mm of mercury diastolic and/or 30 mmHg systolic is indicative of preeclampsia
Nausea or epigastric pain can be an impending sign of...
Seizure (eclampsia)
Respirations below____indicate toxic effects of magnesium sulfate
Urinary output must be monitored when administering magnesium sulfate and should be at least...
30 ML per hour.
An indication of placenta previa is...
Painless and red bleeding beyond 20 weeks. Diagnosis is confirmed by trans abdominal ultrasound
Symptoms of abruptio placenta
Bleeding that has a sudden onset and is accompanied by intense uterine pain indicates abruptio placenta
Monitoring what information is important after anniotomy?
FHR should be assessed before and after the procedure to detect changes that may indicate presence of cord compression or prolapse.
What intervention should be applied when you notice several suddden decreases in the FHR with quick return to baseline with and without contractions?
Place the client in this slight Trendelenberg position. This position is the supine position with the legs slightly elevated. The court compression can drop the FHR with or without contractions.
110 to 160 beats per minute
In early sign of fetal hypoxemia...
FHR greater than 160 beats per minute for a duration of 10 minutes or longer, especially when associated with late decelerations and minimal or absent variability
A late sign of fetal hypoxemia...
Bradycardia, it can be considered a late sign of fetal hypoxia and is known to occur before fetal death.
Define early decelerations
Early decelerations start before the peak of uterine contraction and returns to the baseline at the same time as they uterine contraction. These are due to head compression and are benign.
Define a late decelerations
Late decelerations begin after the contraction has started, and the lowest point of the deceleration occurs after a contract. Persistent and repetative late decelerations unsually indicate Hypoxia stemming from insufficient placental perfussion.
Long, difficult or abnormal labor
Epidural positioning -- a laboring client when pressure drugs from 120/80 to 90/60. What should the nurse do?
Place the client in a lateral position. Other media interventions include increasing the right of the Main line IV infusion and administering oxygen.
What is a sign of hyperventalation?
Tingling and dizziness. it is treated by breathing into cupped hands or a paper bag.
Feelings of passing, tinglling and numbness in fingers
The first stage of labor has 3 phases:
Latent: more progress towards effacement, little descending.
Active: rapid dialation and descent.
The second phase of Labor
Fully dialated to birth.
Infection is a risk ____ hours after rupture of membranes
Good indication baby is being adequately fed...
6-10 straw colored diapers a day.
True or False
Alchohol is excreted in the breast milk.
True. Since this is a saftey issue, it is of primary importance.
Collection of blood between a skull bone and its periosteum, therefore it DOES NOT cross sutures. Caused by forceps or moms pelvis. Resolves in 3 to 6 weeks
Caput Succedaneum
A generalized, easily identifiable area that is most commonly found on the occiput and crosses the suture lines. The sustained pressure of the presenting vertex against the cervix resulting compression thereby slowing venous. This resolves in 3-4 days.
Prophylactic ointment of the eye at birth protects against?
Gonorrheal or Chlamydial infection.
Infant positioning after feeding:
Right sideline position. All other positions encourage aspiration or regurgitation. Never place an infant on her back after feeding.
Fetal presentation
Presentation refers to the part of the fetus that enters pelvic inlet first and leads through the birth canal during labor at term.
fetal attitude
Attitude is the relation of the fetal body parts to each other.
Fetal position
Position is the relation of the presenting part to th 4 quadrants of the mothers pelvis.
Anterior Fontanel
Diamond shaped, closes 18 months after birth
Posterior Fontanel
Triangular shape, closes 6-8 weeks after birth
Signs of Hypoglycemia in Infant
Hypoglycemia signs include jitteriness, irregular respiratory effort, cyanosis, apnea, week, high-pitched cry, feeding difficulty, lethargy twitching eye rolling and seizures.
Moro Reflex
AKA startle reflex: symmetric abduction an extension of arms and fingers fanout and form a C with thumb and forefinger.
Harness most commonly used to manage hip displasia?
HIV in the new born
Maternal Antibodies are present for 18 months.
Can be transmitted in breastmilk.
The head returns to normal shape in 7-10 days.
Group B Strep
GBS the most common cause of neonatal sepsis and meningitis in the US.
Silverman-Anderson Index
Scores new borns respiratory status. 0-10, with 0 meaning no stress at all- opposite of apgar.
Breast feeding and nipple soreness
baby position and latch on are the most crucial elements in preventing nipple soreness.
How often to breast feed?
every 2 hours
Putting the new born to the breast...
Prevents postpartum hemorage by stimulating oxytocin production and causes the uterus to contract.
Lochia rubra
mostly blood occurs immediately after birth. Should only last 3-4 days
Lochia serosa
brownish, red, old blood, tissue, lasts up to about day 10
Lochia alba
yellow, white discharge - leukocytes, epithilium - 2-6 weeks after birth.
Caused by plugged milk ducts related to breast engorgement. Encourage complete emptied of breast.
Paralytic Ileus
Be vigilant post surgery if patient is nauseated and doesn't feel like eating.
yellow of skin caused by elevated billirubin. if not corrected can cause mental retardation
Blue color of hands and feet. common finding because cappillary system is immature.
small white papules on the nose and chin caused by plugged sebaceous glands which disappear in a few weeks.
erethemia toxicum
small red patches on cheek or trunk, common finding in newborns.
CRAVING is the key word in questions. Pica is CRAVING a non-food source.
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