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Hesi OB
Question | Answer |
---|---|
Feelings of passing, tinglling and numbness in fingers | hyperventalation |
The first stage of labor has 3 phases: | Latent: more progress towards effacement, little descending. Active: rapid dialation and descent. |
Infection is a risk ____ hours after rupture of membranes | 24 |
Good indication baby is being adequately fed... | 6-10 straw colored diapers a day. |
Cephalhematoma | 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. |
Infant positioning after feeding: | Right sideline position. All other positions encourage aspiration or regurgitation. Never place an infant on her back after feeding. |
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? | Pavlik |
HIV in the new born | Maternal Antibodies are present for 18 months.Can be transmitted in breastmilk. |
Molding | The head returns to normal shape in 7-10 days. |
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? | Pavlik |
HIV in the new born | Maternal Antibodies are present for 18 months.Can be transmitted in breastmilk. |
Molding | 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. |
Mastitis | 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. |
Jaundice | yellow of skin caused by elevated billirubin. if not corrected can cause mental retardation |
Acrocyanosis | Blue color of hands and feet. common finding because cappillary system is immature. |
Milia | 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. |
Pica | CRAVING is the key word in questions. Pica is CRAVING a non-food source. |
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. | 20th |
Quickening occurs at week _____. | 20 |
Fetus can breath, swallow and regulate temp at______ weeks | 28 |
Fundus reaches the xiphoid at ______ weeks. | 32 |
L/S (lecithin / shingomyelin) ratio should be ____ at ____wks. | 2 to 1 at 38weeks |
Abortions | Dead before 20 weeks |
Para | 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. |
Hgb Values during pregnancy | >11 |
Hct values during pregnancy | >33 |
Rubella antibody screen | >1:10 |
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... | pre-eclampsia-edema |
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 |
Pitocin | The goal is to produce contractions that occur every 2 to 3 minutes, duration of 60-70 seconds. |
Tachycardia | 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. |
Alpha-fetoprotein | 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 | 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 | 12 |
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. |
FHR | 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. |
Dystocia | 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. |
what is chloasma? | the "mask" of pregnancy. it is a hyperpigmentation of the cheek; s, nose and forehead |
what is diastasis recti? | it is a separation of the rectus abdominal muscles than can occur in pregnancy. normally the rectus abdominal muscles are held together by the linea alba |
what is ptyalism? | excessive drooling; occurs in women who are experiencing hyperemesis gravidum, excessive nausea and vomiting far worse than normal morning sickness |
What are the warning signs and symptoms associated with an IUD? (PAINS) | Period late (pregnancy), abnormal spotting and bleeding; Abdominal pain, pain with intercourse,Infection exposure (STD); abnormal vaginal discharge; Not feeling well, fever>100.4, chills;String missing, or shorter or longer than usually felt |
what are the warning signs and symptoms associated with oral contraceptives? (ACHES) | Abdominal pain; Chest pain, cough, and/or shortness breath; Headaches, dizziness, weakness or numbness; Eye problems (blur or change in vision) and speech problems; Severe |