OB Module 1

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Author:
hoving22
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131503
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OB Module 1
Updated:
2012-01-30 21:35:28
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J2 3612 OB Module
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Mostly vocab and info from ppt Ch. 1,5,16,17,18,24
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  1. Delivery addmission and stay
    48 hrs for vaginal

    96 hrs for c/s

    clock starts at delivery or admission
  2. # of live births in 1 year/1000 people
    Birth Rate
  3. # of deaths of infants >28 days age/1000 live births
    Neonatal Mortality rate
  4. # of deaths of infants under 1 yr/1000 live births
    Infant mortality rate
  5. # of maternal deaths/100000 live births. includes 42 days post
    Maternal mortality rate
  6. # of births/1000 woman ages 15-44

    done yearly
    fertility rate
  7. acts of omission and commission
    Negligence
  8. the negligent behavior of a professional
    malpractice
  9. divorced family; child is a member of both the maternal and paternal nuclear households
    binuclear family
  10. up to date systematic reviews and dissemination of reviews of randomized controlled trials of health care
    cochrane pregnancy and childbirth database
  11. range of clinical services provided for an indivdual or group that relects care given during a single hospitalization
    continuum of care
  12. awareness, acceptance and knowledge of cultural differences and adaptation of services to acknowledge and support the culture of the patient
    cultural competence
  13. setting in which one considers the individuals and the family's beliefs and practices
    cultural context
  14. knowlege that includes beliefs and values about each facet of life and is passed from generation to the next
    cultural knowledge
  15. learning about and applying the standards of another person's cuture to activities within a particular culture
    cultural relativism
  16. belief in the rightness of one's culture's way of doing things
    ethnocentrism
  17. practice based on knowledge that has been gained through research and trials
    evidenced based practice
  18. family that includes the nuclear family and other people related by blood
    extended family
  19. pictorial representation of family relationships and health history
    genogram
  20. complementary and alternative therapies in comination with conventional wester modalities of treatment
    integrative health care
  21. Baby born weighing less than 2500 g
    LBW infants
  22. consists of parents and their dependent children
    nuclear family
  23. born before 37 weeks of gestation
    preterm infants
  24. includes stepparents and stepchildren
    reconstituted family
  25. level of practice that a reasonable nurse would provide
    standard of care
  26. use of communication technologies to provide health care and support when patient is seperated from health care team
    telehealth
  27. using one's senses while traveling through a community to obtain info about sociocultural characteristics and the environment, housing, transportation, and local community agencies
    walking survey
  28. consists of an outer layer (trophoblast) and a hollow sphere of cells enclosing a cavity.

    after the morula stage
    blastocyst
  29. vascular protrusions on the chorionic surface that project into the blood sinuses of the uterus and help form the placenta
    chorionic villi
  30. formation of the one celled zygote
    conception
  31. maternal aspect of the placenta made up of uterine blood vessels, endometrial stroma, and glands that shed in lochial discharge after birth
    decidua basilis
  32. conceptus from day 15 of development until approximately the 8th week after conception
    embryo
  33. amnion chorion surrounding the fetus
    fetal membranes
  34. 9th week after conception until birth
    fetus
  35. mature male or female germ cell; sperm or ovum
    gamete
  36. fine hair from 12 weeks and cover body by 20 weeks
    lanugo
  37. process by which germ cells divide and decrese their chromosomal numbers by one half
    meiosis
  38. process of somatic cell division in which a single cell divides, but both of the new cells have the same number of chromosomes as the first
    mitosis
  39. chromosomal aberration characterized by the absence of one chromosome from the normal diploid complement.
    monosomy
  40. developmental stage of the fertilized ovum characterized by a solid mass of cells (16)
    morula
  41. condition in which some somatic cells are normal, whereas others show chromosomal aberrations
    mosaicism
  42. white, cheesy, material that protects the skin of the fetus
    vernix caseosa
  43. cell formed by the union of two reproductive cells or gametes
    zygote
  44. uterus is known as this after implantation
    decidua
  45. pre embryonic stage
    weeks 1-2
  46. embryonic stage
    weeks 3-8

    most critical time of development
  47. fetus
    weeks 9 to term

    HUGE growth burst
  48. Amniotic fluid amounts
    800-1200 ml normal

    oligohydramnios- <300 ml renal abnormalities

    hydramnios- >2000 ml GI or other malfunctions
  49. Umbilical cord
    developed by 5th week

    • 2 arteries- CO2 away
    • 1 vein- deliver O2
  50. Wharton Jelly
    prevents compression of blood vessels and ensures continued nourishment of the baby
  51. maternal placental embryonic circulation
    by day 17
  52. week placenta is in placenta
    12th week
  53. Dizygotic twins
    fraternal

    two ova, two zygotes, 2 amnions, 2 chorions, 2 placentas

    2 eggs dropped
  54. monozygotic twins
    identical

    one ovum, one sperm.

    SAME SEX ONLY.

    split at 4-8 days

    share placenta, amniotic fluid
  55. heart develops and begins to beat
    4 weeks
  56. eyeys, ears, nose mouth recognizable
    8 weeks
  57. sex recognizable
    12 weeks
  58. mother can feel baby move
    16 weeks

    quickening
  59. vernix caseosa and lanugo appears
    20 weeks
  60. baby can hear
    24 weeks
  61. nails appear, eyelids reopen
    28 weeks
  62. subq fat forms, L/S ratio 1.2:1
    30-31 weeks
  63. L/S ratio 2:1
    36 weeks
  64. testes in scrotum; labia majora well developed
    40 weeks
  65. swelling of tissue over the presenting part of the fetal head caused by pressure during labor
    caput succedaneum
  66. swelling of the infants head limited by the margins of the cranial bone
    cephalhematoma
  67. response to a constant or repetitve stimulus is decreased
    habituation
  68. first stool from during fetal life
    meconium
  69. small, white sebaceous glands on head of neonate
    milia
  70. bluish gray or dark nonelevated pigmented areas usually lower back and butt that are present at birth in some infants, usually fade
    mongolian spots
  71. necessary for normal respiratory function that prevents alveolar collapse (atelactasis)
    surfactant
  72. pretective gray-white fatty substance of cheesy consistency covering the fetal skin
    vernix caseosa
  73. 30 minutes after birth, higher HR, resp, crying, maybe pass meconium
    first period of reactivity
  74. sleeping a lot, not alert, poor reflexes. slumber stage. 2-4 hours after birth
    decreased responsiveness
  75. between 2-8 hrs after birth, increased alertness, HR, Resp
    second period of reactivity
  76. when to be concerned with a newborn regarding respirations
    apnea over 20 seconds
  77. normal resp rate for newborn
    30 - 60 breaths/minute
  78. opening between atria that closes immediately after birth
    foramen ovale
  79. opening between pulmonary artery and aorta, closes within 24 hours
    ductus arteriosus
  80. shunts arterial blood into inferior vena cava
    ductus venosus
  81. average HR
    120-140 beats/minute
  82. range of HR in a term newborn
    85 bpm to 170 bpm
  83. WBC in a newborn
    initially high, then go even higher (due to exposure to environment) returns gradually over time
  84. Heat loss of a newborn occurs by
    • evaporation
    • convection
    • conduction
    • radiation
  85. cooler surface directly contacts skin
    heat loss by conduction
  86. heat from body to a coller solid surface in relative proximity
    heat loss by radiation
  87. voiding of the newborn
    1st 24 hrs:
    2nd 24 hrs:
    3rd 34 hrs:

    Daily usual:
    • at least once
    • at least twice
    • at least three times

    6-10 times/day
  88. stomach capacity at 10 days of life
    30-90 ml
  89. size of the stomach the first day of life
    a marbel
  90. jaundice that occurs after 24 hrs of age and is it a concern?
    physiologic jaundice

    no concern
  91. jaundice that occurs before 24 hrs of age or after 7 days of life and is it a concern?
    pathologic jaundice

    yes a concern
  92. kernicterus
    a bilirubin level greater than 25mg/dl.

    bili deposits in the basal ganglia and brainstem
  93. swelling and discharge from the nipple of a newborn
    witches milk
  94. concern over a dimple or tuft of hair on lower back of newborn
    spina bifida
  95. normal response in babinski reflex
    toes flare out
  96. SIDS prevention
    baby on back to sleep
  97. temperature that falls below 35 degrees C
    hypothermia
  98. pathologic process characterized by deposition of bilirubin in the brain
    kernicterus
  99. infants born at 34 to 36 weeks gestation
    late preterm infant
  100. infection in the neonates eyes usually resulting from STD passing through birth canal
    opthalmia neonatorum
  101. done for glucose measurement or newborn screen
    heelstick
  102. most effective intervention for decreasing the pain of circumcision
    DPNB
  103. circumcision;
    no petroleum needed, cleanse with warm water, no alcohol should be used, do not submerge in water until bell dries and falls off in 7-10 days, yellow exudates is normal for 2 to 3 days- do not try and remove it
    plastibell
  104. circumcision; apply petroleum to the glans with each diaper change, cleanse with warm water, no alcohol should be used, soap can be used once circumcision is healed in 5 to 6 days, yellow exudates is normal for 2 to 3 days- do not try and remove it
    gomco
  105. nursing considerations for admin of opthalmalgic med
    within 2 hours of birth

    gloves

    open lids; spread from inner canthus to outer

    Do not touch tube to eye

    after 1 minute may wipe excess

    required in all states by law.
  106. Nursing considerations for vit K admin
    5/8" 25 gauge needle

    Vastus lateralis

    aspirate
  107. early milk, produced from 16 weeks of pregnancy into the first postpartum days.
    colostrum
  108. feeding in response to feeding cues exhibited by the infant that indicate the presnce of hunger
    demand feeding
  109. painful swelling of breast tissue as a result of rapid increase in milk production and venous congestion edema
    engorgement
  110. times of increased neonatal growth that usually occur at 6-10 days, 6 weeks, 3 months, and 6 months.
    growth spurts
  111. physical injury resulting from changing air pressure
    barotrauma
  112. the feelings of loss, pain, desolation and sadness that occur after the death of a loved one
    bereavement
  113. most severe expression of fetal hemolytic disorder with high mortality

    infants exhibit gross edema, cardiac decompensation, and pallor from anemia
    hydrops fetalis
  114. infant whose birth weight is less than 2500g
    LBW
  115. infant whose birth weight is less than 1500g
    VLBW
  116. an infant whose birth weight is less than 1000g
    ELBW
  117. an infant born between the beginning of 38 weeks and the completion of 42 weeks of gestation, regardless of birth weight
    full term infant
  118. C sections may not be covered by insurance if they are performed before week ___
    39
  119. PIH
    pregnancy induced hypertension
  120. most common nursing dx for preterm babies

    (4, in order of importance)
    ineffective breathing pattern

    ineffective thermoregulation

    risk for infection

    parental anxiety
  121. when are lungs considered mature?
    34 weeks L/S 2:1
  122. Reasons for Respiratory problems in preterm babies
    • deficient surfacant
    • decreased alveoli
    • smaller lumen
    • bony thorax not calcified
    • immature lung capillaries
    • weak sk. m.
  123. major s/s of respiratory distress in a newborn
    nasal flaring

    grunting,poor color,tachypnea
  124. factors that increase occurence of RDS (respiratory distress syndrome)
    maternal diabetes

    C section without labor

    hypovolemia

    3rd trimester bleeding
  125. factors that decrease occurence of RDS (resp distress syndrom)
    mom received steroids (increase surfactant)

    prenatal stressors (HTN) (matures lungs faster)

    IUGR
  126. treatment for RDS (resp distress syndrom)
    neutral thermal environment

    blow by 02

    CPAP

    Oxyhood

    Nasal cannula

    ECMO-CO2 exchange w/ heprin. not used for babies less than 34 weeks.
  127. room air O2 level
    21%
  128. normal calorie per oz of milk/formula
    20
  129. surfactant therapy
    given by ET tube

    give 1/4 dose at a time, then reposition

    need informed consent

    SURVANTA
  130. Nursing actions for RDS (resp distress syndrome)
    suction PRN

    assess q 1 hr

    O2 sat

    ABG's or VBG's

    hold feedings until stable
  131. tx of meconium aspiration syndrome
    severe cases- ECMO

    maybe suction
  132. complications of Persistant Pulmonary HTN of the newborn
    fetal circulation continues

    ductus arteriousus opens

    formen ovale opens
  133. reasons preterm babies are a high risk for heat loss
    minimal SQ and brown fat

    increased insensible water loss

    inadequate m. activity and tone

    decreased caloric intake
  134. ways to achieve a neutral thermal environment
    isolette

    kangaroo care

    warm fluids/oxygen
  135. most common infection in preterm babies
    B strep
  136. s/s of infection in the neonate
    temp instability

    feeding problems

    lethargy

    resp distress

    seizures

    tachy
  137. interventions for PV-IVH (periventricular and Intraventricular hemorrhage)
    Head at midline

    HOB slightly elevated

    avoid rapid infusion of fluids
  138. acceptable range for BP for a newborn
    60-80/40-50
  139. range of acceptable Hgb values for a newborn
    14-24 g/dl
  140. range of acceptable HCT level in a newborn
    44-64%
  141. acceptable range of RBC for a newborn
    4.8-7.1 million/mm3
  142. short term acceptable range of WBC in a newborn
    9,000-30,000 cells/mm3

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