Good MC study guide.txt

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Good MC study guide.txt
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2012-09-19 13:16:33
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MC midterm
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MC midterm
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  1. How long is average stay of hospital visit for birth?
    48 hours
  2. What type of thinking is random or memorized thoughts?
    General thinking
  3. What type of thinking is purposeful, goal-directed thinking based on scientific evidence rather than assumption or memorization
  4. When females are born
    they have all the oocytes that will be available during her reproductive years
  5. What would cause a c-section?
    Immobile coccyx, history of pelvic fracture or rickets
  6. If only one parent carries a dominant trait,
    an average of 50% of the offspring will have and display the dominant trait
  7. Monozygotic twins
    identical twins; same sex, develop from a single fertilized ovum; two embryos with own amnion, but common chorion and placenta; if disc does not divide, conjoined twins may form
  8. Dizygotic twins
    fraternal; develop from two separate ova fertilized by two separate sperm; two amnions, two chorions, two placentas; tend to repeat in families
  9. Nagele�s rule
    1. Determine the first day of last normal period 2. Count backwards three months 3. Add 7 days
  10. Cardiovascular system in pregnant woman
    growing uterus displaces heart upwards and to the left; blood volume increases to about 45% more to add blood for placenta, needs of expanded maternal tissue, reserve for blood loss at birth; should place pillow under right hip to help relieve compression
  11. DHA
    Not green leafy vegetables, not olive oil, not fried food; two to three servings per week of fish, egg yolk, red meat, poultry
  12. Posture of pregnant woman
    pelvic joints relax, waddling, instability, balance; DO NOT PICK BACK PAIN FOR ARCH
  13. Pregnant adolescent
    separate planning classes; denial until late in pregnancy; financial problems, relationship problems, low self esteem;
  14. Three types of placenta previa
    marginal-within 2-3 cm of cervical opening; partial-partially covers cervical opening; total-completely covers cervical opening; painless vaginal bleeding; risks are infection or hemorrhage; have woman lie on side or pillow under one hip; vitals every 15 minutes, blood loss, give O2; no vaginal exam unless baby is ready to come-will prepare for vaginal and c-section birth
  15. If mother is diabetic, what happens to baby?
    ONLY ONE ANSWER-hypoglycemia, respiratory distress, injury caused by macrosomia (big baby); growth restriction because placenta functions poorly
  16. Rubella effect on fetus
    microcephaly, mental retardation, congenital cataracts, deafness, cardiac defects, intrauterine growth restriction (IUGR); woman should not get pregnant for one month after immunization; not given during pregnancy since it�s a live virus
  17. Report to the nurse any contractions�
    that occur more frequently than 2 minutes, last longer than 90 seconds, or have intervals shorter than 90 seconds---these may reduce fetal oxygen supply
  18. Efface
    thin
  19. Dilate
    open
  20. Three phases of contractions
    increment, peak, decrement
  21. Anterior fontanelle
    diamond shape
  22. Posterior fontanelle
    triangular shape
  23. Descent
    minus above ischial spine, 0 at ischial spine, plus below spine
  24. The woman should go to the hospital when the contractions
    have a pattern of increasingly frequency, duration and intensity; first child-woman goes when contractions have been regular every five minutes for 1 hour; more kids, 10 minutes apart for one hour
  25. When should mother go to hospital?
    Contractions, if she thinks her membranes have ruptured, bleeding other than bloody show (blood+mucus); decreased fetal movement, any other concers
  26. Patterned paced breathing
    constant pattern and stairstep pattern
  27. Childbirth pain vs. other pain
    childbirth pain is part of normal birthing process, woman has several months to prepare, self-limiting and declines after birth
  28. How can pain be beneficial
    cause woman to feel vulnerable and seek shelter and help from others; motivates her to assume different body positions which can help descent of fetus
  29. Why check BP after epidural block?
    Check every 5 minutes after block is begun and after each reinjection until stable; record fetal heart rate-this and O2 can decrease in baby; full bladder may necessitate catheterization
  30. Adverse effects of epidural block
    maternal hypotension (counteracted by 500-1000 ml of Ringer�s solution is infused rapidly before block is begun) and urinary retention (palpate suprapubic area area for a full bladder at least every two hours)
  31. What is nursing care of precipitous birth?
    Help with breathing and cold applications
  32. Umbilical cord prolapse
    1. Gloved hand pushes fetus upward and off the cord 2. Knee chest uses gravity to shift fetus off pelvis-thighs at right angles to bed with flat chest 3. Hips elevated with two pillows combined with trendelenburg�s position
  33. How would you massage fundus?
    Walk fingers from side to midline; if fundus is firm and at expected level, no massage is necessary
  34. What do you do with boggy uterus?
    Massage until firm but do not overmassage and then empty bladder
  35. Homan�s sign
    DVT-dorsiflex the calf
  36. When is the best time to do breast exam?
    1 week after beginning of menstrual period
  37. Drug interactions with oral contraceptives
    these decrease effectiveness: some antibiotics (ampicillin, tetracycline), anticonvulsants, rifampin, barbiturates
  38. Clomid (clomiphene)
    induces ovulation; may be used with human chorionic gonadotropin (hCG); increases risk of multifetal gestations
  39. What food helps osteoporosis?
    Dairy, dark green leafy vegetables, soybean, wheat bread and calcium supplements
  40. Hot flashes
    avoid caffeine (contribute to insomnia and perspiration), stress worsens hot flashes, stress exacerbates symptoms, hormone replacement, vit E, ginseng other herbs
  41. Moro reflex
    loud noise will cause infant to symmetrically extend and abduct the arms and then adduct in a hug motion; thumb and index in �c�; one sided may mean fractured clavicle; absence pathological condition of CNS
  42. Head lag
    head falls back when infant is lifted from bed
  43. Tonic neck
    head turned to one side, arm and leg extended on same side, opposite arm and leg flexed
  44. Rooting
    infant�s head turns in the direction of anything that touches the check
  45. Babinski
    stroke the side of the foot; big toe dorsiflexes and toes will flare out
  46. Respiratory distress of newborn
    rate and character of respirations, cyanosis, and general behavior. Sternal retractions are reported immediately
  47. Regarding birth weight, 3-4 days after birth
    infant loses about 5-10% of weight; 15% for preterm infants; regain birth weight by 10 days of age
  48. Noninvasive ways of pain relief for infants
    swaddling with hand near the mouth, cuddling, rocking, nonnutritive suckling, quiet environment
  49. Severe pain relief in baby
    morphine, fentanyl, topical anesthesia, oral sucrose
  50. Constipation in newborn
    straining in the newborn period results from undeveloped abdominal musculature
  51. What are physical characteristics of the preterm baby?
    Skin is transparent and loose; superficial veins under abdomen and scalp, lack of subq fat; fine hair covers forehead, shoulders and arms; lots of vernix; short extremities; few feet sole creases, protruding abdomen, short nails, small genitalia, open labia majora
  52. Pre-op hydrocephalus baby
    frequently change position to prevent hypostatic pneumonia and pressure sored
  53. Post-op hydrocephalus baby
    if sunken fontanelles, keep baby flat because too rapid reduction of fluid can lead to seizures or cortical bleeding; if fontanelles are bulging, pit in semi-fowlers to promote drainage of ventricles through the shunt; position in a way that prevents pressure on the operative side
  54. Care after surgery on cleft palate
    when feeding with a spoon, place spoon in side of mouth; spoon must not touch roof of mouth; no straw; no hot foods; no pacifier
  55. If baby has high bilirubin,
    phototherapy-placed in incubator under fluorescent lights; protect eyes; line sides of incubator with aluminum foil or white sheet may increase effectiveness; DC�d when bilirubin goes down to 14 mg/ml
  56. Milia
    white pinpoint �pimples� caused by the obstruction of sebaceous glands on the nose and chin; disappear after a hew weeks
  57. Epstein�s pearls
    lesions on the midline of the hard palate of the milia; caused by a collection of epithelial cells
  58. Weight of child
    birth weight doubles by age 5-6 months and triples by age of 1 year; average baby weighs 6-9 pounds; 5-10% of birth weight is lost by age 3 or 4 days and regains birth weight by 10-12 days
  59. Variable decelerations
    reposition, get off cord, give O2 and IV
  60. Asian culture
    patriarchal in structure; extended families; 1st son inherits family�s worth; eye contact may be rude, do not touch children on the head; yin (dark cold wet) and yang (light, heat and dry); delayed breast feeding because colostrum is considered dirty; delay solid foods up to 18 months; don�t use hand or finger to beckon; don�t praise an infant; parents are more controlling, achievement oriented and more encouraging of independence; value balance and harmony
  61. Puerto Rican diet
    meat cooked in stew; poultry, pork, fish, dried beans or peas mixed with rice; milk with coffee; variety of fruits, starchy vegetables (plantains, cassava, sweet potatoes), salad; soft drinks
  62. Piaget infancy
    sensorimotor stage (birth to 2 years)-reflexes, begins to relate to outside events; concerned with sensations that affect self directly
  63. Piaget toddler
    preoperational stage (age 2-7)-egocentric; thinks everyone sees world as self does
  64. Piaget preschooler
    perceptual stage (4-7 years)-capable of some reasoning but can concentrate on only one aspect of a situation at a time
  65. Piaget school-age
    concrete operations (7-11 years)-reasoning is logical but limited to own experience; understands cause and effect)
  66. Piaget adolescence
    formal operations (11-16)-acquires ability to develop abstract concepts for self; oriented to problem solving
  67. Native American communication
    silence is critical during interactions; strong need to sit quietly before responding; eye contact may be rude; may consider health practitioners to be loud and boisterous; spokesperson may not be decision maker
  68. 4 month physical development
    weighs 13-14 pounds; drooling-appearance of saliva and teething; lifts head and shoulders to look around; turns from back to side; sits with support; begins to reach for objects it sees; coordination between eye and body movements; moves head, arms, and shoulder when excited; extends legs and partly sustains weight when help upright; baby reflexes are no longer present
  69. 4 month sleep
    stirs in crib, sleeps through ordinary household noises
  70. 4 month diet
    mother�s milk or formula
  71. 4 month exercise
    plays with hand rattle and dangling toys; start putting in playpen where infant can roll
  72. 4 month immunization
    second DTaP, IPV, Hib
  73. 4 month poop
    1-2 a day, may skip a day
  74. Colic
    holding infant face down and close to the body while supporting the abdomen and providing gentle rocking motion; abdominal massage
  75. Lethargic infant
    avoid bright lights, move and handle the infant slow and gently; talk in a calm voice; sit the infant upright at intervals; slowly dress and undress infant
  76. Infant feeding
    new solid foods should be introduced before the milk feedings to encourage the infant to try the new experience. As solid food increases, amount of milk should decrease.
  77. Ballard scoring
    based on infant�s external characteristics and neurological development
  78. APGAR
    done at 1 minute and 5 minutes after birth; heart rate, respiratory effort, muscle tone; reflex response; skin color

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