Quiz 3

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Quiz 3
2010-11-14 19:19:46
Pedi Maternity

pedi maternity quiz 3
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  1. Powers of labor
    • the force supplied by the fundus of the uterus
    • implemented by uterine contractions
    • causes cervical dilation and expulsion of the fetus
    • supplemented by the use of abdominal muscles
  2. Phases of a contraction
    • increment: increasing intensity
    • acme: strongest intensity
    • decrement: decreasing intensity
  3. Stages of labor
    • first stage: latent, active, and transition
    • second stage: full dilation to birth
    • third stage: birth to delivery of placenta
  4. Danger signs of labor
    • high/low blood pressure
    • abnormal pulse
    • inadequate/prolonged contractions
    • pathologic retraction ring - indentation in abdomen
    • abnormal lower abdominal contour - bladder too full
    • increasing apprehension
  5. Danger signs of labor
    • high/low heart rate
    • meconium staining
    • hyperactivity - sign of hypoxia
    • oxygen saturation
  6. Accelerations of FHR
    • temporary, normal
    • occur with contractions or fetal movement
  7. Early decelerations of FHR
    • normal periodic decreases in HR
    • begin when the contraction begins, end when the contraction ends
    • normally occurs late in labor
  8. Late decelerations of FHR
    • begin 30-40 seconds after onset of contraction, continue beyond end of contraction
    • suggests uteroplacental insufficiency or decreased blood flow
    • stop or slow oxytocin, if being used
    • change woman's position from supine to lateral
    • prepare for possible prompt delivery if continues
  9. Prolonged decelerations of FHR
    • last longer than 2-3 minutes, less than 10 minutes
    • generally isolated
    • may signify cord compression or maternal hypotension
  10. Variable decelerations
    • unpredictable times in relation to contractions
    • indicates cord compression
    • change woman's position
    • amnioinfusion possible to relieve pressure
  11. Sinusoidal FRH
    • FHR resembles a frequently undulating wave
    • occurs with severe anemia or hypoxia
    • change of 5-15 bpm every 3-5 minutes
  12. Analgesia vs. Anesthesia
    • analgesia: reduces or decreases awareness of pain
    • anesthesia: partial or complete loss of sensation
  13. Narcotic analgesics during labor
    • Demerol, Nubain, Sublimaze, Stadol
    • all can cause fetal CNS depression
    • can possibly slow labor if given early
    • can be givin intrathecal (into spinal cord)
  14. Regional anesthesia during labor
    • Pontacaine or Marcaine
    • includes epidurals
    • woman does not feel contractions
    • counter risk for hypotension by administering fluids
    • to administer, positioned on side, back not flexed
  15. Combined spinal epidural technique during labor
    • immediate pain relief
    • still allows woman to be ambulatory
    • drug in the CSF is a narcotic, not an anesthetic
  16. Local anesthetics during birth
    • injection of lidocaine into perineum
    • pudendal nerve block injection close to spine
  17. General anesthesia during birth
    • not preferred
    • needs 6 drugs readily available:
    • ephedrine: in case BP drops
    • atrophine sulfate: dries oral and resp secretions
    • thiopental sodium: rapid induction
    • succinylcholine: for intubation
    • diazepam: control seizures
    • isoproterenol: reduce bronchospasms
  18. Uterine atony
    • when the uterus becomes relaxed after birth
    • will lose blood very rapidly
  19. Lochia
    • uterine flow of inner layer of decidua
    • rubra: red flow from birth to 3 days
    • serosa: pink/brown flow from days 4-10
    • alba: white/clear flow from day 10-3 weeks
  20. Nevus flammeus
    • port-wine stain
    • most often on face, but sometimes on thighs
    • does not fade with age
  21. Telangiectasia
    (stork's beak marks)
    • a kind of nevus flammeus
    • lighter, pink patches at the nape of the neck
  22. Strawberry hemangioma
    • elevated areas formed by immature capillaries and endothelial cells
    • will disappear by age 10
  23. Cavernous hemangioma
    • resembles a strawberry hemangioma
    • raised dilated vascular space
    • do not disappear over time
    • can also have additional internal spaces
  24. Mongolian spots
    • pigmented cells
    • appear as slate-grap patches across the sacrum or buttocks
    • usually appear in Asian, s. European or African children
    • disappear by school age
  25. Vernix caseosa
    • a white, cream cheese-like substance on a newborn that protects the skin in utero
    • takes on the color of the amniotic fluid
  26. Lanugo
    fine, downy hair that covers a newborn
  27. Desquamation
    • normal drying of skin in 24 hours after birth
    • may resemble a sunburn
    • no treatment necessary
  28. Milia
    • a pinpoint white papule on the cheek or bridge of nose of a newborn
    • disappear by 2-4 weeks
    • normal
  29. Erythema toxicum
    • normal newborn rash across face
    • lack of pattern
    • disappears w/in two days
  30. Anterior fontanelle
    • located at the junction between the two parietal bones and the two fused frontal bones
    • diamoned shaped, 2-3 cm
    • closes between 12-18 months
  31. Caput succedaneum
    • edema of the scalp of a newborn
    • crosses suture lines
    • no treatment needed
  32. Cephalhematoma
    • a collection of blood between the periosteum of a newborn's skull bone and the bone itself
    • caused by rupture of a periosteal capillary d/t birth pressure
    • confined to an individual bone, doesn't cross suture line
  33. Type I allergic response
    • Anaphylaxis - extreme vasodilation -> circulatory shock and extreme bronchoconstriction -> decreases the airway lumens
    • Caused by histamine, leukotrienes and SRS-A
  34. Type II allergic response
    Cytotoxic response - attack and destroy foreign cells
  35. Type III allergic response
    Immune complex - initiates inflammatory response
  36. Type IV allergic response
    • Cell-mediated hypersensitivity - inflammatory response 12-72 hours after expsure
    • e.g. PPD
    • e.g. contact dermatitis
  37. Allergic rhinitis
    • hayfever
    • caused by a type I (hypersensitivity)
  38. Atopic dermatitis
  39. Fifth disease
    • erythema infectiosum
    • bright red rash appears first on cheeks
    • a day later, rash appears on the body
  40. Scarlet fever
    • "strawberry tongue"
    • rash appears 12-48 hours after high fever, sore throat
  41. Impetigo
    honey-colored crusts on face
  42. Roseola infantum
    after 3-4 days, high fever falls abruptly and then rash appears
  43. Pityriasis rosea
    • begins with the herald patch on the trunk
    • then generalized rash appears in Christmas tree shape
  44. Normochromic, Normocytic Anemias
    • impaired production of erythrocytes by the bone marrow or
    • abnormal or uncompensated loss of circulating RBCs
    • causes: blood loss, acute infection, renal disease, neoplastic disease, hypersplenism, aplastic anemia (bone marrow depression), hypoplastic anemia (bone marrow depression)
  45. Hypochromic anemias
    • hemoglobin systhesis is inadequate
    • causes: iron-deficiency, chronic infection
  46. Macrocytic anemia
    • due to nutritional deficiencies
    • causes: folic acid deficiency, pernicious anemia (vit B12 deficiency)
  47. Hemolytic anemia
    • destruction of erythrocytes - fundamental abnormalities or extracellular destruction
    • e.g. sickle-cell anemia (abnormally shaped RBCs)
  48. Thalassemia minor
    • produce both defective and normal hemoglobin
    • no iron supplements
    • no other treatment needed
  49. Purpuras
    a hemorrhagic rash or small hemorrhages in the superficial layer of skin
  50. Thalassemia major
    • bone marrow hypertrophies -> bone pain
    • heptosplenomegaly due to spleen trying to destroy defective RBCs
    • treat with blood transfusions and hematopoietic stem cell transplant
  51. von Willebrand's disease
    • dominant disorder
    • factor VIII defect
    • inability of platelets to aggregate
    • blood vessels cannot constrict to aid in coagulation