MATERNAL-NEWBORN EXAM 2 FULL MATERIAL GUIDE

MATERNAL-NEWBORN EXAM 2 FULL MATERIAL GUIDE What are the 3 P's in Gestational Diabetes? - ANS Polyphagia Polyuria Polydipsia When are women usually screened for diabetes? - ANS At 24-28 weeks A pregnant woman is being screened for diabetes what is the very first screening contain of such as dose and hour? - ANS it is a nonfasting, 50 gram, 1 hour glucose tolerance test When is a 3 hour glucose tolerance test done? - ANS If the 1 hour glucose tolerance test is above 140 mg/dL A pregnant woman had a 1 hour glucose of 145 mg/dL, so she has to go for a 3 hour glucose test; what is the criteria for the diagnosis of gestational diabetes? - ANS She must have two or more of the following: Fasting: 95 mg/dL 1 hour: 180 mg/dL 2 hour: 155 mg/dL 3 hour: 140 mg/dL What is the primary goal for the newborn with a mother who has had gestational diabetes? - ANS To prevent hypoglycemia What condition is being described with symptoms of the following: Polyphagia, polydipsia, polyuria, nausea, hot flashes, fruity breath, abdominal cramps, rapid deep breathing, headache, weakness, drowsiness, malaise - ANS Hyperglycemia What condition includes the following signs and symptoms: Hunger, clammy skin, irritability, slurred speech, seizures, tachycardia, headache, pallor, sweating, disorientation, shakiness, blurred Speech? - ANS Hypoglycemia What are the maternal effects of HIV in pregnancy? - ANS Increased pre-rupture of membranes Increased preterm labor Full immune system compromised What should women not do when positive for HIV after the birth of an infant? - ANS Breastfeed What antiretroviral is used in HIV positive pregnant women to reduce the risk of transmission of HIV to the fetus? - ANS Zidovudine (ZVD) What should physicians avoid in pregnant women who are HIV positive? - ANS Invasive procedures such as amniocentesis and internal fetal monitoring When are weekly NSTs begun in the HIV pregnant woman? - ANS At 32 weeks During the first and second trimester the major cause of bleeding is what? - ANS Abortion What does HELLP stand for? - ANS Hemolysis Elevated Liver Enzymes Low Platelet What is the diagnostic procedure for mild preeclampsia? - ANS New onset of hypertension and proteinuria after 20 weeks gestation BP is 140/90 on at least 2 occasions 6 hours a part Proteinuria between 300 mg/dL and 1 g/L What is the diagnostic procedure for severe preeclampsia? - ANS New onset of hypertension and proteinuria after 20 weeks gestation BP is 160/110 on 2 occasions 6 hours a part while on bedrest Proteinuria is more than 5 g/L in 24 hours The following signs and symptoms are seen in what pregnancy disorder... Epigastric pain Headache Blurred vision Spots before eyes Pulmonary edema Impaired liver functions (increased AST and ALT) Fetal growth restriction - ANS Severe preeclampsia What drug is used to help mature fetal lungs? - ANS Bethamethosone What is the drug of choice for seizure prophylaxis? - ANS Magnesium sulfate What is the therapeutic range of magnesium? - ANS 4.8 - 8.4 mg/dL What is the rating scale for deep tendon reflexes? - ANS Hyperreflexia = 4+ Above normal, brisker = 3+ Normal = 2+ Low = +1 Absent = 0 What drug do physicians prescribe for polyhydraminos that interferes with fetal urine output to decrease amniotic fluid volume? - ANS Indomethicin What is the criteria for preterm labor? - ANS Uterine contractions every 5 minutes for 20 minutes OR 8 contractions in 60 minutes AND documented cervical change (cervical effacement of 80%+) OR dilation 1 What two drugs are used to try and stop labor for preterm labor? - ANS Magnesium sulfate and terbutaline What is the dosage for magnesium sulfate when used for preterm labor? - ANS 4-6 gram loading dose with maintenance dose of 1-2 grams every hour on PUMP When should terbutaline be held? - ANS Fetal heart rate above 160 Maternal heart rate above 120 Maternal respirations above 24 Patient has "wet" lung sounds or shortness of breath Systolic BP is less than 80-90 mmHg What are the side effects of magnesium sulfate? - ANS Thirst Flushing Diaphoresis What are the signs and symptoms of magnesium toxicity? - ANS Decreased or absent deep tendon reflexes Respiratory depression Oliguria While on magnesium sulfate, how often should nurses check vital signs? - ANS Every hour What is the antidote for magnesium sulfate? - ANS Calcium gluconate When should magnesium sulfate be withheld? - ANS Absent reflexes Urine output less than 30cc/hour Respirations less than 12 The following symptoms are found in what... Vaginal bleeding (like prune juice color) Anemia Passage of hydropic vesicles Uterine enlargement greater than expected Absence of fetal heart tones Elevated HcG levels Very low levels of maternal serum alpha-fetoprotein Hyperemesis gravidarum Pregnancy induced hypertension - ANS A molar pregnancy If pregnancy induced hypertension (preeclampsia) is seen in the first half of the pregnancy what should physician's be suspicious the woman may have? - ANS A molar pregnancy Women who are diagnosed with a molar pregnancy must get what follow up testing to determine if choricarcinoma has developed, what test and for how long? - ANS HcG levels must be checked weekly until 2 consecutive levels are negative then monthly for 1 year Hyperthyroidism is a complication in what pregnancy disorder? - ANS A molar pregnancy What drug is used in ectopic pregnancy if it has not ruptured yet? This is used to dissolve the pregnancy without the need for surgery - ANS Methotrexate What are two tests that are performed to test for rupture of membranes? - ANS Nitrazine paper (blue-green if present) Fern Test What are the 5 functions of amniotic fluid? - ANS 1. Cushion to protect against injury 2. Helps control fetus's temperature 3.Permits symmetric external growth 4. Allows freedom of movement 5. Prevents adherence to the amnion What is the normal range of amniotic fluid? - ANS 700-1000 mL What are the four P's for the process of labor? - ANS P = passage P = passenger P = power P = psyche What type of pelvis has a rounded inlet, is the most common among women, and is the most favorable for vaginal birth? - ANS Gynecoid What type of pelvis has a heart shaped inlet, short posterior sagittal diameter and is not favorable for vaginal birth? - ANS Anthroid