Exam 3 Nuggets

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  1. Anterior Pituitary releases......which
    • Prolactin
    • prepares breasts
  2. Posterior Pituitary releases.....which
    • oxytocin
    • causes milk ejection and increases UC
  3. When a laboring mom is in pain she will increase her respirations and their depth....which increases tidal volume causing
    hyperventilation and respiratory alkalosis
  4. What does estrogen do to the liver?
    • causes an increase in alkaline phosphate and cholesterol....but
    • a decrease in albumin
  5. What does Progesterone do to the gallbladder?
    decreases it's tone so less emptying which causes an increase in bile salts causing gallstones and pruritus
  6. Risks of having bile salt retention
    • premature passing of meconium
    • stillborn birth
  7. What does the growing fetus do to the ureters?
    compresses them causing an obstruction....UTI
  8. Hep B vaccine rules
    • given as prophylactic babies if mom has positive titer
    • **delay dose till baby is 40 weeks post conception
  9. Who gets HBIG....and how is it given
    Given ONLY to mom's who have antibodies for HBSAG or have developed Hep B during pregnancy

    • *IM within 12 hours of birth (ASAP)
    • *Bathe baby before giving (prevention of inoculation)
  10. Rubella vaccine rules
    • don't give during pregnancy cuz it crosses the placenta
    • Give after delivery to protect subsequent unborn children
    • *Pt Ed-don't get prego for 3 months after injection
  11. Vitamin K rules
    given by IM within first hour of deliver and BEFORE circumcision if a boy
  12. Erythromycin rules
    • given within first 1 hr. after birth
    • hold tube horizontally
    • wipe excess after 1 minute
  13. What is IV solution is run with an epidural?
    Lactated Ringers 500-1000 mL Bolus
  14. With all epidurals watch for....
    • decreased BP
    • decreased RR
    • increased HR
  15. How is Nubain given?
    through the IV and injection is given at the start of the contraction
  16. For Nubain what are the RR #'s that signal respiratory depression?
    • Mom <12/min
    • Newborn <30/min
  17. Narcan helps with 2 things
    respiratory depression and pruritus
  18. How is cytotec (synthetic prostaglandin) administered?
    tablet placed intravaginally for induction ripening

    tablet placed intrarectally for pp hemorrhage
  19. How are prostaglandins administered to ripen the uterus (even though most facilities don't use this any more)
    gel placed on cervix
  20. What is prepadil used for? 
    cervical ripening and stimulation of contractions

    syringe of gel is placed in the cervix

    lie flat for 20 min after insertion to prevent leakage and monitor FHT's for 30 min after insertion
  21. If a person is getting a c section what will they have?
    a spinal block at T6-T7
  22. How is Betamethasone givern?
    IM q24hr x 2 doses
  23. How is Terbutaline given?
  24. How much does a lactating mom increase her calories?
    • first 6 months by 330 calories
    • next 6 months 400 calories
  25. Name the 2 hormones that are suppressed during pregnancy and why?
    FSH and LH....don't need to ovulate
  26. Hegar's sign
    thinning of lower uterine segment
  27. McDonald's sign
    flexing of uterus against cervix
  28. Pregnancy test type and when given?
    • ELISA
    • 1 week post ovulation
  29. How do you help with n/v
    • eat dry crackers/toast before getting out of bed
    • eat carbs/proteins q3h
    • eat foods with ginger or peppermint
    • take prenatal vitamins at bedtime
    • take V. B6 or antihistamines
  30. How do you help with heartburn?
    • eat small meals q3h
    • avoid spicy foods
    • chew gum
    • eat a tbsp. of cream prior to eating
    • don't eat before bed
    • walk or sit up after meals for 1-2 hrs
    • don't take antacids high in sodium or calcium
  31. antacids high in sodium

    antacids high in calcium
    sodium-alka seltzer and baking soda

    calcium-tums and alka mints
  32. How do you help decrease urinary frequency
    • decrease fluids in the evening
    • avoid caffeine
    • perform kegels....practice by stopping the flow of urine mid stream
  33. How can you help with constipation
    • reduce intake of sweets
    • fold a towel and use as a foot rest when using the toilet to help avoid straining
  34. How can you help with leg cramps?
    • elevate legs often during the day
    • avoid foods high in phosphorous
    • check with dr. about taking extra ca or mag
  35. Emotional Response to pregnancy by trimester
    1st-uncertainty, ambivalence, focus on self

    2nd-focus on fetus, body image and sexuality changes

    3rd-protection of baby, increased dependence and acceptance of fetus as separate but dependent
  36. Physical validation to pregnancy by trimester
    1st-no obvious signs of fetal growth

    2nd- quickening

    3rd-fetal growth, discomfort, decreased maternal activity
  37. Role changes by trimester to pregnancy
    1st-seeks safe passage

    2nd-seeks acceptance of fetus and role as a mother

    3rd-prepares for birth
  38. involves observing and copying the behaviors of other women who are prego or already moms in an attempt to discover what the role is like
  39. searches for opportunities to hold or care for infants in the presence of another person.  Looking to receive validation from an observer especially her partner or mom
    role play
  40. mental images of how the infant will look and what characteristics he or she will have, can be fearful about the bad things that can happen
  41. internalized view of a "good" mothers behavior, this process implies that the women has explored the role of mother long enough to develop a sense of herself in the role and to be able to select behaviors that reaffirm her sense of herself fulfilling the role
    Looking for a role fit
  42. sense of sadness that she will never again be a care free woman without a child
  43. What is a Pudendal block used for?
    cutting the perineum to prepare for forceps
  44. What is the side effect of a subarachnoid epidural injection?
    rapid intense motor and sensory block....loss of sensation
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Exam 3 Nuggets
Exam 3 Nuggets
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