NCM 107: Maternal and Child Nursing

gawa ni jc pogi

High Risk Pregnancy

complications wherein both mother and child are endangered, it can be cause by a disorder, exists before pregnancy or unique during pregnancy

Biophysical Risk

Refers to genetics, medical and obstetric that can endanger the pregnancy

Behavioral Risk

Refers to nutritional status, substance abuse, dental hygiene, abuse and hygiene that can endanger the pregnancy

Psychological Status

refers to failure to seek prenatal care and may caused by extreme stress that leads to endangerment to pregnancy

Identify risk factors

The role of the nurse in High Risk Pregnancy is

unsafe abortion

These are the leading cause of Maternal mortality EXCEPT: 

Death

What is maternal mortality?

Bleeding

what is hemorrhage

Ectopic Pregnancy

Abnormal implantation of the placenta outside the uterus

Gestational Hypertension

This is one of the normal changes that happens during pregnancy

Placenta will detach to the uterus

What would happen if the mother developed a high blood pressure during pregnancy?

Organogenesis

Formation of organs

2nd trimester

when does the blood vol. go through its peak?

All organs

Affected organs during Gestational Hypertension

Pregnancy Induced hypertension

Hypertension that the patient gets during pregnancy

40-50%

Normal increase of blood volume during 2nd trimester

Weak blood vessels

At risk patients like:

• 40+ year old pregnant

• under 18 y/o pregnant

• nutritional problems (obesity and malnourishment) and;

• vascular disorder patients

have this in common

Vasospasm

During PIH the increase of blood volume damages the artery due to the high pressure. What is the mechanism that counteracts this problem?

2nd trimester

The time for screening for PIH is

Systolic: +30
Diastolic: +15

140/75

If the patient’s systolic and diastolic pressure has increased this number from the base line you should check again after 6 hours and report if the BP is still abnormal:

Eg: 110/60

Decreased BP

When giving drugs like CCB, Beta Blockers, and Vasopressors to a pregnant client with PIH we should watch out for?

Proteinuria

Urinalysis is one of the test that are done to check if the patient has PIH (pregnancy induced hypertension), what are the complication/s that can be found during the test

Albumin

What type of protein pulls the water in the intravascular spaces of the blood vessels?

Hyperalbunemia

if too much albumin goes to the urine, the water on the blood vessels will go to the interstitial spaces and will cause generalized edema

Preeclampsia

Complicated htn with renal involvement, “before seizure”

Cerebral edema

This edema could lead to brain irritation and then seizure

eliminate bright lights and sudden noises

Nursing management for preeclampsia

regular 20%

Protein intake of a preeclamptic patient

5-8 mg/dL

Magnesium Sulfate is a muscle relaxant that are use for preeclampsia, due to its high risk of toxicity it’s therapeutic range is:

Calcium Gluconate

What is the antidote for Magnesium sulfate

Diazepam IV

The goal of the nurse during eclampsia (seizure) is to stop convulsion wha IV medication are we going to give

Puerperium

6 weeks after child birth

Involution

is the process whereby the reproductive organs return to their nonpregnant state.

Postpartum

Also called the 4th trimester

Seal off

Process of the uterus to prevent postpartum hemorrhage

pre-gestational size

process wherein the uterus goes back to its normal size, moving 1cm per day/ 1 finger breadth until it reaches the pelvic area

uterine atony

state of the uterus wherein it is relaxed, soft/boggy and no contraction occurs leading to post partum hemorrhage

Lochia Rubra

Lochia is a discharge of the vagina that comes in 3 phases. What phase is the bright red, mainly blood, tissue debris, decidua (1st week) 

Lochia Serosa

Lochia is a discharge of the vagina that comes in 3 phases. What phase is the pinkish to brownish, leukocytes, decidua cells, cervical mucus (4th - 10th day)

Lochia Alba

Lochia is a discharge of the vagina that comes in 3 phases. What phase is the Decline weekly flow, endometrial epithelializing, clear mucous secretion of uterine glands (10th day - 6th week)

soft and malleable to palpation

After birth the cervix will feel?

soft and has a few rugae

After birth the vagina will feel?

edematous and tender

After birth the perineum will feel?

paralytic ileus

You should report to the doctor if there is no bowel movement or it is also called as?

Bladder Distention

The common cause of uterus displacement after birth is?

Deep Vein Thrombosis

The abnormal finding for performing the Homan’s Sign Test is?

Stranger

The parent will engage with their newborn after delivery as?

en face position

This is the sign of effective attachment/bonding wherein the mother and baby is having an eye contact

Postpartal Blues

after childbirth, feeling sad, tearful, or irritable due to hormonal changes—especially the drop in estrogen and progesterone after delivery

Taking in

Ruben’s has 3 phases of adaptation to postpartum period, which is the phase wherein the mother doesn’t care about others and focuses on herself?

Taking Hold

Ruben’s has 3 phases of adaptation to postpartum period, which is the phase wherein the The mother becomes more independent and starts to take charge of her care and the baby's.

Letting go

Ruben’s has 3 phases of adaptation to postpartum period, which is the phase wherein the The mother accepts her new role and the reality of her baby and family structure.