CA2 MATERNAL & PEDIA

RA 9262 (2004)

Anti violence against women and their children

RA7610 1992

special protection of children against abuse (including older than 18 but unable to protect themselves)

3-5 contractions per 10 mins ; 60-90 sec each

Normal Contractions

Hypotonic Uterine Contraction

not more than 2-3 occuring in a 10 min period; uterine resting tone less than 10mmHg

Hypertonic uterine contraction

lack of relaxation; uterine resting tone more than 15mmHg

latent

hypertonic most common phase of occurence

active

hypotonic most common phase of occurence

Hypertonic

sharp, static, persistent pain

Hypotonic

mild, mestrual cramping, intermittent and sporadic pain

sedatives, no oxytocin

medication for hyperonic

oxytocin, no sedatives

medication for hypotonic

Precipitate Labor

labor that progresses extremely quick

Prolonged Labor

labor that lasts longer than expected

prolonged latent

contraction becomes ineffective during 1st stage of labor; slow cervical dilatation

prolonged deceleration

labor extends beyond 3 hours in primipara, beyond 1 hour in multipara; may result in abnormal fetal head position

prolonged descent

slow descent thru the birth canal; CS is indicated

uterine rupture

rupture of uterine during labor

dystocia

obstructed labor

Uterine Inversion

uterus turns inside out; partial or complete

placenta accreta

deep implantation of placenta

placenta previa

placenta obstructing the birth canal

Brant Andrews Manuever

technique used to deliver placenta during 3rd stage of labor

hyperemesis gravidarum

severe type of vomiting of pregnancy which has ot deeterious effect on health of the patient

ectopic pregnancy

implantation f fertilized egg outside the uterus

interstitial, ismus, ampulla, infundibullum, fimbriae

parts of fallopian tube

ampulla

most common implantation for ectopic

Iatrogenic

conditions brought about by medical/nursing intervention

hypotension, tachycardia, tachypnea

Sx of ectopic

transvaginal UTZ

confirmatory test od ectopic; probe inside vagina

medical mngt of ectopic; expulsion of embryo and inhibits cell division

IM methotrexate

laparoscopic salpingectomy - removal of part

salphingotomy - opening

surgical mngt for ectopic

Gestational Trophoblastic Disease

rare tumors that develop from trophoblastic cells of placenta during pregnancy

H-Mole

benign tumor and abnormal growth of trophoblast cells

choriocarcinoma

malignant tumor that develops throphoblast cell and not managed, h-mole that progressed

Dx of GTD

granular or snowstorm appearance

mngt for molar preg

suction curettage

anti-d prophylaxis

mngt for choriocarcinoma, placental & epithelioid

chemo, surgery

placental site trophoblastic tumor

malignancy of intermediate trophoblasts

epithelioid throphoblastic tumor

malignancy of trophoblastic placental cells

miscarriage

loss of pregnancy less than 24 weeks gestation

misoprostol

medical mngt for miscarriage; for cervical ripening

evacuation of retained products of conception (ERPC) raspa

surgical mngt for miscarriage

threatened miscarriage

occurs under 16 wks (early) ; 16-24 wks (late)

Inevitable/Imminent

body is in the process of expelling products of conception; heavy bleeding, clots

Missed

asymptomatic, no fht, type of miscarriage

incomplete

POC partially expelled, Sx of missed mscarriage or bleeding clot; no fht, vaginal and abdominal pain

complete

no POC seen in uterus

Septic

infected POC; fever, rigors

episiotomy

surgical cut between vagina and anus

episiorrhaphy

repair of episiotomy

120-160

normal hr of baby

left side lying

position for abnormal hr of baby

Premature Rupture Of Membranes

PROM

perinatal asphyxia

fetus does not get enough oxygen in uterus, during delivery or after birth

shoulder dystocia

head has come out but ne of the shoulders gets stuck

excessive bleeding

worldwide leading cause of maternal death

intrapartum infections

potentially leading to sepsis or other health issues; can affect mother and baby

Nosocomial Infection

infection in reproductive organs or on site of incisions (3 days after delivery)

endometriosis

infection/inflammation of endometrial lining

thromboembolic disorders

promblems in coagulation, presence of blood clots

puerperal mastitis

inflammation of breast

preterm labor

labor before 38th week of preg

magnesium sulfate, 2 IM, 1 IVF check for DTR

meds to help delay delivery, stop uterine contraction site? check for?

corticosteroids: betamethasone, dexamethasone

for lung maturity, lung expansion

fern test

test to examine dried vaginal fluid under microscope

Nitrazine test, amniotic is alkaline

ph test for amniotic fluid; alkaline or acidic?

terbutaline

medication that can stop labor

protenuria

hallmark symptom of preeclampsia

fast for 8 hrs, take 100mg glucose, measure 1,2,3 hours after taking.

directions for oral glucose tolerance test (OGTT)

abruptio placentae

placenta prematurely separates from uterine lining

placenta previa

painless, bright red, soft, boggy, flaccid

abruptio placentae

sharp, colic like pain, dark red, firm, rigid

post term pregnancy

pregnancy longer than 42 wks

stasis, damage, hypercoagulability

venous thromboembolism triad SDH

pseudo anemia

increase blood volume but more plasma than rbc concentration

congenital hypothyroidism

slow baby, lack of thyroid hormone

Phenylketonuria

phenylalanine piles up

heinz bodies

abnormal shaped rbc

G6PD deficiency

nutrient that protects rbcs from oxidative damage is lacking

Congenital Adrenal Hyperplasia

low cortisol; high androgen; enlarged genitals in males, ambigious in females.

atrial septal defect (ASD)

abnormal opening betwee RA and LA

secundum ASD

middle of septum; most common

Primum ASD

lower part of atrial septum; less common

Sinus Venosus ASD

upper part of atrial septum; rare type

Ventricular Septal Defect (VSD)

opening between RV and LV

patent ductus arterious

fetal shunt fails to close after several days of life

indomethacin

meds for prostaglandid inhibitor that will help close ductus arteriosus

coarctation of aorta

narrowing of aorta

aortic stenosis

narrowing of valve opening

pulmonic stenosis

narrowing of pulmonary valve

1. VSD

2. Pulmonic stenosis and Pulmonary stenosis

3. Overriding aorta (RV and LV both go to aorta)

4. Right Ventricular Hypertrophy (thickening/ overworked)

4 defects in tetralogy of fallot

Tricuspid Atresia

RA to RV is broken (tricuspid)

iron deficiency anemia

low number of RBC insufficient iron

sickle cell anemia

affects the production of hemoglobin

Aplastic anemia

bone marrow fails to produce enough blood cells

thalassemia

affects production of hemoglobin, can cause bone deformity and bone marrow expansion

hemophilia

inability of blood to clot properly

idiopathic thrombocytopenic purpura

autoimmune disorder; low platelet count, bleeding and petechiae