Maternal-Newborn and Pediatric Nursing Comprehensive Review

Comprehensive practice flashcards reviewing hypertensive disorders of pregnancy, pediatric oxygenation and respiratory diseases (asthma and RSV), antepartum and intrapartum obstetrics, and pediatric developmental stages.

Chronic Hypertension (CHTN) in Pregnancy

Blood pressure of $\ge 140/90\,\text{mmHg}$ that is present before pregnancy or diagnosed before $20\,\text{weeks}$ of gestation.

Gestational Hypertension (GHTN)

New onset of blood pressure $\ge 140/90\,\text{mmHg}$ recorded on $2$ occasions at least $4\,\text{hours}$ apart after $20\,\text{weeks}$ of gestation, presenting without proteinuria.

Pre-Eclampsia

A pregnancy-specific multisystem vasopressive disease characterized by blood pressure $\ge 140/90\,\text{mmHg}$ on $2$ occasions at least $4\,\text{hours}$ apart after $20\,\text{weeks}$ of gestation, accompanied by proteinuria ($\ge 300\,\text{mg}$ in a $24\,\text{hour}$ urine collection or $1+$ on a dipstick).

Eclampsia

A severe progression of pre-eclampsia characterized by the development of $1$ or more generalized tonic-clonic seizures in the absence of other neurological conditions.

HELLP Syndrome

A severe complication of pregnancy occurring with or without pre-eclampsia, defined by Hemolysis (breakdown of red blood cells leading to hyperbilirubinemia), Elevated Liver enzymes (tissue ischemia from vasospasm), and Low Platelets ($< 100 \times 10^9\,\text{L}^{-1}$ due to endothelial damage and platelet aggregation).

Magnesium Sulfate (Obstetric)

A central nervous system depressant and smooth muscle relaxant administered intravenously with a $4\text{--}6\,\text{g}$ loading dose followed by a maintenance infusion of $2\,\text{g/hour}$ to prevent eclamptic seizures.

Calcium Gluconate

The specific antidote administered immediately to reverse central nervous system and respiratory depression caused by magnesium sulfate toxicity.

Magnesium Toxicity Serum Thresholds

Serum magnesium reference values where normal is $1.5\text{--}2\,\text{mg/dL}$, the therapeutic target is $4\text{--}7\,\text{mg/dL}$, electrocardiogram changes occur at $5\text{--}10\,\text{mg/dL}$, deep tendon reflexes disappear at $8\text{--}12\,\text{mg/dL}$, respiratory depression develops at $15\,\text{mg/dL}$, and cardiac arrest occurs at $25\,\text{mg/dL}$.

Antihypertensive Blood Pressure Goal in Pregnancy

Medical therapy aimed at reducing maternal cerebral vascular accident risk while preserving uteroplacental perfusion, maintaining blood pressure strictly below $160/110\,\text{mmHg}$ using medications such as Labetalol, Hydralazine, or Procardia.

Asthma Triad

The three classical pathophysiologic components of asthma: bronchial smooth muscle spasm, inflammation and edema of the bronchial mucosa, and production and retention of thick pulmonary secretions.

Albuterol

A short-acting beta-2 adrenergic agonist (SABA) that rapidly relaxes bronchial smooth muscle during acute asthma attacks, lasting $4\text{--}6\,\text{hours}$ per dose.

Fluticasone (Flovent)

An inhaled corticosteroid (ICS) prescribed for daily maintenance to suppress airway inflammation and prevent asthma exacerbations; requires mouth rinsing after administration to prevent oral candidiasis (thrush).

Montelukast Sodium (Singulair)

An oral leukotriene modifier taken once daily at bedtime or $2\,\text{hours}$ prior to exercise for long-term control of chronic asthma and exercise-induced bronchospasm; monitored for adverse effects including liver injury, depression, and suicidal ideation.

Asthma Action Plan Zones

A self-management color-coded triage tool: Green indicates well-controlled symptoms, Yellow signifies beginning exacerbation requiring medication adjustment, and Red indicates severe symptoms necessitating immediate emergency intervention.

Bronchiolitis (RSV)

A contagious lower respiratory tract viral infection characterized by mucosal inflammation, thick secretions, and neutrophil infiltration leading to bronchiolar obstruction and air trapping, with an incubation period of $4\text{--}6\,\text{days}$ and peak incidence in infants under $1\,\text{year}$ of age.

Nirsevimab

A monoclonal antibody administered as passive immunization to prevent severe respiratory syncytial virus (RSV) lower respiratory tract disease in infants and high-risk pediatric populations.

Gynecoid Pelvis

The classic, round-inlet female pelvis shape that provides the most favorable anatomical passage for normal vaginal childbirth.

Platypelloid Pelvis

A pelvis classification characterized by a wide, flattened, transversely oval shape that is unfavorable for vaginal delivery.

TORCH Infections

An acronym representing a cluster of teratogenic pathogens capable of crossing the placenta and causing fetal harm: Toxoplasmosis, Other agents, Rubella, Cytomegalovirus (CMV), and Herpes simplex virus (HSV).

Nagele's Rule

A standardized clinical calculation to establish the estimated date of delivery (EDD) by subtracting $3\,\text{months}$ and adding $7\,\text{days}$ to the first day of the last normal menstrual period.

Vena Caval Syndrome (Supine Hypotension)

Maternal dizziness, pallor, and hypotension caused by compression of the inferior vena cava and descending aorta by the gravid uterus when supine; corrected by repositioning the patient to a left lateral recumbent position or placing a wedge under the right hip.

GTPAL Classification

An obstetric parity scoring system: Gravida (total pregnancies), Term deliveries (at or beyond $37\,\text{weeks}$), Preterm deliveries (between $20\,\text{weeks}$ and $36\,\text{weeks}$ and $6\,\text{days}$), Abortions (spontaneous or induced before $20\,\text{weeks}$), and Living children.

Leopold Maneuvers

A systematic four-step external abdominal palpation technique used to assess fetal lie, presentation, attitude, position, degree of descent, and point of maximal impulse (PMI) for auscultating fetal heart tones.

Ectopic Pregnancy

An abnormal extrauterine gestation occurring when a fertilized ovum implants outside the uterine cavity (commonly within the fallopian tubes), presenting clinically with unilateral stabbing pelvic pain, delayed menses, and scant dark brown or red vaginal spotting.

Placenta Previa

An obstetric complication where the placenta implants abnormally in the lower uterine segment, partially or completely covering the internal cervical os, classically manifesting as sudden, painless, bright red vaginal bleeding in the second half of pregnancy.

Placenta Abruptio

The premature premature detachment of a normally implanted placenta from the uterine wall before delivery, presenting with sudden, severe, continuous uterine pain, board-like abdominal rigidity, and dark or bright red vaginal hemorrhage.

Reactive Non-Stress Test (NST)

An antepartum electronic fetal monitoring assessment showing at least $2$ fetal heart rate accelerations of at least $15\,\text{bpm}$ above baseline lasting at least $15\,\text{seconds}$ within a $20\,\text{minute}$ monitoring period.

Negative Contraction Stress Test (CST)

A reassuring finding during an oxytocin challenge test in which at least $3$ uterine contractions occur within a $10\,\text{minute}$ window with zero late decelerations present.

Fetal Heart Rate Baseline

The mean fetal heart rate rounded to increments of $5\,\text{bpm}$ over a $10\,\text{minute}$ segment, with normal physiologic baseline values ranging from $110\text{--}160\,\text{bpm}$.

Moderate Baseline Variability

Fluctuations in baseline fetal heart rate amplitude ranging between $6\text{--}25\,\text{bpm}$, serving as the single most reliable clinical indicator of fetal autonomic nervous system integrity and adequate oxygenation.

Early Deceleration

A gradual, symmetrical decrease in fetal heart rate whose nadir coincides with the peak of the uterine contraction; caused by transient fetal head compression during labor, representing a benign physiologic response.

Late Deceleration

A gradual decrease in fetal heart rate beginning after the onset of a contraction, reaching its nadir after the peak of the contraction, and recovering after the contraction ends; caused by uteroplacental insufficiency and fetal hypoxia.

Variable Deceleration

An abrupt decrease in fetal heart rate of $\ge 15\,\text{bpm}$ lasting $\ge 15\,\text{seconds}$ but $< 2\,\text{minutes}$, varying in onset, depth, and duration; caused by transient umbilical cord compression.

Pelvic Station

The measurement in centimeters of the relationship between the presenting fetal part and the maternal ischial spines, where station $0$ signifies engagement, negative numbers ($-4\text{ to }-1\,\text{cm}$) designate a high unengaged presenting part, and positive numbers ($+1\text{ to }+4\,\text{cm}$) represent progression toward the pelvic outlet.

Initiative vs. Guilt

Erik Erikson's developmental stage for preschoolers ($3\text{--}6\,\text{years}$), wherein children seek independence, explore their environment, initiate activities, and develop a conscience, with over-restriction leading to feelings of inadequacy.

Associative Play

The characteristic play style of preschool-aged children where children engage in similar or identical activities together and share materials without rigid rules or formal organization.

Animism

A cognitive feature of preoperational preschool children characterized by attributing lifelike qualities, intentions, and feelings to inanimate objects.

Centration

A cognitive limitation in preschool children described by Jean Piaget as the tendency to focus entirely on one perceptual dimension of an object or situation while ignoring all other relevant attributes.

Industry vs. Inferiority

Erik Erikson's developmental crisis for school-age children ($6\text{--}12\,\text{years}$), centered on acquiring a sense of competency through task mastery, academic success, and social collaboration, whereas failure to achieve mastery produces a sense of inadequacy.

Concrete Operations

Jean Piaget's cognitive development stage occurring between ages $7$ and $11\,\text{years}$, where children acquire logical thinking regarding physical, concrete situations, understanding cause-and-effect relationships, conservation, and reversibility.

Identity vs. Role Confusion

Erik Erikson's psychosocial stage for adolescents ($12\text{--}18\,\text{years}$), marked by exploring personal beliefs, career ambitions, values, and gender expression to forge a coherent personal identity separate from parents and peers.

Formal Operations

Jean Piaget's final cognitive stage beginning around age $11\text{--}15\,\text{years}$, characterized by the capacity for abstract thought, hypothetical deductive reasoning, meta-cognition, and systematic problem analysis.