The Basics Maternal IFC r/t Status Post Hysterectomy o presence of catheter keep the bladder decompressed avoid

id pressing of expanded bladder @ wound & delay wound healing o remove if patient can ambulate o monitor UO after IFC is removed Basal Body Temperature o lowers prior to ovulation (1C) o rises slightly @ ovulation (1-2) o rises slightly after ovulation o temperature should decrease 2-4 days prior to menstruation ; if temperature remains unchanged, (+) pregnancy o AVOID unprotected intercourse from the day the BBT drops & for 3 days after temperature elevates COLPOSCOPY o exam vagina with cervix with colposcope o magnifies tissue for examination o identifies precancerous lesions o HEALTH TEACHING : some bleeding may occur may use tampons

CULDOSCOPY o view structures in the pelvic cavity o post-procedure : position on abdomen, with pillow underneath to expel air that entered abdominal cavity o assess vital signs monitor for vaginal bleeding CYSTOSCOPY o post-procedure : report bleeding to physician o visualize bladder LAPARSOCOPY under G.A o directly examines ovaries, fallopian tubes, uterus, and small intestine STATUS POST MASTECTOMY o encourage prescribed exercise and elevate extremity on affected side to prevent lymphedema pooling of lymph circulation in involved arm after removal of lymph gland position on pillow with each joint higher than the proximal point o Health Teaching (X) sleep on arm use arm for ADL early use of hand and arm prevents contractures, atrophy, & enhance fluid return o Exercise hand wall climbing ; pulley exercise ; rope turning

NORMAL Weight Gain o 1st trimester 2-4 lbs. nd o 2 trimester 12-14 lbs. rd o 3 trimester 8-12 lbs. Narcotic Analgesic transition phase newborn respiratory depression Panting breathing --prevent pushing APGAR Scoring o cardiac tone, muscle tone, respirations, reflexes, color 0-3 severe distress 4-6 moderate distress 7-10 good adjustment to extrauterine life Moro Reflex o startle reflex ; disappears @ 3-4 monts Babinski reflex o reverts to adult response @ 12 months (Child - fanning ; Adult - downward) Tonic Neck reflex o fencing position ; disappears @ 3-4 months Rh - isoimmunization o (+) 1 Rh-parent = Rh positive infant IFC and enema r/t internal radiation o if bowel/ bladder distended, risk for implant to dislodge ; keeping bladder from overfilling decrease chance of distention ergo displacement of radiation implant ; o complete bed rest without BRP --HOB flat Breast Lumps o cancer of the breast

single, small, painless, lump ; firm & nonmobile o fibroids of the breast benign tumors in uterus or endometrial lining o fibrocystic disease of the breast benign cysts of the breast soft, tender, movable ; freely moving masses becomes enlarged during menstruation o hyperplasia of the breast reduction mammoplasty Diaphragm o remain in place for 6 hours after coitus to be effective o can be inserted 6 hours prior to coitus ; o spermicide inserted every coitus o refitted if there is significant weight change Braxton - Hicks Contraction o irregular, painless, contraction o gone with movement Tx : rest change positions practice breathing techniques Danger Signs of Pregnancy swelling of hands and feet regular uterine contractions abdominal pain gush of fluid from vagina severe headaches persistent vomiting visual disturbances fever / chills bleeding / spotting

Choking - Pregnant woman o chest thrust immediately if unable to speak (means there is obstruction) o establish airway afterbirth contractions are normal because of uterine contractions o prevent hemorrhage Palpation of uterine contractions o one hand in abdomen over fundus ; press gently with fingertips MILD : fundus easy to indent with fingertips MODERATE : feels like touching the nose tip difficult to indent : feels like touching the chin BOARDLIKE : feels like touching the forehead and impossible to indent normal fundus after delivery (3rd stage of labor) o FIRM, GLOBULAR, SHOULD RISE soft = hemorrhage o after delivery, uterus changes from discoid to globular Fetal Heart Rate o early deceleration occurs before peak of contraction (early in the contraction) reassuring fetal heart pattern ; NORMAL FINDING

FHR falls below baseline for 15 seconds or more, followed by a return normal to void LARGE AMOUNTS OF URINE after delivery, usually 2-3 days postpartum, to decrease retained fluids from pregnancy o dieresis is due to estrogen levels & venous pressure in lower extremities alcoholic beverages r/t breastfeeding o contraindicated o CNS depressant normal WEIGHT LOSS (neonates) o lose up to 10% of birth weight 2 to low level of intake and fluid excretion through lungs, bladder, bowel o regain lost weight by 10-14 days initiate change in cardio/ circulatory system after birth o begins with pulmonary ventilation (baby breathes) 1. lung inflation pressure in right atrium declines 2. pressure in left atrium increase foramen ovale closes 3. ductus arteriosus becomes occluded (closes) becomes a ligament Anesthesia with Caesarean section o narcotic amount decreases (prevent respiratory depression in infant) reversal of narcotics : admin Narcan 15 mins. before delivery o sedative and hypnotic remains the same ; potentiate analgesia of lower dose narcotic

Meconium - stained amniotic fluid o fetal distress & perinatal asphyxia o possibly indicates hypoxia-induced peristalsis & sphincter relaxation Low birth weight - @ risk for RDS 2 to underdeveloped lungs and lack of surfactant Congenital Scoliosis o may occur with myelomeningocele Hypoglycemia [usually seen with newborns from diabetic mothers (+) Gonorrhea o urethritis epidydimitis o woman = asmptomatic Tx : Ceftriaxone Doxycycline may result to PID and cause sterility (+) Syphilis o sore on penis painless chancre - fades after 6 months o copper colored rash (palms & soles) o CNS involvement (late stage) Tx : Erythromycin Penicillin G IM (+) Candidiasis o cheesy, white, vaginal discharge o vulvular and vaginal pruritus Tx : antifungal preparation

Modified Radical Mastectomy o breast, axillary nodes, superior apical nodes removed o muscles preserved Total (Simple) Mastectomy o only the tissue is removed (whole breast) o muscle and lymph nodes intact & preserved Lumpectomy o breast, axillary nodes, major & minor pecetoral muscles preserved Vulvectomy o removal of tissue due to cancer of the vulva ; no debridement o () Sitz bath circulation to vulva - promote wound healing Menstrual Cycle o regular : 28 days o ovulation : 28th day Onset of Labor o ruptured membranes ; labor usually begins within 24 of ROM o bloody show (blood-tinged vaginal discharge) o regular, uterine contractions o fetal movements during labor is same with during pregnancy Toxoplasmosis o protozoan infection o from undercood (infected) meat or kitty litter o cross placenta & infect fetus o wear latex gloves and wash hands well afterwards