exam 1 Flashcards
(121 cards)
1
Q
Four goals when providing care for infertility
A
Provide couple with accurate information
Assist in identifying cause
Provide emotional support
Guide and educate about treatment options
2
Q
What classifies someone as infertile
A
If under 35 and have unsuccessfully been trying for 1 year
If over 35 and unsuccessfully been trying for 6 months
3
Q
What can increase chance of infertility
A
obesity and hypothyroidism
4
Q
Semen analysis
A
Gold standard test for men
Assess ability of sperm to move around and number of sperm ejaculated
5
Q
Hormone analysis for men
A
Must abstain from sex for 2-3 days prior
6
Q
Clomiphene/Clomid
A
Increase release of the egg
Increase chance of multiple fetuses
When taken with Metformin increases effectiveness
7
Q
In vitro fertilization- embryo transfer
A
Woman’s eggs collected from ovaries, fertilized in lab and transferred to uterus
8
Q
Gamete intrafallopian transfer (GIFT)
A
Oocytes retrieved from ovary, placed in catheter with washed sperm and transferred to end of uterine tube.
Fertilization occurs in uterine tube.
9
Q
Therapeutic donor insemination (TDI)
A
Donor sperm used for inseminate female
10
Q
Intracytoplasmic sperm injection
A
One sperm cell is injected directly into egg used with IVF
11
Q
Cryopreservation of human embryos
A
Can freeze embryos and still be viable many years later
12
Q
Contraception
A
Intentional prevention of pregnancy
May still be at risk for pregnancy
13
Q
Peak fertility days
A
days 8-19
1 week before and 24 hours after ovulation
14
Q
Coitus interruptus
A
withdrawal/pullout method
15
Q
Fertility awareness methods (FAMs)
A
rely on avoidance of intercourse during fertile periods
16
Q
Calendar method
A
11 days from longest cycle
18 days from shortest cycle
longest is 34 days - 11 = 23
shortest is 28 days - 18 = 10
need to be careful during days 10-23
17
Q
Cervical mucus ovulation detection method
A
Cervical mucus will change
Prior to ovulation discharge is egg white and stretchy, then becomes watery, followed by thicker mucus that would accompany a pregnancy
18
Q
Breastfeeding and contraception
A
inhibits estrogen levels and prevents ovulation, causes dry vaginal canal
Should prevent pregnancy for at least 6 months
19
Q
Diaphragm
A
Barrier method
reusable.
Clean after each use.
Check for proper fit after pregnancy or weight changes
20
Q
Cervical cap
A
Barrier method
More of a one size fits all diaphragm
21
Q
Contraceptive sponge
A
Barrier method
Can be left in 24 hours but longer increase risk for toxic shock syndrome
22
Q
Condoms
A
Petroleum jelly can cause condom to break
23
Q
Hormonal methods
A
increase risk for cerebrovascular and vascular issues
Increase risk of DVT (increase when over 35 and smokers)
24
Q
Progestin-only contraceptives
A
mini pill, injectables, implantable- Nexplinon)
Used for postpartum
Shot good for 3 months
25
Emergency contraceptives
Used within 72 hours
Plan B most readily available- increase progesterone- blocks ovulation
Copper IUD- need in provider office within 100 hours of intercourse
25
Emergency contraceptives
Used within 72 hours
Plan B most readily available- increase progesterone- blocks ovulation
Copper IUD- need in provider office within 100 hours of intercourse
26
IUDs
Small T shaped device inserted into uterus
Mirena loaded with pregestational agent
Copper is only nonhormonal IUD
27
Common complications with abortion
infection
retained products of conception
excessive vaginal bleeding
28
Gravidity
# of pregnancies
29
Gravida
Woman who is pregnant
30
Nulligravida
Woman who has never been pregnant
31
Primigravida
Woman pregnant for the first time
32
Multigravida
Woman who has had 2 or more prgnancies
33
Parity
# of pregnancies that reached 20 weeks
34
Nullipara
Woman who has not completed a pregnancy that reached 20 weeks
35
Primipara
Woman who has had 1 pregnancy reach 20 weeks
36
Multipara
Woman who has had 2 or more pregnancies reach 20 weeks
37
Preterm
20 weeks to 36 weeks 6 days
38
Early preterm
20 weeks to 33 weeks 6 days
39
Late preterm
34 weeks to 36 weeks 6 days
40
Early term
37 weeks to 38 weeks 6 days
41
Full term
39 weeks to 40 weeks 6 days
42
Late term
41 weeks to 41 weeks 6 days
43
Post term
42 weeks and beyond
44
Viability
Capacity to live outside uterus
22 weeks to 25 weeks
45
Two digit summarizing obstetric hx
GP
gravida para
46
Five digit summarizing obstetric hx
GTPAL
Gravidity, term, preterm, abortion, living children
47
hCG
Earliest biochemical marker of pregnancy
Can be detected as early as 7 to 8 days after ovulation
48
ELISA
Basis for most OTC home pregnancy test
Medication use, hormone-based tumors, or improper collection cause inaccurate results
49
Signs of pregnancy
Presumptive- changes felt by the woman
Probable- changes observed by examiner
Positive- attributed only by presence of fetus (heart tones, US, movement)
50
Factors affecting labor
Five P's
Passenger (fetus and placenta
Passageway (birth canal)
Powers (contractions)
Position of mother
Psychologic response
51
Elements about passenger that affect birth
Size of fetal head
Fetal presentation
Fetal lie
Fetal attitude
Fetal position
52
Molding
bones shift to fit through birth canal
53
Fontanels
Soft spots
Triangle- anterior
Circle- posterior
Bulging fontanels could indicate increase intracranial pressure
54
Vertex or cephalic
Head down
55
Breech
Head up
56
Transverse
side to side
57
Occipitoanterior
Fetus has neck flexed and the occiput of head is facing anterior aspect of pelvis
Also called OA, can be right or left
58
Occipitoposterior
Fetus neck extended and occiput is facing posterior pelvis.
Also called OP or sunny side up
Takes longer to deliver and cause more back pain
59
Frank breech
Sacrum presenting and legs are straight up by head
60
Complete breech
Sacrum and feet presenting
61
Single footling breech
1 leg is extended down
62
Vertex presentation
Chin all the way to chest
Presents smallest part of head
Most ideal
63
Sinciput presentation
Chin tucked some
Military position
64
Brow presentation
Neck flexed
Delays labor and delivery is more difficult
65
Fully engaged or zero station
baby head positioned at ischial spine
66
Start actively pushing at what station
+1 or +2
67
Station of crowning
+5
68
Gyneocoid pelvis
most desired
More traditional size pelvis
69
Cephalopelvis disproportion
Pelvis is too small for larger size of head
70
Powers
Primary powers (uterus contractions)
Secondary powers (maternal efforts- can be affected by epidural, fatigue, and lack of glucose)
71
Position of laboring woman
Widen the pelvis and relax muscles
If baby in OP place mom on hands and knees in hope to turn the baby
72
Effacement
Thinning of cervix
Fingertip length is no thinning
0-100%
73
Dilation
0-10
10 can not feel any cervix
74
Labor
Process of moving fetus, placenta and membranes out of uterus and through birth canal
75
Signs preceding labor
lightening or dropping
bloody show
braxton hicks
mucus plug
nesting
diarrhea
water break- true sign of labor
76
Stages of labor
1st stage- onset of contractions to full dilation
2nd stage- full dilation to birth
3rd stage- birth of fetus to delivery of placenta
4th stage- 2 hours post delivery of placenta (recovery)
77
7 cardinal movements of labor
engagement
descent
flexion
internal rotation
extension
restitution (external rotation)
expulsion (birth)
78
Normal fetal HR
110-160
79
Nursing care focus during labor and birth
assessment
support
best possible outcome
Role is mostly assessment
80
First stage of labor
Begins with onset of regular uterine contractions
Ends with full effacement and dilation
81
Three stages of the first stage of labor
Latent phase
Active phase
Transition phase
82
Latent phase
first stage of labor
Up to 3 cm
Longest phase
Cervix is thinning and dilating
Mothers alter/happy/anxious
83
Active phase
first stage of labor
4 to 7 cm
Stronger and closer contractions
Mothers can only answer questions between contractions
84
Transition phase
first stage of labor
8 to 10 cm
Hardest spot of labor
Contractions are strongest and longest
Mothers less interactive
85
True labor
Must have cervical change, rupture of membranes, stronger and closer contractions, back contractions
86
False labor
Contractions irregular and do not get stronger or closer together, braxton hicks, 1 sided contractions
87
EMTALA
Emergency medical treatment and active labor act
Ensures women receive emergency treatment or labor care
Must check every woman who comes in to make sure they are not in labor
88
Prenatal data
assessment
Due dates
Blood type
Any titers they have done
Anatomy scan
Low or high risk pregnancy
89
Admission data
assessment
Update all questions and info
Ensure all info is correct
# of pregnancies
90
Psychosocial factors
assessment
Exposure to smoking
Use of drugs
Abuse hx
91
Labor plan
assessment
Epidural
Support team
How they react to pain
Comfort measure preference
92
Cultural factors
assessment
Any ritual or practices
Need for translator
93
Physical exam
assessment
Head to tie
Fetal heart tones (should be below belly button)
VS (closely watch BP)
Leopold maneuver (find fetal position)
Vaginal exam (cervix, discharge, leaking fluids)
94
Contraction duration
How long takes to reach peak then go back to normal
95
Frequency of contraction
Start of one contraction to start of another
96
Amniotic fluid
Should be clear and odorless
Yellow- infection
Green- baby had BM in womb
97
Second stage of labor
Infant is born
Begins with full dilation and effacement
Ends with baby's birth
Usually 3 hours for first time moms and 2 hours for second time moms
98
Two phases of second stage of labor
Latent phase- laboring down. allowing contractions to move baby down birth canal
Descent phase- Active pushing and urge to bear down. baby's head is molding
99
Supplies needed for second stage of labor
2 clamps
suction bulb
scissors
blanket
placenta bucket
sterile gloves
towels
gauze
gown
100
Crowning
largest part of head is through
101
Episiotomy
purposeful cuts to allow extra room
1st degree- through first layer of skin
2nd degree- extend through muscle of peritoneum
3rd degree- extend through anal sphincter
4th degree- extend through rectal mucous. Rectum exposed to vagina
102
Third stage of labor
Baby has been born, waiting on placenta
Umbilical cord will change color
Once placenta releases will be gush of blood, pt then gibes small push
103
Fourth stage of labor
VS and fundal massage every 15 minutes for first 2 hours
VS and assessment on baby every 30 minutes
Skin to skin!!!
104
Trimesters
First- week 1 through 13
Second- week 14 through 26
Third- week 27 through 40
105
Nagele rule
Determine first day of LMP subtract 3 months add 7 days plus 1 year
Alternatively add 7 days to LMP and count forward 9 months
106
Maternal adaptations of pregnancy
Accepting the pregnancy
Identifying with mother role
Reordering personal relationships
Establishing relationship with fetus
Preparing for childbirth
107
Paternal adaptations of pregnancy
Accepting the pregnancy
Identifying with father role
Reordering personal relationship
Establishing relationship with fetus
Preparing for childbirth
108
Barriers to obtaining prenatal care
Lack of motivation to seek care
Inadequate finances
Lack of transportation
Inconvenient clinical hours
Problems with child care
109
Initial Prenatal visit
Reason for seeking care
Current pregnancy
Obstetric and gynecologic hx
Health hx
Nutrition hx
drug use and herbal preparations
Family hx
Mental health screening
Intimate partner violence
Physical exam
Lab test
110
Follow-up prenatal visits
Physical exam
Fetal assessment- fundal height, fetal heart tones, gestational age, health status
Clean catch urine
Group B strep test between 35 and 37 weeks
111
Components of early pregnancy classes
Early fetal growth and development
Physiologic and emotional changes of pregnancy
Human sexuality
Nutritional needs
Environmental and workplace hazards
112
Components of late pregnancy classes
Management of discomfort in labor
Relaxation
Breathing techniques
Imagery and visualization
IV meds and epidurals
113
Nutrient needs before conception
Healthful diet before conception ensures adequate nutrients are available for developing fetus
Folate or folic acid intake is important
114
Factors that contribute to increase in nutrient need during pregnancy
Development of uterine-placental-fetal unit
Increase maternal blood volume and constituents
Maternal mammary development
Increased metabolic rate
115
Nutrition issues during pregnancy
Alcohol
Caffeine
Artificial sweeteners
PICA
Food cravings
116
Adolescent pregnancy needs
Nurses work to-
Improve nutritional health by focusing on knowledge and planning of meals
Promote access to prenatal care
Develop nutrition interventions and educational programs effective with adolescents
Understand factors that create barriers to change in adolescent population
117
Preeclampsia
Cause still unknown
Speculation that poor intake of specific nutrients may be contributing factor
Adequate diet best means of prevention
118
Physical activity during pregnancy
Moderate exercise improves muscle tone, shortening course of labor
Liberal amounts of fluid before, during and after
Sufficient calorie intake for pregnancy and exercise
119
Nutrient needs during lactation
Similar to during pregnancy
Calorie intake increase of 330 kcal
Increase maternal weight loss during lactation
Smoking, alcohol, and excessive caffeine should be avoided
120
Nutrition care and teaching
Components of adequate diet
Individualizing diet related to needs, culture, finances
Coping with nutritional-related discomforts
Use nutrition supplements appropriately
Consult or refer to other professional
