exam 1 Flashcards
(215 cards)
1
Q
how should fundus feel post partum
A
firm.
it should also be midline near the umbilical
2
Q
how is pregnancy weeks dated
A
by last period
3
Q
ovum
A
conception to day 14
4
Q
embryo
A
day 15 to week 8
this is a critical time for organ development
5
Q
fetus
A
week 9 to end of pregnancy
this is the stage when the baby actually starts to look like a baby
6
Q
chorion
A
outer most layer of fetus membrane
7
Q
amnion
A
inside layer closest to baby. Doesn’t have any blood vessels. Gets its nutrients from amnionic fluid. It is more translucent than chorion
thin and translucent, but high in tensile strength
8
Q
yolk sac
A
supplies embryo with oxygen and nutrients until placenta is ready to take over
9
Q
functions of amniotic fluid
A
- Temp regulation
- Cushioning
- Protection for cord
- Keeps embryo from tangling with membranes
- Source of oral fluid- baby swallows it
- Holds waste
- Electrolytes
- Allows for baby to move around
Infection prevention
10
Q
what can too much or not enough amniotic fluid mean
A
possible renal issue
11
Q
explain baby veins and arteries
A
The arteries are carrying deoxygenated blood and vein carries oxygenated blood
This is because blood has to go to placenta from arteries to get oxygen then it returns in vein
12
Q
how many arteries and veins are in the umbilical cord
A
2 arteries, 1 vein
13
Q
wharton’s jelly
A
connective tissue around arteries and veins that keeps them from being compressed
14
Q
nuchal cord
A
Umbilical cord wrapped around baby’s neck
15
Q
where should umbilical cord be at on placenta
A
in the center
16
Q
schultz
A
fetal side of placenta
17
Q
duncan
A
maternal side of placenta
18
Q
does mother’s blood mix with babies
A
no
19
Q
human chorionic gonadotropin (hCG)
A
what pregnancy tests check for. Keeps the corpus ledum functional to maintain pregnancy
If these are high then suddenly drop- miscarriage
placental hormone
20
Q
human chorionic somatomammotropin (hCS)
A
fetal growth hormone, breast development for lactation. Causes insulin resistance
placenta functions
21
Q
Estrogen and progesterone
A
hormones that maintain pregnancy
they increase over pregnancy
22
Q
maintains endometrium during pregnancy
A
progesterone
23
Q
stimulates uterine growth and blood flow during pregnancy
A
estrogen
24
Q
relaxin
A
hormone that relaxes ligaments to help prepare for baby to go through birth canal. Makes women waddle
25
placenta metabolic functions
respiration- functions as lungs
nutrition and storage of nutrients
excretion
26
hormone that spikes in early pregnancy then settles down around 20 weeks
hCG
27
what stage is teratogens most concerning
embryo
28
normal fetal heart rate
110-160 bpm
29
Monitors contractions and baby's HR
external fetal monitor
30
variable deceleration
a decrease in heart rate from baseline caused by umbilical cord being compressed
needs to be 15 beats below baseline to be considered for this
looks like a V shape on monitor
we want to reposition mom when this happens
31
early deceleration
gradual decrease in fetal heart rate that occurs with contractions. Caused by head compression. This is usually a good thing because it means the baby is descending and we should begin to prepare for birth
32
late deceleration
a gradual onset of deceleration that happens after the peak of contraction. It is not reassuring, and means there is a placenta insufficiency. We need to reposition, stop pitocin, call provider and possibly prepare for C section
33
acceleration
increase in baseline of baby HR by 15 beats above for at least 15 secs. This is good so we know baby has good oxygen
34
variability
fluctuation in baby baseline HR. We want to see this
35
absent variablity
no variability/change in HR. Not reassuring, call provider
36
minimal variability
some variability, but less than 5 bpm. If this occurs more than 30 mins a intervention is needed
37
moderate variability
What we like to see, bpm is 6-25 beats above baseline. lets us know fetus has good oxygen reserve
38
what causes minimal variability - 3 S's
sleeping- baby
sedative
sick
39
nadir
lowest point of baby's deceleration on monitor
40
peak
upper point of moms contraction on monitor
41
priority intervention after water breakage
monitor fetal HR to make sure umbilical cord isn't decompressed
42
timed from beginning of one contraction to the beginning of another
frequency
43
measured by counting the seconds between onset and ending of a contraction
duration
44
measured by palpation when you have a external monitor, or by a internal monitor
strength
44
fetal tachycardia
above 160 bpm for 10 mins
44
fetal bradycardia
below 110 for 10 mins
45
how should fundus feel
Should feel like bouncy ball
Expected to be around umbilicus- it should go lower each day
We want it to be midline
46
how long will post partum mom bleed
Mom can bleed up to 6 weeks. But more commonly 3-4 weeks
47
Magnesium sulfate
mineral/electrolyte replacement. prevents seizures from severe eclampsia and preeclampsia
neuroprotective
tocolytic- stop contraction
diarrhea common
48
terbutaline
tocolytic- stops contractions
bronchodilator
may cause nervous tremor
49
nifedipine (procardia)
tocolytic- stops contractions
CCB relaxes smooth muscle
SE- arrhythmia, peripheral edema
50
indocin
tocolytic- stops contractions
antirheumatic, NSAID
51
Oxytocin
tocogenic- increases contractions
prevents/treats postpartum hemorrhage
hormone- induces labor. also has antidiuretic effects
SE- coma, seizure, painful contraction, intracranial hemorrhage
52
misoprostol (cytotec)
tocogenic- increases contractions
prevents/treats postpartum hemorrhage
antiulcer, prostaglandin
causes labor induction
SE- miscarriage, abdominal pain, diarrhea
53
cervidil
tocogenic- increases contractions
oxytocic, prostaglandin
given to ripen the cervix
dilates cervix, stimulates myometrium
SE- amniotic fluid embolism
54
betamethasone (celestone)
anti inflammatory, corticosteroid
unlabeled- gave to high risk mothers to prevent resp distress syndrome in new borns
SE- thromboembolism, HTN, nausea
55
common analgesics gave for postpartum patients
ibuprofen (motrin)
acetaminophen (tylenol)
ketorolac (toradol)
oxycodone
hydrocodone/acetaminophen (norco)
morphine
56
antiemetics for post partum patients
prevents nausea
ondansetron (zofran)
promethazine (phenergan)
57
common antihypertensives for postpartum patients
nifedipine (procardia)- CCB. SE- peripheral edema, flushing
labetalol- beta blocker. SE- bradycardia, orthohypo, fatigue
hydralazine (apresoline)- vasodilator. SE-drug induced lupus, tachycardia
58
postpartum meds for GI issues
docusate (collate)- laxative stool softener
simethicone- antiflatulent
59
methylergometrine (methergine)
prevents/treats postpartum bleeding
oxytocic- ergot alkaloids
SE- HTN, stroke, N/V
60
Carboprost tromethamine (hemabate)
prevents/treats postpartum hemorrhage
oxytocic. prostaglandin
SE- diarrhea, uterine rupture, N/V
61
antibiotics commonly used for newborns
ampicillin, gentamycin
62
drugs commonly given to newborns for neonatal abstinence syndrome
morphine
lorazepam (ativan)- anti anxiety
clonidine- antihyp. management of opioid withdrawal
63
common drugs given to newborns
surfactant
erythromycin eye ointmemt
vitamin K
hep B vaccine
64
hormones from placenta
human chorionic gonadotrophin', human placental lactogen, placental growth hormone, relaxin and kisspeptin.
65
gravida
pregnancy
66
gravidity
number of pregnancies. includes miscarriages and abortion
twins count as 1
67
nulligravida
woman who has never been pregnant
68
primigravida
woman pregnant for the first time
69
multigravida
woman who has had 2 or more pregnancies
70
viability
capacity to live outside the uterus.
occurs 22-24 weeks after last menstrual period or when fetus weighs 500g
71
parity
number of pregnancies in which fetus/fetuses have reached viability
not counted until baby is born
72
nullipara
woman who has not completed a pregnancy with fetus/fetuses who have reached stage of fetal variability
73
primipara
woman who has completed one pregnancy with fetus/fetuses who have reached stage of fetal viability
74
multipara
woman who has completed two or more pregnancies to stage of fetal viability
75
preterm
pregnancy that has reached 20 weeks of gestation but birthed before 37 weeks
76
early term
37-38 weeks
77
full term
39-40 weeks
78
late term
41 weeks
79
posttterm
42 weeks and beyond
80
GTPAL
G= gravidity
T= term - 37 weeks and above
P= preterm - before 37 weeks
A= abortion or spontaneous abortion "miscarriage"
L= living children
81
what can cause a higher than normal level of hCG in pregnancy
multiple fetuses, down syndrome baby
82
give an example of decreased hCG in pregnancy
miscarriage, sickness
83
3P signs of pregnancy
presumptive- subjective from mom
probable- objective from health care
positive- ultrasound confirmation
84
Normal pregnancy changes of the uterus
changes in size, shape, positions
changes in contactility
uteroplacental blood flow
Hegar sign
85
Hegar sign
uterus softens
normal in pregnancy
86
normal changes of cervix in pregnancy
goodell sign
friability
change in shape
87
friability
Tissue is very easily damaged- mom may have bleeding with vaginal exam due to increased vascularity
normal change in pregnancy
88
goodell sign
cervix softens
normal change in pregnancy
89
normal changes of vagina and vulva in pregnancy
chadwick's sign
leukorrhea- Increase vaginal discharge- good b/c it helps prevent infection. White or gray. Smells musty. Make sure its not an infection discharge
changes in vaginal microbiome
edema
90
chadwick's sign
Bluing of mucosa of vagina/mucosa 6 weeks in due to vascularity
normal change in pregnancy
91
ballottement
The fetus could float a little bit if provider taps on cervix
normal pregnancy finding
92
quickening
First fetal movements- small. Happens in 14-20 weeks. First time moms usually 20.
93
normal breast changes in pregnancy
more sensitive and sore
fullness/heaviness
areolae becomes more pigmented
montgomery tubercles
colostrum
striae gravidarum- stretch marks. Never goes away only fades
94
montgomery tubercles
Sebaceous oil glands on areola that secrete oil and anti-infective on areola
95
inhibits contraction of smooth muscle- relaxes
progesterone
96
normal GI effects of pregnancy
morning sickness related to increased hHG
decreased motility- N/V/C
hemorrhoids
bleeding gums related to vasocongestion
indigestion related to increased progesterone
PICA- weird cravings
increased incidence of gall stones
97
how is blood volume affected in a healthy pregnancy
it increases by 1200-1500 mL or 40-50%
97
how is BP affected in healthy pregnancy
it will either go down 5-10 mmHg or stay the same. This is due to vasodilation
98
how much will maternal pulse go up in healthy pregnancy
15-20 bpm
99
what happens to moms RBC, WBC and plasma in healthy pregnancy
RBC will go up 20-30%
plasma will go up 40-60%
WBC could go up to about 15, but could go even higher in delivery (unpregnant normal is 5-10)
100
what happens as a result of the more plasma then RBC in pregnant woman
anemia because of the dilution of the higher amount of plasma
101
H&H levels in pregnant woman
Normal female hemoglobin- 12-16. expect 10.5-11 in pregnancy
Normal hematocrit 37-47. expect 32-33 in pregnancy
102
what happens to cardiac output in pregnancy
it will increase by 30-50% by first 32 weeks, then decrease 20% by week 40
103
why are pregnant women more at risk for clots
clotting factors are increased and fibrinolytic activity is decreased.
5-6x more at risk for clot
This is good if mom hemorrhages because theyre more likely to clot
104
how should mom lay
ON SIDE NOT ON BACK
Lying on side helps reduce compressing the vena cava, and facilitates renal perfusion
105
what changes occurs related to respiratory system in mom during pregnancy
o2 requirements increase
RR increases slightly
BMR increases b/c of o2 demands
SOB increases due to lower co2 threshold
nasal stuffiness increases
nose bleeds due to increased vascularity
106
normal renal changes of mom during healthy pregnancy
anatomic changes
hormonal activity
pressure from enlarged uterus
increase in BV
Increased GFR
increased renal plasma flow
moms will feel like they need to pee more
107
normal integumentary changes during pregnancy
chloasma- blanching on face
linea nigra- Pigmentation line from pubic bone to umbilicus. Will fade away after
striae gravidum
palmar erythema
angiomas
pruritus gravidarum- itching over abdomen
gum hypertrophy
accelerated nail growth
hirsutism
increased perspiration
108
normal musculoskeletal changes for mom in pregnancy
center of gravity shifts forward
lordosis
pregnant waddle
109
normal neurologic changes for mom in healthy pregnancy
sensory changes in legs related to compression of pelvic nerves or vascular stasis
carpal tunnel syndrome from edema
acroesthesia (numbness and tingling of hands), tension headache and lightheadedness and syncope related to vasomotor instability, postural hypotension, hypoglycemia
110
serum prolactin
Prepares breasts for lactation
111
oxytocin
Stimulates uterine contractions; stimulates milk ejection from breasts after birth
112
different ways to say when baby will be born
EDC- estimated date of confinement
EDD- estimated date delivery
EDB- estimated date of birth
113
naegeles rule
predicts when the baby will be born by last menstrual period
114
sibling adaptation to pregnancy
Age 1-2 not very aware
3-4 lots of questions
School age- ask how its coming out/getting in
Adolescents- embarrassed
Older teenagers- excited but don’t care
115
grandparent adaptation to pregnancy
Can be excited
Might be over the top for mom trying to control her
Might be unhappy because they feel old
116
parent adaptation to pregnancy
mom adapts emotionally and early
dad typically reacts later in pregnancy
117
initial visit: first pregnancy visit: what is discussed
OBGYN history
medical history
nutritional history
reason for seeking care
medications/drugs currently being taken
family history
social and occupational history
mental health screening
intimate partner violence
review of symptoms
physical exam-Head-toe, pelvic exam, pap smear
lab test- urine, cervical, blood
STI test
118
healthy pregnancy follow up visits entails what
interview
physical exam
fetal assessment
labs- glucose, MSAFP (screens for nueral tube defects), urine test for protein, glucose, GBS (checks for group B strep in vagina/anus- if not then antibiotics needed)
ultrasound
amniocentesis
119
should pregnant moms receive live vaccines
No
119
expected weight gain for underweight woman for pregnancy
12.5-18kg (28-40 lbs)
120
expected weight gain for normal BMO woman for pregnancy
11.5-16 kg (25-35 lbs)
121
expected weight gain for overweight woman for pregnancy
7-11.5 kg (15-25 lbs)
122
expected weight gain for obese woman for pregnancy
5-9 kg (11-20 lbs)
123
how much folic acid should woman in childbearing ages take
400mcg/day
pregnancies with low folic acid are more likely to develop neural tube defects like spina bifida
124
how many kcal for 1st trimester
1800
125
how many kcal for 2nd trimester
2200
126
how many kcal for 3rd trimester
2400
127
what direction should uterus rotate to
right
128
braxton hicks
intermittent uterine contractions that may occur after 4 months
129
biochemical assessment
uses blood, body fluid or tissue samples
130
biophysical assessment
uses technology.
physical assessment of fetal well being
131
factors that originate within the mother or fetus and affect the development or functioning of either one or both
ex- nutrition status
biophysical risks
132
maternal behaviors and adverse lifestyle
ex- smoking
psychosocial risk
133
arises from mother and her family
ex- poverty
sociodemographic risks
134
hazards in work place and general environment
environmental factor risks
135
daily fetal movement count
kick count
simple way to evaluate the condition of the fetus
several methods
- once a day for 60 mins
-2-3 times daily for 2 hours or until 10 movements are counted
-10 movements in 12 hour period
136
ultrasound
can indicate fetal heart rate, gestational age, fetal growth, fetal anatomy, fetal genetic disorders, placental position
assesses doppler blood flow analysis, amniotic fluid volume, biophysical profile
137
transvaginal vs abdominal ultrasound
Abdominal- mom needs full bladders
Transvaginal is done thru vaginal and can diagnose pregnancy earlier. Works better than abdominal for obese patients.
138
decrease in amniotic fluid
oligohydramnios
139
increase in amniotic fluid
polyhydramnios
140
what can doppler blood flow analysis diagnose
fetal anemia and restricted growth, can measure amniotic fluid volume
141
biophysical profile (BPP)
includes amniotic fluid volume, fetal breath movements, fetal movements, fetal tone, fetal heart rate reactivity from nonstress test.
measured bt ultrasound, done in late 2nd trimester or early 3rd
normal score is 8-10
142
amniocentesis
used to look for genetic concerns or fetal lung maturity
done as early as 15 weeks gestation
143
maternal risk amniocentesis
hemorrhage, infection, labor, abruptio placentae, damage to intestines/bladder, amniotic fluid embolism
144
fetal risk amniocentesis
death, hemorrhage, infection (amnionitis), injury from needle, miscarriage or preterm labor, leakage of amniotic fluid
145
chronic villus sampling (CVS)
performed between 10-13 weeks gestation
removes small tissue specimen from fetal portion of placenta
146
percutaneous umbilical blood sampling (PUBS)
Offers direct access to fetal circulation.
insertion of needle directly into fetal umbilical vessel under ultrasound guidance.
used for fetal sampling and transfusion. can assess infection
147
alpha fetoprotein (AFP)
Screens for neural tube defects
148
Multiple marker screens
Detects chromosome abnormalities
149
coombs test (indirect)
Screens for RH alloimmunization- if mom produces antibodies against RH pos blood
150
cell free (DNA) screening
Non invasive prenatal genetic diagnosis test that can look at gender and more
151
hydrops fetalis
baby is at risk for this is mom has positive coombs. Causes edema
152
reactive NST vs nonreactive
Reactive- 2 accelerations in 20 mins
Nonreactive- if fetus doesn’t show 2 accelerations in the 20 min period. Is baby possibly sleeping?
153
Nonstress Test (NST)
Noninvasive, easy to perform, no contraindications, inexpensive
Determines if interoutero environment is supportive to fetus
Mom is put on monitor and we monitor fetal HR. testing starts 32 weeks if needed. Mom presses a button when she feels fetal movement
154
Contraction Stress Test (CST)
May also be called oxytocin stress test (OCT)
Identifies if fetus is compromised when put under stress- contractions
uses fetal monitoring
DONT PERFORM THIS IF PATIENT IS PRETERM OR DOING C SECTION BIRTH
155
Positive CST
baby has late decelerations after contraction,
156
pregestational diabetes
type 1 or 2 diabetes prior to pregnancy
157
gestational diabetes
carbohydrate intolerance that develops during pregnancy
158
metabolic changes with pregnancy
1st trimester- insulin sensitivity- Body will require smaller amounts of insulin to lower BG
2nd & 3rd trimester- insulin resistance- Hormones act as insulin antagonist, leading to insulin resistance
159
why does insulin needs drop after birth
the placenta was the source of need
160
does most pregestational woman need insulin
yes
161
maternal risks of pregestational diabetes
fetal macrosomia
spontaneous abortion
preterm labor/birth
HTN/preeclampsia
polyhydramnios
infections
DKA
hypoglycemia
162
fetal macrosomia
Baby is larger, greater than 4000g
163
fetal complications of pregestational diabetes
congenital anomalies
hypoglycemia
fetal macrosomia
IUGR- intrauterine growth hormone
prematurity
stillbirth
164
why is fetus at risk for hypoglycemia when mother is hyperglycemic
because baby is producing insulin due to moms hyperglycemic state
165
LGA
large for gestational age
Risk for shoulder dystocia
166
IUGR
Intrauterine growth restriction, also called FGR. From placental insufficiency
167
Hypoglycemic symptoms
nervousness, headache, shaking, hunger, blurred vision, sweaty, irritability
168
hyperglycemia symptoms
increased thirst, difficulty concentrating, fruity breath, increased hunger, N/V
169
Intrapartum management of diabetes
Labor causes stress, can increase BG. We monitor them very closely
We try to keep there blood sugar between 90-100
170
what could GDM lead to
preeclampsia, C section, developing type 2 diabetes
171
risk factors for developing GDM
HTN, family history, obesity, diet
172
BG levels we want to see for GDM
Fasting- 60-105
1hr post meal <140
2hr post meal <120
2am-6am >60
173
Glucose test
First glucose test- 1 hour, 50g glucose
If they fail that,
Second test (days later)- 3hr test, 150g glucose
174
fetal macrosomia effects that could happen to baby
brachial plexus palsy
facial nerve injury
humerus/clavicle
cephalhematoma
175
antepartum care for GDM
Insulin therapy
Urine testing-looking for ketones
Diet and exercise
Fetal surveillance - NST, ultrasound, fetal monitoring
Moms should be checking their BG 4x daily
176
antepartum
before birth phase
177
intrapartum
during birth phase
178
cardiac disorder management
focused on minimizing stress on the heart
treat infections asap
high protein, adequate calories, fluid and fiber, balanced diet with iron & folic acid supplements
meds
cardiac meds
stool softeners
anticoagulant therapy
If mom doesn’t have cardiac output baby wont get good oxygen
Moms are in a hypercoagulative state- blood thinners
179
gestational HTN
Systolic BP of 140 or more; or diastolic of 90 or more. It can be one or the either, or both
this needs to occur after 20 weeks gestation in a woman with a previously normal BP.
needs to have 2 separate occasions at least 4 hours apart
180
preeclampsia
HTN and proteinuria develops in a pregnant, greater than 20 weeks gestation
181
proteinuria diagnostics
300 mg of protein in a 24hr urine
Protein creatinine ratio- 0.3
protein on dipstick
182
Eclampsia
onset of seizure activity or coma in a woman with preeclampsia who has no history of pre-existing pathology that can result in seizure activity
183
chronic HTN disorder
defined as HTN that is present before pregnancy or before 20 weeks gestation
women with this are more at risk for superimposed preeclampsia with a greater risk for fetal mortality
184
etiology of preeclampsia
BP is increased, arteries are constricted not allowing much blood, causing decreased placental effusion. Epithelial cell activation- blood vessels are leaking, causing 3rd spacing. Low platelet levels occurs because platelets are trying to fix damaged cells. overall this leads to decreased organ perfusion
185
preeclampsia without severe features
HTN >140/90
proteinuria of >300mg in 24 hr specimen
low platelet count under 100
elevated ALT, AST
creatine above >1.1
pulmonary edema
cerebral/visual disturbances
at home care
monitor daily weight, BP, kick counts
186
severe preeclampsia
worsening symptoms overall
BP >160/110
abnormal liver function with RUQ pain unresponsive to meds
and same symptoms of preeclampsia but worse
hospitalization occurs.
mag sulfate, & hydralazine or labetalol or nifedipine given
pad side rails in case of seizure
187
HELLP syndrome
hemolysis- increased RBC bc trying to make more bc of damage
elevated liver enzymes (AST, ALTL
low platelets
delivery will occur no matter the fetus age with this syndrome
If they develop this they are most at risk for DIC (disseminated intravascular coagulation) which could cause them to bleed out
188
what can happen with increasing liver enzymes
risk for liver rupture
assess for RUQ pain.
they may describe it as epigastric
189
what to monitor for with mag sulfate
refluxes, RR, pulse ox, mag tox
190
normal dosing of mag sulfate and antidote
Bolus- 4g over 30 mins
Maintence- 2g/hr
antidote- calcium gluconate
191
eclampsia management
call for assistance- dont leave bedside
maintain airway
assist to side laying
suction
O2 at 10L/min
monitor vitals
insert foley
admin mag sulfate
maintain quiet environment
prepare for delivery
192
hyperemesis gravidarum
excessive vomiting causing weight loss, electrolyte imbalance, nutritional deficiencies, ketonuria
possible TPN needed
NPO for 24-48 hrs
administer pyridoxine (vitamin B6) and doxylamine (unisom)
assess nutritional status, emotional status, FHR, daily weight, I&O
labs to monitor- CBC, UA, liver function, bilirubin levels, electrolytes
193
causes of early pregnancy bleeding
miscarriage
ectopic pregnancy
molar pregnancy
194
miscarriage (spontaneous abortion)
unintended loss of pregnancy before viability of fetus (<20 weeks gestation), or weight of <500g
caused by chromosomal abnormalities or from medical conditions
provide emotional support
assess vaginal bleeding
assess for s/s of hypovolemic shock
monitor I&O
refer to social support
195
threatened abortion
Bleeding and cervix remains closed. May subside and pregnancy could be fine
196
inevitable/imminent abortion
Bleeding and cervical dilation. Typically pregnancy can't continue
197
incomplete abortion
Products of conception still left. Causes heavy bleeding
198
missed abortion
Baby no longer has heart beat
199
complete abortion
no products of conception left in body
200
cervical insufficiecy
asymptomatic, back pain, heavy discharge
manages by cerclage placement
201
ectopic pregnancy
pregnancy occurs outside uterus
before rupture may go unnoticed but after rupture is a lot of pain and bleeding
diagnosed by ultrasound
202
hydatidiform mole (molar pregnancy)
fertilized egg with no nucleus
could lead to choriocarcinoma
HCG levels should drop, not increase
after this occurs pregnancy should be avoided for at least a year to avoid the cancer risk
203
placenta previa
placenta is implanted in uterine segment near cervix
these patients must deliver via C section
204
different types of placenta previa
Marginal- less than 2cm away then cervix
Partial- covers part of cervix
Complete- covers entire cervix
205
PREVIA- symptoms
P=painless bright red bleeding
R=relaxed soft uterus non tender
E= episodes of bleeding
V= visible bleeding
I= intercourse post bleeding
A= abnormal fetal position
206
abruptio placentae
premature separation of placenta
-serious complication that accounts for significant morbidity or mortality
riskfactor - HTN
207
placenta abruptio symtoms- DETACHED
D= dark red bleeding
E= extended fundal height
T=tender uterus
A= abdominal pain
C= concealed bleeding
H= hard abdomen
E= experience DIC
D= distressed baby
208
what anemia is most common in pregnancy
iron deficiency
209
intrahapatic cholestasis of pregnancy
common liver disease of pregnancy. It is characterized by generalized pruritus that usually begins in the third trimester of pregnancy.
cause is unknown
jaundice may be present
210
Antidote for magnesium sulfate
Calcium gluconate
211
APGAR
Activity
Pulse
Grimace
Appearance
Respiration
