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OB > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

Antepartum

A

time between conception and onset of labor, usually used to describe the period during which a women is pregnant, interchangeable with prenatal

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2
Q

Intrapartum

A

time from onset of labor until the birth of the infant and placenta

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3
Q

Postpartum

A

time from birth until the woman’s body returns to an essentially prepregnant condition

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4
Q

gestation

A

number of weeks since the first day of the last menstrual period

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5
Q

Abortion

A

birth that occurs before 20 weeks gestation or birth of fetus-newborn who weighs less than 500g

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6
Q

term

A

normal duration of pregnancy

38-42 weeks

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7
Q

preterm or premature labor

A

labor that occurs after 20 weeks but before the completion of 37 weeks gestation

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8
Q

Posterm labor

A

labor that occurs after 42 weeks

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9
Q

Gravida

A

any pregnancy, regardless of duration, including present pregnancy

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10
Q

Nulligravida

A

a women who has never been pregnant

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11
Q

Primigravida

A

a women who is pregnant for her first time

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12
Q

Multigravida

A

a woman who is in her second or any subsequent pregnancy

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13
Q

Para

A

birth after 20 weeks, regardless of whether the infant is born dead or alive

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14
Q

Nullipara

A

a woman who has not given birth at more than 20 weeks gestation

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15
Q

Primipara

A

a woman who has had one birth at more than 20 weeks geastation, regardless of whether the infant is born dead or alive

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16
Q

Multipara

A

a woman who has had two or more births at more than 20 weeks gestation

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17
Q

stillbirth

A

a fetus born dead after 20 weeks gestation

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18
Q

chloasma

A

brownish pigmentation over the bridge of the nose and cheeks during pregnancy

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19
Q

linea nigra

A

the darker line of pigmentation extending from the umbilicus to the pubis noted in some women during the later months of pregnancy

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20
Q

straie

A

stretch mars, shiney purplish lines that appear on the abdomen, breast and thighs of some pregnant women

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21
Q

Diastasis Recti

A

Seperation of the recti abdominis muscle alone the median line usually seen with repeated childbirths

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22
Q

Presumptive signs of pregnancy

A 
Fatigue (12 weeks) 
breast tendernesss (3-4 weeks)
Nausea and vomiting (4-14 weeks)
amenorrhea (4 weeks)
Urinary frequency (6-12 weeks)
Hyperpigmentation of skin (16 weeks)
fetal movements (16-20 weeks)
Uterine enlargement (7-12 wks)
breast enlargment (6 wks)
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23
Q

probable signs of pregnancy

A 
braxton hicks contractions (16-28 wks)
positive pregnancy test (4-12 wks)
abdominal enlargement (14 wks)
ballottement (16-28 wks)
goodell's sign (5 wks)
chadwick's sign ( 6-8 wks)
hegars sign (6-12 wks)
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24
Q

positive signs of pregnancy

A

ultrasound (4-6 wks)
fetal movement felt by clinician (20 wks)
doppler of fetal heart tones (10-12 wks)

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25
Q

Hegar’s sign

A

softening of the lower uterine segment or isthmus

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26
Q

Goodell’s sign

A

softening of the cervx

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27
Q

Chadwick’s sign

A

bluish-purple coloration of the vaginal mucosa and cervix

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28
Q

how much folic acid should women take to reduce the risk of neural tube defects?

A

400-800 mcg

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29
Q

Weight gain for health BMI

A

1st trimester = 3- 5.5 lb
2nd & 3rd = 1 lb/ week
25-35 lbs

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30
Q

weight gain for underweight BMI (

A

1st tri = 5lb
2nd &3rd= 1+ / week
28-40 lbs

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31
Q

overweight BMI (>25) weight gain

A

1st = 2 lb
2nd & 3rd = 2/3 lb/week
15-25 pounds

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32
Q

how many extra calories a day does a pregnant woman need to intake?

A

300

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33
Q

how many extra calories a day does a breastfeed mom need to intake?

A

500

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34
Q

how much fluid should a pregnant women be drinking and why?

A

8-10 8 oz glasses

help with constipation and bladder infections

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35
Q

Why should all pregnant women take Iron?

How much?

A

hematocrit in pregnancy lowers
increase fetal demands in 3rd trimester
30 mg

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36
Q

what should pregnant women watch out for and not consume?

A
  • Caffeine- less than 300 mg/day
  • alcohol
  • fish- limit to 12 oz/week and dont eat same more than once a week
  • artificial sweeteners- 50 mg/kg/day
  • herbal supplements-some known to stimulate contractions
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37
Q

placenta abruption assessment

A
  • rigid board like abdomen
  • dark red bleeding
  • knife like pain
  • decreased fetal movement and activity
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38
Q

variables on FHR monitors

interventions?

A

cord compression

reposition mom

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39
Q

earlys on FHR monitor and interventions?

A

head compression

vaginal examination
prepare for delivery

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40
Q

accelerations on FHR monitor and interventions?

A

optimal

baby is doing well

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41
Q

late on the fetal heart monitor and interventions?

A

placenta insufficiency

turn off pitocin
administer oxygen
reposition

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42
Q

what happens when the placenta is retained after delivery?

A

postpartum hemorrhage

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43
Q

what is the average time period a mom knows she is pregnant?

A

2 weeks after she misses her period

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44
Q

Embryonic stage

A

end of 2nd week through 8th week

basic structures of major body organs and main external features

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45
Q

when a baby implants what starts developing?

A

placenta

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46
Q

Functions of the placenta

A
  • interface between the mother and fetus
  • releases hormones
  • protects fetus from immune attack
  • removes waste from fetus
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47
Q

stages of fetal development

A

preembryonic
embryonic
fetal

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48
Q

what do anterior placentas cause?

A

bleeding

**need have blood ready

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49
Q

oligohydramnios

A

too little amniotic fluid

associated with uteroplacental insufficiency & fetal renal abnormalities

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50
Q

polyhydramnios

A

too much amniotic fluid

associated with maternal diabetes, neural tube defects, chromosomal deviations and malformations of CNS or GI tract

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51
Q

what does the umbilical cord contain?

A

1 large vein

2 small arteries

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52
Q

whats the average size of the umbilical cord at term?

A

22 inches long

1 inch wide

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53
Q

what is meconium?

A

babies first stool

think about baby breathing in and meconium aspiration

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54
Q

what happens if there is to much amniotic fluid? (polyhydramnios)

A
  • pressure on the uterus and its hyper-extended

- risk for uterine rupture and preterm labor

55
Q

if there is a suspected rupture of amniotic fluid what is the definitive test to do?

A

FERN test

56
Q

what are mom and baby at risk for if water is broken?

A

infection

57
Q

what is considered viable for OB?

A

23 weeks

58
Q

what is considered viable for twins?

A

26 weeks

59
Q

3 shunts present during fetal life

A

ductus venosus
ductus arteriosus
foramen ovale

60
Q

how is oxygenated blood carried to the fetus ?

A

through the umbilical vein

61
Q

Amniocentesis safety concerns

A 
infection 
pregnancy loss 
fetal needle injuries 
***educate mom on risk factors 
**definitive test & tells genetic and sex disorders
62
Q

chorionic villus sampling

A

removal of small tissue specimen from the fetal portion of the placenta which reflects the fetal genetic makeup
complications- severe transverse limb defects & spontaneous pregnancy loss

63
Q

percutaneous umbilical blood sampling

A

insertion of a needle into a fetal umbilical vessel under ultrasound
complication- fetal hemmorhage & infection

64
Q

preimplantation genetic diagnosing

A

genetic testing of embryos produced through in vitro fertilization

65
Q

what if a mom tells you they cant take their prenatal vitamins or iron?

A

tell them to change their diet

  • increase green leafys
  • grilled meats
  • strawberry salad
66
Q

what do you do if a pt comes in complaining of midepigastric pain?

A

gallbladder issues

check liver labs

67
Q

what will mom complain of if chest circumference is increasing?

A

their tops not fitting

68
Q

whats the best side for a pregnant mom to lay on?

A

left side

- increases cardiac output

69
Q

what do you worry about when they lay flat on their back?

A

decreased blood flow from the kidneys to the superior vena cava

70
Q

preembryonic stage

A

fertilization to second week

71
Q

embryonic stage

A

end of second week to eighth week

-basic structure of all major body organs and main external features are completed

72
Q

Fetal stage

A

end of 8th week till birth

73
Q

what week can mom tell the gender of the baby?

A

week 12

74
Q

week 13-16 of fetal development

A
  • lanugo develops on head
  • “quickening” detected by mom
  • fingernails and toenails present
  • sucking motions made by mouth
  • external geitalia are recognizable
  • weight quadruples
75
Q

week 17-20 of fetal development

A
  • rapid brain growth
  • fetal heart tones heard with stethoscope
  • muscles are well developed
76
Q

week 21-24 of fetal development

A
  • alveoli forming in the lungs
  • lungs begin to produce surfactant
  • eyelids remain sealed
77
Q

weeks 25-28 of fetal development

A
  • rapid brain development
  • eyes open and close
  • nervous system controls some function
  • blood formation shifts from spleen to bone marrow
  • fetus assumes head down position
  • fingerprints are set
78
Q

week 29-32 of fetal development

A
  • increase in body fat
  • lungs are not fully mature
  • fetus stores iron, calcium and phosphorus
  • aware of sounds outside moms body
79
Q

week 33-38 of fetal development

A
  • lanugo disappears
  • earlobes form
  • strong grasp reflex
  • fetus fills uterus
  • small breast buds
  • mother supplies baby with passing antibodies
80
Q

When does the fetal heart begin to beat at a regular rhythm?

A

5th week

81
Q

alpha fetoprotein

A

sample of womans blood is drawn to evaluate plasma protein.

  • performed at 15-18 weeks
  • increased levels might indicate neural tube defect, turner syndrom, tetralogy of fallot, multiple gestation
  • decreased: downs or trisomy 18
82
Q

when does the uterus move up out of the pelvis into the abdomen?

A

12 weeks

83
Q

cardiovascular adaptations

A
  • 50% increase in blood volume
  • increase CO
  • increase venous return
  • BP drops in 2nd trimester
  • physiologic anemia from increase in RBC’s leading to hemodilution
  • increase iron demands
  • increase fibrin and plasma levels leading to a hypercoagulable state
84
Q

respiratory adaptations

A
  • breathing more diaphragmatic than abdominal due to increase diaphragmatic excursion, chest circumference and tidal volume
  • increase O2 consumption
  • congestion secondary to increased vascularity from estrogen
85
Q

urinary-renal adaptations

A
  • dilation of renal pelvis
  • increase in length and weight of kidneys
  • increase in GFR
  • increase urine flow and volume
  • increase kidney activity with woman lying down
86
Q

integumentary adaptations

A
  • hyperpigmentations
  • linea nigra
  • striae
  • varicosities
  • palmar erythema
  • decline in hair growth
  • increase in nail growth
87
Q

interventions to reduce the risk of developing varicosites

A
  • elevate both legs when sitting or lying down
  • resting in the left lateral position
  • walking daily for exercise
  • avoid tight clothing or knee high hoisery
  • wearing support hose if they are pre-existing condition to pregnancy
88
Q

Thyroid gland adaptations

A
  • slight enlargment
  • increased activity
  • increased BMR
89
Q

Pituitary gland adaptations

A
  • enlarges
  • decrease in TSH and GH
  • inhibition of FSH and LH
  • increase in prolacting & MSH
  • gradual increase in oxytocin with fetal maturation
90
Q

Ambivalence

A
  • having conflicting feelings at the same time
  • experienced during first trimester
  • evolves into acceptance by the second trimester when fetal movement is felt
91
Q

introversion

A
  • focusing on oneself

- heighten during first and third trimester when the mom is focused on a safe and healthy pregnancy outcome

92
Q

acceptance

A
  • second trimester

- physical changes of fetus and enlarging abdomen bring reality and validity of pregnancy

93
Q

Mood swings

A
  • emotional liability is characteristic throughout most pregnancies
  • clear explanation about how common mood swings are during pregnancy are essential
94
Q

medications used for spontaneous abortions

A
  • Misoprostol (cytotec)
  • Mifepristone
  • Cervidil
  • Rh immunoglublin
95
Q

hallmark sign of etopic pregnancy

A

abdominal pain with spotting withing 6 to 8 weeks after missed period

96
Q

nursing assessment of gestational trophoblastic disease

A
  • brownish vaginal bleeding/spotting
  • extremely high levels of hCG
  • uterine size larger than normal for pregnancy date
  • severe morning sickness
  • early development of preeclampsia
97
Q

cervical insufficiency

A

premature dilation of the cervix without contraction that occurs in the second trimester or early in the third trimester before the point of fetal viability.

98
Q

therapeutic management of cervical insufficiency

A
  • bed rest
  • pelvic rest
  • avoidance of heavy lifting
  • cervical cerclage
99
Q

placenta previa

A

when the placenta implants over the cervical os

100
Q

Nursing assessment for placenta previa

A
  • advanced maternal age
  • previous c-section
  • multiparity
  • smoking
  • hypertension or diabetes
  • previous induced abortions
  • infertility treatment
  • painless, bright red bleeding in 2nd or 3rd trimester
  • spontaneous cessation than recurrence
101
Q

Nursing management for placenta previa

A
  • monitor maternal-fetal status
  • assessing signs of vaginal bleeding
  • pad count
  • avoid vaginal exams
  • FHR
  • bed rest
  • no sex
102
Q

abruptio placentae

A

seperation of placenta leading to compromised fetal blood supply after the 20th week of gestation

103
Q

nursing management for abrupto placentae

A
  • bed rest
  • optimizing tissue perfusion while preparing for delivery
  • left lateral position
  • O2
  • IV fluids
  • vitals q 15 mins
  • foley to assess output
  • assess fundal height
  • be on alert for DIC
104
Q

Mild preeclampsia management

A
  • bed rest
  • daily BP monitoring
  • fetal kick counts
  • IV mag sulfate during labor
105
Q

Severe preeclampsia management

A
  • complete bed rest in a dark quite room to reduce any stimulus that may trigger seizures
  • for labor: oxytocin & mag sulfate
106
Q

eclampsia management

A
  • seizure management: clear the airway and administer O2
  • IV fluids
  • Mag sulfate
  • antihypertensive meds
  • then birth
107
Q

antidote for mag toxicity?

A

calcium gluconate

108
Q

HELLP

A

hemolysis
elevated liver enzymes
low platelets

109
Q

HELLP syndrome lab test

A
  • low hematocrit
  • elevated LDH
  • elevated AST
  • elevated ALT
  • elevated BUN
  • elevated bilirubin
  • elevated uric acid and creatinine
  • low platelet
110
Q

signs of infection in a pregnant women with PROM

A
  • elevation in temp and pulse
  • abdominal/uterine tenderness
  • fetal tachycardia
  • elevated WBC and C-reactive protein
  • cloudy, foul smelling amniotic fluid
111
Q

true labor

A
  • contractions are regular , becoming close together, 4-6 mins apart last 30 secs
  • contractions strength gets stronger
  • start in back and radiates to front
  • continue no mater what position your in
  • stay home until they are 5 minutes apart and last 45-60 seconds
112
Q

false labor

A
  • contractions are irregular and dont occur close together
  • they alternate between weak and strong
  • usually felt in the abdomen
  • go away when position is changed
  • drink fluids and walk around to see if there is any change
113
Q

5 P’s

A
  • Passageway (birth canal)
  • passenger (fetus and placenta)
  • powers(contractions)
  • position (maternal)
  • psychological response
114
Q

molding

A

the changed shape of the fetal skull at birth as a result of overlapping of the cranial bones

115
Q

caput succedaneum

A

fluid collected in the scalp along with molding

disappears in 3 to 4 days

116
Q

cephalohematoma

A

collection of blood between the periosteum and the bone that occurs several hours after birth.
does not cross suture lines and resolves in 6 to 8 weeks.

117
Q

anterior fontanel

A

“soft spot”
diamond-shaped space that remains open for 12-18 months allowing the brain to grow.
helps determine the position

118
Q

fetal attitude

A
  • refers to posturing on joints and relationship of fetal parts to one another
  • flexion or extension
119
Q

Cardinal movements of labor

A
  1. engagement
  2. descent
  3. flexion
  4. internal rotation
  5. extension
  6. external rotation
  7. expulsion
120
Q

frequency

A

how often the contractions occur.

measured from the beginning of one contraction to the beginning of the next

121
Q

duration

A

how long the contraction last.

122
Q

benefits of upright and lateral positions during labor

A
  • reduce the length of the first and second stage of labor
  • reduce #of assisted deliveries
  • increase comfort/ reduce request for pain meds
  • enhances mothers sense of control
  • alters shape and size of pelvis
  • assist gravity to move the fetus downward
123
Q

maternal responses to labor

A 
↑ heart rate, cardiac output, increased BP
↑ WBC count
↑ respiratory rate and O2 consumption
↓ gastric motility and food absorption
↓ gastric emptying and gastric pH
Slight temp elevation
Muscle aches/cramps
Increased BMR
↓ blood glucose levels
124
Q

fetal responses to labor

A

Periodic FHR accelerations and slight decelerations
↓ in circulation and perfusion
↑ in arterial carbon dioxide pressure
↓ in fetal breathing movements
↓ in fetal oxygen pressure; ↓ in partial pressure of oxygen

125
Q

first stage of labor

A

true labor to complete cervical dilation. consist of latent, active and transition phase.

126
Q

latent phase

A
  • cervical dilation from 0-3 cm

- vitals every 30-60 minutes

127
Q

active phase

A
  • cervical dilation from 4-7 cm

- vitals q 30 minutes

128
Q

transition phase

A

8-10 cm cervical dilation

-vitals q 15-30 minutes

129
Q

second stage of labor

A

from complete dilation to birth of the newborn.

  • vitals q 5-15 mins
  • FHR q 5-15 mins
130
Q

third stage of labor

A

separation and delivery of the placenta

-vitals q 15 mins

131
Q

fourth stage of labor

A

1 to 4 hours following delivery

-vitals q 15 mins

132
Q

uterine atony

A

boggy fundus with red blood flowing

133
Q

retained placenta

A

boggy fundus with dark blood and clots

OB (1 decks)

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