Exam 1 Content Flashcards
(110 cards)
1
Q
Gravida (G)
KNOW THIS!!!!!
A
Total number of confirmed pregnancies
- regardless of whether the pregnancies resulted in birth, miscarraige, abortion, or ectopic pregnancy
2
Q
Para (P)
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A
Number of pregnancies in which the fetus or fetuses have reached 20 weeks gestation
*
Para has 4 categories:
* Term (T)
* Preterm (P)
* Abortion (A)
* Living (L)
- NOT the number of individual fetuses (twins = 1 pregnancy)
3
Q
Term (T)
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Can also be “F” for full term
A
Number of pregnacies resulting in full term birth
* 37+ weeks gestation
4
Q
Preterm (P)
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A
Number of pregnancies resulting in preterm birth
* 20 - 36 weeks gestation
5
Q
Abortion (A)
KNOW THIS!!!!!
A
Number of pregnancies that ended BEFORE 20 weeks gestation
- due to miscarraige or elective abortion
6
Q
Living (L)
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A
Number of currently living children the woman has
7
Q
How many weeks is considered full term?
KNOW THIS!!!!!
A
37+ weeks gestation
8
Q
How many weeks is considered a pre-term birth?
KNOW THIS!!!!!
A
20 - 36 weeks gestation
9
Q
An abortion is a pregnancy that ends before how many weeks gestation?
KNOW THIS!!!!!
A
BEFORE 20 weeks gestation
10
Q
Define each trimester
A
First Trimester
* 1 - 13 weeks
Second Trimester
* 14 - 26 weeks
Third Trimester
* 27 - 40 weeks
11
Q
What is EDC?
KNOW THIS!!!!!
A
Estimated Date of Confinement
* due date
12
Q
Naegle’s Rule
KNOW THIS!!!!!
A
Used to determine estimated date of birth
- date of LMP - 3 months + 7 days
13
Q
Primigravida
A
First pregnancy
14
Q
Multigravida
A
2 or more pregnancies
15
Q
Precipitous Birth
A
Quick birth
* onset to birth is less than 3 hours (from time water breaks to birth of the baby)
16
Q
What is the postpartum period?
A
From delivery of the placenta to the return of the reproductive system to the non-pregnant state
- usually 6-8 weeks
17
Q
Prenatal Visit Schedule
A
- First visit within first trimester (12 weeks)
- Monthly visits between 16 - 28 weeks
- Visits every 2 weeks from 29 - 36 weeks
- Weekly visits from 36 weeks until birth
18
Q
What is involution?
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A
When the uterus returns to pre-birth state
* within 12 hours palpate the fundus 1 cm above the umbilicus; make sure the bladder is empty
- by 2 weeks the fundus should NOT be palpable
19
Q
When should the fundus no longer be palpable after birth?
KNOW THIS!!!!
A
2 weeks
20
Q
What is subinvolution?
KNOW THIS!!!!!
A
Uterus fails to return to pre-pregnancy state / size
- caused by retained placental fragments & infection
21
Q
There is an increased risk of what if the placenta is left inside the body and not all segments are removed?
KNOW THIS!!!!!
A
Risk of hemorrhage
22
Q
Lochia
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A
Combination of blood, mucus, & tissue discharged from the uterine lining
* 3 types: rubra, serosa, alba
23
Q
Lochia Rubra
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A
- Rubra = Ruby Red
- 1-3 days
- May have small clots
- Reddish or red-brown vaginal discharge that occurs immediately after childbirth
- mostly composed of blood with clots (grape sized clots)
24
Q
Lochia Serosa
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A
- Pinkish brown
- 4 - 10 days after delivery
- pink, serous, or blood-tinged vaginal discharge
- pinkish / brown
- little to no clotting
25
**Lochia Alba**
| **KNOW THIS!!!!!**
* **Whitish yellow**
* **10 - 14 days**
* Can last *3 - 6 weeks*
## Footnote
* *White, cream-colored, or yellow* vaginal discharge that occurs *10 days but can last up to 6+ weeks* after delivery
* contains WBCs
26
**What are the 3 types of lochia & how long do they last?**
| **KNOW THIS!!!!!**
**R**eally **S**ore **A**fter
**Lochia Rubra**
* **R**uby **R**ed
* **1-3 days**
**Lochia Serosa**
* Serous / pink-ish
* **3 - 10 days**
**Lochia Alba**
* white / cream-colored
* **10 - 14 days; may be up to 6 weeks**
## Footnote
**R**eally **S**ore **A**fter
27
**Mnemonic for types of Lochia**
* **R**eally
* **S**ore
* **A**fter
## Footnote
**Really = R**ubra (1-3 days; ruby red)
**Sore = S**erosa (4-10 days; pink/brown)
**After = A**lba (10-14 days but up to 3-6 weeks; white / yellow)
28
**What is the normal Quantitative Blood Loss (QBL) for vaginal & c-section deliveries?**
| **KNOW THIS!!!!!**
**Vaginal < 500 mL**
**C-Section = 1,000 mL**
* 1 g = 1 mL of blood
29
**What might the presence of free-flowing, bright red blood indicate?**
| **KNOW THIS!!!!!**
**Cervical laceration**
30
**Pregnancy is considered to be what type of state?**
| **KNOW THIS!!!!!**
**Hypercoaguable**
## Footnote
* due to increased levels of fibrinogen & clotting factors
31
**What is the most common postpartum complaint?**
| **KNOW THIS!!!!!**
**HEADACHE**
## Footnote
* **Tx = magnesium sulfate**
32
**Preeclampsia**
| **KNOW THIS!!!!!**
A complication of pregnancy characterized by:
* **hypertension** (↑ BP)
* **edema**
* **proteinuria** (protein in urine)
33
**What is a common cause of excess bleeding?**
| **KNOW THIS!!!!!**
**Uterine atony**
34
**What is uterine atony?**
| **KNOW THIS!!!!!**
**Failure of the uterine muscle to contract**
## Footnote
**Tx: hemabate or methergine**
35
**What is the treatment for uterine atony?**
| **KNOW THIS!!!!!**
**Hemabate or Methergine**
36
**Presumptive Signs of Pregnancy**
| **KNOW THIS!!!!!**
**subjective changes experienced by the woman**
* fatigue
* breast changes
* amenorrhea
* nausea / vomiting
* urinary frequency
37
**Probable Signs of Pregnancy**
| **KNOW THIS!!!!!**
**Objective changes** observed / perceived by the examiner that **strongly suggest pregnancy**
* positive pregnancy test
* Hegar sign (softening of uterus)
* Chadwick sign (bluish discoloration of cervix, vagina, labia due to increased blood flow to the area)
* Braxton Hicks contractions
38
**Positive Signs of Pregnancy**
| **KNOW THIS!!!!!**
**Objective changes** observed by the examiner that **indicate proof of pregnancy**
* fetal heart tones
* ultrasound
* fetal movements visible / palpated by examiner
39
**Beta hCG**
**Earliest marker of pregnancy**
* can be detected in maternal serum or urine as soon as 7-8 days before expected menses
* usually doubles every 2 days for first 4 weeks of pregnancy
40
**What are the 4 types of thermal heat loss in a newborn?**
| **KNOW THIS!!!!!**
* **Conduction -** loss of heat from body surface to cooler surface via direct contact
* **Convection -** flow of heat from body surface to cooler air
* **Evaporation -** liquid turns to vapor (*dry baby immediately after birth*)
* **Radiation -** body heat is lost to the envirionment (window, fan, ac, cold walls, etc.)
## Footnote
* **CO**nvection **= CO**ol (air)
41
**What are the 4 factors that stimulate initiation of respiration / breathing for a newborn?**
| **KNOW THIS!!!!!**
* **Chemical**
* **Mechanical**
* **Thermal**
* **Sensory**
## Footnote
* **C**hemical **= C**ontractions
* **M**echanical **=** pressure from labor pushing fluid out of the lungs
* **T**hermal **=** womb temperature to outside temperature
* **S**ensory **= S**uctioning / drying
42
**What is the first organ system to develop in utero?**
**Cardiovascular**
43
**Non-shivering Thermogenesis**
**Use of brown fat to generate heat** without muscle shivering
44
**Normal Respiratory Rate**
**30 - 60 breaths per minute**
## Footnote
* tachy = over 60 bpm
* brady = less than 30 bpm
45
**Normal Fetal Heart Rate**
**120 - 160 bpm**
46
**Normal Fetal Blood Pressure**
**75 - 95**
over
**25 - 45**
47
**Newborn Voiding**
**Should void by 24 hours of life**
* day 1 = 1 void
* day 2 = 2 voids
* etc.
48
**Meconium**
**First BM; passed within 12-24 hours of life**
49
**Can maternal glucose cross the placenta in utero?**
| **KNOW THIS!!!!**
**YES**
50
**When are Apgar scores done?**
| **KNOW THIS!!!!!**
**1, 5, & 10 minutes**
* can be done every 5 minutes up to 20 minutes
51
**What is the difference between newborn tremors & newborn seizures?**
| **KNOW THIS!!!!!**
* **Newborn Tremors or jitters will stop with gentle restraint**
* *Newborn Seizures* are uncontrolled electrical disturbances that *do NOT stop with gentle restraint*
52
**Do newborn seizures or newborn tremors stop with gentle restraint?**
| **KNOW THIS!!!!!**
**Newborn tremors**
53
**Chorioamnionitis**
| **KNOW THIS!!!!!**
**Inflammation of amniotic sac** (the chorion & amnion)
54
**Newborn Eye Prophylaxis**
| **KNOW THIS!!!!!**
**Prevents gonorrhea** tramsnission from mother to baby
* **erythromycin 0.5 - 1 mg within 1-2 hours of birth**
55
**Vitamin K Injection**
| **KNOW THIS!!!!!**
**Given to prevent hemorrhage because the baby's gut is sterile**
* aquamephyton **0.5 - 1 mg IM**
56
**AGA**
| **KNOW THIS!!!!!**
**Appropriate for Gestational Age**
* 50th percentile
57
**LGA**
| **KNOW THIS!!!!!**
**Large for Gestational Age**
* > 90th percentile
58
**SGA**
| **KNOW THIS!!!!!**
**Small for Gestational Age**
* < 10th percentile
59
**Caput Succedaneum**
| **KNOW THIS!!!!!**
generalized scalp **swelling** that **CROSSES the suture line**
## Footnote
* common after vacuum assisted delivery
60
61
**Who is Rh immune globulin administered to?**
| **KNOW THIS!!!!!**
**Rh negative (Rh -) mothers**
62
**What happens if an Rh- mother gives birth to an Rh+ fetus?**
| **KNOW THIS!!!!!!**
**Rh immune globulin is repeated within 72 hours of birth**
63
**What are the 5 P's of Labor & Birth?**
| **KNOW THIS!!!!!!**
* **Passenger:** fetus & placenta
* **Passageway:** birth canal
* **Powers:** contractions
* **Position** of the laboring woman
* **Psychology / Psychological Response**
64
**What 3 fetal indicators does Leopold's Maneuver assess?**
| **KNOW THIS!!!!!!**
* **Fetal Presentation** (breech, head down / vertex, shoulder etc.)
* **Fetal Lie** (relation of fetus' spine to mother's spine)
* **Fetal Attitude** (relation of fetal body parts to one another; *usually flexed*)
65
**Fetal Lie**
**relationship of the spine **(long axis) **of the fetus to the spine** (long axis) **of the mother**
## Footnote
* either longitudinal/vertical or transverse/horizontal or oblique
66
**Fetal Attitude**
**Relation of the fetus' body parts to one another**
* usually in a **flexed** position
67
**Fetal Position**
Describes the **relationship of the presenting part** of the baby **to the 4 quadrants of the mother's pelvis**
68
**What term is used to describe the relationship of the presenting part to the 4 parts of the mother's pelvis?**
| **KNOW THIS!!!!!!**
**Fetal Position**
69
**Fetal Station**
| **KNOW THIS!!!!!!**
* **Relationship of fetal part ot imaginary line between the maternal ischial spine**
**OR**
* Measure of the **degree of descent of the presenting part through the birth canal**
## Footnote
-5
-4
**-3 = Minimum to rupture membranes;** risk of prolapsed cort if not at -3
-2
-1
**0 (baby is engaged)**
+1
+2
+3
**+4**
**+5** (birth is imminent)
70
**Engagement**
| **KNOW THIS!!!!!!**
**Presenting part of the baby has passed the true pelvis** / is in line with the mother's ischial spine
* **Station 0 = engaged**
71
**Effacement**
| **KNOW THIS!!!!!!**
**Thinning & shortening of the cervix**
## Footnote
**Measured in %**
* when 100%, only thin edge can be palpated
72
**Dilation**
| **KNOW THIS!!!!!!**
**Enlargement or widening of the cervical opening**
* measures from less than 1 cm to 10 cm
## Footnote
**Full Dilation = 10 cm**
73
**Primary Powers**
| **KNOW THIS!!!!!!**
**Involuntary** contractions that are **responsible for effacement & dilation of the cervix, as well as fetal decent**
74
**Secondary Powers**
| **KNOW THIS!!!!!!**
**Voluntary bearing down efforts by the mother**
75
**What is bloody show?**
A small amount of blood at the vagina from ruptured capillaries when the cervix effaces
76
**What is the definition of true labor?**
**dilation & effacement of the cervix AND descent of the fetus**
77
**Stages of Labor**
| **KNOW THIS!!!!!!**
* **First Stage:** onset of regular contractions to full cervical dilation
* **Second Stage:** full dilation of cervix to birth of infant
* **Third Stage:** birth of infant until delivery of placenta
* **Fourth Stage:** delivery of placenta to first 2 hours postpartum
78
**Define the first stage of labor**
| **KNOW THIS!!!!!!**
**Onset of regular contractions**
to the
**full cervical dilation**
79
**Define the second stage of labor**
| **KNOW THIS!!!!!!**
**Full cervical dilation**
to
**birth of the infant**
80
**Define the third stage of labor**
| **KNOW THIS!!!!!!**
**Birth of the infant**
to the
**delivery of the placenta**
81
**Define the fourth stage of labor**
| **KNOW THIS!!!!!!**
**Delivery of the placenta**
to the
**first 2 hours postpartum**
82
**What is the difference in an ultrasound transducer and a tocotransducer?**
| **KNOW THIS!!!!!**
**Tocotransducer = ** measures **uterine contractions** and is placed **over uterine fundus**
*
**Ultrasound Transducer =** measures the **fetal heart rate (FHR)** and is placed **over fetal back, BELOW mother's umbilicus**
83
**Epidurals**
| **KNOW THIS!!!!**
Can cause **hypotension**
* give fluid bolus of LR 15-30 minutes prior
84
**Ultrasound Transducer**
| **What is the difference in an ultrasound transducer and a tocotransduce
**Measures Fetal Heart Rate**
* placed on **fetal back** & **below mother's umbilicus**
85
**Tocotransducer**
| **KNOW THIS!!!!!**
**Measures uterine contractions**
* placed over **uterine fundus**
86
**Intrauterine pressure catheter (IUPC)**
| **KNOW THIS!!!!!**
Measures **changes in uterine pressure**
87
**Fetal Scalp Electrode**
| **KNOW THIS!!!!!**
**Measures fetal heart rate**
* invasive procedure since electrode goes into fetus' head
* can only be done if membranes are ruptured
88
**What is baseline fetal heart rate (FHR)?**
| **KNOW THIS!!!!!**
**Average rate during a 10 minute segment**
89
**What is the normal range for baseline fetal heart rate (FHR)?**
| **KNOW THIS!!!!!**
**110 - 160 bpm**
## Footnote
* Brady is < 110 bpm
* Tachy is > 160 bpm
90
**What is variability in fetal heart rate?**
| **KNOW THIS!!!!!**
**Irregular waves or fluctuations in the baseline fetal heart rate**
91
**Describe the 4 categories of baseline fetal heart rate variability**
| **KNOW THIS!!!!!**
**Absent -** amlitude range is **undetectable**
* fetal sleep cycle
**Minimal -** amplitude range **≤ 5 bpm**
**Moderate -** amplitude range **6-25 bpm**
**Marked Variability -** amplitude range **> 25 bpm**
* many cases this is likely a normal variant
92
**Absent Variability**
Amplitude range is **undetectable**
93
**Minimal Variability**
Amplitude range is **≤ 5 bpm**
94
**Moderate Variability**
Amplitude range is **6 - 25 bpm**
95
**Marked Variability**
Amplitude range is **> 25 bpm**
96
**Baseline Fetal Heart Rate Accelerations**
| **KNOW THIS!!!!!**
**Acceleration to peak is < 30 seconds**
*
**Peak must be ≥ 15 bpm for at least 15 seconds**
## Footnote
Abrupt increase in FHR
97
**What are fetal heart rate decelerations?**
| **KNOW THIS!!!!!**
**Decreases in fetal heart rate**
* early
* late
* variable
* prolonged
98
**Explain VEAL CHOP!!!!!!**
| **KNOW THIS!!!!!**
* **Variable** decelerations **= C**ord compression
* **Early** decelerations **= H**ead compression
* **Accelerations = O**kay
* **Late** decelerations **= P**lacental insufficiency / perfusion issues
99
**What are early decelerations & what is the cause?**
| **KNOW THIS!!!!!**
**Mirrors contractions**
* *CAUSE:* **C**ord compression (**V = C** in VEAL CHOP)
100
**What are late decelerations & what is the cause?**
| **KNOW THIS!!!!!**
**Dip in fetal heart rate AFTER the peak of the contraction**
* *CAUSE:* **P**lacental insufficiency (**L = P** in VEAL CHOP)
101
**What is the management for abnormal fetal heart rates?**
| **KNOW THIS!!!!!**
**LIONS PIT**
*
**1.) STOP PITOCIN = FIRST STEP**
*
* **L**eft side lying
* **IV** fluid bolus
* **N**otify physician
* **1.) S**top **Pit**ocin
102
**Babies have root & suck reflex until what age?**
4 months
103
**Babies have moro reflex until what age?**
6 months
104
**Babies have palmar grasp reflex until what age?**
4-6 months
105
**Babies have plantar grasp reflex until what age?**
9 months - 1 year
106
**Babies have Babinski reflex until what age?**
1 year
107
**Babies have tonic neck / fencing position reflex until what age?**
4 months
108
**Babies have stepping reflex until what age?**
3-4 months
109
**Contraindications for spinal / epidural block**
* platelets greater than 100,000
* HTN
* Infection
* coagulopathy
110
**What is the treatment for maternal hypotension with decreased placental perfusion after anesthesia?**
* **Left side**
* **IV bolus**
* **Displace uterus**
* **Elevate legs**
* **Vasopressors**
