Midterm SP 16 Flashcards Preview

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Flashcards in Midterm SP 16 Deck (21)
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1

Quickening/ Lightening

First perception of fetal movement __- __ weeks in primigravidae and __-__ weeks in multigravidae
Later on it helps in determining the health of fetus and its ______ level

Quickening/Lightening
first perception of fetal movement by the mother 18-20 wks in primigravidas (1st mom) and 14-16 wks in multigravidas (mother that has had a baby already)
Later used in determining health of fetus via activity level

2

Skin manifestations

Cholasma / melasma – mast of pregnancy, darkened skin on _______, nose, ________

Linea nigra – dark line in lower abdomen from ______ to _______. Both usually disappear when baby ________.

Piscaceks sign – ______ enlargement of the uterus looking inside pelvic cavity

Chadwick’s sign – bluish/purplish discoloration of vagina and cervix – may be indicative of pregnancy

Skin

Cholasma / melasma – mast of pregnancy, darkened skin on forehead, nose, cheekbones

Linea nigra – dark line in lower abdomen from umbilicus to pubis

Both usually disappear when baby born

Piscaceks sign – asymmetrical enlargement of the uterus – looking inside pelvic cavity

Chadwick’s sign – bluish/purplish discoloration of vagina and cervix – may be indicative of pregnancy

3

Uterine contractions – Braxton Hicks contractions usually occur about ___ weeks gestation, can disappear with ______ or _________

"Uterus doing its own “workout” before labor – preparing itself for labor"

..

4

Morning Sickness

Morning sickness – nausea/vomiting esp 1st trimester
Occurs during 5-18 wks of gestation in_____ of pregnancies

Very common with women who are having a _____–bc of the high _____ levels

Caused by an increase in estrogen, _______ of muscles in uterus which may also relax the stomach causing more acids

Avoiding empty stomach – eating lots of small meals a day – eat crackers

More severe in mornings and can be brought on by strong _____ or Odors

Morning sickness – nausea/vomiting esp 1st trimester
5-18 wks gestation in 50% of pregnancies

Very common with women who are having a girl – bc of the estrogen (high levels)

Caused by an increase in estrogen  relaxation of muscles in uterus which may also relax the stomach causing more acids

Avoiding empty stomach – eating lots of small meals a day – eat crackers

More severe in mornings and can be brought on by strong smells/odors

5

Hyperemesis gravidum – extreme morning sickness

Weight loss >__%  less than____5% is______ in 1st trimester

Dehydration

Ketosis

Electrolyte abnormalities – mother feeling tired bc baby taking Hb from mom due to lack of ____ and eating habits

Hyperemesis gravidum – extreme morning sickness
Weight loss >5%  less than 5% is normal in 1st trimester
Dehydration
Ketosis
Electrolyte abnormalities – mother feeling tired bc baby taking Hb from mom due to lack of Fe and eating habits

6

Rh incompatibility

Rh Negative woman  Rh______ baby

Mothers immune system attacks Rh-positive RB Cs and produces antibodies against them

Rhogam (treatment) – make sure you get the mercury free version (thiomersal)

Maternal antibodies pass to fetus attacking fetal Rh positive RBCs

Baby can be born with ______ , ______, ______ in severe cases

Rh incompatibility
Rh Negative woman  Rh positive baby
Mothers immune system attacks Rh-positive RBCs and produces antibodies against them
Rhogam (treatment) – make sure you get the mercury free version (thiomersal)
Maternal antibodies pass to fetus attacking fetal Rh positive RBCs
Baby can be born with Anemia, jaundice, and heart failure in severe cases

7

Breech Presentations:

Complete
Frank
Footling
Kneeling

Breech Presentations:

Complete
Frank
Footling
Kneeling

8

The #1 challenge with transverse lie and breech is a

prolapsed cord

9

Imaginary line between ischial spines; it is a measurement of the fetus as it descends into the birth canal.

Fetal Station

10

Skull at ischial spine = station
High in pelvis/floating = -4 station
Crowning or at intriotus = +4 station
Baby descends from –4 to +4 during labor
Labor often begins at station 0.

O

-4

+4

+4
Labor begins at O

11

Preeclampsia aka _________or Pregnancy Induced Hypertension (PIH) - abnormal state of pregnancy characterized by ________ fluid retention, and _________; can lead to eclampsia aka if untreated.

This is the MC thing that can go wrong with a pregnancy and very often happens during a woman’s first pregnancy

3 Cardinal signs
Hypertension - Sudden severe increase in blood pressure in last ___of pregnancy (#1 sign headaches)

Edema – look at momma and she may look puffy from edema, and may complain of carpal tunnel due to swelling in the wrists

Proteinuria
Doc should take BP, and if you don’t have cuff, send them out instantly. If 180/100, then need to go to OB now
Can be fatal in severe cases
Occurs in 5-10% of pregnancies usually in 1st pregnancy

Hypertension and diabetes are risk factors which weaken the maternal physiology may contribute to _________
Resulting in in ______ uterine which creates contractions  pre-mature labor.

Immediate best rest, reduce salt intake, and stress levels

Sometimes given _________ – stops uterine contractions (drug)

Rest and Brethene should take care of this.

Preeclampsia aka Toxemia of pregnancy or Pregnancy Induced Hypertension (PIH) - abnormal state of pregnancy characterized by hypertension, fluid retention, and albuminuria; can lead to eclampsia if untreated.
MC thing that can go wrong with a pregnancy and very often happens during a woman’s first pregnancy
3 Cardinal signs
Hypertension - Sudden severe increase in blood pressure in last 1/3 of pregnancy (#1 sign headaches)
Edema – look at momma and she may look puffy from edema, and may complain of carpal tunnel due to swelling in the wrists
Proteinuria
Doc should take BP, and if you don’t have cuff, send them out instantly
If 180/100, then need to go to OB now
Can be fatal in severe cases
5-10% of pregnancies usually in 1st pregnancy
Hypertension, diabetes are risk factors which weaken the maternal physiology may contribute to toxemia
Results in hypertonic uterine which creates contractions  pre-mature labor
Immediate best rest, reduce salt intake, and stress levels
Sometimes given Brethene – stops uterine contractions (drug)
Rest and Brethene should take care of it

12

High blood pressure greater than 2 weeks can hurt baby. Babies lowest ideal weight 5.5 pounds.

T or F

True

13

Diabetes in pregnancy – Gestational Diabetes

Can drink orange juice instead of ________.
Big differences between craving and wanting.
Increased risk of respiratory distress _______, congenital abnormalities, neonatal hyperbilirubinemia.
____________ – 12-15 pound babies due to fat accumulation
_____ – infants of diabetic mothers
Prenatal morality rate = .7% in USA, 15% in well cared for diabetic moms. 50% in poorly attended diabetic mothers.

Diabetes fasting >130

Diabetes in pregnancy – Gestational Diabetes
Can drink orange juice instead of glucola.
Big differences between craving and wanting.
Increased risk of respiratory distress syndrome, congenital abnormalities, neonatal hyperbilirubinemia.
Macrosomia – 12-15 pound babies due to fat accumulation
IBM – infants of diabetic mothers
Prenatal morality rate = .7% in USA, 15% in well cared for diabetic moms. 50% in poorly attended diabetic mothers.
Diabetes fasting >130

14

Urinary syndromes

Polynephritis – occurs in _____trimester, symptoms begin with a chill followed by a rise in _________, severe low back pain (may not be pain over kidneys), nausea and vomiting.

Glomerulonephritis – no fever however have ______ from increased blood pressure. No ________ can occur anytime during pregnancy.

Urinary syndromes

Polynephritis – occurs in 3rd trimester, symptoms begin with a chill followed by a rise in temperature, severe low back pain (may not be pain over kidneys), nausea and vomiting.

Glomerulonephritis – no fever however have headaches from increased blood pressure. No edema can occur anytime during pregnancy.

15

Iron deficiency anemia – 95-98% are due to iron ________, every pregnant women needs to take a ________ vitamin.

Symptoms: pallor, angular _________ (cracks and fissures of angles of the mouth) and other oral lesions, GI complaints and thinning or brittle nails, fatigue.

Iron deficiency anemia – 95-98% are due to iron deficiency, every pregnant women needs to take a prenatal vitamin. Symptoms: pallor, angular stomatitis (cracks and fissures of angles of the mouth) and other oral lesions, GI complaints and thinning or brittle nails, fatigue.

16

Erythroblastosis fetalis

The RH factor. Usually occurs in _______child. Incompatibility b/w the blood group of the mother and the offspring

Accelerated destruction of _______ and subsequent ________


Kernicterus may result – a degenerative disease of the _____

Hydrops fetalis – gross ______ of entire body of baby, it is fatal to baby and dangerous to mother as well

Erythroblastosis fettles

The RH factor thing. Usually occurs in second child. Incompatibility b/w the blood group of the mother and the offspring

Accelerated destruction of erythrocytes and subsequent jaundice

Note:

Kernicterus may result – a degenerative disease of the brain

Hydrops fetalis – gross edema of entire body of baby – it is fatal to baby and dangerous to mother as well

17

Fundal height – tells you where you are at in terms of _____

After 20 wks should be _____ cm
30 wks 30 cm
40 wks 40 cm

Important Note
35 wks at 30 cm – ______ baby or issue with growth of baby possibly bad

35 wks at 40 cm –______ or ____ ______ possibly caused by diabetes

Fundal height – tells you where you are at in terms of weeks

After 20 wks should be 20 cm

30 wks 30 cm
40 wks 40 cm

Important Note
35 wks at 30 cm – small baby or issue with growth of baby possibly bad

35 wks at 40 cm – twins or big baby possibly caused by diabetes

18

shortening, thinning of cervix right before labor begins preparing for the baby

Effacement

19

fetal head passes into the cavity of the pelvis – the fetal head drops down

Engagement

20

Bloody show – mucous plug released from cervix usually as ________ ________

_______ plug goes into cervix when it hardens to block anything from going out

If a stream of blood = crisis

water breaks

Mucous plug goes into cervix when it hardens to block anything from going out

If a stream of blood = crisis

21

Lochia – postpartum _______ discharge occurs __-__ wks after birth

1st – red/rubra-blood tinged (lochia rubra)
2nd – yellow (not really important)
3rd – white/alba – just mucous (lochia alba)

Lochia – postpartum vaginal discharge occurs 1-2 wks after birth

1st – red/rubra-blood tinged (lochia rubra)
2nd – yellow (not really important)
3rd – white/alba – just mucous (lochia alba)