Flashcards in Normal Pregnancy Deck (104):
Metherigine (Methylergonovine Maleate)
Stimulates uterine contraction, decreases bleeding.
Pitocin (Oxytocin, Syntocinon)
Acts directly on myofibrils.
Stimulates uterine contractions.
Stimulates breast milk.
Decreases acetylcholine in motor nerve terminals, which is responsible for seizure prevention in pre-eclampsia and eclampsia.
Signs and symptoms of magnesium sulfate toxicity.
Nausea, vomiting, flushing (warmth, redness, or tingly feeling), feeling very hot, bradycardia, drowsiness, syncope.
Indicates a pregnant woman.
Indicates number of births.
A woman pregnant for the first time.
Softening of the opening of the cervix.
A probable sign of pregnancy.
Braxton Hick's Contractions.
Irregular tightening of the pregnant uterus that begins in the first trimester and increases in frequency, duration, and intensity as pregnancy progresses.
Near term, strong Braxton Hick's contractions are often difficult to distinguish from real labor.
Sensation of decreased abdominal distention produced by uterine descent into the pelvic cavity as the fetal presenting part settles into the pelvis. It usually occurs 2 weeks before the onset of labor in nullparas.
Where does implantation usually occur?
Implantation usually occurs in the fundus of the uterus on either the anterior or posterior surfaces.
The embryonic stage.
Embryonic stage begins with implantation and encompasses approximately the first 8 weeks of pregnancy. Cell growth is rapid. A simple heart begins beating and rudimentary forms of all the major organs and systems develop.
When can you expect fetal heart activity?
Fetal heart shows activity by the 7th week of gestation.
Practitioners can auscultate fetal heart tones between 10 and 12 weeks by using Doppler mode.
What is a Non-Stress Test (NST)?
A nonstress test (NST) is done to evaluate how the fetal heart rate responds to periods of fetal movement.
Probable signs of pregnancy.
Changes in reproductive organs (enlargement of uterus), positive pregnancy tests, Hegars sign, Goodells sign, ballottement.
Softening of the vaginal side of the cervix.
Used at 16 to 18 weeks. Technique involves palpating the uterus feels for rebound of the floating fetus.
Signs and symptoms to report to the doctor during pregnancy.
Visual disturbances, diplopia, blurring or spots, headaches (sever, sudden, continuous), edema of the face presacral area or fingers, rapid wt gain, sever abd or epigastric pain, signs of infections (fever, chills, diarrhea, changes in vaginal drainage, pain or burning with urination), vaginal bleeding (of any kind), vaginal drainage (aside from normal mucus), persistent vomiting, muscular irritability or convulsions, absence of decrease in fetal movement once felt.
The mask of pregnancy, is an irregular darkening of the cheeks, forehead and nose.
Pubococcygeal muscles support the pelvic floor, bladder, and urethra. To strengthen these muscles, kegel exercises should be performed.
Sex during pregnancy.
There is no physiological reason to limit sexual activity during pregnancy. Sexual activity should cease if there is any vaginal bleeding until the cause of the bleeding is determined and the physician determines no danger exists.
Cervical effacement refers to a thinning of the cervix. It can be expressed as a percent. Effacement is accompanied by cervical dilation.
Artificial rupture of the fetal membrane. Measure the FHR immediately before and after this procedure Asses amount and color of amniotic fluid.
Signs of placental separation.
Sudden gush of blood from the vagina, womans uterus becomes globular in shape and the umbilical cord lengthens.
Indication of the second stage of labor.
Bearing down reflex.
Periodic decrease in the FHR in response to contractions; classified as early, late or variable.
Caused by pressure on the fetal skull; tend to be uniform ; onset, shape and recovery correspond to contractions.
Caused by decreased oxygen and blood flow to fetus through the placenta; usually noted at or after the peak of the contraction; may indicate fetal distress, particularly if associated with changes in baseline FHR and absence of variability.
Caused by compression in the umbilical cord; occur randomly and onset may be sudden; FHR decreases below normal range.
Contractions follow a regular pattern, contractions come closer together, are stronger and tend to last longer, contractions get stronger with ambulation, they start at the lower back and then travel to the lower abdomen, usually not stopped by controlled breathing, sedation or other relaxation interventions, cervix softens, effaces and dilates, fetus cont. descent into pelvis. (Summarized by book – true labor is marked by the onset of regular, rhythmic contractions that cause progressive cervical dilation and effacement).
Contractions rarely follow pattern, vary in length and intensity, frequently stop with ambulation or position change, may be felt in back but most often noticed in the fundus, eventually stop with relaxation interventions, cervix may soften but little or no change in effacement or dilation, no significant change in fetal positioning.
As soon as the head is delivered, it moves to realign with the body and shoulders.
Most common method is called Nagele’s rule – start with first day of woman's last menstrual period and count back 3 months then add 7 days. (pg 787)
First sign of fetal movement.
Week 10 is when the first fetal movements begin. Some women describe the sensation of these first movements as if something were blowing bubbles through a straw in their stomachs.
A blue discoloration of the cervix, vagina, and labia caused by the hormone estrogen.
Usually visible at 6-8 weeks after conception. Presumptive sign of pregnancy.
Arteries and veins in umbilical cord.
Normally two arteries and one vein are apparent in the umbilical cord and give it a rope like appearance.
RhoGAM is indicated for administration to Rh-negative women not previously sensitized to the Rho(D) factor, unless the father or baby are conclusively Rh-negative.
Delivery of an Rh-positive baby. Antepartum prophylaxis at 26 to 28 weeks of gestation. Antepartum fetal-maternal hemorrhage (suspected or proven) as a result of placenta previa, amniocentesis, chorionic villus sampling, percutaneous umbilical blood sampling, other obstetrical manipulative procedure (e.g., version) or abdominal trauma. Actual or threatened pregnancy loss at any stage of gestation. Ectopic pregnancy.
Concerns for German Measles during First Trimester.
Rubella, or German measles, is most dangerous to your baby if you catch it during the first 16 weeks of pregnancy. Rubella can cause miscarriage, stillbirth, or birth defects in unborn babies, such as: deafness, brain damage, heart defects, and cataracts.
How to assess the fundal height
Have the patient lay on her back, then turn on her left side.
The true pelvis is small bowl-like shape containing the unrinary bladder and sexual organs.
The false pelvis is the area been the alla or wings of the pelvis. This is a much larger area and contains some of the abdominal organs like part of the small intestine and part of the colon.
Ideal pelvis for delivery.
Gynecoid: Ideal shape, with round to slightly oval (obstetrical inlet slightly less transverse) inlet: best chances for normal vaginal delivery.
5-P's for "standing and wiggling hips"
Exercise to strengthen coccygeal area.
How many weeks in a trimester.
Why do you instill Erythromycin into newborn eyes?
Prophylactically to prevent infection by gonorrhea and chlamydia.
Eclampsia is seizures (convulsions) in a pregnant woman that are not related to a preexisting brain condition.
Preeclampsia is when a pregnant woman develops high blood pressure and protein in the urine after the 20th week (late 2nd or 3rd trimester) of pregnancy.
Pregnancy-induced hypertension (PIH) is a form of high blood pressure in pregnancy, also called preeclampsia.
Presents with hypertension, proteinuria, visual disturbances, and edema.
Expected birth date: Last period was July 20.
Month -3 (or +9)
Nausea, vomiting, breast tenderness, and missing period are what type of signs of pregnancy?
Patient teaching for leg cramps during pregnancy.
Extend leg and dorsiflex foot during cramp.
Indication of the baby's first movement.
A flutterlike feeling called "quickening".
Safe level of alcohol intake during pregnancy.
Dangerous sign during pregnancy requiring contact of a healthcare provider.
Discomforts often experienced during third trimester.
Discomfort often not experienced during third trimester.
The concept of NST is based on what phenomenon?
Fetal heart rate increases in connection with fetal movement.
Best measure to relieve constipation?
6 to 8 glasses of water daily.
Sonography can be used to assess:
Number of fetuses.
Gestation age of fetus.
Symptom during first trimester that is a serious warning sign.
At 23 weeks of gestation complains of fluid leaking from vagina.
Signifies an emergency.
GTPAL: In labor with 3 living children.
39 weeks, 34 weeks, 35 weeks.
Alternative therapies for morning sickness and hyperemesis.
Acupuncture, acupressure, shiatzu, herbal.
Lemon, mint, ginger, raspberry leaf, chamomile, hops.
Five Digit: GTPAL system
(Four Digit: TPAL)
G: gravidity (all pregnancies)
T: term births (>37 weeks)
P: preterm births (<37 weeks)
L: living children
Type of sign of pregnancy where fetal movement is palpated by the primary caregiver.
Ability to live outside the uterus.
Why turn patient on side when doing fundal measurement at 32 weeks when complaints of lightheadedness and dizzy?
Weight of pregnancy is cutting off blood flow through vena cava.
The process of determining outcomes and interventions is what stage of the nursing process?
What assessment finding would indicate labor has begun for primigravida?
To determine fetal lie, presentation, and position use which assessment technique?
How to assess the frequency of labor contractions.
Measure from beginning of one contraction to the beginning of next.
When can an internal fetal monitor be applied?
Cervix 2-3 cm dilated and membranes ruptured.
Validates the rupture of membranes.
Periodic decrease in FHR in response to contractions.
Caused by pressure on fetal skull. Tend to be uniform. Correspond to contractions.
Caused by decreased oxygen and blood flow to fetus through the placenta. usually noted after the peak of contractions. May indicate fetal distress.
Caused by compression on the umbilical cord. Occur randomly and onset may be sudden. FHR decreases below normal range.
Normal FHR baseline.
120 to 160 bpm.
Expected behaviors during the transition phase to active labor.
Irritability, resistance to touch, withdrawal.
Assessment finding indicating second stage of labor has begun.
Expected maternal cardiovascular finding during labor.
Increased cardiac output.
Periodic increase in FHR.
Delivery of baby, sudden gush of blood from vagina. woman's uterus becomes globular, and the umbilical cord lengthens. What does this indicate?
Separation of the placenta.
What is the patient at risk for whose membranes have ruptured?
Indicators of False Labor.
Contractions dont follow a pattern.
Contractions stop with ambulation.
No significant change in fetal position.
Indicators of True Labor.
Contractions start at lower back and travel to lower abdomen.
The cervix softens, effaces, and dilates.
Stages of Labor.
Second: Delivery of fetus
Third: Delivery of placenta
First Stage of Labor
Begins with onset of regular contractions. Ends with complete dilation of cervix.
Early latent phase: 0-3 cm
Middle (Active) phase: 4-7 cm
Transitional phase: 8-10 cm
Longest stage of labor.
Second Stage of Labor.
Begins with complete dilation of cervix (10cm). Ends with birth of the baby.
Third Stage of Labor.
Begins with the delivery of the baby. Ends with the delivery of the placenta.
Fourth Stage of Labor.
The 2 to 4 hours following delivery is critical in monitoring the mother as her body recovers.
Presumptive Signs of Pregnancy.
Amenorrhea, nausea, vomiting, polyuria, breast changes, quickening, skin changes, Chadwick's signs.
Probable Signs of Pregnancy.
Changes in reproductive organs. Positive pregnancy test.
Positive Signs of Pregnancy.
Auscultation of heart tones.
Antepartal: Conception to labor.
Intrapartal: Labor to placenta.
Postpartal: 6 weeks post delivery, until reproductive organs return to normal.