OB Exam 1 Flashcards
1
Q
What shape is the uterus? How would you describe the muscle?
A
pear like
hollow, smooth muscle with rythmic contractions
2
Q
What is the difference between the myometrium and the endometrium?
A
myo= muscle
endometrium= effects hormones
3
Q
How can your pt know she is ovulating?
A
thick, sticky, egg white like discharge “Spinnbarket”, decrease in BBT (basal body temperature) and then spikes up half a degree, positive for LH
4
Q
What hormone decreases to trigger her period?
A
Progesterone
5
Q
What is the area most likely to be damaged during childbirth?
A
perineum
6
Q
1st degree perineal tear
A
1st= superficial, goes thru the skin
7
Q
2nd degree perineal tear
A
2nd= skin and muscle
8
Q
3rd degree perineal tear
A
3rd= all the way into the anal sphincter
9
Q
4th degree perineal tear
A
4th= all the way to the rectal wall
10
Q
A mom at 6 weeks of pregnancy asks why she has to urinate so often, what do you say?
A
your bladder is right behind the uterus, so the uterus is pressing on your bladder all the time
11
Q
What is the primary mechisms to stop hemorrhage from the uterine arteries after childbirth (postpartum hemorrhage)?
A
contraction of the uterine smooth muscle that compresses the arteries (d/t oxytocin)
12
Q
What is counted as the first day of the menstrual cycle?
A
1st day of last menstrual period
13
Q
How long after intercourse could a woman get pregnant?
A
however long the sperm lives, it be 3-6 days
wrap it before you tap it bc the spermies linger
14
Q
How long after ovulation could a woman get pregnant?
A
24 hours, egg is only viable for that long and then it decomposes
15
Q
How does fertilization happen?
A
ovum +sperm, chromosomes combine
fertilization occurs in outer 1/3 of tube, forming zygote
zygote travels the length of the tube to the uterus in 3-4 days, cleavage
16 cell** morula** “solid ball of cells” gives rise to blastocyst with a hollow cavity
16
Q
What 2 structures is the blastocyst made up of?
A
embryoblast- becomes embryo
trophoblast- becomes placenta
17
Q
On average, how long does implantation take after fertilization?
A
6-10 days
18
Q
What surrounds vessels in the umbillical cord?
A
whartons jelly
19
Q
fetal circulation to get oxygenated blood from mom to baby
A
oxygenated blood from placenta enters
umbillical vein
bypasses liver
ductus venosus (a shunt)
inferior vena cava
right atrium
foramen ovale
left atrium
left ventricle
aorta
out to the body
20
Q
fetal circulation for deoxygenated blood
A
blood returning from body
right atrium
right ventricle
ductus arteriosus
aorta (bypassing lungs)
placenta through the umbillical arteries
21
Q
do arteries carry blood to or away from the baby?
A
arteries= AWAY
veins= to
22
Q
What do I mean when I say that the arterous venous is a shunt?
A
allows blood to bypass the liver and lungs bc the liver isnt neccesary yet and the lungs dont work until born
23
Q
what is vernix cassiosa? what is languo?
A
cheesy like white substance covering the baby, teeny fine hairs
24
Q
What reproductive system physiological changes happen to mom during pregancy?
A
uterine wall thinkens (early pregnancy) and then thins (late pregnancy)
aerolas darken and breasts increase in size (to support lactation)
uterize size changes from 50-1000g
25
What are the cardiac phsyiological changes of mom during pregnancy?
CO increases
Blood volume increases to meet the greater metabolic needs
HR increases during pregnancy (w5) and peaks at w32
Heart muscles enlargen 10%
26
What is a common complaint of pregnant woman in regards to blood flow? How do you alleviate the discomfort?
legs cramps, calcium
## Footnote
hypocalcemia causes leg cramps during pregnancy
27
What mineral is common for pregnant women to lack? Why does it happen?
Iron, mom is producing extra blood volume but they are not taking in enough iron. they are not going to have enough blood cells
28
Clotting is common in pregnant women. Why?
there is an increase in clotting factors, especially post partum. encourage ambulation!!
29
Physiological changes GI for pregnant women
Heartburn (progesterone relaxes the esophageal sphincter so all the stomach acid creeps back up)
N/V
Constipation
30
Physiological changes Renal in pregnant women
filtration increases
urine production remains the same but frequency is common d/t pressure
31
Skin changes in pregnant moms
chloasma: increased facial pigmentation
linea nigra: dark line of pigmentation from umbillicus to pubic area
striae gravidarum: stretch marks
32
Musculoskeletal changes in pregnancy
healthy weight increase 25-30 lbs
pelvic joint relaxes and tilts forward (lordosis)
gait change d/t relaxin relaxing pelvic joints
## Footnote
encourage light excercise during pregnancy
33
Common pregnancy discomforts include..?
N/V and Heartburn
Backache and round ligament pain
Frequency
Varicosities and leg cramps
Constipation and hemorrhoids
34
How would you educate your patient who was experiencing 1st trimester N/V and heartburn?
eat small frequent meals and try to keep something on your stomach, eat ginger root, preggy pops like sour candies
avoid spicy foods, stay sitting up for at least 30 minutes after eating
## Footnote
NO zofran or phenergan for pregnancy
35
What are some patient education points for backache and round ligament pain during pregnancy?
backache: swimming, stretching excercises, yoga, gentle excercises
round ligament pain: pregnancy support belts (supports the belly and takes pressure off)
36
Patient education for urinary frequency in pregnancy?
not much you can do here, try to avoid sweet tea, coffee (drinks that are diuretics) but drink enough water to stay hydrated
37
What are some danger signs during pregnancy?
Facial edema, blurred vision, floaters, edema in hands, HEADACHES, epigastric pain (s/s of HTN condition and preecalmpsia)
1^ burning during urination
hyperemesis gravidarum
2^ Diarrhea/ fever/ chills
Abdominal cramping or pain/ vaginal bleeding/ gush of fluid from vagina
fetal activity changes
hyper/hypoglycemia
## Footnote
1^ UTI can send you into preterm labor
2^ bacterial and viral infections can cause long term defects of the fetus
38
Can insulin cross the placental barrier?
NO!
babies have to make their own insulin, so even if we get moms blood sugar down, baby's pancreas is still trying to get the high glucose level managed with its own insulin
## Footnote
moms blood sugar is babies blood sugar
moms insulin is not babies insulin
39
The fundus is 8 cm above the umbillicus, how far along is mom?
28 weeks
40
Pregnant mom is 24 weeks pregnant, but her fundus is only at the height of the umbillicus. What should the nurse do?
Investigate, contact the provider. Baby is not progressing as expected
41
What is colostrum?
1st little bit of breast milk, thick and yellow in consistency, full of antibodies, antibacterials. secreted around 16 weeks
42
What does it mean when a baby is in the occipus anterior position on an ultrasound? Occipus posterior?
occipus anterior: baby is looking at moms back, good for birthing
occipus posterior: baby is looking at moms front and back of babies head is gliding down moms spine as it comes out, painful and slower birth
## Footnote
if the baby is OP, have mom give birth on her hands and knees
43
What are some foods high in folic acid?
spinach, cereals, seeds, nuts, artichokes, liver
sslanc
44
What are neural tube defects?
birth defects of brain, spine, and spinal cord which happens within the first month of pregnancy.
45
How can neural birth defects be prevented?
taking folic acid before and during pregancy
46
How do you obtain a chorionic villus sampling?
Take part of the chorionic villi near the placenta tissue where it implants and tests for DNA matter. Can be performed abdominally or vaginally but its more common vaginal.
## Footnote
because the placenta has the same genetic makeup of the baby. the placenta is the trophoblast out of the embryoblast
47
What is the earliest genetic testing? What does the patient need to perform it? What are the risks?
chorionic villus sampling, 10-13 weeks, a full bladder, infection and fetal tests
48
What is an amniocentesis? What are the risks?
invasive procedure, sample amniotic fluid. can be performed 15 weeks to birth. risks are fetal limb loss, fetal death
49
What is Alpha-fetoprotein (AFP)? What does a high or low result mean?
*screening tool* to test maternal blood (15-18 weeks)
high = neural tube / abdominal defect
low = down syndrome
50
Level 2 ultrasound/ targeted ultrasound is...?
complete scan of fetal anatomy (after 18 weeks)
51
Placenta previa is what?
placenta covers cervix
52
What are the 4 different types of placenta previa?
low lying (lower segment of uterus, can still pass baby)
marginal (covering half of the cervical outlet)
partial (partially covering)
complete (covers entire cervix)
53
What are the signs and symtpoms of placenta previa?
**painless**, bright red vaginal bleeding
54
When a woman comes in with placenta previa, the nurse can expect that the baby will be?
in a breeched, oblique, or transverse laying position
55
When does placenta previa typically occur?
2nd or 3rd trimester
56
What are some risk factors for placenta previa?
previous previa
uterine scarring
mom is >35
multifetal pregnancy
multiple gestations
smoking
## Footnote
smoking bc it causes vasoconstriction
57
With placenta previa, will the fundus be lower, higher, or at an expected height?
higher
58
The nurse should prepare for the patient to deliver their baby in what way when mom has placenta previa?
c-section
59
What should the nurse avoid doing what with any woman who is having abornmalities with a pregnancy?
stick things in the vagina
60
A woman comes in with placenta previa. She asks her nurse why is she bleeding with no pain. How should the nurse respond?
the placenta tears as the cervix opens
61
What are some nursing interventions for a placenta previa?
do not put anything in the vagina, give IV fluids, blood and bethamesasone (steroid to develop the babies lungs), encourage bed rest
62
A placenta previa can result in what during the 3rd timerster of pregnancy?
bleeding as the cervix begins to dilate and efface
63
what is a placental abruption?
placenta detaches prematurely and basically explodes
64
What are s/s of placental abruption? What are nursing interventions?
**sudden onset** of intense, localized uterine pain, pain may diffuse over the uterus, **boardlike abdomen** with **dark red blood**, hypertonicity contractions, fetal distress
## Footnote
boardlike d/t constant contractions d/t so much blood in the uterus
65
What are the nursing interventions for a placental abruption?
palpate uterus for tenderness, serial monitoring of fundal height, *FHR monitoring*, emotional support
66
What is the only management for a placental abruption?
delivery
67
What is the leading cause of maternal death?
abruptio placentae
68
What are risk factors for placental abruption?
trauma
cocaine
maternal hypertension
hx of abruption
smoking
premature rupture of membrane (water bag broke, labor has not started)
multifetal pregnancy
## Footnote
anything that causes vasoconstriction
69
What is an etopic pregnancy?
"tubal pregnancy", fertilized ovum is outside the uterus, account for 9% of all pregnancy related maternal death
70
What will be shown on the transvaginal ultrasound if a woman has an ectopic pregnancy?
absolutely nothing , baby isnt in uterus, its somewhere else
71
A woman who potentially has an ectopic pregnancy is getting a vaginal and bimanual examination. What should the nurse do?
use caution
72
A women has a suspected ectopic pregnany. How should the nurse perform treatment?
RAPIDLY
73
What are the s/s of an ectopic pregancy?
bleeding, spotting, unilateral stabbing pain where the fallopian tube is, refered pain up the shoulder
74
What is the drug of choice to treat a non ruptured ectopic pregnancy?
**methotrexate**, its a chemo drug that inhibits cell division and embryo enlargement, dissolving the pregnancy
## Footnote
baby will be dead
75
What is the procedure to treat a nonruptured ecotopic pregancy?
salpingostomy , salvages the fallopian tube
76
What is the treatment of a ruptured ectopic pregnancy?
laparoscopic salpingectomy, removal of the tube after it has ruptured
77
What are presumptive signs of pregnancy?
**P**eriod absent (amenorrhea)
**R**eally tired
**E**nlargened breasts
**S**ore breast
**U**rination increased
**M**ovement percieved (quickening)
**E**mesis and nausea
78
What are probable signs of pregnancy?
**P**ostive pregnancy test
**R**eturning of fetus when utrus pushed with fingers (Ballottement)
**O**utline of fetus palpated
**B**raxton Hicks contractions
**A** softening cervix (Goodells sign)
**B**luish color vulva, vagina, cervix (Chadwicks)
**L**ower uterine segment soft (Hegars)
**E**nlarged uterus
79
What are positive signs of pregnancy?
**F**etal movement felt by examiner
**E**lectronic device detects heart tones
**T**hey delivery of the baby
**U**trasound detects baby
**S**ee visible movement (examiner)
## Footnote
FETUS
80
What is a nonstress test?
noninvasive, monitors FHR to fetal movement, takes 20-30 minutes. Mom presses a button attached to the monitor whenever she feels the baby move, which is noted on the tracing. Two transducers attached to the bottom left of moms stomach and at the fundus
81
What is a reactive stress test?
2 or more accelerations within a 20-minute period
82
What is a nonreactice stress test?
lower than 2 accelerations in a 40 minute
83
What is an contraction stress test?
Aka, oxytocin test that analyzes the FHR response to contractions (which decreases placental blood flow
84
How do you administer a contraction stress test?
Hook patients up to monitor and we stimulate contractions either by nipple stimulation or if that doesn’t work, oxytocin infusion (can be difficult to stop contractions with oxytocin which leads to. Preterm labor). Causing contractions just to see how baby will respond, however you can start labor without be able to stop it
85
What are some adverse effects of a contraction stress test? What should you avoid when administering?
Can cause infection if water breaks and mom is dilated. Avoid hyperstimulation (uterine contractions longer than 90 min or 5 or more contractions in 10 min)
86
What is a contraindication of a contraction stress test?
placenta previa, preterm labor, multiple gestations, previous classing incision from C-section, reduced cervical competence
87
What is a positive contraction stress test? Negative?
Positive= babies HR slows down and stays slow after contraction
Negative= babies HR doesnt stay slow after contraction
88
What is a BPP?
Biophysical profile, uses ultrasound to visualize physical characteristics of fetus, combination of FHR monitoring and fetal ultrasound
89
When is a BPP ordered?
ordered when there is suspected poly/oligohydramnios, fetal hypoxemia, NST results come back as nonreactive
90
What does a BPP assess?
FHR (110-160) and 2 accels in 20 minutes
Fetal breathing (breathining mimicking)
Body movements (are they coordinated, are they moving at all)
Fetal tone (flaccid in tone versus skilled coordinated reflex)
amount of amniotic fluid ***on the exam
91
What is the score range for a BPP and what does it mean?
8-10 normal, low risk of chronic fetal asphyxia
4-6: abnormal, suspect; abnormal
less than 4, strong suspect
92
How long does gestation last for?
40 weeks
93
What is the preembryonic stage?
conception to day 14
94
What is the embryonic stage?
day 15- 8 weeks
95
What fetal development stage is the most critical iin the development of organ systems and the most vulnerable to environmental teratogens?
embryonic
96
By what week are all organ systems present?
8 weeks
97
What is the fetal stage?
9 weeks gestation till pregnancy ends. Eyes ears nose and mouth recognizable, heart beat detected by doppler
98
trust
is to mistrust
99
What is amniotic fluid? What is its purpose?
cushions against impacts to the maternal abdomen, maintains a stable environment, allows symmetric development, prevents membranes from adhering to developing fetal parts, allows room and buoyancy for fetal movement
100
Does the baby drink water in the womb?
No!! Baby drinks and excretes sterile urine
101
What is quickeing? When is it felt?
fetal movements felt by mom at 20 weeks. feels like fluttering or gas bubbles
102
Monozygotic twins
identical from 1 ovum and 1 sperm, share a placenta
103
What are the r/f monozygotic twins?
Risks include high rates of miscarriage, preterm birth, low birth weight, dysplasia, growth restriction, perinatal morbidity, and mortality for mom
104
Dizygotic twins
fraternal from 2 ova and 2 sperm
105
What are r/f for dizygotic twins?
gestational diabetes
106
What is the endometrial cycle?
Menstrual days 1-6
Proliferative days 7-14 (most fertile)
Secretory 15-25
107
How long does the menstrual cycle last?
1st day of period to 1st day of next period. avg is 28 days
108
How long can sperm remain viable in the reproductive tract?
3-6 days
109
What is the ovarian cycle?
follicular
ovulation
luteal
110
How does estrogen impact the menstrual cycle?
matures the egg follicle
111
How does progesterone impact the menstraul cycle?
SMOOTH MUSCLE RELAXANT, thickens endometrium redy for zygote, relaxes uterus to maintain pregnancy, promotoes growth of the lobes, lobules, and alveoli
112
What happens to the hormones in the body if you do not get pregnant?
both hormone levels drop off, letting endometrium decompose and shed, resulting in the bledding
113
How do prostaglandings impact the mestrual cycle?
help release of egg in ovulation, increases labor contractions and opening of the cervix for birth. Pro- pregnancy hormone because it keeps everything relaxed
114
What hormone is produced during pregnancy?
Human chorionic gonadotropin (HcG)
115
What that placenta do?
Prevent direct contact between fetal and maternal blood (placental barrier)
Transfers oxygen and nutrients an antibodies
Removes waste products and CO2
Makes hormones (Chorionic gonadotropic, prolactin, estrogen, progesterone, relaxin)
116
The umbical cord is the ________ for a fetus?
lifeline
117
How do you calculate a due date using Naegles rule?
First day of LMP + 9 months + 7 days
OR
First day of LMP - 3 months + 7 days (add a year if needed)
118
How else do you calculate a due date?
measured in cm from symphysis pubis to top of fundus. At 20 weeks the top of the fundus will be at the umbilicus (halfway mark)
119
How to calculate GTPAL?
G= gravidity (currently pregnant or has been pregnant)
T= #term deliveries (>37week)
P= # preterm deliveries (<37 week)
A= # abortuses <20week or <500g
L= # living children
120
What is supine hypotension? How do you alleviate it?
compression of the inferior vena cava when mom is laying supine, shift mom to left lateral position to alleviate pressure
121
HTN--> preeclampsia --> eclampsia
Progression
122
Gestational HTN BP level
BP >140/90
123
When does gestational HTN begin and does it end?
begins after 20 weeks, ends 12 weeks postpartum
124
How do you diagnose gestational HTN?
mom comes in twice in a week at least 4-6 hours apart and BP is recorded
125
Preeclampsia may have what in the urine?
protein, pt will also have HTN
## Footnote
pt will have had neither protein in urine or HTN before preeclampsia
126
What is the cause of preeclampsia?
unknown! something to do with abnormal placental invasion, immune response, genetics, dietary
## Footnote
whos your daddy? cuz he may have given you preeclampsia
127
What does a focused assessment for preeclampsia include?
dereased liver perfusion , neurocomplications, hyperreflexia, RUQ pain and **headache**
## Footnote
do a manual BP
128
What lab will you need to monitor with preeclampsia?
elevated liver enzymes d/t impaired liver function
129
What are some r/f for preeclampsia?
family member had it before, age extreme, AA descent, multifetal gestation
130
What is mild preeclampsia?
possible prtoein, headache, etc >140/90`
131
What is severe preeclampsia?
severe, COGNITIVE EFFECT “spots, floaters, blurry vision, RUQ and epigastric pain”, BP> 160/110, peripheral edema
132
What lab will be elevated with severe pre eclampsia?
elevated blood creatinine d/t kidney dysfunction d/t HTN and proteinuria (protein in urine means baddd kidney damage)
133
HELLP syndrome r/t preecalmpsia
hemolysis, elevated liver enzymes, low platelets
134
What precautions will you put a patient with preeclampsia on?
**seizure** , nonstim environment, emergency meds avaliable (hydralazine)
135
What is the key difference between preeclampsia and eclampsia?
new onset of seizure activity
136
When does eclampsia occur?
usually 48 hours after delivery , can happen during labor, pushing, postpartum
137
Seizure precautions
do not leave the bedside, turn pts on their side, keep airway patient, protect with padded side rails, suction at the bedside
138
What is magnesium sulfate used for?
seizure prevent
139
What are the s/s of mag toxicity?
lethargy and muscle weakness, decreased or absent DTRs, double vision and slurred speech, maternal hypotension, decreased RR
## Footnote
extreme vasodilator
140
What is the antidote for mag sulfate?
calcium gluconate
141
Nursing interventions for mag sulfate
continuous fetal HR monitoring, I&O , monitor LOC
142
What other medications can you give for eclampsia/ gestational HTN?
methyldopa (antiHTN), nifedipine (calcium channel blocker), hydralazine (vasodilator), labetalol (beta blocker)
143
What mneumonic is used for Mag sulfate toxicity?
**B**lod pressure decrease
**U**O decreased
**R**R <12
**P**atella reflex absent
144
What is the normal range for amniotic fluid?
10-25
145
What is polyhydramnios? What does it indicate?
excessive amniotic fluid in sac, gestational diabetes
## Footnote
d/t fetal hyperglycemia, the baby will excrete more urine causing excessive fluid
146
What is oligohydramnios? What can it effect?
too little amniotic fluid in the sac, can effect fetal development
## Footnote
fluid helps grow lungs, provide a cushioning environment to move limbs, and developes kidneys. this is why with less, you have these fetal issues
147
What is hyperemesis gravidarium? How do you treat it?
excessive vomiting during pregnancy, relaxation of the smooth muscle with increasing estrogen, progesterone, and Hcg
148
What are r/f for hyperemesis gravidarium?
age <30 yrs, multifetal gestation, high levels of stress, diabetes, GI disorders, family hx. of hyperemesis, thyroid issues (all bc of too many hormones for the body to handle)
149
What are some nursing interventions for hyperemesis gravidarium?
look at albumin levels
daily weights
**I&O**
monitor for electrolyte imbalances
hormone levels
thyroid levels (hormones cause them to be much sicker)
give fluids
keep them NPO if severe
if not keep something light on their stomach
150
What are the medications used to treat hyperemesis gravidarium?
LR, vitamin B6 (pyridoxine), antiemetic (metoclopramide )
151
What are some pt teaching points for hyperemesis gravidarium?
advance diet once vomiting has stopped, frequent small meals, enteral feeding TPN
152
What is gestational diabetes?
discovered during pregnancy
153
Class A1 gestational diabetic
no meds, diet controlled
154
Class A2 gestational diabetic
meds needed
155
What is the diagnostic test for gestational diabetes?
oral gluose tolerance test (1 and 3 hr)
156
What week do you give an oral glucose tolernce test?
24-28
157
What does the patient have to do for a 1 hour glucose test?
50g drink, must keep it down, HgA1c is checked an hour later
158
With GD, the fetus will display these characteristics
macrosomia, birth trauma, electrolyte imbalances, hypoglycemia
159
What diagnostics will be used to assess a fetus when mom has GD?
BPP, nonstress test, amniocentesis
160
What is a natural way to go into preterm labor ?
sex
## Footnote
semen contains prostaglandins
161
What are some r/f for a spontaneous abortion?
chromosome abnormalities
mom is sick
being older than 35
premature dilation
chronical maternal infections
maternal malnutrition
trauma
substance abuse
162
What are common expected findings with an abortion?
abdominal cramping, rupture of membranes, dilation, fever, s/s of hemorrhage
163
What are therapuetic procedures for an abortion?
ultrasound, cervical exam, D&C or D&E, Prostaglandins (naturally found in semen) and oxytocin
164
What are some nursing interventions for an abortion?
perform a pregnancy test (blood test)
observe color and bleeding
avoid vaginal exams
determine how much tissue has been passes
assist with termination of cervix
don’t use the term “abortion”, use the term “miscarriage”
provide emotional support and education
165
What are some patient education points for an abortion?
notify provider of heavy, bright red vaginal bleeding
report high temp, or foul smelling vaginal discharge
small amt of discharge is normal for 1-2 weeks
take prescribed Abx
refrain from tubs, sex, placing anything in vagina for 2 weeks
166
A woman just had an abortion. She wants to go take a relaxing bath after such a stressful time and reconnect intimacy with her partner. What should the nurse say?
Avoid baths, sex, and putting anything in the vagina after an abortion.
167
A woman just had an abortion and she notices a foul smelling discharge. What should the nurse do?
Call the provider, as this is abnormal
168
A family experienced an abortion a year ago. They are now trying to get pregnant. What should they do before getting pregnancy?
discuss grief and loss with the provider
169
What are the characteristics of a threatened abortion?
mild cramps, slight spotting, no passed tissue, cervix is closed
170
What are the characteristics of an inevitable abortion?
mild to moderate cramps, moderate bleeding, no tissue passed YET but its inevitable, cervix is usually dilated, 1st trimester so baby is small but they will lose it
171
Incomplete abortion
severe cramping, heavy or profuse bleeding, tissue is apssed, dilated with tissue in the cervical canal
172
What is a DNC/DNE?
(Dilation and curettage) Dilate and evacuate everything from the utrus
173
What is a complete abortion?
mild cramping, minimal bleeding, lots of tissue passed, cervix closed after the tissue passed or slightly
174
What is a missed abortion?
no cramping, no bleeding or spotting, cervix is closed
## Footnote
its like a ghost came thru and took the baby
175
Septic abortion
cramps may vary, various malodorous discharge, tissue passed varies, usually dilated
## Footnote
varies varies varies varies nasty blood
176
Recurrent abortion
cramps and bleeding vary, tissue is passed and is usally dilated. mom may have cervical problem with recurrent abortions
177
Women with ____ are commonly known to have an ectopic pregnancy.
IUD
178
If a baby does grow outside of the fallopian tube, can the baby survive? Can we move the baby and put it in the uterus?
NO!! We do not have the science for that.
179
What is cerclage?
a stitch to sow cervix up, used for cervical insufficiency
180
What do you need to teach a patient who has a cerclage?
put NOTHING in the vagina, go to provider immediately you feel any s/s of labor. if that stitch tears, you will have a lot of vascular damage
181
How does pregnancy affect blood pressure in the first trimester?
with the increase in progesterone, blood pressure will likely decrease.
## Footnote
progesterone relaxes smooth muscle and vasodilates
182
How does pregnancy affect BP during the second trimester?
meh it stabilizes, blood volume increases
183
How does pregnancy affect BP in the 3rd trimester ?
HTN d/t increased vascular resistance and pressure of the uterus. body prepares for birth
184
Pregnancy cat A
no risk in human studies
185
Pregnancy cat B
no risk in animal studies
186
Pregnancy cat C
cant be ruled out, be cautious
187
Pregnancy cat D
risk to fetus
188
Pregnancy cat X
contraindicated
189
When does the fundal height decrease?
30 weeks as baby and body prepare for labor
190
What is fetal demise?
death of baby in womb
191
What is intrauterne fetal demise (IUFD) assosciated with?
hyperglycemia, DKA, congetial anomolies, infections, postdates
192
Fetal monitoring (daily kick count and nonstress test 2x/week) occurs in late pregancy to monitor for this condition.
fetal demise, if tests are unsuccessful then it has occured
