OB EXAM 2 Flashcards Preview

6TH SEMESTER > OB EXAM 2 > Flashcards

Flashcards in OB EXAM 2 Deck (202):
1

woman who is pregnant.

Gravida

2

pregnancy

gravidity

3

woman who has never been pregnant.

Nulligravida:

4

: woman who is pregnant for the first time.

Primigravida:

5

woman who has had two or more pregnancies

Multigravida:

6

number of pregnancies in which fetus or fetuses have reached viability (20 weeks when they are born), not the number of fetuses born.

parity

7

woman who has NOT completed pregnancy with a fetus or fetuses who have reached 20 weeks gestation.

nullipara

8

: woman who has completed one pregnancy with a fetus or fetuses who have reached 20 weeks gestation.

primipara

9

woman who has completed two or more pregnancies to 20 weeks of gestation or more.

Multipara:

10

pregnancy that has reached 20 weeks of gestation but ends before completion of 37 weeks of gestation.

Preterm:

11

pregnancy that has reached between 34 weeks 0 days and 36 weeks 6 days of gestation.

late term

12

pregnancy that has reached between 37 weeks 0 days and 38 weeks 6 days of gestation.

early term

13

pregnancy that has reached between 39 weeks 0 days and 40 weeks 6 days of gestation.

full term

14

pregnancy that has reached between 41 weeks 0 days and 41 weeks 6 days of gestation.

late term

15

term pregnancy is ____ - ____ weeks

37-42

16

preterm is before week ____

37

17

post term is a PG that reached btwn ___ weeks ___ days and beyond gestation

42 weeks & 0 days

18

capacity to live outside the uterus. Book says 22-25 weeks gestation.

viability

19

GTPAL

gravida
term
preterm
aborted
living

20

gravida =

# of pregnancies

21

term=

# of term pregnancies.

37-42 weeks

22

preterm

# of preterm pregnancies
20-37 weeks

23

aborted=

# of abortions. spontaneous or induced

24

living=

# of living children

25

3 types of signs of pregnancies

presumptive
probable
positive

26

presumptive signs of PG are ____ changes.

subjective

27

ex of presumptive signs

no period
breast tenderness
N/V
fatigue

28

probable signs are ___ changes.

objective

29

ex of probable signs of PG

hegar's sign
goodell sign
chadwick sign

30

• The softening of the lower uterine segment while the uterus remains firm.

hegar's sign

31

when can you notice hegar's sign

6 weeks

32

softening of the cervical tip

goodell sign

33

when can you observe godless sign

5-6 weeks

34

vaginal mucosa and cervix turn violet blue color

chadwicks sign

35

when can you notice chadwicks sign

6-8 weeks

36

signs attributable only to fetal presence

positive sx of pregnancy

37

ex of positive signs of PG

fetal heart tones
ultrasound
palpate fetal movement

38

when is fundal height assessed?

2nd trimester

39

fundal height is an indicator of?

fetal growth

40

check fundal height from ___ to ___ gestational weeks

18-32 weeks

41

low fundal height may be

IUGR

42

IUGR menas

intrauterine growth restriction

43

high fundal height may be?

multifetal gestation or hydraminios

44

hydraminios =

too much amniotic fluid

45

lightening occurs between ___-___ weeks gestation

38-40

46

when the fundal height drops

lightening

47

The fetus begins to descend and engage into the pelvis

lightening

48

nullapara mother with lightening when?

2 weeks before onset of labor

49

multipara mother lightening occurs when?

time of labor occuring

50

pregnancy may "show" after the ___ week

14th week

51

increases as the uterine size increases

BV

52

BV is ____ - ___ ml per min of blood at full term

450-650

53

- Oxygen consumption increases to

meet fetal demands

54

- rushing or blowing sound of maternal blood rushing through the uterine arteries, should be synchronized with maternal pulse

uterine souffle

55

sound heard as blood rushes through umbilical cord. Synchronized with fetal heart rate.

funic souffle

56

cervical changes

o Passive movement of unengaged fetus.

57

- First recognition of movement.
- Mom starts to feel baby moving.
- The movement will gradually increase in intensity and frequency.

quickening

58

quickening can occur when?

14-16 weeks

59

- Tap finger of bottom of cervix to feel vibration of baby inside.

ballottement

60

ballottement occurs when?

16-28 weeks

61

o Softening of lower part of uterus where cervix remains firm

hegar sign

62

o Training for labor
o Irregular
o Painless
usually go away with movement

do not increase in intensity and frequency

braxton hicks contractions

63

braxton hicks contractions occur intermittently during PG, but become more defined after ____ weeks

28

64

do braxton hicks contractions dilate the cervix?

NO

65

located around nipples and provides lubrication to nipples to prepare for breast feeding.

montgomery tubercles

66

changes in breast are due to

increase in estrogen & progesterone

67

stretch marks

striae gravidarum

68

colostrum by ____ weeks

16

69

BV is increased ____% above pre-pregnant levels

30-45%

70

increase in RBCs by ____%

20-30%

71

the increase in BV is a protective measure?

to be able to hydrate maternal and fetal needs of enlarged uterus

72

how much blood loss in vaginal birth

200-400 cc

73

how much blood loss in c section

500 cc blood loss

74

Women who are pregnant are 5-6x times like to develop

thromboembolic disease

75

RISK FOR thromboembolic disease due to

increase in clotting factors

76

respiratory changes during PG

nasal & sinus stuffiness

c/o nose bleeds

77

mask of pregnancy. Blochy brownish pigmentation that covers the cheek nose and forehead of a pregnant woman. Can appear up to 50-70% of women. 16 weeks of gestation & will increase until delivery. Darker complected women are more affected. The sun intensifies this. Usually after delivery this will fade.

melasma

78

symphisis pubis to top of fundus. Dark line.

linea nigra

79

stertch marks on lower abd. And also on woman thighs and breasts. Can cause scars. They may lighten but will not go away.

Striae gravidarum

80

increase curvature of lumbosacral area. Her center of gravity is off, so the curve allows them to remain balanced.

“Proud walk of Pregnancy”

81

pregnancy spans ___ calendar months

9

82

PG spans ___ lunar months

10

83

1st trimester:

1-13 weeks

84

2nd trimester

14-16 weeks

85

3rd semester

27-40 weeks

86

how to estimate date of birth

nagele's rule

87

nagele's rule calculation:

1st day of LMP, subtract 3 months, add 7 days

88

♣ Consuming non food substances such as clay, soil, laundry detergent, food substances with no nutritional values, ice, baking soda, or baking powder, or corn starch)

PICA

89

what happens with PICA?

anemia & prevents them from absorbing iron

90

as mom progresses through pregnancy, weight of abd. Contents will compress vena cava. Faintness, dizziness, nausea.

Supine hypotension

91

intervention for supine hypotension

turn woman on side until sx subside & VS return WNL

92

clean catch urine @ each visit checks for?

glucose
protein
nitrates
leukocytes

93

kick count test results should be

10 movements of fetus in 2 hours

94

call physician if kick counts are?

none in 12 hours

95

response of the fetal HR to fetal movement

non stress test

96

babies HR should do what during non stress test?

should increase 15 BPM when we have fetal movement and needs to remain elevated for 15 seconds

97

what considers a healthy non stress test?

2 accelerations

98

¥ Signs of potential complications Pg. 314

o #1- vaginal bleeding
o discharge from vagina
o decrease or no fetal movement
o sudden weight gain
o severe vomiting or HA
o C/O fever & chills
o Diarrhea or c/o abd. Cramping
o c/o burning at urination

99

Escessive vomiting.

Hypereremesis gravidum

100

Hypereremesis gravidum can cause:

weight loss
electrolyte def.
ketonuria
esophageal rupture

101

how to treat Hypereremesis gravidum

IV therapy
eat freq.
separate fluids & solids
eat bland diet

102

who sweats more?

women!

103

women can take tub baths when pregnant except for ?

when the membranes have ruptured

104

PG woman are more predisposed to ___ which are asymptomatic

UTIs

105

how to prevent UTIs

drink water
personal hygiene
eat yogurt
don't ignore the feeling of needing to urinate

106

o Allows the muscles to stretch more during L&D. prevents urinary incontinence during PG, during labor, & later in life

kegel exercises

107

how to clean the nipples after breastfeeding

warm water

108

can you have a dental exam during pregnancy?

YES

109

when to do childbirth education programs?

3 months prior to delivery

110

• professionally trained as support people to support patient during delivery. Can’t do anything medical with delivery.

doulas

111

• Conception is the union of

a single ovum and sperm

112

o Implantation of the fertilized ovum in the endometrium _____ days after conception

6-10

113

where does fertilization occur?

upper 1/3 of fallopian tube

114

• An ovum is fertile for ___ after it is released

24 hours

115

• Primary germ layers ( pg. 274)

ectoderm
mesoderm
endoderm

116

upper layer or outermost layer of embryonic disk

ectoderm

117

ectoderm will form?

nervous system
tooth enamel
nails
hair
floor of amniotic cavity

118

middle layer

mesoderm

119

what will mesoderm form?

bones
teeth
muscles
cardiovascular system
kidneys

120

lower layer or innermost layer

endoderm

121

endoderm will form?

epithelial lining of resp and digestive tracts

122

o Substances or exposure that causes abnormal development

teratogens

123

examples of teratogens

♣ Cigarette smoking
♣ Cocaine
♣ Coumadin anticoagulant
♣ Rubella
♣ Syphilis or any STDs
♣ Alcohol

124

o In the first ___ weeks of pregnancy there are two affects that can occur

2

125

examples of the 2 things that can occur

♣ The baby can be exposed to a teratogen and will die bc too many cells damaged

♣ The baby can be exposed but only a few cells affected it does not have an ill effect on the baby.

126

• Once born, cannot fix defects caused by ____

teratogens

127

• Use _______ _____ instead of months because of the rate of development from week to week

gestational weeks

128

Development of the embryo
Lasts from

day 15 until 8 weeks after conception

129

o 9 wks gestation until the pregnancy ends

fetus

130

mucous plug

operculum

131

• fetal membrane closest to the uterine wall and gives rise to the placenta contains the major umbilical blood vessels as they branch out over the surface of placenta-will become chorionic membrane

chorion

132

• inner membrane that form the sac and contain fetus and the amniotic fluid

amnion and amniotic cavity

133

what is the significance of the amnion and amniotic cavity

o It is a good cushion for this baby
o Helps to control temperature
o It promotes symmetrical growth of the fetus

134

o precursor of the placenta-aids in transferring maternal nutrients and oxygen which diffuse through the chorion to the embryo

yolk sac

135

♣ Fluid that baby is in in the amniotic sac
♣ Cushions embryo/fetus
♣ Controls temperature
♣ Promotes growth
♣ Prevents fetal adherence to amnion
♣ Allows freedom of movement to amnion
♣ Contain fetal cells that can provide important info about fetus

amniotic fluid

136

• withdrawal of amniotic fluid for genetic testing, LS ratio (breathing)

amniocentesis

137

• measuring amount of amniotic fluid in amniotic sac

amniotic fluid volume test

138

: less than 300cc amniotic fluid, usually abnormality in renal system in neonate

oligohydramnios

139

: more than 2L of fluid

poligohydramanous

140

Umbilical cord contains

3 vessels

1 vein & 2 arteries

141

Umbilical cord is covered by?

Whartons jelly

142

Cord connects what?

Placenta to fetus

143

Carries oxygenated blood

Umbilical vein

144

Carries un-oxygenated blood and wastes

Arteries

145

What covers the 3 vessels

Very thick & mushy

This is where the vessels are embedded

Whartons jelly

146

The maternal placental embryonic circulation is in place by day

17

147

Located on maternal side of placenta and serve as functional units

Cotyledons (lobes)

148

Which side is very vascular?

Moms side

149

Functions of the placenta

Produces estrogen& progesterone

150

Placenta stores and excretes nutrients such as

Carbs
Ca
Iron

151

Basis for pregnancy test

Human chorionic gonadotropin

152

Placental function depends on the maternal ______ supplying the circulation

Blood pressure

153

When will nutrients not reach the placenta

Low BP

154

Stage of the fetus lasts from?

9 weeks until end of PG

155

Fetus ability to survive outside the uterus

Viability

156

Viability is usually

22-25 weeks

157

Openings between foramen ovale and the aorta and the pulmonary artery

Fetal circulatory system

158

Opening to aorta

Ductus arteriosus

159

Allows oxygenated blood into aorta to send back to baby

Ductus arteriosus

160

Where liver (oxygenated blood) & vena cava

Ductus venosus

161

Opening between R/L atrias

Foramen ovale

162

Some heart beats can be detected when?

7 weeks

163

Cardiovascular system complete by the ____ week

8th

164

First organ in fetus to function

Heart

165

After ____ weeks sufficient surfactant levels present in alveoli for survival

34 weeks

166

Active phospholipids in the amniotic fluid can be used to check for lung function

Pulmonary surfactants

167

Amniocentesis checks for

Adequate surfactant level

168

Line alveoli of baby's lungs & cost lungs to get oxygen in

Surfactants

169

If not enough surfactant what will happen

Alveoli will stick & baby won't be able to breathe

170

LS ratio stands for

Lecithin sphinomyelin

171

Used to check lung maturity

LS ratio

172

Ratio for LS

2:1

173

Lung maturity is reached by

35 weeks

174

This will cause a decrease flow to the placenta and cause hypoxia in the baby but will cause the baby to increase the surfactant level

Maternal hypertension

175

Stressors in utero that can accelerate lung maturity

Maternal HTN
Placental dysfxn
Infection
Corticosteroids use

176

Corticosteroids increase

Surfactant

177

Will decrease surfactant levels

Gestational diabetes & glomerulineohritis

178

Twins ratio

1 in 30 pregnancies

179

Examples of twins: 3!

Dizygotic or fraternal twins

Monozygotic

Conjoined

180

Two ova are produced and fertilized by separate sperm

Dizygotic or fraternal twins

181

Identical twins develop from one fertilized ovum which then divides. Same sex. Same genotype

Monozygotic

182

Chances of monozygotic

4 per 1000

183

Type of monozygotic twins in which there is incomplete embryonic separation

Conjoined

184

Chances of conjoined

1 in 50,000

185

When will the conjoined twins occur

13-15 days post conception

186

Increased risk of mulifetal pregnancies with?

Fertility drugs

187

Multi fetal pregnancies often end in?

Premature labor because amniotic bag may rupture

188

Safest prevention of STIs

Abstinence

189

Low but potential risk for STIs

Wet kissing
Vaginal intercourse with condom
Oral sex with women wearing female condom
Mutual mastiff will without contact with semen or vaginal secretions

190

High risk for STIs

Unprotected sex --oral anal contact

Multiple sex partners

Sex that causes tissue damage or bleeding

Oral sex on man or woman without latex or plastic barrier

191

Most common STI

Chlamydia

192

If left untreated chlamydia can lead to

Acute salpingitis and PID

193

Infant born from mothers with chlamydia

Conjunctivitis or pneumonia

194

How to treat baby from mom who had chlamydia

azithromycin 1gr by mouth

195

Treat Mom's for chlamydia with

Azithromycin and doxycycline

196

Instruct women with chlamydia

Sex partners be treated at saw time & no sex with themselves or others until treatment is finished

197

When should women be retested for chlamydia

3-4 months

198

Called "clap" or "drip"

Oldest communicable disease in US

Asymptomatic/complains of menstrual issues

Gonorrhea

199

Diagnosis of gonorrhea

Made by exclusions of other dx processes

200

Can loose what if you have gonorrhea

Reproductive abilities

201

Specifically genital warms more frequently in PG women due to immunosuppression


Usually asymptomatic until PG, then lesions appear

Human papillomavirus HPV

202

Numerous warty growths on the vocal cords

Can occur which would lead to death or significant morbidity of the neonate

Juvenile laryngeal papillomata