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MATERNAL > PREGNANCY > Flashcards

PREGNANCY Flashcards

1
Q

Refers to the medical and nursing care given to the pregnant woman between conception and the onset labor

Consideration is given to the physical, emotional, and social needs of the woman, the unborn child, her partner, and other family members

A

Pregnancy-antepartum

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2
Q

The process of carrying or being carried in the womb between conception and birth

A

Gestation

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3
Q

Is the ability of a fetus to survive outside of the womb at the end of 20 weeks

A

Viability

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4
Q

Is the number of times pregnant, regardless of duration and outcome, including the present pregnancy

A

Gravida

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5
Q

Is a woman who has not and never has been pregnant

A

Nulligravida

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6
Q

Is a woman pregnant for the first time

A

primigravida

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7
Q

Is the number of pregnancies that lasted more than 20 weeks, regardless of outcome

A

Para

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8
Q

Is a pregnant for second or subsequent time

A

Multigravida

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9
Q

is a woman who has not given birth to a baby beyond 20 weeks gestation

A

Nullipara

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10
Q

Is a woman who has given birth to one baby more than 20 weeks gestation

A

Primipara

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11
Q

Para is subdivided to reflect births that went to Term, Premature births, abortions, and living children

A

TPAL

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12
Q

A newbord born before 37 weeks of gestation

A

Preterm

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13
Q

Is a newborn born after 37 weeks to 40 weeks of gestation

A

Term

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14
Q

Is a newborn born after 40 weeks

A

Post term

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15
Q

LMP

A

Last Menstrual Period

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16
Q

EDC

A

Expected date of delivery/confinement

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17
Q

AOG

A

Age of Gestation

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18
Q

CIL

A

Cephalic in Labor

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19
Q

Duration of pregnancy

A

266-280 days, 38-42 weeks, 9 calendar months, 10 lunar months (28 days)

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20
Q

Periods of pregnancy

A

First trimester, 2nd, 3rd

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21
Q

Period organogenesis; teratogens are highly damaging

A

First trimester

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22
Q

Most comfortable period for mother, fetal growth continues

A

Second trimester

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23
Q

rapid deposition of fats, thus period of most rapid growth, with rapid iron and calcium deposition

A

Third Trimester

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24
Q

CONDITIONS FOR FERTILIZATION

A
  1. live, motile, normal sperm present in cervical mucus
  2. Fallopian tubes paten
  3. endometrial biopsy indicates adequate progesterone and secretory endometrium
  4. Semen is supportive to pregnancy at least 2 ml semen and contain at least 200 million sperm/ml >60% normal and >50% motile (moving forward)
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25
Q

The production of offspring; in general humans copulate purely for the purpose of procreation

A

Procreation

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26
Q

TWO RELATED THEORIES FOR PROCREATION

A

CREATION AND EVOLUTION

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27
Q

God created the world and all that’s in it, including humans, and they reproduce through sexual intercourse

A

Creation

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28
Q

Darwin’s theory that humans evolved over the years through natural occurrences and from the growth and development of monkeys and other creatures

A

Evolution

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29
Q

This happened during sexual intercourse

A

some sperm ejaculated from the male penis swim up through the female vagina and uterus toward an oocyte (Egg cell) floating in one of the uterine tubes

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30
Q

Fertilization takes place where

A

ampula (outer 1/3) portion of the fallopian tube

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31
Q

The sperm and egg are ___

A

gametes

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32
Q

the sperm and egg contain half the ____ necessary for production. When a sperm cell penetrates and fertilizes an egg, that genetic information combines

A

genetic information

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33
Q

The 23 chromosomes from the sperm pair with 23 chromosomes in the egg, forming a 46- chromosome cell called a

A

zygote

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34
Q

___ Starts to divide and multiply. As it travels toward the uterus it divides to become a ___, which will burrow into the uterine wall

A

zygote ; blastocyst

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35
Q

A fertilized egg, or zygote takes about how many days to reach the uterus from the uterine tube

A

Five days

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36
Q

As the zygote moves, the zygote divides and develops into a ___, with an inner mass of cells and a protective outer ring

A

blastocyst

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37
Q

attaches to the wall of the uterus and gradually implants itself into the uterine lining

A

blastocyst

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38
Q

During implantation, its cells differentiate further. At day 15 after conception, the cells that will form the embryo become an

A

embryonic disc

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39
Q

the___, on one side of the disc, will become part of the digestive tract

A

yolk sac

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40
Q

As the cells multiply, they will also separate into two distinctive masses:

A
  1. the OUTER CELLS will eventually become the placenta and umbilical cord, which will bring in nutrients and eliminate waste and
  2. the inner cells from the embryo
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41
Q

On the other side, the ___ fills with fluid and will surround the embryo as it develops

A

amnion

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42
Q

By week 4, the embryo ____

A

the embryo has a distinct head and tail and a beating heart

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43
Q

Over the next six weeks, _________ form. Primitive versions of all body systems appear

A

limbs, eyes, brain region, and vertebrae form

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44
Q

In eight weeks, the embryo develops
contains a flat embryonic disc that now differentiates into three layers:

A

endoderm, mesoderm, ectoderm

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45
Q

skin and nervous system

A

ectoderm

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46
Q

digestive and respiratory system

A

Endoderm

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47
Q

Muscle and skeletal systems

A

Mesoderm

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48
Q

All organs of the human body derive from these three tissues called___. They begin to curve and fold and to form an oblong body

A

Ectoderm, Endoderm, Mesoderm

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49
Q

10th week of pregnancy

A

your baby will change names from an embryo to a fetus. There are about 40 weeks to a typical pregnancy. These weeks are divided into three trimesters

50
Q

Pregnancy is often measured in terms

A

gestational age

51
Q

age of the fetus starting with the first day of a woman’s last menstrual period

A

gestational age

52
Q

actual age of the growing fetus.

A

embryonic or fetal stage

53
Q

STAGES OF FETAL DEVELOPMENT

A

Ovum- from ovulation to fertilization
Zygote - (12-14 days after fertilization) from the time the ovum is fertilized until is is implanted in the uterus
Embryo- from implantation to 5-8 weeks. During this period, embryo is most vulnerable to teratogens: viruses drugs radiation or infection can cause major congenital anomalies
Fetus- 8-10 weeks until term(38-41 weeks)

54
Q

from ovulation to fertilization

A

Ovum-

55
Q

(12-14 days after fertilization) from the time the ovum is fertilized until is is implanted in the uterus

A

Zygote -

56
Q

from implantation to 5-8 weeks. During this period, embryo is most vulnerable to teratogens: viruses drugs radiation or infection can cause major congenital anomalies

A

Embryo-

57
Q

8-10 weeks until term(38-41 weeks)

A

Fetus-

58
Q

is the developing embryo or fetus and placental structures throughout pregnancy

A

Conceptus

59
Q

the earliest age at which fetuses could survive if they were born at that time, generally accepted as 24 weeks, or fetuses

A

Age of viability

60
Q

During intra uterine life the fetus derives _______, not from O2 exchange in the lungs but from the ____

A

O2 and excrete carbon dioxide ; placenta

61
Q

is connected by the umbilical cord to the placenta, the organ that develops and implants in the mother’s uterus during pregnancy

A

fetus

62
Q

How does fetus receive all the necessary nutrition, oxygen, and life support from the mother through the placenta

A

through the blood vessels in the umbilical cord

63
Q

Where the gas exchange takes place during fetal life

A

Placenta

64
Q

carry unoxygenated blood from the fetus to the placenta

A

Umbilical arteries

65
Q

Brings oxygenated blood coming from the placenta to the fetus

A

Umbilical vein

66
Q

Connects the left and the right atrium. It pushes blood from the right atrium to the left atrium so that blood can be supplied to brain, kidney, and heart.

A

Foramen ovale

67
Q

Carry oxygenated blood from umbilical vein to inferior venacava, by passing fetal liver

A

ductus venosus (vein to vein)

68
Q

carry unoxygenated blood from the pulmonary artery to aorta, by passing

A

Ductus arteriosus (artery to artery)

69
Q

FETAL CIRCULATION

A

The oxygenated blood enters the umbilical vein from the placenta -> enters ductus venosus that connects the umbilical vein to the inferior venacava, w/c allows oxygenated blood to be supplied directly to the fetal liver -> it passes through inferior venacava -> enters the right atriums (heart) -> enters the foramen ovale (opening bet. rt. atrium and left atrium)
-> goes to the left atrium -> passes through the left ventricle -> flows to ascending aorta to supply nourishment to the brain and upper extremities -> it enters superior venacava (return to the heart) goes to the right atrium -> enters the right ventricle -> enters pulmonary artery with some blood going to the lungs to supply oxygen and nourishment -> it flows to ductus arteriosus (channel bet. aorta and main pulmonary artery) Allows blood to bypass the fetal lung. It closes during normal respiration -> It enters descending aorta (some blood going to the lower exteremities) -> and enters hypogastric arteries that return the blood to the placenta (unoxygenated blood because it is away from the fetal heart) -> and goes back to the placenta

70
Q

During pregnancy, the pregnant mother undergoes significant anatomical and physiological changes in order to:Wh

A

nurture and accomodate the developing fetus

71
Q

When do maternal changes start?

A

after conception. and it affects every system in the body. These changes resolve after pregnancy with minimal residual effects

72
Q

Maternal changes 8 weeks AOG

A
  • Nausea persists up to 12 weeks
  • Uterus changes from pear to globular shape
  • hegar’s sign: softening of the isthmus cervix
    -goodell’s sign: softening of the cervix
    -leukorrhea increases
    -ambivalence about pregnancy may occur
    -no noticeable wieght gain
    -chadwick’s sign appears (dark bluish or purplish) appears as early as 4 weeks’ gestation
73
Q

Fetal development 8 weeks AOG

A

-Rapid development
- heart begins to pump blood
-limb buds are well developed
-facial features discernible
-major divisions of brain discernible
-ears develop from skin folds
-tiny muscles are formed beneath this skin
-embryo weighs 2 grams

74
Q

Nursing intervention 8 WEEKS AOG

A
  • Teach prevention of nausea
    *Eat dry crackers before getting out of bed in the morning
    *Eat small, frequent meals and avoid fatty foods
    *increase fluid intake to 3L/day
    -Teach safety
    *Avoid hot tubs, saunas, and steam rooms throughout pregnancy (hypotension may cause fainting)
    -Prepare for pregnancy
    *Discuss attitudes toward pregnancy
    *discuss value of early pregnancy classes that focus on what to expect during pregnancy
    *provide information about childbirth preparation classes
    *include father/family in preparation for childbirth (expectant fathers experience many of the same feeling/conflicts experienced by the expectant mother)
75
Q

Maternal changes (28 weeks aog)

A

-Fundus halfway between umbilicus and xiphoid process
-thoracic breathing replaces abdominal breathing
-fetal outline palpable
- woman becomes tired of pregnancy and eager for delivery
-heartburn may begin
-hemorrhoids may develop

76
Q

Fetal Development 28 weeks (AOG)

A

Fetus can breathe, shallow, regulate temperature
-surfactant forms in lungs
-fetus is 2/3 birth size
-baby can hear
-eyelids open
-period of greatest fetal weight gain begins
-fetus weighs 1100 gms (21/2 lbs)

77
Q

Nursing intervention 28 WEEKS AOG

A
  • Treatment for hemorrhoids
    *Sit’z bath
    *gentle reinsertion of hemorrhoids with lubricated fingertips
    *suppositories as ordered
    *topical anesthetic agents
    *stool softeners as ordered
  • Teach comfort measures
    *elevate legs when sitting
    *assume side-lying position when resting
    -Teach measures to avoid heartburn
    *eat small frequent meals
    *avoid fatty foods
    *avoid lying down after meals
    *Maalox or Mylanta may be helpful
    *avoid sodium bicarbonate
    -Prepare for delivery and parenthood
    *discuss mother’s/father’s/family expectations of labor and delivery
    *discuss mother’s/father’s/family expectations caring for infant
    *start childbirth preparation classes
78
Q

Maternal changes ( 32 weeks AOG)

A

-fundus reaches xiphoid process
-breast full and tender
-urinary frequency returns
-swollen ankles may occur
- sleeping problems may develop
- dyspnea may develop

79
Q

Fetal development (32 weeks AOG)

A

-brown fat develop beneath skin to insulate baby following birth
-fetus is 15-17 inches in length
- begins storing iron, calcium and phosphorous
-fetus weighs 1800-2200 gms (4-5 lbs)

80
Q

Maternal Changes 38 WEEKS AOG

A

Lightening occurs
-placenta weighs approximately 20oz
Mother eager for birth, may have burst of energy
-backaches increase
-urinary frequency increases
-braxton hick’s contractions intensify (cervix and lower uterine segment prepare for labor)

81
Q

Fetal Development (38 weeks AOG)

A

Fetus occupies entire uterus; activity is restricted
-maternal antibodies are transferred to fetus (provides immunity for approximately 6 months, until infant’s own immune system can take over)
-fetus weighs 3200 grams and more (7lbs)

82
Q

Nursing interventions 38 weeks AOG

A

-Teach safety measures
*wear low heeled shoes or flats
*avoid heavy lifting
*sleep on side to relieve bladder pressure; urinate frequently
-prepare for delivery
*continue pelvic tilt exercises
*pack a suitcase for delivery
*fundus reaches xiphoid process
*breast full and tender
*urinary frequency returns
*swollen ankles may occur
*sleeping problems may develop
*dyspnea may develop

83
Q

Is probably caused by reduced blood circulation due to uterine pressure and gen fluid retention

A

Ankle edema

84
Q

Management for Ankle Edema

A

-sitting with your feet elevated
-resting in left side lying position
-avoid standing for long period of time
-avoid using restrictive garments on the lower half of your body.

85
Q

To maintain the balance that may lead to backache (lumbar lordosis) or the pride of pregnancy

A

Backache

86
Q

Management for backache

A

-Apply local heat
-Avoid long periods of standing
-Advise to squat rather than bent to pick up objects
-Wear low-heeled shoes
-maintain correct posture
-used of firm mattress
-tailor sitting, pelving rocking and shoulder circling exercises to strengthen back
-Acetaminophen (tylenol) in usual adult dose may help

87
Q

Breast tenderness Management

A
  • wear a supportive bra with a wide shoulder strap
    -decrease the amount of caffeine and carbonated beverages ingested
88
Q

As the weight of the growing uterus presses against the bowel that slows down the peristalsis and also due to increase progesterone level

A

Constipation

89
Q

Management constipation

A

-increase fiber in your diet
-drink additional fluids
-have inhibits gastric motility a regular time for bowel movements
-exercise and use stool softener as prescribed. Enema is contraindicated

90
Q

A pregnant women experiencing difficulty in sleeping due to enlarged abdomen that compresses the diaphragm

A

Difficulty sleeping

91
Q

Difficulty sleeping management

A

Drink a warm caffeine-free drink before bedtime
-practice relaxation techniques

92
Q

Is a feeling of constant tiredness or weakness and can be physical mental or combination of both

A

Fatigue

93
Q

Management for fatigue

A

-Schedule rest periods daily
-Have a regular bedtime routine
-use extra pillow for comfort

94
Q

Management for faintness

A

-move slowly
-avoid crowds
-remain in a cool environment
-always lie on your left side when at rest

95
Q

Is due to expanding blood volume which put pressure on cerebral arteries

A

Headache

96
Q

Management for headache

A

-avoid eye strain. Visit your eye doctor
-Rest with a cool cloth on your forehead
-and report immediately on persistent headaches to your primary care provider

97
Q

is due to increase progesterone that slows gastric motility

A

Heartburn

98
Q

Management for heartburn

A

-eat small, frequent meals each day
-avoid overeating as well as spicy, fatty, and fried foods

99
Q

Is a condition that causes the overproduction of saliva
- due to hyperacidity that increases salivation

A

Ptyalism

100
Q

Management of ptyalism

A

-Use mouthwash as needed
-chew gum or suck on hard candy
-brush and floss daily, watch your diet

101
Q

is an uncomfortable sensation in the abdomen near the hips or into the groin area

A

Round ligament pain/abdominal discomfort

102
Q

Round ligament pain/ abdominal discomfort management

A

-avoid twisting motions
-rise to a standing position slowly and use your hands to support the abdomen
-bend forward to relieve discomfort
-rest and yoga exercises may help, and you may want to avoid sudden movements.

103
Q

Due to to compression in the diaphgram related to growing fetus

A

Shortness of breath

104
Q

Shortness of breath management

A

-use proper posture
-use pillows behind the head and shoulders at night
-adequate rest period

105
Q

URINARY FREQUENCY

A

1st trimester - increase urination due to increase blood supply to kidney
2nd trimester - decrease urination
3rd urination- increase urination due to pressure

106
Q

Management urinary frequency

A
  • Void as necessary at least every 2 hours
  • increase fluid intake
  • avoid caffeine
  • practice kegel exercises (contracting and relaxing perineal muscles) to decrease urinary incontinence
107
Q

Due to increase progesterone level

A

Vaginal discharge/ Leukorrhea

108
Q

Management for Vaginal discharge/ Leukorrhea

A

Wear cotton underwear and bathe daily
-avoid tight pantyhose and
-use of perineal pad

109
Q

Due to pressure on the veins returning blood from the lower extremities. This causing blood pool

A

Varicose veins

110
Q

Management for varicose veins

A

-walks regularly
- rest with feet elevated for 15-20 minutes
-avoid long periods of standing
-do not cross your legs when sitting
-avoid knee-high stockings
-wear support hosiery and take vitamin c or fresh fruits

111
Q

Varicosities of rectal veins due to gravid uterus

A

Hemorrhoids

112
Q

Management for hemorrhoids

A
  • avoid constipation and straining with a bowel movement
    -practice regular bowel movement
    -knee chest position for 10 to 15 mins to relieve pressure and replacing hemorrhoids with gentle finger can be helpful
    =take a sitz bath
    -use of stool softener as prescribed
113
Q

Is due to increased calcium levels and decrease phosphorous level and interference with circulation due to increase pressure due to gravid uterus

A

Leg cramps

114
Q

Management for leg cramps

A

-avoid pointing your toes
- Lie on her back, straighten your leg and dorsiflex your ankle
-lowering milk intake and supplementing this with calcium lactate
-stretching

115
Q

See your doctor, If you’re pregnant or have any of these conditions and are experiencing more leg crams than usual

A
  • addison’s disease
  • alcohol use disorder
  • kidney failure
  • thyroid issues’
  • parkinson’s disease
  • type 2 diabetes
  • sarcoidosis
  • cirrhosis
  • vascular disease
116
Q

Medications that contribute to leg cramp

A
  • birth control pills
    -diuretics
  • naproxen (aleve)
    -albuterol, an asthma medication
  • statins
117
Q

Due to increase HCG resulting to increase gastric acid

A

Nausea

118
Q

Management for nausea

A

-eat 6 small meals/day rather than three
- eat a piece of dry toast or some crackers before getting out of bed
- avoid foods or situations that worsen the nausea if it persists, report this problem toyour primary care provider
- drink fluid seperately rather than with your meals and avoid fried, greasy gas producing or spicy foods and foods with strong odors

119
Q

This causes nasal congestion. Increased blood flow to the nasal passages and enlargement of the nasal veins also play a role

A

Nasal stuffiness

120
Q

Management for nasal stuffiness

A

Use cool air vaporized or humidifier
- increase fluid intake
- place moist towel on the sinuses and massage the sinuses

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