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NUR 213 > Unit 2 > Flashcards

Unit 2 Flashcards

1
Q

What percentage of pregnancies are planned in the US?

A

50%

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2
Q

How much folic acid should all women of reproductive age take?

A

400µg folic acid daily

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3
Q

Gravidity

A

Number of pregnancies, regardless of outcome

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4
Q

Parity

A

number of pregnancies carried to 20 weeks (this number may vary by region)

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5
Q

Term

A

of pregnancies* that ended at 37 weeks or beyond

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6
Q

Preterm

A

of pregnancies* ending between 20 and 36 weeks 6 days

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7
Q

Abortion

A

of pregnancies* ending prior to 20 weeks (may be further split into “spontaneous” and “induced”). Stillbirths are not included

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8
Q

Living Children

A

of children alive at time of recording

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9
Q

EDD

A

estimated due date

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10
Q

Naegele’s rule

A

Take first day of Last Menstrual Period, subtract 3 months from the date and add 7 days.

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11
Q

When should ultrasound measurements be taken to accurately measure due dates

A

20 weeks

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12
Q

Physicians

A

May be Obstetrician (generalist or high-risk perinatologist) or Family Practice.
Able to perform cesarean deliveries, operative vaginal births, and complex repairs.

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13
Q

Midwives

A

May be Nurse Midwife or Lay midwife
Cannot perform cesarean deliveries or complex repairs
Midwife births tend to have fewer interventions

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14
Q

Doulas

A

Birth support, not responsible for the birth itself but for anticipating and responding to a family’s nonmedical needs
Provide emotional, physical, and informational support

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15
Q

Tests to obtain for pregnant women

A
  • CBC
  • Blood Type
  • VDRL (screening for syphilis)
  • TB screening
  • Hepatitis B screen
  • HIV screen
  • Urinalysis
  • Pap Test
  • Maternal serum alpha protein, hCG level, Inhibin A, and nuchal lucency
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16
Q

Glucose Challenge Test done..

A

24-26 weeks, 1 hour GCT done, if elevated, 3 hour done

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17
Q

Each visit includes:

A
  • VS
  • Weight
  • Urine
  • Fundal height
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18
Q

Wt. gain in first trimester

A

1.1-4.4 lb

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19
Q

Wt. gain in second trimester

A

majority of the weight is gained in this trimester

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20
Q

Third Trimester wt. gain

A

weight gain should slow down. Large swings in weekly weight gain can indicate fluid retention

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21
Q

Nutritional education for pregnant women

A
  • Start taking a prenatal vitamin if not already doing so; include DHA Omega-3 fatty acid)
  • Increase carbohydrate in 45g daily above nonpregnant needs
  • Increase protein in 25-30g daily above nonpregnant needs
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22
Q

Caloric intake in pregnant women

A

First Trimester: no change needed
Second Trimester: increase in 340kcal above nonpregnant needs
Third trimester: increase in 452 kcal above nonpregnant needs

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23
Q

Nutrient needs of pregnant women

A
  • Water soluble vitamins (B6, B12, C, folic acid, riboflavin, thiamine and niacin) are not stored by the body and should be included in the daily diet.
  • The pregnant woman needs 27mg of iron daily (increase from 18mg).
  • Calcium
24
Q

What food should be avoided by pregnant women?

A
  • Raw fish
  • Raw eggs
  • Deli meat
  • Unpasteurized juices
  • Raw sprouts
  • Unwashed fruits and vegetables
  • Undercooked meats
  • Alcohol
  • Specific meds
25
Q

Pica

A
  • cravings for nonnutritive substances such as ice, clay or dirt.
  • Often associated with iron-deficiency anemia or other nutritional deficiencies
26
Q

Harmful Substances

A
  • Smoking
  • Caffeine
  • Alcohol
  • Drugs
27
Q

Pain relief during labor

A

Epidural Anesthesia
IV narcotics
Natural pain relief methods such as HynoBirthing, patterned breathing, essential oils and hydrotherapy

28
Q

Prepregnant uterus wt. and capacity

A

70g with a capacity of 10ml

29
Q

38-42 weeks uterus wt. and capacity

A

1100-1200g and has a capacity of 5 L

30
Q

Braxton Hicks Contractions

A

irregular, painless contractions with intermittent tightening and relaxation

31
Q

Hegar’s sign

A

Softening of the isthmus (lower portion) of the uterus

32
Q

Changes of cervix in pregnancy

A
  • Most obvious change is in consistency and color
  • Increasing levels of estrogen cause hyperemia (congestion of blood)
33
Q

Chadwick’s sign

A

bluish-purple color that extends to include the vagina and labia, one of the earliest signs of pregnancy

34
Q

Goodell’s sign

A

After conception, the cervix feels soft more like the lips or earlobes

35
Q

Operculum

A

mucous plug in the cervix that creates a barrier against outside pathogens

36
Q

Vagina and Vulva changes in pregnancy

A

More vascularity gives it the same bluish color
Softening of the connective tissue allows it to distend during birth.
Leukorrhea of pregnancy
- White, thick discharge, may be copious
- Should not smell foul or fishy

37
Q

Progesterone purpose

A
  • must be present in adequate amounts for a healthy pregnancy in the earliest stages.
  • Progesterone suppresses contractions of the uterus that would reject the fetus.
38
Q

Colostrum is secreted when?

A

early as 16 weeks

39
Q

How common is a systolic murmur in pregnancy?

A

90% of women have it

40
Q

How common is a third heart sound in pregnancy?

A

80% of women have it

41
Q

Cardiovascular changes in pregnant women

A
  • Myocardium increases in size
  • Total Blood Volume increases
  • Plasma increases
  • Diluted Hgb/Hct
  • Increase in cardiac output
  • Increase in heart rate
  • Systemic vascular resistance drops during pregnancy
42
Q

Blood pressure and blood flow changes in pregnant women

A
  • Diastolic blood pressure drops slightly, 10-15mmHg
  • Supine hypotension in late pregnancy
  • Increase in WBC
  • Hypercoagulable state
  • Renal plasma flow increases by 30% to remove more metabolic waste
  • Blood pools in lower extremities as the uterus obstructs the inferior vena cava and the iliac veins
43
Q

Respiratory System changes in pregnant women

A
  • Oxygen consumption increases 15-20% in pregnancy
  • Increased tidal volume
  • As the uterus grows, the diaphragm is elevated leading to rib cage expansion
44
Q

GI System changes in pregnant women

A
  • Unless the woman is nauseated the appetite increases. Food intake may increase 15-20% in early pregnancy
  • gingivitis and bleeding gums called epulis, which regresses after birth
  • ptyalism
  • Esophageal sphincter tone decreases causing heartburn
  • constipation
  • Liver is pushed up and alkaline phosphate levels are 2-4 times higher
  • Emptying time of gallbladder is slowed predisposing to gallstones.
45
Q

ptyalism

A

excess saliva

46
Q

Urinary System changes in pregnant women

A
  • Increased frequency and urgency is normal in pregnancy
  • Bladder capacity doubles by term, tone decreases due to progesterone.
  • Nocturia is common
  • Kidneys increase in size and change shape
  • GFR increases by up to 50%, glucose excretion increases and glycosuria is common.
  • Urine output is increased, mild proteinuria can be common in pregnancy.
  • Increased risk for UTIs starting in week 6 through week 24 because of changes in the urinary tract
47
Q

Skin, Hair, Nails changes in pregnant women

A
  • Increased circulation to skin helps to dissipate more heat produced by increased metabolism.
  • Increase in blood vessel dilation causes angiomas, redness of palms and soles of feet known as palmar erythema.
  • Striae gravidarum
  • Hair grows more rapidly and less falls out, nails become more brittle
48
Q

melasma, chloasma, or “mask of pregnancy”

A

Hyperpigmentation on cheeks, forehead or the bridge of the nose.

49
Q

Linea alba

A

longitudinal line marking the middle of the abdomen, darkens to become the linea nigra. It usually disappears after pregnancy.

50
Q

Musculoskeletal changes in pregnant women

A
  • lordosis
  • round ligament pain
  • diastasis recti
51
Q

Diastasis Recti

A

abdominal muscles separate

52
Q

Normal Discomforts of Pregnancy

A
  • Fatigue
  • Dyspnea
  • Orthostatic hypotension
  • Supine Hypotension
  • Edema
  • Varicosities
  • Varicose veins, vulvar varicosities, or hemorrhoids
  • Headaches
  • Breast tenderness and leaking
  • Urinary frequency and stress incontinence
  • Nausea and vomiting (Usually stops at end of 1st trimester)
  • Food aversions or cravings
  • Heartburn
  • Constipation
  • Acne, pigmentation changes, and dry skin
53
Q

Preeclampsia

A

Edema that arises suddenly, particularly with other symptoms such as blurred vision, epigastric pain, or headache

54
Q

Presumptive Symptoms of Pregnancy

A
  • Amenorrhea
  • Nausea
  • Fatigue
  • Urinary frequency
  • Breast tenderness or enlargement
55
Q

Probable Signs of Pregnancy

A
  • Positive hCG pregnancy test
  • Abdominal enlargement
  • Goodell’s sign
  • Hegar’s sign
  • Chadwick’s sign
  • Ballottement
    -Braxton Hicks Contractions
56
Q

Ballottement

A

Palpation of fetal outline

57
Q

Positive Signs of Pregnancy

A
  • Auscultation of fetal heart sounds on Doppler
  • Fetal movement palpated by an examiner
  • Ultrasound visualization of pregnancy

NUR 213 (3 decks)

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