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NURS372 > Week 2: Antenatal care > Flashcards

Week 2: Antenatal care Flashcards

(74 cards)

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1
Q

Ontario perinatal record

A

standardized document that collects demographic info helpful in understanding info about family, education, history, etc.

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2
Q

what hormones are responsible for physiological changes and maintaining pregnancy

A

estrogen and progesterone

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3
Q

estrogen jobs

A
  • stimulates tissue growth in uterus and breasts
  • prevents ovulation by suppressing LH and FSH
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4
Q

what happens to the heart rate

A

increase by 10-15 bpm

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5
Q

what happens to the blood volume

A

increase by 1500 mL or 40-50% above pre-pregnancy

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6
Q

what does more plasma do

A

create hemodilution effect causing hemoglobin and hematocrit levels to drop
- AKA anemia

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7
Q

what happens to the cardiac output

A

increase pre-load
- increase by 30-50%

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8
Q

what hormone causes vasodilation of blood vessels and what does that cause

A

progesterone
- slight decrease in BP and hypostatic hypotension

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9
Q

what are the changes in systolic and diastolic pressures

A

systolic has slight or no decrease
diastolic has slight decrease at 24-32 weeks

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10
Q

what occurs as a result of compression of the iliac vein and inferior vena cava

A

dependent edema
varicose veins
hemorrhoids

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11
Q

what are individuals at risk for regarding the CVS changes

A

increase risk of blood clots due to increased clotting factors
- a lot of coagulation changes
- acts protectively for post partum hemorrhage but increases risks during pregnancy

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12
Q

how do you prevent varicose veins

A
  • avoid prolonged standing
  • compression stocking
  • elevating legs
  • physical exercise to improve circulation
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13
Q

supine hypotensive syndrome

A
  • second half of pregnancy
  • laying on back causes compression of vena cava
  • we see initial bradycardia to compensate and then tachycardia
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14
Q

signs and symptoms of supine hypotensive syndrome

A

pallor
dizziness
faintness
breathlessness
tachycardia
nausea
clammy and diaphoretic

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15
Q

interventions for supine hypotensive syndrome

A

LEFT LATERAL RECOVERY POSITION to recover perfusion

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16
Q

how does fetal heart rate respond to supine hypotensive syndrome

A

bradycardia due to less perfusion
- called a deceleration

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17
Q

what happens to oxygen consumption

A

increases by 20-40% and works 50% harder to increase oxygenation of increased blood volume

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18
Q

what happens to respiratory rate

A

unchanged or slightly increased

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19
Q

what happens to chest expansion

A

increases due to estrogen and progesterone
(estrogen causes loosening of ligaments)

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20
Q

what happens to the tidal volume

A

increases by 30-40%

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21
Q

what happens to congestion and vascularity

A

both increase
- nasal stiffness, nosebleeds
- increase vascular nature causing rupture and lead to nosebleeds

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22
Q

what happens to the renal pelvis and ureters

A

they dilate
- progesterone causes more vasodilation increasing GFR, increasing urine output

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23
Q

what is urinary stasis or stagnation? what causes it

A

decreased motility and backflow of urine
- increases risks of UTIs
- caused by progesterone

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24
Q

why do we screen for UTIs

A
  • pre-term birth risk
  • weakening of amniotic membrane causing premature rupture of membranes
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25
what happens to urination
increases due to increased bladder sensitivity and later compression on bladder
26
what happens to bladder tone
decreases due to progesterone
27
what is the impact on edema and renal blood flow
increase edema due to decrease renal blood flow and GFR close to end of pregnancy
28
what happens to the nipples
darkening to physiologically allow baby to find food source
29
what is chloasma
mask of pregnancy - blotchy, brown hyperpigmentation in cheeks, nose, forehead - due to hormonal changes
30
what is linea nigra
pigmented line extending from symphysis pubis to top of fundus
31
what is striae gravidarum
stretch marks
32
what happens to the breasts and what causes the changes
estrogen and progesterone cause increase in fullness and sensitivity
33
what are montgomery tubercles
sebaceous glands that secrete lubrication and anti-infective substances to protect nipple during breastfeeding
34
what is colostrum
creamy premilk fluid expressed from nipples - initial part of breast milk that contains high immunological properties and is rich in protein
35
what happens to the uterus
changes in size, shape, position due to estrogen and progesterone levels
36
when is uterus palpable
inbetween 12-14 weeks
37
explain the shape change and when uterus rises to level of umbilicus
20-22 weeks upside down pear and then becomes globular
38
hegar sign
internal and external assessment of the softening and compressibility of the lower uterine segment
39
what are the hegar signs of the cervix between nullipara and multipara
nulipara: cervix round multipara: cervix is more horizontal oval and external os is transverse slit
40
when do braxton hicks contractions begin and what are they
begin ~ 4 months practice contractions, not painful they supply oxygen blood flow to area
41
what is godell sign
softening of cervical tip
42
what is chadwick sign
increased vascularity to cervix causing violet-blue colour of vaginal mucosa and cervix
43
what is leukorrhea
white/grey mucoid discharge with faint musty odour due to estrogen and progesterone
44
what happens to the thickness and pH of vaginal secretions
thickening increases and pH changes to act as barriers against organisms
45
what happens to the appetite and GI motility
fluctuate appetite - progesterone decreases motility and nutrient absorption - can result in constipation
46
what is hyperemesis gravidirum
extreme and consistent nausea
47
what are pharmacological interventions for nausea and vomiting
diclectin ondansetron
48
what happens to the gum
become swollen and vascular with excessive saliva
49
what can gingivitis and poor dental health result in
preterm birth low birth weight pre-eclampsia
50
what causes carpal tunnel syndrome
edema that compresses medial nerve (welling)
51
what is acroesthesia
numbness of hands
52
why do tension headaches occur
due to hormonal changes
53
what are the 9 routine antenatal assessments
1. confirm gestation age 2. current weight 3. blood pressure 4. urinalysis 5. symphysis fundal height 6. fetal presentation 7. fetal heart rate 8. fetal movement 9. health teaching
54
what is fundal height and what is it used for
distance from symphysis public bone to top of uterus (fundus) and is used as an indicator of fetal growth
55
when do you begin measuring fundal height
18-20 weeks
56
at week 18, what should the fundal height equal
equal gestational age +/- 2 cm
57
influences of fundal height
- amniotic fluid - carrying multiples (do not use this measurement) - position of fundus - position of fetus - maternal obesity - examiner technique
58
why does the fundal height drop at 36-40 weeks
baby descends into pelvis - lightening (dropping of fetus)
59
what is used for intermittent auscultation
doppler stethosoe or fetoscope
60
what do you do to measure FHR
count for 1 minute and note quality and rhythm
61
where is FHR best heard
inbetween scapulas on the back
62
in continuous monitoring, what do the top and bottom electrodes measure
top: uterine contraction including frequency, duration, and resting tone in between contractions bottom: fetal heart rate
63
on an external monitor, what does the one small square symbolize and what does one big box symbolize
small: 10 seconds big: 1 minute
64
when are leopold's maneuvers completed and what do they assess
third trimester to assess for fetal lie, presentation, flexion/attitude, position and engagement
65
when do fetal movements begin
13-16 weeks but 100% by 24 weeks
66
how do you measure fetal movements
use kick counts - count for 2 hours - need minimum 6 movements in 2h
66
what can impact fetal movement
placenta placement - usually upper back but we can have anterior placenta that blocks fetal movement
67
what do we assess for prenatal nutrition
- dietary intake - seeing if we are gaining the appropriate weight to support pregnancy
68
what are some common lab tests completed
- hemoglobin - ABO/Rh - Antibody screen - Maternal cell volume (RBC volume indicating iron deficiency or thalassemia) - platelets (thrombocytopenia = low)
69
when do we repeat the hemoglobin, platelet and antibody test
28 weeks
70
when do we do 1h glucose challenge test and why
screening for gestational diabetes done routinely at 28 weeks
71
when do we do a group B streptococcus swab
35-37 weeks
72
explain the development of maternal sensitization to Rh agents
If fetal Rh+ enters maternal system and mother is Rh-, mother creates antibodies that start to attack the surface of fetal RBC. We give immune globulin.
73
which immunizations are recommended for pregnant women
- tetanus - diphtheria - pertussis (Tdap - 21-32 weeks) - influenza / covid - RSV vaccine (32 and 36 weeks)

NURS372 (5 decks)

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