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215 Cards in this Set
- Front
- Back
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What is a Chadwick's sign?
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a violet or purplish discoloration in the vagina, cervix, and vulva.
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What is amenorrhea?
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absence of menstruation
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What does quickening mean?
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sensation of fetal movement
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How accurate are presumptive signs of pregnancy?
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They indicate pregnancy, but may also signify disease. Not very accurate.
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What are the presumptive signs?
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- Amenorrhea
- n/v - frequent urination - swelling, tingling, or tenderness of the breasts - changes in abdominal shape - quickening - skin changes - chadwick's sign |
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How accurate are probable signs?
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They indicate a likelihood, but not 100%
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What are the probable signs of pregnancy?
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- enlargement of the uterus
- positive pregnancy tests (using HCG) |
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How accurate are positive signs of pregnancy?
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100% - these ONLY occur with a pregnancy.
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What are the positive signs of pregnancy?
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- visualization of the fetal skeleton in XRAY or ultrasound
- fetal movement felt by an examiner - auscultation of fetal heart beat via doppler at 10 to 12 weeks or fetoscope after 18 weeks. |
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_______ is the time from when sperm fertilizes an egg until a baby is born.
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gestation
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What are the three periods of pregnancy? NOT trimesters.
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antepartal
perinatal postpartal |
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What period is antepartal?
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begins with conception and ends with the onset of labor
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what period is perinatal?
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beginning of labor to delivery of the placenta
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what period is postpartal?
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delivery of the placenta to 6 weeks later or when reproductive organs have returned to prepregnancy state
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nulligravida
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none
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primagravida
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one
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multigravida
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multiple
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A woman who has given birth five times or more is called a ____ _____?
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grand multipara
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What is the branch of medicine concerned with reproductive health, pregnancy, and birth?
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obstetrics
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What is preconceptual care?
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care of the woman before she is pregnant.
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What patient teaching is involved with preconceptual care?
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- balanced nutrition
- vitamins (especially folic acid) - adequate rest - possible genetic counseling |
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G-gravida is what?
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total number of pregnancies a woman has had - period.
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P-para is what?
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the total number of babies born after 20 weeks gestation.
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F-full term means what?
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the total number of babies born at 37 weeks gestation
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P-preterm means what?
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the total number of babies born between 20 and 37 weeks gestation
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A-abortions means what?
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the total number of abortions (spontaneous and elective) before 20 weeks gestation.
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L-living means what?
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the total number of children currently alive.
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Where in the fallopian tube does fertilization occur?
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outer third
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What determines the sex of the baby?
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The sperm
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What does it mean when the sperm is a Y chromosome?
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BOY - XY
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What does it mean when the sperm is an X chromosome?
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GIRL - XX
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Why in the beginning of pregnancy may a woman slightly bleed and think she is just having a light menstrual cycle?
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when the zygote implants into the endometrium.
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The outermost cell layer surrounding the embryo and fluid cavity is called the ________?
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Chorion
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What are chorionic villi? And what do they do/excrete?
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- roots through which the embryo receives oxygen and nourishment from the mother.
- also secrete human HCG |
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The period of embryo lasts until what week?
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8th
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When do all the major body systems and the placenta develop?
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the embryonic phase - first 8 weeks.
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What's the purpose of amniotic fluid?
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cushioning, regulating fetal temperature, and allow room for growth.
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How much volume does amniotic fluid fluctuate?
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30ml early - up to 1L at delivery.
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What is amniotic fluid primarily composed of in late pregnancy?
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fetal urine and lung fluid.
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What month are the foundations for nervous system, genitourinary system, skin, bones, and lungs formed?
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1st lunar month
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During what month do buds of arms and legs begin to form?
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1st lunar month
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During which month do rudiments of eyes, ears, and nose appear?
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1st lunar month
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During what month is the fetus markedly bent?
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2nd lunar month
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During what month is the head disproportionally large, owing to brain development?
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2nd lunar month
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During what month does sex differentiation begin?
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2nd lunar month
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During what month do centers of bone begin to ossify?
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2nd lunar month
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During what month does the heart pulsate?
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2nd lunar month
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During what month are the toes and fingers distinct?
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3rd lunar month
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during what month is the placenta complete?
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3rd lunar month
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during what month is the fetal circulation complete?
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3rd lunar month
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during what month are the organ systems complete?
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3rd lunar month
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during what month is the sex differentiated?
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4th lunar month
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during what month do rudimentary kidneys secrete urine?
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4th lunar month
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during what month does the nasal septum and palate close?
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4th lunar month
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during what month does lanugo cover the entire body?
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5th lunar month
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during what month are fetal movements first felt by the mother?
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5th lunar month
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during what month are heart sounds perceptible by auscultation?
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5th lunar month
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during what month does the skin appear wrinkled?
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6th lunar month
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during what month does vernix caseosa appear?
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6th lunar month
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during what month does eyebrows and fingernails develop?
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6th lunar month
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during what month does the skin appear red?
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7th lunar month
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during what month does the pupillary membrane dissapear from the eyes?
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7th lunar month
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at what month does the fetus have an excellent chance of survival?
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7th lunar month
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during what month do the eyes begin to open and close?
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7th lunar month
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during what month is the fetus considered viable?
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8th lunar month
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during what month are the fingerprints set?
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8th lunar month
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during what month does lanugo dissapear?
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9th lunar month
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What functions as an endocrine gland, secreting HCG, estrogen, and progesterone, which maintain the pregnancy?
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placenta
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What supplies food and oxygen to the developing fetus?
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placenta
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what carries wastes away for excretion by the mother?
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placenta
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what slows maternal immune response so that her body does not reject fetal tissue?
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placenta
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the side of the placenta attached to the uterine wall is what color? what texture? and what is it's documented name?
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Dark red
rough surface Dirty Duncan |
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the side of the placenta against the fetus has what texture? and is documented with the name of?
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smooth and shiny
Shiny Schultze |
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Most of the umbilical cord is a pale, white gelatinous-mucoid substance called ________ _____, which prevents compression of the blood vessels.
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Wharton's jelly
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Does the umbilical cord hurt when cut?
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NOPE you fool! It has NO pain receptors.
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from the umbilical vein, blood goes to the inferior vena cava through an acessory structure called the +++++
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ductus venosus
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What allows the blood to bypass the right ventricle?
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foramen ovale
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Explain how the respiratory and digestive tracts come about?
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They are originally one tube, by the end of the 4th week a septum begins to divide the esophagus from the trachea. at the same time lung buds appear on the trachea
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spontaneous respiratory movements begin as early as _ months of pregnancy.
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3
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At __ weeks gestation, ______ excreted by the alveolar cells decreases surface tension on expiration, preventing alveolar collapse.
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24 weeks
surfactant |
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Why will the woman possible note breast fullness, tenderness, and tingling during a pregnancy?
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because of increased estrogen levels.
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What happens to the areolae and nipples during pregnancy?
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they darken and increase in size.
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By about how many weeks should the nipples be juicing out colostrum?
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16 weeks
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How do levels of estrogen and progesterone fluctuate during pregnancy?
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they rise steadily from early pregnancy until near term when they begin to decline slowly.
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How does human placental lactogen (HPL) and HCG fluctuate during pregnancy?
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They drop during the second trimester.
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What is a Coombs test?
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Test to determine if Rh antibodies are present, indicating Rh incompatibility.
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Between 15 and 19 weeks, what blood test is done? To screen for what?
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maternal serum-alpha fetoprotein (MS-AFP) to screen for neural tube defects
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When are women usually screened for gestational diabetes?
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between 24 and 28 weeks
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After the 8th month what is the frequency of visits?
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every 2 weeks
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after the 9th month what is the frequency of visits?
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every week until delivery.
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The placenta functions as an endocrine gland, secreting what hormones that maintain the pregnancy?
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HCG
estrogen progesterone |
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What organ slows maternal immune response so that her body does not reject fetal tissue?
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placenta
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The side of the placenta attached to the uterine wall is what color and what texture? Named what?
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Dark red
rough surface named dirty duncan |
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How is the side of the placenta against the fetus? and what is it named?
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smooth and shiny
shiny schultze |
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What is a normal length for an umbilical cord?
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20 to 22 inches
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Most of the cord is a pale, white gelatinous-mucoid substance called _______ ______, and what is it's purpose?
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Wharton's Jelly
prevents compression of the blood vessels. |
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Are there pain receptors within the umbilical cord?
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no
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How soon does blood exchange with the chorionic villi?
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3rd week gestation
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The umbilical vein carries blood to the inferior vena cava through an accessory structure called what?
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ductus venosus
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What allows most blood to bypass the R ventricle?
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foramen ovale
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Spontaneous respiratory movements begin as early as _ months.
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3
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At 24 weeks' gestation, what is excreted by the alveolar cells to decrease surface tension on expiration, preventing alveolar collapse?
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surfactant
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What is the name of the curvature of the lower back that goes along with pregnancy?
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lordosis
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Why might a pregnant women note breast fullness, tenderness, and tingling?
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as a result of increased estrogen levels
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What happens to the areola and nipples during pregnancy?
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darken and increase in size.
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At how many weeks may the nipples expel colostrum?
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16 weeks
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What is colostrum?
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a thin, watery, high-protein fluid that is the precursor to human milk
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How does estrogen and progesterone change during pregnancy?
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levels rise steadily from early pregnancy until near term when they begin to decline slowly
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How does human placental lactogen (hPL) and HCG change during the second semester?
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drops
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What test is completed and generally repeated at 28 weeks to determine if Rh antibodies are present, and what does it indicate?
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indirect Coombs test
indicates Rh incompatibility |
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When should a maternal serum-alpha fetoprotein (MS-AFP) done? And what does it screen?
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Between 15 to 19 weeks
Done to screen for fetal neural tube defects |
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Between 24 and 28 weeks what are women usually screened for? And what do they use to do the test?
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gestational diabetes
1-hour random glucose tolerance test |
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What is the schedule of visits after the 8th month?
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Every 2 weeks
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What is the schedule of visits during the 9th month?
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weekly visits until birth
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How much should the pregnant woman increase her daily caloric intake?
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approx 300 calories
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Should calcium intake be increased or decreased while pregnant? How many cups a day? Why?
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Increased to 3-4 cups/day. Before the last half of pregnancy to ensure proper development of fetal bones and teeth and for blood clotting.
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Protein should be increased, why?
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to build and repair body tissues and to aid in milk production for the nursing mother.
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Avoid empty calories such as: ....
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alcohol, sugared soda drinks, sweets, and salty foods.
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What should you do with salt and a pregnancy?
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limit it!
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What should your fluid intake be increased to?
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10 glasses daily to assist in kidney and bowel function
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Can you have laxatives and enemas during a pregnancy? Why?
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They should be avoided - use fiber in the diet or a stool softener, if needed.
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What is pica? And do you increase or decrease this?
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it is the craving and eating of substances not normally considered edible (clay, dirt, cornstarch) - hell no you shouldn't be eating this stuff you dip shit!
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What is the total average weight gain for a pregnant woman?
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25 - 35 pounds in an average sized woman.
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How much weight should have been gained by the 20th week gestation?
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10 pounds
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How much weight loss during the first trimester is of concern?
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8 pounds - due to excessive nausea and vomiting.
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While sleeping, what should you do to make yourself more comfortable?
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placing pillows under the abdomen and legs. promoted better body alignment and rest.
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What is a main position a pregnant woman who is approaching her due date shouldn't be in? Why?
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supine
because it may cause excessive pressure on the aorta and vena cava |
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What is the main body position that is recommended?
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side lying
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How can you relieve back pain during pregnancy?
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- wear shoes with a slight heel that provide good support
- change position frequently - limit time spent on feet |
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How can you relieve breast tenderness during pregnancy?
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- wear a bra with good support
- ensure good posture |
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What can you do to relieve constipation during pregnancy?
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- increase fluids, fiber intake, and activity
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What can you do to relieve heartburn during pregnancy?
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- eat small, frequent meals
- avoid caffeine intake - do not lie down after meals |
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What can you do to relieve insomnia during pregnancy?
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- place a pillow under the abdomen, between the legs, or both to help improve body positioning during sleep
- do not eat heavy meals before bedtime - eliminate caffeine intake - take a warm bath or shower before retiring |
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What can you do to relieve itching during pregnancy?
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- bathe with baking soda, cornstarch, or colloidal oatmeal. Do not use soap on affected areas.
- use moisturizer |
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How can you relieve mood swings during pregnancy?
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- engage in relaxation exercises (meditate, listen to soothing music)
- ask friends and family for support, understanding, and help. |
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How can you relieve nausea and vomiting during pregnancy?
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- avoid heavy and fatty meals
- drink peppermint or ginger tea |
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How can you relieve skin pigment changes during pregnancy?
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- minimize sun exposure
- use sunblock |
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How can you relieve stretch marks during pregnancy?
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- apply coconut, olive, or vitamin E oil to affected areas.
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How can you relieve swollen feet and legs during pregnancy?
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- elevate legs when sitting
- ensure adequate calcium and potassium intake |
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How can you relieve urinary frequency during pregnancy?
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- void whenever needed
- decrease fluid intake before bedtime |
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How can you relieve vaginal discharge during pregnancy?
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- do not use soap on vulva
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What is the Lamaze method?
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includes education and training. learn toning and relaxation exercises and breathing techniques. Coach provides support.
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What are other methods of coping with stress and pain during childbirth besides the Lamaze method?
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message therapy, water therapy, relaxing music and lighting, and aromatherapy.
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What is lightening? How long until labor will begin after lightening?
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when the fetus seems to settle into the pelvis and usually means labor will begin in approximately 2 weeks.
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What the hell is the bloody show?
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blood tinged vaginal mucus and indicates that the cervix has begun to change in consistency.
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What is the word for "thin"?
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efface
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What is the word for "open"?
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dilate
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What are braxton hicks contractions?
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irregular tightening of the pregnant uterus that begins in the first trimester and increases in frequency, duration, and intensity as pregnancy progresses.
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What two things are common as pregnancy reaches term?
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backache and braxton hicks contractions.
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What are examples of false labor contractions?
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- remain irregular and short
- do not strengthen or change with walking - may be relieved with rest - usually occur in the front - are not accompanied by significant cervical changes - do not lengthen, become more frequent, or happen close together. |
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What are examples of true labor contractions?
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- become regular with progression of labor
- strengthen over time and with walking - do not disappear with rest - start in the back and radiate to the front - are accompanied by dilation and effacement of the cervix - become longer and more frequent with labor (every 20 to 30 minutes or more) |
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Who is allowed to have birth outside of a hospital?
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only women in good health with uncomplicated pregnancies.
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What is the name for the lower portion of the pelvis?
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true pelvis
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What are the three segments of the true pelvis?
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cavity
midpelvis outlet |
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What is pelvimetry?
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using xrays from different views to determine pelvic size
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How may the anus appear during birth?
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dilated and bulging
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This is a term used to compare the position of the fetal and maternal spinal cords.
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Lie
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How is a normal fetal lie?
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longitudinal (up and down), placing the spine parallel to the mother's
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What is this: the fetus lies crosswise in the uterus and cannot be vaginally delivered without alteration. C section may be required.
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transverse lie
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What is the name: the relationship of the fetal body parts to one another?
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fetal attitude
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What's cephalic presentation?
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head first
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What's vertex presentation?
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face first
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What is breech presentation?
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butt first
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What are the 4 types of breech presentation?
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complete
frank footling kneeling |
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Explain complete breech presentation.
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the buttocks present and the thighs are flexed on the abdomen
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Explain frank breech presentation.
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the buttocks present and the thighs extend across the abdomen
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Explain footling breech presentation.
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either one or both legs are extended both at the hip and the knee
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Explain kneeling breech presentation.
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the legs extend at the hip but are flexed at the knee.
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What occurs when the fetal head presents at the vulva?
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crowning
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The reshaping of the skull bones in response to pressure against the maternal pelvis during birth is called what?
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molding
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What is a good indicator of fetal condition and what is the normal range?
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Fetal Heart Rate - 120 - 160 bpm
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What increase or decrease in fetal heart rate may indicate fetal distress and should be reported immediately?
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30bpm
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How often should you monitor the heart rate during the first stage of labor?
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every 15-30 minutes
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How often should you monitor the heart rate during the second stage of labor?
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every 5 minutes
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When a rupture of the membrane occurs, what should you do immediately?
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Check fetal heart rate fhr
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What does a tocodynamometer do?
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External monitor for the frequency and duration of contractions.
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Where is a tocodynamometer placed?
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directly over a woman's uterus
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A decrease in FHR in response to a contraction is called a _______ and can indicate fetat distress.
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deceleration
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What is an acceleration? And when it it considered a complication?
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a brief increase in FHR of 15 bpm or more. It's considered a complication if it is 60bpm or more.
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What's the term used for involuntary uterine contractions?
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primary powers
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What do primary powers tell you?
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it's the beginning of labor
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What are secondary powers?
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voluntary bearing down efforts by the mother
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Where do involuntary contractions originate?
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in the thickened muscle layers of the upper uterine segment
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What are primary powers?
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involuntary contractions
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What is the frequency in regards to contractions?
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time from the beginning of one contraction to the beginning of the next
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What is duration in regards to contractions?
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the length of contraction
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What is intensity in regards to contractions?
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strength of the contraction
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What is duration in regards to contractions?
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the length of contraction
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What is intensity in regards to contractions?
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strength of the contraction
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When is dilation complete?
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10cm
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What are secondary powers?
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bearing down - voluntary pushing
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When do contractions become expulsive?
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as soon as the presenting part reaches the pelvic floor
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Does the secondary powers have any effect on cervical dilation?
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nope
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How is the pain during the first stage of labor?
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mild
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What is the most common pain related complaint during stage 1 early latent phase of labor?
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backache
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What does frequent position changes do to labor during the early latent phase of stage 1?
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enhances the progress
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how dilated is the cervix in the early latent phase of stage 1 labor?
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0-3cm
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How dilated is the cervix in the mid/active phase of stage 1 labor?
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4-7cm
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How dilated is the cervix in the transitional phase of stage 1 labor?
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7-10cm
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How is the pain during the transitional phase of stage 1 labor?
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getting rough - may request pain meds. and nausea may be present.
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What are some nonpharmacologic methods of relieving pain during labor?
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- conscious relaxation
- music - massage - breathing techniques - diversional activities - water therapy - aromatherapy |
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Should a woman use the valsalva maneuver for pushing during labor?
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hell no! it increases intrathoracic pressure, reduces venous return, and increases venous pressure. Fetal hypoxia may occur.
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What is it called when they are doing an episiotomy on someone who has a small perineum, and they need to cut the muscle too?
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mediolateral incision
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What has less infection? Episiotomy or a regular perineal tear?
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tearing has LESS infection
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During stage 2 of labor when how often should vital signs be assessed?
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every 15-30 minutes
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During stage 2 of labor how often should you look for vaginal show?
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every 15 minutes
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During stage 2 of labor how often should you check for signs of fetal descent?
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every 10-15 minutes
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What's the average time for placenta delivery?
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5-20 minutes
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What should you expect when the placenta detaches from the uterine wall?
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a sudden outpouring of blood
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Total blood loss during labor is between what and what?
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200-300ml
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What is considered excessive blood loss during labor?
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500ml+
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During stage 3 of labor how often should vital signs be assessed?
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every 15 minutes
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After birth what is the typical position for delivery of the placenta?
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lithotomy
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How long does the 4th stage of labor last?
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2-4 hours
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during the 4th stage of labor, how often should vital signs be taken?
First hour? Next hour? |
15 minutes for first hour
30 minutes for next hour |
