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253 Cards in this Set
- Front
- Back
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The 6 rights |
drug client dose time routine documentation |
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the other 3 rights |
reason to know to refuse |
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drug classification therapeutic |
actual usefulness |
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drug classification pharmacologic |
how the drug works |
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onset of drug |
onset of the action |
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peak level |
highest concentration |
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trough level |
the lowest concentration |
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therapeutic level |
from onsent -> trough level |
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half life |
the period of time required for the concentration or amount of drug in the body to be reduced by one half |
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duration |
period of time in which the medication has pharmacological effect |
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side effect |
often predictable usually tolerated well may be immediate or delayed |
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ADR |
harmful, unintended usually unpredicted more severe than side effects often requires d/c of drug may be dose related or pt is sensitive |
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Toxic RXN |
body isn't metabolizing fast enough dangerous, damaging effects to an organ/tissue more serve than ADR RXN antidotes are sometimes availble |
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estrogen |
prompts hyperplasia and hypertrophy cause the uterine muscles to contract the effect is one of "growth" |
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progesterone |
enable the pregnancy to thrive by its relaxation effect on the smooth muscle causes vasodilation -> more blood to tisses slows GI tract relaxed uterine muscle to prevent the onset of labor the effect is one of "maintenance" |
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First Trimester Nausea and Vomiting |
lead to dehydration |
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First Trimester Abdominal pain & vaginal bleeding |
may indicate spontaneous abortion or miscarriage |
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First Trimester Infection |
can include chills, fever, UTI, diarrhea (may need abx) |
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Second Trimester Preeclampsia |
most common pregnancy complication - increased BP >140/90 after 20 weeks's gestation |
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Second Trimester |
premature rupture of membranes must be monitored for infection |
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Second Trimester Preterm Labor |
uterine contractions and cervical dilation before the end of 36 weeks' gestation |
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Second Trimester Signs & Warning |
fundus height measurement should correlate to the weeks of gestation from ~ 22 - 34 weeks |
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Hypoxia |
deficiency in the amount of o2 reaching the fetal tissues |
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absence of the fetal movement after quickening |
woman is instructed to drink 2 glasses of h20 rest on her left side for 2 hrs and assess for fetal movement if fewer than 10 - should be seen |
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Third Trimester Gestational Diabetes |
a glucose challenge test is performed between 24- 28 weeks |
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Third Trimester placenta previa |
an implantation of the placenta in the lower segment of the uterus near of over the cervical opening |
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third trimester Abruptio placentae |
the premature separation of the implanted placenta from the uterine wall |
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OTC Meds |
Tylenol & Robitussin are often used for minor problems such as headaches, coughs and colds |
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Herbal & Homeopathic Meds |
COMPLETELY AVOID not regulated by FDA |
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RX |
some are necessary prenatal vitamins are used ACCUTANE MUST BE AVOIDED- associated with spontaneous abortion |
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dyspareunia |
painful intercourse |
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nocturia |
excessive nighttime urination |
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Lamaze Method |
is empowerment, recognizing the woman's innate ability to give birth, while finding strength and support from her family and the members of the health care team during labor and birth process |
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Bradley Method |
focus the woman on inward relaxation, by means of breathing, abdominal breathing, and general relaxation. "husband coached childbirth" |
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Dick- Read Method |
focuses on the natural aspect of giving birth- no drugs, pain management during labor or delivery |
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Hyponobirthing Method |
based on dick read couples are taught relaxation techniques to eliminate the pain associated with the fear and tension - deep, total relaxation is key |
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LeBoyer Method |
baby is born in low light that is conductive to relaxation and facilities a tranquil entrance to the world. baby can open eyes to minimal external stimulation. Fetus is placed in warm h20 after birth, then on mother's skin |
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Odent method |
moving mother into warm h20 bath, crease easy intrauterine -> extrauterine environment. Not for women with ruptured membranes |
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Birthing from Within Method |
views childbirth as a rite of passage for parents and their newborn, The focus is not on the birth process, but the experience of birth. |
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lightening |
marks the beginning of engagement |
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bloody show |
expulsion of mucus plug |
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position changes |
beneficial in helping to promote the descent of the fetus |
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4th stage of labor |
time of delivery of placenta through the first couple hrs after birth |
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Uterus after birth |
should be grapefruit sized should be firm |
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Vital Signs after Vaginal Birth |
q 15 min x 4, q 30 min x 2, q 60 min x 1 , q 8 hr until d/c |
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Vital signs after Cesarean birth |
q 30 min x 4 hrs, q 60 min x 3, q 4-8 hrs |
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REEDA |
redness edema ecchymosis drainage/ dishcarge approximation of the episiotomy if present |
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internal mammary artert |
supplys ~60% of the blood to the breasts |
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lactogenesis |
the process by which the breasts secrete milk, is depended on the release of prolactin and oxytocin |
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prolactin |
stimulates the alveoli or milk producing cells to secrete milk |
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oxytocin |
prompts contraction of the smooth muscle myoepithelial cells surrounded the alveoli to eject milk from the alveoli into the lactiferous |
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milk ejection reflex the let down reflex |
movement of milk into the large lactiferous ducts for removal |
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en face |
the mother's face and infant's face are 8 inches apart |
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taking in |
first 1-2 days physical exhaustion elation, excitement, anxiety or confusion reliving, verbally and mentally, the events of labor and birth |
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taking hold |
2nd or 3rd day asking for help with self care begin caring for baby be anxious about her mothering abilities |
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letting go |
first 2-6 weeks begins to see her infant an an emerging individual starts to focus on issues larger than those associated directly with herself and newborn |
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Neonatal Respiratory difficulty |
grunting sounds nasal flaring rib or sternal retractions |
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umbilical cord |
2 arteries 1 vein |
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Neonatal HR - apical pulse |
120-160 |
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Neonatal RR |
30-60 |
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Neonatal Temp |
97.7-99.3 degrees |
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Neonatal Weight |
2,500g - 4,300g |
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Neonatal Length |
45-54 cm |
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Nevus flammeus |
a birthmark often referred to as a "port wine stain" |
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telangiectatic nevus |
a red birthmark often seen at the nape of neck commonly referred to as a "stork bite" or "angel kiss" |
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nevus vasculosus |
"strawberry mark" is a red raised capillary hemangioma that can occur anywhere on the neonate's body |
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caput succedaneum |
diffuse edema that crosses the cranial suture lines and disappear without treatment during the first few days of life |
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cephalhematoma |
serious condition results from a sub-periosteal hemorrhage that doesn't cross the suture line |
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low set ears |
may signal evaluation of chromosomal abnormalities |
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micrognathia |
small jaw may interfere with tooth development, sucking, swallowing, and tongue movement inside the mouth |
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First Trimester |
1-13 weeks |
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Second Trimester |
14-28 weeks |
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Third Trimester |
29-40 weeks |
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Heart function |
10th week |
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Important brain growth |
From the 5th month on |
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20th week |
half way point |
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Lung growth |
complete at 38-40th week |
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18-20th week |
can determine baby's gender |
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4th month |
fetal movement |
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involution |
the process whereby the uterus returns to the nonpregnant state |
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How much does the uterus approx. weigh in the immediate postpartal period |
1,000g |
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How much does the uterus weigh by the end of the first week |
500g |
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How much does the uterus weigh by the end of the 2nd week |
300g |
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How much does the uterus weight after the 2 weeks |
100g or less |
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placental site surface area -after birth |
8-10 cm |
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placental site surface area end of the end of 2nd week after birth |
3-4 cm |
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placental site surface area -completely healed |
6-7 weeks after birth |
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uterine involution results from |
a decrease in the size of the myometrial cells -results in myometrial thickening and ischemia from reduced blood flow to the contracted uterus |
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subinvolution |
the failure of the uterus to return to the nonpregnant state |
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hydramnios |
a condition in which excess amniotic fluid accumulates during pregnancy
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exfoliation |
process of placental site healing |
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regeneration of the endometrium is completed |
by the 16th postpartum day except at the placental site |
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active phase of the first stage of labor
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when the cervix is dilated from 5 to 8 cm
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latent phase begins
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at the onset of regular uterine contractions and ends with rapid cervical dilatation of 1 to 5 centimeters.
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The transition phase
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Cervical dilatation increases from 8 to 10 cm
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preconception
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the earliest stage of the pregnancy continuum
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periconception
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refers to the time immediately before conception through the period of organogenesis
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teratogen
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anything that adversely effects the normal cellular development int he embryo or fetus
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pica
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the consumption of nonnutritive substances or food, is a common eating disorder that can affect pregnancy
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ayurveda
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is a system of natural and medical health that includes diet, herbs, massage, exercise, music therapy, medications, yoga, aromatherapy |
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oogonia
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an immature female reproductive cell that gives rise to primary oocytes by mitosis |
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interconception
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the time period between the end of one pregnancy and the beginning of the next pregnancy |
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Hyperemesis gravidarum |
persistent, continuous severe nausea and vomiting, often accompanied by dry retching |
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dyspepsia |
indigestion |
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ptyalism |
excessive salivation |
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hydatidiform mole |
is the growth of abnormal tissues that results from conception but doesn't give rise to a viable fetus |
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spontaneous abortion |
termination of pregnancy by natural cases before 20 weeks |
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lamaze method |
is empowerment, recognizing the woman's innate ability to give birth, while finding strength and support from her family and the members of the health care team during the labor and birth process |
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contraction intensity |
measured by uterine palpation and is described in terms of mild, moderate, and strong |
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contraction duration |
measured from start of one contraction to end of same contraction |
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contraction frequency |
measured from the beginning of one contraction to the beginning of another |
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decrement |
decrease in the contraction |
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acme |
peak of contraction |
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increment |
building of the contraction |
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involution |
the reduction in uterine size after birth |
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nulliparous |
woman who has never given birth |
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The "Ps" of labor |
powers passageway passenger passageway & passenger psychosoical influences-sometimes position |
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acrocyanosis |
bluish or purple coloring of the hands and feet caused by slow circulation. |
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apgar scale |
standardized assessment for infants |
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The Duncan mechanism |
occurs when the placenta separates from the outer margins inward, rolls, up and presents sideways |
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The Schultze mechanism |
occurs when the placenta separates from the inside to the outer margins with the shiny, fetal side of the placenta presenting first |
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3rd stage of labor |
the period of time from the birth of the baby to the complete delivery of the placentallasts 5-30 min |
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fourth degree laceration |
extend into the rectal mucosa and expose the lumen of the rectum |
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decelerations |
defined as any decrease in FHR below the baseline FHR. Classified according to their shape, timing, and duration in relation to the uterine contraction |
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acceleration |
defined as an increase in the FHR of 15bpm above the fetal heart baseline that lasts for at least 15 seconds to less than 2 min |
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episodic changes |
FHR acceleration and deceleration patterns that aren't associated with uterine contraction |
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tocdynamometer |
external contraction measuring - is pressure sensitive device that is applied against the uterine fundus |
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Vertex Presentation |
fetal head fully flexed - most frequent and optimal presentation |
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Military Presentation |
fetal head presents in a neutral position, which is neither flexed nor extended |
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Brow Presentation |
fetal head is partly extended. Unstable presentation that converts to a vertex if the head flexes or to a face presentation if they head extends. |
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Face Presentation |
fetal head is fully extended and the occiput is near the fetal spine |
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Frank Breech |
the most common of all - butt presentation knees are extended feet are near head |
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Complete (Full) Breech |
the fetal butt presents first - legs are flexedreversed cephalic presentation |
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Footling Presentation |
one or both of fetal legs are extended with one foot or both feet presenting first into the maternal pelvis |
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lightening |
baby head drops marks the beginning of engagement |
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bloody show |
expulsion of a blood tinged mucus plug - it's presence often indicates the labor will begin within 24-48 hrs |
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amniotomy |
the artificial rupture of the membranes by the primary care provider |
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Latent Phase 1st Stage |
begins with the establishment of regular contractionscan last for 10-14 hrs |
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Active Phase 1st stage |
increasing discomfort as contractions become stronger and more regular, may have backache |
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transition phase 1st stage |
strong contractions with little time of relaxation most intense phase of labor |
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2nd Stage of labor |
begins with full dilation and ends with expulsion of fetus |
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Fetal Heart Sound |
Cephalic position heard below the level of the maternal umbilicus |
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2nd stage of labor |
may have urge to push - head crowns many woman get a second wind |
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ROA position |
fetal heart sound sounds are heard loudest in the right lower quadrant |
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internal fetal monitor |
composed of spiral electrode that must be inserted into the fetal scalp or presenting part during a vaginal examination |
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baseline fetal heartrate |
referred to as the average fetal HR observed between contractions over a 10 min period~110-160 bpm |
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periodic changes |
accelerations and deceleration in the FHR that occur in relation to uterine contractions and persist over time |
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uteropacental insuffciency |
a decline in placental function |
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first degree laceration |
involve the perineal skin and vaginal mucous membrane |
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second degree laceration |
involve the skin, MM, and fascia of the perineal body |
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third degree laceration |
involve the skin, MM, and muscle of the perineal body and extend to the rectal sphincter |
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uterine inversion |
the uterus is turned inside out |
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couvelaire |
the accumulation of blood between the separated placenta and the uterine wall |
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velamentous |
insertion of the umbilical cord occurs when the fetal vessels separate at the distal end of the cord and insert into the placenta at a distance away from the margin |
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vasa previa |
occurs when the unprotected fetal vessels cover the cervical os and precede the fetus |
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placenta accreta |
a slight penetration of the myometrium by the trophoblast |
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placenta increta |
describes a deep placental penetration of the myometrium |
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anaphylactoid syndrome of pregnancy |
obstruction of a blood vessel by amniotic fluid |
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placenta percreta |
describes perforation of the uterus |
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perinatal loss |
the death of a fetus or infant from the time of conception through the end of the newborn period 28 days after birth |
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postterm pregnancy |
defined as one that extends beyond 294 days or 42 weeks past the first day of the last normal menstrual period |
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postdate |
identifies a pregnancy that has gone past the estimated date of death |
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hydramnios |
> 2L of amniotic fluid |
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oligohydramnios |
< 300mL of amniotic fluid |
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Cephalopelvic disproportion (CPD) |
sometimes termed fetopelvic disproportionsoften used to describe unsuccessful attempts at vaginal birth |
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version |
turning of a fetus from one presentation to anothermay be done either externally or internally by the physicians |
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asynclitism |
the fetal head is presenting at a different angle than expected |
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HELLP |
Hemolysis Elevated Liver enzymes Low Platelets |
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augmentation of labor |
used to stimulate uterine contractions after labor has begun spontaneously but is not progressing satisfactorily |
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bishop score |
a rating system that may be used to determine the level of cervical inducibility |
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induction |
the use of chemical or mechanical modalities to initiate uterine contractions to bring about childbirth |
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umbilical cord |
prolapse protrusion of the umbilical cord in advance of the presenting part |
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trial of labor TOL |
surveillance of a woman and her fetus for a set amount of time ~4-6hr |
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Bandl's ring |
a pathological retraction ring that develops between the upper and lower uterine segments |
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precipitous labor |
contractions produce very rapid, intense contraceptions - labor lasts less than 3 hrs |
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macrosomia |
occurs in 1/4 of all pregnanciesthe leading cause of uterine hypotoniaa fetus whose birth weight is over the 90th percentile |
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hypotonic labor |
more common type of uterine dysfunction pattern that contributes to poor labor progression |
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hypertonic labor |
contractions are strong and often painful but are ineffective in producing cervical effacement and dilationanxiety plays a major role |
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Dysotcia |
a long, difficult or abnormal laborused to identify poor labor progression3 components: process, powers, the passenger or passageway |
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regional anesthesia |
temporary and reversible loss of sensation |
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acupuncture therapy |
used in traditional Chinese medicine involves the insertion of fine, sterile, stainless steel needles into specific points in the body |
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acupressure |
Chinese massage involves the application of pressure or heat/cold to identified acupuncture point decrease the sensation of pain |
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Intradermal h20 |
block a technique that involves the use of a small needle to inject small amounts of sterile h20 into four locations on the pts lower back to relieve pain |
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Transcutaneous electrical nerve |
stimulationTENS involves the delivery of an electric current through electrodes that are applied to the skin over the painful region of a peripheral nerve |
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aromatherapy |
use of essential oils, is thought to have a therapeutic effect in treating illnesses and promoting health and well being |
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hypnotherapy |
structured technique that enables the patient to achieve a state of heightened awareness and focused concentration that can be used to alter the perception of pain |
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hydrotherapy |
use of warm h20 to promote comfort and relaxation |
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counterpressure |
often effective in enhancing the woman's ability to cope with discomfort from internal pressure and lower back pain |
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effleurage |
is a gentle stroking technique performed in rhythm with contractions |
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guided imagery |
a state of intense, focused concentration that one uses to create persuasive mental images |
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primigravid |
pregnant for the first time |
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somatic pain |
faster, well localized intense, sharp burning, prickling pain, occurs during the 2nd stage of labor |
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referred pain |
describes pain that originates in the uterus than radiates to the abdominal wall |
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visceral pain |
describes the predominant discomfort experienced during the first stage of labor r/t changes in the cervix slow, deep, poorly localized |
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covaude |
is the observance of certain rituals and taboos by the male to signify his transition to fatherhood. |
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pyrosis |
heartburn |
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supine hypotension syndromevena caval |
syndrome the pressure from the fetus is exerted on the vena cava decreased the amount of venous return from the lower extremitiescauses decreased BP, dizziness and pallor |
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prolactin |
is responsible for initial lactation |
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Diastasis recti |
the rectus abdominis muscles separate |
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pruritus gravidarum |
excessive itching |
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ptyalism |
excessive saliva production often with a bitter taste, may occur and can be unpleasant or embarrassing |
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Epulis gravidarum |
raised nodules |
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syncope |
a transient loss of consciousness and postural tone with spontaneous recovery - frequently attributed to orthostatic hypotension and/or inferior vena cava compression by the fetus |
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angiomas |
vascular spiders |
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Operculum |
muscus plug |
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melanotropin |
a hormone secreted by the pituitary gland, causes nipples to become tender and more pronounced with darkening of the areola |
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striae gravidarum |
stretch marks |
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Goodell's sign |
stimulation from the hormones estrogen and progesterone produces cervical softening |
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Decidua capsularis |
is the endometrial tissues that covers the embryo |
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cholasma |
the mask of pregnancy |
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Decidua basalis |
the uterine lining beneath the site of implantation |
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Deciduavera: |
is the external layer, no contact with the fetus |
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Third Stage of Labor |
Placental separation |
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Second Stage of Labor |
Period from full dilatation and cervical effacement to birth of the infant |
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nulligravida |
a pregnant woman who has never been pregnant before |
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gravida |
a pregnant woman |
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Transcutaneous electrical nerve |
stimulation TENS is the use of electric current produced by a device to stimulate the nerves for therapeutic purposes. |
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Pundendal nerve block |
are a minimally invasive, non-surgical treatment for chronic pain. |
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Pressure anesthesia |
loss of sensation produced by pressure applied to a nerve. |
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Pain |
physical suffering or discomfort caused by illness or injury. |
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Epidural anesthesia |
block the nerve impulses from the lower spinal segments. |
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Endorphins |
any of a group of hormones secreted within the brain and nervous system and having a number of physiological functions. |
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Doula |
a woman who is trained to assist another woman during childbirth and who may provide support to the family after the baby is born. |
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Anesthesia |
is a temporary induced state with one or more of analgesia, paralysis, amnesia, and unconsciousness. |
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Analgesia |
the inability to feel pain |
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Expulsion |
BIRTH |
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External rotation |
when head is born - baby's head will externally rotate so shoulders will be born |
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Extension |
baby extends head - cervix dilates |
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Internal Rotation |
baby turns head so it will fit through birth canal |
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Flexion |
when baby's head is at pelvic floor |
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Descent |
baby's head moves down into true pelvis |
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Engagement |
widest diameter of the fetal head starting to pass through pelvic inlet |
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Signs of true labor |
uterine contractions show rupture of membranes |
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Cephalic Presentation |
Identifies that the fetal head will be the first to come into contact with the maternal cervix Occurs ~ 95% of births |
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Breech Presentation |
occurs when the fetal buttocks enter the maternal pelvis first. Occurs ~ 3% of births |
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Fetal Attitude |
describes the relationship of the fetus's body parts to one another |
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Amino-infusion |
A method in which isotonic fluid is installed into the amniotic cavity in order to thin thick meconium that has passed into the amniotic fluid |
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Pathological Retraction Ring Bandl's Ring |
abnormal junction between the two segments of the uterus - A late sign with obstructed labor |
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Physiologic Retraction Ring |
A ridge on the inner uterine surface at the boundary between the upper and lower uterine segments that occurs in the course of normal labor |
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Position |
Refers to the location of a fixed reference point on the fetal presenting part in relation to a specific quadrant of the maternal pelvis. |
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False Contractions |
Begin and remain irregularfelt first in abdomenoften disappear with ambulation and sleepdon't increase in duration, frequency or intensitydoesn't achieve cervical dilation |
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True Contractions |
begin irregular - become regular and predictablefelt first in lower backcontinue no matter activity levelincrease in duration, frequency and intensityachieves cervical dilation |
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Preliminary sign of Labor |
lightening increase in level of activity braxton hicks contractions ripening of the cervix |
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Newborn Head Molding |
abnormal head shape that results from pressure on the baby's head during birth **overlapping cranial bones** |
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Fetal Lie |
refers to the relationship between the long axis of the fetus with respect to the long axis of the mother |
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Station |
refers to the level of the presenting part in relation to the maternal ischial spines |
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Leopold's Maneuvers |
common and systematic way to determine the position of a fetus inside the women's uterus.Also used to estimate term fetal weight |
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Fetal Descent |
the presenting part of the fetus into the birth canal particularly in a first pregnancy, is another result of pre-labor |
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Episiotomy |
A surgical cut in the muscular area between the vagina and the anus. Enlarge vaginal opening |
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Effacement |
Is the process by which the cervix prepares for delivery. The cervix gets softer and thinner "ripens" "cervical thinning" |
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Dilatation |
is the opening and enlargement of the cervix that progressively occurs throughout the first stage of labor |
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Crowning |
means that birth is imminent, occurs when the fetal head is encircled by the vaginal opening |
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Ripening
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the cervix softens and becomes more distensible |
