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28 Cards in this Set

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What is term pregnancy?
38 to 42 weeks gestation.
What is Preterm?
less than 38 weeks gestation.
Post Datism (post term)
greater than 42 weeks gestation.
When a pregnant women is asked for a Hx?
Medical problems, Presenting signs and symptoms, allergies, childhood illnesses, accidents, family hx, and OB Hx.
What is checked during a physcial exam?
Reproductively oriented!
Baseline Heart Rate, blood pressure, and weight. Possible head to toe exam (usually only reproductively based)
Physical Exam continued...
Check the breasts
Thyroid (hypo or hyperthyroidism can affect fertility)
Pelvic check: including PAP, cultures.
Pelvimetry
Usually checked if the pt has been in some sort of accident that has caused injury to the pelvis.
Lab Work
Dip stick check:
Albumin (PIH)
glucose(DM)
client is instructed to bring in first morning urine sample.
H & H
Blood type, Rh factor
STORCH... etc..
Teaching
Teach about prenatal vitamins. Warning signs to check for
Hygiene (increased sweating, and vaginal discharge)
Employment (how to not overwork, proper rest is a must)
Nutrition (sm. frequent meals)
Visit schedules
and explanation of EDC, delivery date.
Nageles Rule
most frequently used method of determining the EDC.
subract 3 months from the first day of the LMP and then add 1 year and 7 days.
Other methods to determine the EDC
Wheel method: take the 1st day of the LMP, and line up the dates.
Also you can use ultrasound.
Maternal Task
to be able to say I am pregnant and accept the fact. Ambivalance is normal.
Ectopic Pregnancy
gestation implantation outside of the uterus. Can occur in the fallopian tubes, ovaries, or abdomen. Statistics are 16/1000 pregnancies.
Causes of Ectopic Pregnancy
PID and Endometriosis.
Use of IUDS
Tubal surgery
Congenital tubal anomalies
tubal tumors
Hx of previous ectopic pregnancies
Abdominal or pelvic surgery
Appendicitis/therapeutic abortion/infertility
S & S of ectopic Pregnancy
Abdominal pain and localized pain to the L or R pelvic area, amenorrhea, abnormal vaginal bleeding (may or may not be present)
S&S of ectopic preg. continued
If a rupture occurs;
Abd. pain, N&V, diarrhea, unilateral palpable pelvic mass, dizziness, and hypovolemic shock.
Spontaneous Abortions
early; occurs before 12 weeks gestation
late; occurs between 12 and 20 weeks gestation
Habitual: when a women has 3 or more consecutive spon. abortions.
Threatened abortion
suggested when a woman experiences vaginal spotting or bleeding early in pregnancy (occurs approx. in 20% of all diagnosed pregnancies; half abort)
Inevitable
occurs when the cervix has begun to dilate, uterince contractions are uncomfortable, and vaginal bleeding increases. The membranes rupture as the process proceeds. This type cannot be prevented.
Incomplete
occurs when cervical dilation results in partial expulsion of the products of conception, with some of these products retained in the uterus. Excessive vaginal bleeding results; risk of infection is increased.
Complete
all products of conception are entirely expelled. Very few physical complications that occur but emotional support is necessary.
Septic
immediate termination of pregnancy by methods appropriate to the duration of the pregnancy. Cervical culture and sensitivity studies are done and broad-spectrum antibiotic therapy is started. Treatment for septic shock is initiated if necessary.
Hyaditform Mole AKA Trophoblastic Disease AKA Molar Pregnancy
developmental error of the placenta, ovum disintegrates. Two types:
Complete mole (empty egg no chromosomes)
Partial Mole (has part of amniotic sac or fetus)
Occurs in 1/1000 pregnancies. Occurs in women over 45 10 times more often than women 20-40
S&S of Hyaditform Mole
uterine bleeding is most outstanding sign
iron deficiency anemia often seen d/t bleeding
Uterine Size (often exceeds what is expected for gestational age)
Fetal activity and heart tones are absent
hyperemesis gravidarum
PIH notably develops prior to 20 weeks gestation
very high levels of hCG
ultrasound can confirm this.
Care of pt with Hyaditform
immediate evacuation of the mole and follow up for prevention and early detection of malignant transformations.
Serum hCG levels monitored q1-2 weeks until normal nonpregnancy levels achieved.
Then they are check every 6 mons, and then every 2 mos for 1 year.
Pregnancy should be avoided during the one year follow up
Baseline X-Ray of lungs taken and compared to pre-evacuation x-ray.
Hyperemesis Gravidarum
increased or prolonged N&V in pregnancy affecting the health of mom and baby.
Etiology of Hyperemesis Gravidarum
likely caused by a combination of factors. It appears to be related to high or rapidly increasing levels of hCG or estrogen. Evidence of transient hyperthyroidism has been noted. Psychological and social factors, as family conflict can all play a role.
Care of a client with Hyperemesis Gravidarum
hospitalization is often required to change womens enviornment if psychosocial factors are contributing.
IV therapy initiated to treat dehydration; adequacy of hydration assessed by measuring Urinary Output.
Sm. frequent feedings ad lib. High calorie tube feedings are an option.
Sedatives may be used to relax hyperactive GI tract.
Acupressure has been used successfully.