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76 Cards in this Set
- Front
- Back
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Uterine position after stage 3
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2 cm below umbilicus and midline
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uterine position after 12 hr
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1 cm above umbilicus, midline
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uterine position after 24 hr
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about same size as it was at 20 wks gestation
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uterine position after 6 days
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halfway between umbilicus and symphisis pubis
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uterine posititon after 2 weeks
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within true pelvis
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What is lochia and what does it look like?
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postbirth uterine discharge
initially bright red then brownish pink |
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When does blood loss stabilize?
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2 weeks and normalized in 6 months
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involution
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returning of fundus to pre-pregnancy state; immediatey after delivery
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subinvolution
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the failure of uterus to return to pre-pregnancy state; usually caused by retained placental fragments or infection
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What is contained in Rubra lochia?
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blood and trophoblastic tissue (bright red)
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What is contained in Serosa lochia?
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blood, serum, leukocytes, and tissue debris (brown or pink)
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What is contained in Alba lochia?
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occurs ten days postpartum; leukocytes, epithelial cells, mucous, serum , bacteria
may continue for six weeks (yellow/white) |
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How long should lochia last?
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May get worse 7-14 days post d/t healing placenta site. Should not have offensive odor
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Where does fertilization take place?
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lower 1/3 of fallopian tube
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What is a morula?
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a zygote with 16 cells
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When does implantation occur?
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4-6 days following conception
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What is the function of the placenta?
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Functions as metabloc exchange. Functional by day 17 when heart starts beating. Complete by week 12
grows until week 20 and covers approx half of uterine surface. produces hormones to maintain pregnancy, endometrium, and stimulates contractions in late preg. |
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What is the function of amniotic fluid?
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Gained through diffusion of maternal blood. Helps maintain fetal temp. source of oral fluid and outlet for fetal waste. cushions fetus and allows movement for musculoskeletal growth.
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What is olighydramnios?
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< 300 mL; fetal renal anomalies
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What is hyramnios?
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>2000 mL of fluid: fetal GI impairments
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What arises from the ectoderm?
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everything superficial and the CNS and PNS
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What arises from the mesoderm
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Bones, teeth, muscles, connective tissues
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What arisises from the endoderm?
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major organ system, lining of lungs
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When do cells become an embryo?
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day 15 to approx 8 weeks, most dangerous time to be exposed to teratogens
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When is the umbilical cord developed?
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by the 3rd week
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When does the fetal period begin?
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9 weeks until delivery
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When is viability possible?
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from week 20 or 500 g
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When is the most critical time for normal heart development?
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4th and 5th weeks
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What major factors affect the birth process?
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passenger (fetus and placenta), passageway, powers, position of mother, psychological response
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What are the anatomic structurs of the bony pelvis?
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False pelvis- above pelvis brim
True pelvis- inlet, medpelvis, outlet |
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Gynecoid
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round
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android
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heart-shaped
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anthropoid
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oval shaped
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platypelloid
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flat
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What is the normal measurement of the diameters of effacement?
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2-3 cm long and 1 cm thick
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what is the normal measurements for dilation
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normally <1 but opens to 10 for delivery;
full dilation marks the end of stage one pregnancy |
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What is biparietal deameter (BPD)?
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ear to ear; important indicator of fetal size; largest portion that passes into pelvic inlet
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What is suboccipitobregmatic diameter?
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smallest and most critical head diameter
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Describe the letters of fetal position
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1st letter: presenting part to the R or L of mother's pelivs
2nd letter: Presenting part (occiput, mentum, breech, scalpula) 3rd letter: location of presenting part in relation to the specitic portion of womb (anterior, posterior, transverse) |
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Discuss the use of sedatives
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Barbituates:
relieve anxiety and induce sleep for early labor ONLY Never give without analgesic resp depression possible |
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Discuss the use of analgesia
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Systemic: BBB, could have profound effects on fetus
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Opioid agonist analgesics
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most effective and dangerous
for relief of SEVERE PERSISTANT PAIN cause maternal and fetal resp depression |
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What are expamples of opioid agonist analgesics?
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Dilaudid, Demoral
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When should birth occur when giving opioid agonist analgesics?
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<1 hr or more than 4 hr after admin
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What are examples of opioid agnonist antagonist analgesics?
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Stadol and Nubain
No resp depression |
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What is the name of an opioid antagonist?
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Narcan!
Pain will return immediately |
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What is a pudendal nerve block and when can it be given?
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Second stage, episiotomy, and birth
Does not relieve contraction pain, just vulva, vagina, and perineum |
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Discuss spinal analgesia
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Anesthetic solution and fentanyl
C/S Nipple to feet for C/S, hips to feet for vaginal |
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What is a risk of spinal analgesia?
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HYPOTENSION
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Discuss lumbar epidurals
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Most common
Resp depression, increase delivery time, PDPH |
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Discuss combined spinal-epdiural anagesia
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blocks pain without the inability to move
Allows for bearing down |
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What are contraindications for combined spinal epidural analgesia?
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Hemorrhage, infection at infection site, allergy, maternal refusal
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What is fetal tachycardia?
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>160 bpm
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What is fetal bradycardia?
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<70 bpm
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What are the values for absent variability?
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1-5 bpm
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What are the values for moderate variability?
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6-25 bpm
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What are the values for market variability?
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>25 bpm
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What are nursing interventions for intrauterine resuscitation?
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side lying position
amnioinfucsion or trendelenburg D/C oxytocin, O2 facemask |
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Fetal O2 sat monitoring should be?
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30-70%
membranes must be ruptured cervix must be 2 cm fetal station -2 |
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Define a 1st degree perineal laceration
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Extends through the skin and superficial to muscles
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Define a 2nd degree perineal laceration?
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Extends through muscles of the perineal body
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Define 3rd degree perineal laceration?
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continues through anal sphincter muscle
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Define 4th degree perineal laceration?
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involves the anterior rectal wall
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What are nursing priorities given in the fourth stage of labor?
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monitor fetal and maternal recovery
identify and manage abnormal occurances Promote and suport parent-infant attachment |
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What are common medicaitons prescribed for discharge?
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stool softeners, pain meds, prenatal vitamins
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What are the times for routine uncomplicated vaginal birth mother/baby checkups?
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6 weeks
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What are times for routine C/S mother/ baby checkups?
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Within 2 weeks
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When is the first baby visit?
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By age 2 weeks
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What is the most importnat factor to consider when communicating with a child?
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Childs developmental level
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What domains are tested in the DDST 2?
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personal social, fine motor adaptive (hand eye coordination), language, speaking and understanding, gross motor (hop, run, jump)
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Calculating childs age
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YMD
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How do you adjust for prematurity?
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first two years of life, the results may be effected.
If child was born at least 2 weeks premature, subtract that |
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What is developed at 4 weeks (fetal)?
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fetal heart begins to beat
body flexed C shaped with arm and leg buds present |
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What is developed at 8 weeks (fetal)?
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All body organs formed
first indication of musculoskeletal ossification |
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When can the fetal heart rate be heard using a doppler?
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8-12 weeks
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What is happening at 12 weeks gestation?
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the sex of the fetus can be determined
blood forming in marrow kidneys able to secrete urine |
