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135 Cards in this Set

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Ovum fertilized with a sperm thru 1st week of prenatal life
zygote
12-16 cell division
morula
Embryo: from ____ to _____
implantation-8wks
Blastocyst: inner and outer cell masses.

inner-->_____
outer--> ______ & _______
fetus
placenta & membranes
where does the blastocyst implant?
into fundus of uterus
Fetus: from ____ (____) to ____
8 complete weeks (9weeks) to delivery
when does the fetus become viable? (when can the fetus survive?)
24 weeks
How long is the first trimester?
1-12/14 weeks
how long is the second trimester?
12/14-28 weeks
how long is the third trimester?
28 weeks to term
what the the presumptive signs of pregnancy?
-amenorrhea (lack of menstruation)
-n/v
-urinary frequency
-breast tenderness / enlargment
-fatigue
-quickening
what does quickening mean?
mother's perception/sensation of fetal movement
are presumptive signs objective or subjective?
subjective
for multips (women that have given birth before, when does the women feel quickening?
16-18 wks
for primips (first pregnancy), when does the women feel quickening?
18-20 wks
painless uterine contractions:
braxton-hicks
whooshing sound auscultated over uterine artery/same as Mom's pulse
uterine souffle
softening of the cervix
goodell's sign
softening of uterine isthmus- the neck/area between the lower uterus and upper cx
hegar's sign
blue/purplish discoloration of cx and vagina
chadwick's sign
the examiner taps lower uterine segment sharply, feels fetus moving in amniotic fluid.
ballottement
when is ballottement possible?
16-20 wks
probable signs of pregnancy are objective or subjective?
objective
when does urine pregnancy test become positive?
10-14 days after 1st missed period
when is the best time during the day to take a urine pregnancy test for adequate concentration?
early a.m.
any ______ in urine will give a false positive (pregnancy test)
bld
how long does it take for a serum pregnancy test become positive?
within a few days of implantation
how accurate is a OTC UCG pregnancy test?
97% accurate
this type of pregnancy test is based on antigenic properties og hCG:
immunoassay tests
after this trimester, all organs are formed
first
when is goodell's sign seen?
2nd month of pregnancy
_________<37 wks gestation
preterm
_________=38-42 wks gestation
fullterm
This is a stage of really rapid growth...most susceptible to bad environment at this time (smoking)
embryo
Sonographic visualization of fetur: (+) dx at ___wks with ____ _____
6
cardiac activity
Sonographic visualization of fetur: you can see gestational sax at ____-____wks
5-6
Braxton-hicks contractions: occur throughout pregnancy, beginning at _____________
end of 1st trimester
bluish color of cervix:
chadwick's sign
softening of the cervix:
goodells sign
softening of the cervial isthmus
hegar's sign
Ovarian changes: ______ ceases and the corpus luteum maintains ____ and ____ until 10-12 wks
ovulation
estrogen
progesterone
what 3 things cause the breast to grow?
estrogen
progesterone
increase in adipose tissue
blood volume increases by ____-____%
45-55
what is supine hypotension caused by?
pressure on vena cava when lying supine
with supine hypotension a woman experiences: (3)
pallor
dizziness
feeling clammy
with supine hypotension, the nurse should encourage:
Left lateral position
No supine position after ____ wks gestation
20
b/p decreases ___-___ wks then returns
24-32
Pregnancy lab values: almost everything increases except _______.
H&H
"mask of pregnancy" is called:______. It is when the cheeks nose and forehead are red
chloasma
reddish, wavy, depressed streaks
striae
where does striae occur?
abd, breasts, thighs
what is striae caused by?
reduced connective tissue strength due to increased adrenal steroid levels, genetics
striae turn what color after delivery? will they go away?
silver/white

no, they're permanent
small, bright red elevations of skin radiating from a central body.
vascular spider nevi
where does vascular spider nevi appear?
5
chest, neck, face, arms and legs.
what is the clinical significance of vascular spider nevi?
none; often disapper with delivery
redness and itching of palms due to elevated estrogen
palmar erythema
palmar erythema is common with _______ & ________, and disappears with delivery
Caucasians
african americans
______________ occurs which causes darkening of the nipples, vulva and aerolas
hyperpigmentation
the accentuated lumbar curve is a musculo skeletal adaptation called:
lordotic posture
sacroiliac, sacrococcygeal and pubic joints relax in latter part of pregnancy due to ____________
hormonal changes
slight separation of what is common (musculoskeletal)
symphysis pubis
rectus abdominis muscle separates
diastasis recti
if separation is severe and muscle tone isn't regained during post partum, there will not be adequate support during future pregnancies and abd will appear pendulous, ____ ____ possible
umbilical hernia
pregnant mother should increase calories by
300/day
pregnant mother should increase protein to
60gm/d
pregnant mother should increase iron to
30mg/deciliter
pregnant mother should increase calcium to
1000mg/day
pregnant mother should increase folic acie to
400mcg/d-1mg/d
___% pregnancies unplanned and range of emotional responses in part reflects that
52
African americans, mexican americans and native americans see pregnancy as
state of wellness
_________ don't name a baby prior to its birth
orthodox jews
asian families see pregnancy as a normal process but also time of
anticipation and anxiety.
with hindu women, pregnancy is considered a "___ ___" so they eat _____ ___ to counterbalance
hot time
cool foods
mexicans may be concerned about ___ ___ which is related to evil spirits, that can enter the body and cause harm to the fetus
mal aire (bad air)
asian women: ____ foods after birth since pregnancy is considered a ____ state
hot
cold
vietnamese women are warned to avoid:
1.
2.
3.
in order to avoid evil spirits
funerals
places of worship
streets at noon and 5pm
Maternal response: 1st trimester.
Task: _______&_________
acceptance and validation
Emotions during the 1st trimester: (4)
-uncertainty/denial
-ambivalence/surprise
-focused on self
-anxiety
Maternal response: 2nd trimester.

Task: __________
accepting the baby
emotions in the 2nd trimester
-physical evidence
-focused on fetur
-narcissism
-introversion
-body image
-sexuality
maternal response: 3rd trimester.

Task: _______
preparation for parenthood
emotions during the 3rd trimester:
vulnerability
increasing dependence
preparation for birth
anxiety
Psychological tasks of pregnancy: (4)
- ensuring safe passage
- seeking acceptance
- learning to give of oneself
- committing herself.
_________ syndrome:
-common in primitive cultures
-father does mock labor & confinement
-experience physical symptoms of pregnancy
-n/v, backache, fatigue, increase appetite, heartburn, h/a, irritability
couvade
imagining the fetus is an independent, self reliant child is:
abnormal acceptance of pregnancy
If sibling is in a crib, move to a bed how long before birth of new child?
3 mos before delivery
If the sibling is ready for potty training, dont start until
several months before of after birth
with adolescent pregnancies, there is an increased incidence of:
preterm births
low birth weight
PIH (preg. induced htn), iron deficiency anemia, cepahlopelvic disproportion (pelvis isn't big enough) , std's, smoking, drug use
with the adolescent pregnancy, who is usually told first?
the mother of the pregnant girl
teen usually wants who present for the birth?
mother
Estimated due date: Nagele's rule:
LMP - 3mo + 7 days
___________: # of times pregnant
gravida
____: # of pregnancies >20 wks
para
38-42 weeks is considered:
term births
< 38 wks:
preterm births
Scheduling of prenatal visits:

Until 28 wks:
every 4 wks
Scheduling of prenatal visits:

28-36 wks:
q2wks
Scheduling of prenatal visits:
36wks to delivery:
every week
________: woman who is pregnant for the 1st time
primigravida
_______: woman who has completed 2 or more prenancies past the point of viability
primipara
__________; woman who has had 2 or more pregnancies
multigravida
_____;woman who has completed 2 or more pregnancies past the point of viability
multipara
G TPAL stands for
gravida
term
preterm
abortions
living children
common discomforts of the first trimester:
(8) hnfnubpl
h/a
n/v
fatigue
nasal stuffiness/epistaxis
urinary freq
breast tenderness
ptyalism
leukorrhea
white vag d/c.
leukorrhea
if a woman has ptyalism, teach them:
decrease carb intake
chew gum/hard candies
excess saliva=
ptyalism
common discomforts of 2nd and 3rd trimester: (12)
hdvhcfblfsir
heartburn
dependent edema
varicose veins
hemorrhoids
constipation
flatulence
backache
leg cramps
faintness
sob
insomnia
round ligament pain
what 5 categories of teratogenic substances are there?
abcdx
with this category of tertogenic substances, there is a positive evidence of risk
d
with this category of tertogenic substances, there is adverse effects w/o study or no studies available. Only given if benefit outweighs the risk
C
with this category of tertogenic substances, there is no fetal risk documented
B
with this category of tertogenic substances, there is no known risk
a
with this category of tertogenic substances, there is a demonstrated risk, CI
X
pregnancy warning signs:
-vag bleeding
-4 or more pains/hr
-leakage of fluid
-decreased fetal movement
-swelling of face/hands
-blurred vision, spots before eyes
-chills/fever
-painful urination
-persistant vomiting
aspiration of amniotic fluid containing fetal cells
amniocentesis
excessive amt of amniotic fluid removed by amniocentesis:
polyhydramnios
how does polyhydramnios occur?
if placenta is producing too much amniotic fluid or if fetus isn't ingesting enough
polyhydramnios is done for
comfort, not curactive
when is polyhydramnios done?
after 14th wk (15-16wks optimal)
what are some maternal risks for polyhydramnios?
-hemorrhage
-infection
-labor
-abruptio placenta
-damage to intestines/bladder
-amniotic fluid emboli-rh isoimmunization with rh incompatability
fetal risks with polyhydramnios?
-death
-hemorrhage
-infection
-injury from needle
-abortion
-premature labor
-leakage of amniotic fluid
why is an amniocentestis done?
to detect chromosomal abnormalities
with the amniocentestis, if there is a presence of phosphotidiglycerol (PG) this means
lungs are mature
With the non stress test, the pt. should sit how? And why?
in a reclining chair or in semi fowlers

to avoid supine hypotension
this is a device which sneds sounds to the fetus and is used to stimulate fetal heart.
vibroacoustic stimulation test
fetus is monitored for 5 minutes prior to sound source being placed on maternal abdomen over fetal head:
vibroacoustic stimulation test
With this test, endogenous oxytocin is produced in response to stimulation of breasts or nipples.
nipple stimulated stress test
warm moist washcloths to both breasts for several minutes. Roll one nipple at a time until contraction.
nipple stimulated stress test
contraction stress tests determine:
fetal well being
3 types of contraction stress tests:
natural UC's
nipple stimulation
oxytocin challenge test
with this test, oxytocin (pitocin) is given in low doses IV until adequate UCs
oxytocin challenge test
what is a risk of the oxytocin challenge test?
hyperstimulation (contractions lasting more than 90 seconds or more frequently than every 2 minutes)