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105 Cards in this Set
- Front
- Back
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What is the Apgar? What are the five things assessed by it? What are the score ranges?
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permits rapid assessment of the newborns transition to extrauterine existence based on the following five signs - heart rate, respiratory effort, muscle tone, reflex irritability, generalized skin color
7 to 10 is normal; 4 to 6 is fairly low; 3 and less is critically low |
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What is gravida?
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a woman who is pregnant
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What is gravidity?
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pregnancy
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What is multigravida?
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a woman who has had two or more pregnancies
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What is multipara?
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woman who has had two or more pregnancies to > or equal to 20 wks
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What is nulligravida?
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woman who is not pregnant and has never been pregnant
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What is a stillbirth?
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infant born dead after 20 wks
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What is an abortion?
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birth that occurs before end of 20 wks
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What is nullipara?
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not completed a pregnancy beyond 20 wks
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What is parity?
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number of pregnancies > or equal to 20 wks; NOT NUMBER OF FETUSES BORN
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What is a postdate/postterm pregnancy?
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pregnancy > than 42 weeks
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What is a preterm pregnancy?
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between 20 and 37 weeks
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What is a primigravida?
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pregnant for the first time
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What is a primipara?
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has completed one pregnancy with a fetus(es) who have reached 20 wks
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What is a term pregnancy?
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between 38 and 42 wks
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What is viability? What is threshold?
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capacity to live outside the uterus (22-25 wks considered threshold)
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What is the five numbered system of summarizing the obstetric history?
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GTPAL
gravidity - term - preterm - abortions - living |
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What is hCG?
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the earliest biologic marker for pregnancy
pregnancy tests are based on the recognition of hCG or a beta subunit of hCG |
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What is ELISA?
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enzyme-linked immunosorbent assay
technology that is the basis for most OTC home pregnancy tests |
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What is the Goodell sign?
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a probable sign of pregnancy
softening of the cervical tip; can been seen at 6th wk |
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What is the Chadwick sign?
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probable sign of pregnancy
violet-bluish color of the vaginal mucosa and cervix; can been seen as early as 6th week - definitely by 8th |
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What are the changes that occur in BP during pregnancy?
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systolic usually remains the same but may decrease; diastolic decreases in 1st trimester and continues to drop until 24-32 wks and gradually increases and returns to prepreg levels by term
in general stays the same during first trimester, decreases in second, and increases in third |
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What are presumptive signs of pregnancy?
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those felt by the women
breast changes, amenorrhea, N/V, urinary frequency, fatigue, and quickening |
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What are probable signs of pregnancy?
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those observed by the examiner
Goodell sign, Chadwick sign, Hegar sign, Positive pregnancy tests (serum or urine), Braxton Hicks contractions, ballottement |
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What are positive signs of pregnancy?
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those that can only be attributed to the fetus
visualization of fetus using a U/S, FHTs heard, visualization of fetus sing radiographic study, FHTs detected by Doppler U/S, FHTs detected by stethoscope, fetal movements palpated, fetal movements visible |
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What is Hegar sign?
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softening and compressibility of the lower uterine segment (uterine isthmus)
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What is ballottement?
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passive movement of the unengaged fetus; felt generally between the 16th and 18th week
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What is quickening?
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the first recognition of fetal movements; commonly described as a flutter and is difficult to distinguish from peristalsis
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What is Nagele's Rule?
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determines due date
1st day of LMP add seven days and count forward 9 months |
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How do you determine MAP?
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systolic + 2(diastolic)/3
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What is supine hypotension syndrome?
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a fall of more than 30 mmHg in systolic pressure = reflex bradycardia, cardiac output is reduced by half and woman feels faint
teach patient not to lie on back |
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What is the New Ballard Score?
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frequently used method of determining gestational age; can be used to measure gestational ages of infants as young as 20 wks of gestation
it assesses six external physical and six neuromuscular signs lowest score is -10 and the highest is 44 |
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What is complementary therapy?
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adjunct to conventional medical treatment that has been through rigorous scientific testing
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What is alternative therapy?
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substance or procedure that has not undergone rigorous scientific testing in this country - costs not covered under most insurance plans
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What is menarche?
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denotes the first menstruation
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What are the four stages of the endometrial cycle?
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menstrual phase
proliferative phase secretory phase ischemic phase |
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What is the menstrual phase of the endometrial cycle?
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1st stage of endometrial cycle
during which the shedding of the functional two thirds of the endometrium occurs |
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What is the proliferative phase of the endometrial cycle?
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2nd phase
period of rapid growth lasting from about the 5th day of ovulation; relies on increased amounts of estrogen |
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What is the secretory phase of the endometrial cycle?
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3rd phase
extends from day of ovulation to about three days before next menstrual period; lots of progesterone |
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What is the ischemic phase of endometrial cycle?
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4th phase
occurs if fertilization doesn't occur; rapid decrease in estrogen and progesterone; blood supply to endometrium is blocked and necrosis occurs - menstrual cycle restarts |
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What is the hypothalamic-pituitary cycle?
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cycle that involves secretion of hormones required to stimulate ovulation
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What is the ovarian cycle?
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consists of follicular phases and luteal phases
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What is the follicular phase of the ovarian cycle?
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1st phase of the ovarian cycle
involves the maturation, ovulation, and transformation of the corpus luteum ends with ovulation involves FSH and estrogen (estradiol) |
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What is the luteal phase of the ovarian cycle?
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2nd stage of ovarian cycle
begins immediately after ovulation and ends with the start of menstruation corpus luteum secretes estrogen and progesterone if no implantation occurs the corpus luteum regresses and steroid levels drop |
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What is the ovum stage? The embryo stage? The fetal stage?
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ovum - conception to day 14
embryo - day 15 to 8 wks (most critical) fetal - 9 wks to completion of pregnancy |
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What is mittelschmerz?
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localized lower abdominal pain that coincides with ovulation
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What is antepartum? Intrapartum? Postpartum? Preterm?
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antepartum - time between conception and the onset of labor
intrapartum - time from onset of true labor until birth of infant and placenta postpartum - time from birth until woman's body returns to prepregnant condition preterm - labor between 20 and 37 weeks |
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What are prostaglandins?
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oxygenated fatty acids classified as hormones
may play a key role in ovulation |
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What is TORCH?
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group of infections caused by viruses and protozoa that can cause serious fetal problems when contracted by the mom during pregnancy
T - toxoplasmosis O - Other (Hep, Parvo, HIV, West Nile) R - Rubella C - Cytomegalovirus (CMV) H - Herpes (HSV) |
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What is the extrusion reflex?
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when you touch or depress tip of the tongue the newborn forces tongue outward
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What is the Glabellar (Myerson) reflex?
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tape over forehead, bridge of nose, or maxilla of newborn whose eyes are open and the newborn will blink for the first four or five taps
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What is the Moro reflex?
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the startle reflex
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What is the Babinski reflex?
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also called the plantar reflex
on the sole of the foot, beginning at heel, stroke upward along lateral aspect of sole; then move finger across ball of foot all toes hyperextend with dorsiflexion of big toe---recorded as a positive sign |
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What is the Galant reflex?
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truncal incurvation - when you run finger down it's back (lateral to spine one side then the other) the trunk is flexed and pelvis is swung toward stimulated side
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What is the Magnet reflex?
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when infant is placed in supine position and you partially flex both lower extremities and apply light pressure with fingers to soles of feet both of the lower limbs should extend against examiner's pressure
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What is the first period of reactivity?
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the first 30 minutes after birth
increased HR (160-180 bpm), irregular respirations (60-80/min), spontaneous startles, tremors, and crying marked with nasal flaring, grunting, retractions |
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What is the period of decreased responsiveness?
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about 60-100 minutes after birth
respirations are rapid and shallow (up to 60/min) but unlabored |
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What is the second period of reactivity?
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2-8 hours after birth
tachycardia, tachypnea occur increased muscle tone, skin color changes, mucus production when meconium is passed |
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How are fetal levels of leukocytes, RBCs, and platelets differ form those of an adult?
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average levels of RBCs, hemoglobin, and hematocrit are high than those of an adult
WBC counts are higher in a newborn than in an adult Platelet count ranges are generally the same in the newborn as in an adult |
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What is convection?
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flow of heat from the body surface to cooler ambient air
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What is radiation?
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loss of heat from the body surface to a cooler solid surface not in direct contact but in relative proximity
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What is evaporation?
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loss of heat that occurs when a liquid is converted to a vapor
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What is conduction?
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loss of heat from the body surface to cooler surfaces in direct contact
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What is "brick dust"?
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pink-tinged uric acid crystal stains that may appear in the diaper
are normal but may be misinterpreted as blood |
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What is the normal glucose range for a baby?
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50 to 60 mg/dL, within the fist week they should be ~ 60 to 80 mg/dL
levels < 40 mg/dL are considered abnormal |
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What is the normal newborn infant capable of digesting?
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simple carbs and proteins but has a limited ability to digest fats
amylase is produced after ~3 months by the salivary glands and 6 months by the pancreas |
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What is jaundice? What is the difference between physiologic and pathologic?
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the visible yellowish color of the skin and sclera; occurs when levels of unconjugated bilirubin exceed the ability of the liver to conjugate it, plasma levels of bilirubin increase and jaundice appears
physiologic - appears after 24 hours and usually resolves without tx pathologic - appears w/i the first 24 hours and requires intervention |
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What is vernix caseosa?
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cheeselike, whitish substance that is fused with the epidermis and serves as a protective covering
has emollient and antimicrobial properties and prevents fluid loss through the skin |
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What is acrocyanosis?
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hands and feet appear cyanotic; caused by vasomotor instability and capillary stasis
is normal and appears intermittently over the first 7 to 10 days |
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What is lanugo hair?
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fine hair that may be noted over the face, shoulders, and back
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What is a simian line?
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a single palmar crease
often seen in Asian infants and infants with Down Syndrome increased number of creases correlates with increased maturity |
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What are mongolian spots?
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bluish-black areas of pigmentations which are noted most commonly on the back and buttocks
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What are nevi?
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"stork bites" "angel kisses"
flat, pink capillary hemangiomas that are easily blanched; appear on the upper eyelids, nose, upper lip, lower occiput bone, and nape of the neck |
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What is erythema toxicum?
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transient rash with lesions in different stages (erythematous macules, papules, and small vesicles)
has no clinical significance and requires no treatment |
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Signs of risk for integumentary problems:
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pallor, plethora (deep purplish color from increased circulating RBCs), petechiae, central cyanosis, or jaundice
bruising can indicate the risk of hyperbilirubinemia |
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What is caput succedaneum? When would you see it?
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edematous area of the scalp, bruising may be seen; seen in infants who are vacuumed extracted
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What is cephalhematoma? When would you see it?
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collection of blood between a skull bone and its periosteum; often occurs with caput succedaneum; doesn't pulsate or budge and spontaneously resolves
can occur with forcep extraction |
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What does bluish discoloration of the scrotum suggest?
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testicular torsion, which needs immediate attention
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What does fecal discharge form the vagina suggest?
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rectovaginal fistula
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What is hypospadias or epispadias?
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undescended or maldescended testes
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What is subgaleal hemorrhage?
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bleeding into the subgalean compartment of the skull; early detection is vital
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What is a pilonidal dimple?
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if present on the spine with a sinus and hairy nevus it can be a sign of spina bifida
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What is oligodactyly? polydactyly? syndactyly?
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oli - missing digits
poly - extra digits syn - digits that are fused together |
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What is DDH?
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developmental dysplasia of the hip
affected hip is unlikely to be dislocated at birth; instead it is easily dislocated |
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What is the Barlow and Ortolani test?
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Barlow - examiner places the middle finger over the greater trochanter and the thumb along the midthigh - hip is flexed to 90 degrees and adducted, followed by gentle downward pushing of the femoral head - if the hip can be dislocated with this maneuver, the femoral head moves out of the acetabulum the examiner feels a "clunk"
Ortolani test - the hip is then checked to determine if the femoral head can be returned into the acetabulum - as the hip is abducted and upward leverage is applied, a dislocated hip returns to the acetabulum with a clunk that is felt by the examiner |
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What is the optimal state of arousal? What is state modulation?
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quiet alert state is the optimal state of arousal
state modulation is the ability to make smooth transitions between sleep-wake states |
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What is postmature?
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born after 42 weeks and showing signs of progressive placental insufficiency
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What are clinical signs of hypoglycemia?
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can be transient or recurrent and can be present in the absence of clinical s/s
jitteriness, lethargy, poor feeding, abnormal cry, hypotonia, temperature instability (hypothermia), respiratory distress, apnea and seizures |
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What are the signs of hypocalcemia?
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can be asymptomatic
jitteriness, high-pitched cry, irritability, apnea, intermittent cyanosis, abdominal distention, and laryngospasm |
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What is plagiocephaly?
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positional misshaping of the head
caused from laying infant in same position, usually accompanied by loss of hair |
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What can hyperextension of the head with pain on flexion indicate?
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meningeal irritation
should be referred for immediate medical examination |
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What is an "early" term infant? What are they at increased risk for?
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infants born from 37 0/7 to 38 6/7 weeks of gestation
long-term problems such as learning difficulties (e.g., ADHD) |
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What is a late preterm infant? What are they at risk for?
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born between 34 0/7 and 36 6/7 weeks of gestation
at increased risk for respiratory distress, temperature instability, hypoglycemia, apnea, feeding difficulties, and hyperbilirubinemia |
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What is the Ishihara test and the Hardy-Rand-Rittler test?
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tests for color vision
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What is the Romberg test?
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have child stand with eyes closed and heels together; falling or leaning to one side is abnormal is called Romberg sign
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What are striae gravidarum?
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stretch marks
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What is the case management model?
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makes use of care maps and critical pathways
is one system that promotes comprehensive care with limited overlap in services |
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What is placenta previa?
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the placenta is implanted in the lower uterine segment such that it completely or partially covers the cervix or is close enough to the cervix to cause bleeding when the cervix dilates or the lower uterine segment effaces
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What is placental abruption?
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the detachment of part or all of a normally implanted placenta from the uterus
separation in the area of the decidua basalis after 20 wks of gestation and before the birth of the infant |
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What is fetal presentation, lie, attitude, position, and station?
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presentation - refers to the part of the fetus that enters the pelvic inlet first and leads through the birth canal during labor at term
lie - the relation of the long axis (spine) of the fetus to the long axis (spine) of the mother attitude - relation of the fetal body parts to one another position - relationship of a reference point on the presenting part to the four quadrants of the mother's pelvis station - the relationship of the presenting fetal part to an imaginary line drawn between the maternal ischial spines and is a measure of the degree of descent of the presenting part of the fetus through the birth canal |
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What are the five Ps of the labor and birth process?
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passenger (fetus and placenta)
passageway (birth canal) powers (contractions) position of the mother psychologic response |
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What is effacement?
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the shortening and thinning of the cervix during the first stage of labor
degree of effacement is expressed in percentages from 0% - 100% |
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What is dilation of the cervix?
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the enlargement or widening of the cervical opening and the cervical canal that occurs once labor has begun
measured in cm (1 - 10) |
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What are the stages of labor?
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1st stage - lasts from the onset of regular uterine contractions to full dilation of the cervix
2nd stage - lasts from the time the cervix is fully dilated to the birth of the fetus 3rd stage - lasts fro the birth of the fetus until the placenta is delivered 4th stage - arbitrarily lasts about 2 hours after delivery of the placenta |
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What is the difference between anesthesia and analgesia?
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anesthesia encompasses analgesia, amnesia, relaxation, and relfex activity
analgesia refers to the alleviation of the sensation of pain or the raising of the threshold for pain perception without loss of consciousness |
