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173 Cards in this Set
- Front
- Back
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Abortus
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a fetus that is born
<20 wks <500 g <25 cm |
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Birthrate
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# of live births : 1000
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Infant mortality rate
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# of deaths : 1000 live births
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Maternal Mortality rate
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# of deaths (42 days) : 100,000
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Neonatal mortality rate
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# of infant deaths (28) : 1000
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stillbirth
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Infant who at birth demonstrates no signs of life:
1. breathing 2. heartbeat 3. voluntary muscle movement |
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LBW
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Low birth weight
<2500 g (5lb 8oz) |
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VLBW
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Very low birth weight
<1500 g |
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CH 10 - Gravida
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A pregnant person
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CH 10 - Gravidity
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Pregnancy
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CH 10 - Multipara
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multiple 20 wk pregnancies
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Nulligravida
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Never been pregnant
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Nullipara
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Never completed 20 wk pregnancy
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Parity
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Number of 20 wk pregnancies
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Postterm or postdate
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pregnancy that goes beyond 42 wks
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Preterm
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Pregnancy between 20-37 wk
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Primigravida
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1st pregnancy
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Primipara
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completed only one 20 wk pregnancy
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Term
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38-42 wk pregnancy
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Viability
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Capacity to live outside the uterus
occurring about 22-25 wks |
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GTPAL
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Gravidity
Term Preterm Abortions Living children |
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Human Chorionic gonadotropin (hCG)
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Earliest biologic marker for pregnancy
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Home pregnancy tests - detect pregnancy how many days after conception?
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7-10 days
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human Chorionic gonadotropin (hCG) -
High levels indicate? |
Abnormal Gestation
Multiples |
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human Chorionic gonadotropin (hCG) -
Low levels indicate? |
Ectopic
Impending miscarriage |
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Home pregnancy test -
Causes of false positives? |
anticonvulsants
Tranquilizers |
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Home pregnancy tests -
Causes of false negatives? |
Diuretics
Promethazine (phenergan) |
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Signs of pregnancy - Presumptive
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amenorrhea
fatigue breast changes |
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Signs of pregnancy - Probable
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Hegar sign
Ballottement pregnancy tests |
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Signs of pregnancy - Positive
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Fetal heart tones
visualizing the fetus palpating fetal movements |
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Chloasma
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Mask of pregnancy
Blotchy, brownish hyperpigmentation of the cheeks, nose and forehead. |
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CH 10 - linea nigra
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pigmented line extending from the symphysis pubis to the top of the fundus along the midline
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CH 10 - Striae gravidarum
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Stretch marks
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CH 10 - Neurologic changes during pregnancy?
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Carpal Tunnel
Acroesthesia (numb hands) Tension headache |
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CH 10 - ptyalism
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excessive salivation
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CH 20 - Involution
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the return of the uterus to a nonpregnant state
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CH 20 - Involution - progression
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descends 1-2 cm / 24 hrs
starts - 2 cm below umbilicus 12 hrs - 1 cm above umbilicus 24 hrs - same size as at 20 wks 6 days - halfway between umbilicus and symphysis pubis 2 wks - nonpalpable |
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subinvolution
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failure of uterus to return to nonpregnant state
Causes - retained placental frags and infection |
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postpartum contractions
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Caused by oxytocin
Assist in involution exogenous pitocin may be needed breastfeeding stimulates oxytocin |
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Lochia
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postpartum uterine discharge
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Lochia - types
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lochia rubra - bright red (3 days)
lochia serosa - pink/brown (3-4 D) Lochia Alba - yellow/white (2-6 wk) |
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episotomy
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incision in perineum to enlarge the vaginal outlet
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Amount of time for abdomen to return to normal after birth
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6 weeks
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Diastasis recti abdominis
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separation of the abdominal wall muscles because of a large fetus or multiple fetuses
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Maternal GI changes after birth
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Increased appetite
delayed bowel movement (2-3 days) |
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Maternal physiologic changes - Breasts
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Colostrum transitions to milk by 72-96 hrs
Breasts become nodular (lumpy) |
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duration of engorgement
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24-48 hrs
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CH 20 - amount of normal blood loss during birth -
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vaginal - 500 mL
C-sec - 1000 mL |
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CH 20 - hypovolemic shock deterrents postpartum
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1. 10%-15% reduction in maternal vascular bed
2. Loss of placenta reduces stimulus for vasodilation 3. extravascular water stored during pregnancy increases blood volume |
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CH 8 - Euploidy
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46 Chromosomes
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CH 8 - Polyploidy
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Chromosome deviation is a multiple of the haploid set (23)
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CH 8 - Aneuploidy
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Chromosome deviation is not a multiple of the haploid set (23)
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CH 8 - Monosomy
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Missing 1 chromosome from a pair
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CH 8 - Trisomy
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3 copies instead of the normal 2 of a particular chromosome
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CH 8 - Oogenisis
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The production or development of an ovum
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Ch 8 - Populations at risk for genetic disorders
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1. Ashkenazi jews - Tay-sachs
2. Mediteraneans - Thalessemia 3. African-americans - sickle cell |
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Ch 8 - Genetic testing - amniocentesis
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The sampling of amniotic fluid using a hollow needle inserted into the uterus, to screen for developmental abnormalities in a fetus.
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Ch 8 - Turner syndrome
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Most common sex chromosome abnormality in females
S&S - juvenile external genitalia, undeveloped ovaries, short stature, webbing(neck, hands, feet) impaired intelligence |
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Ch 8 - Klinefelter's syndrome
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Most common sex chromosome deviation in males
S&S - poorly developed secondary sex characteristics, small testes, infertile, tall, effeminate, slow to learn |
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Ch 8 - time ova are considered to be fertile
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24 hrs
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Ch 8 - average transit time of sperm
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4-6 hrs
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Ch 8 - sperm remain viable within a woman for how long?
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2-3 days
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Ch 8 - pregnancy lasts how long?
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10 lunar months
9 calendar months 40 wks 280 days |
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Ch 8 - LMP
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Last menstrual Period
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Ch 8 - conception occurs how long after LMP?
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2 wks
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Ch 8 - EDD
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Estimated date of delivery
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Ch 8 - Naegle's Rule
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EDD = LMP + 7 days - 3 months + 1 year
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Ch 8 - Amniotic Fluid - functions
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1. Waste repository
2. cushions fetus 3. allows movement 4. maintain constant body temp |
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Ch 8 - Oligohydramnios
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having less than 300 ml of amniotic fluid.
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Ch 8 - Placenta - functions
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1. means of metabolic exchange
2. Endocrine gland (hCG, hCS, Estrogen, Progesterone) |
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Ch 8 - Fetal Maturation - lungs r/t gestational age
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35 weeks
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Ch 8 - Fetal Maturation - Surfactant r/t gestational age
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32 weeks
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Ch 8 - Fetal Maturation - heartbeat begins at what week of gestation?
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3rd week
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Ch 8 - Dizygotic
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Fraternal twins (not identical)
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Ch 8 - MOnozygotic
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Identical twins
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Ch 4 - preconception counseling - period of critical organ development?
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17-56 days after fertilization
2-8 wks |
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Ch 4 - preconception counseling - folic acid
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400 mcg/day
reduce neural tube defects (spina bifida, anencephaly) |
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Ch 4 - Major goals of prenatal Care
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1. define health status of mother & fetus
2. Determine gestational age 3. id woman at risk for complications 4. provide education |
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Ch 4 - Percentage of couples with infertility?
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15%
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Ch 4 - Barriers to receiving health care?
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1. Financial
2. Cultural 3. Gender issues |
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Ch 4 - Health risks during childbearing years - Age
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STIs
sexually active teens chance of pregnancy without birthcontrol is 90% within 1 year |
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Ch 4 - Battered women - 3 questions to ask
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1. Are you with a partner that threatens / physically hurts you
2. Within the past year has anyone hit / hurt you 3. Has anyone forced you into sexual activity that made you uncomfortable |
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Ch 4 - Reporting domestic violence
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Mandatory in 40 states
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Ch. 5 - Vulva
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External genital organs
mons pubis, labia majora, labia minora, clitoris |
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Ch. 5 - Internal Structures of female reproductive organs
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Vagina, uterus, uterine tubes, ovaries
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Ch. 5 - Average length of menstrual cycle
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28 days
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Ch. 5 - menstrual flow - average daily blood loss
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50 ml / day (range of 20-80 ml)
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Ch. 5 - Bleeding begins _____ days after ovulation
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14 days
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Ch. 5 - the 4 phase of the endometrial cycle
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1. the menstrual phase ( shedding of endometrium)
2. the proliferative phase (rapid growth of endometrium) 3. the secretory phase (ovulation) 4. the ischemic phase (necrosis of endometrium) |
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Ch. 5 - 4 phases of sexual response.
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1. excitement
2. Plateau 3. orgasmic 4. resolution |
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Ch. 7 - Female infertility - Causes
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Hx of infection
obsturction organ abnormalities Hormonal abnormalities |
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Ch. 7 - Male infertility - Causes
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Previous sterilization
Obstruction Sperm count |
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Ch. 7 - infertility - non-invasive treatment
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lifestyle changes (nutrition, exercise, smoking/alcohol reduction)
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Ch. 7 - Infertility - Pharmacologic therapy
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Clomid - ovulation / spermatogenesis stimulation
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Ch. 7 - Contraception - types
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1. Oral birth control pills
a. progesterone & estrogen b. mini-pill - progesterone 2. Barrier a. Diaphragm, b. Cervical cap, c. Condom) 3. IUD a. copper (10 yr) b. Mirena (5 yr) 4. emergency contraception a. Plan B (take within 72 hrs) |
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Ch. 7 - Induced abortion
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Purposeful interruption of pregnancy before 20 wks
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Ch. 7 - 1st trimester abortion - types
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1. Surgical (aspiration) abortion
2. Medical Abortion (drugs used to induce abortion) |
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Ch. 7 - 2nd trimester abortion
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Dilation and evacuation
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Ch. 7 - common complication of induced abortion
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infection
retained products of conception excessive vaginal bleeding |
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Ch. 9 - 3 leading causes of maternal mortality in the US
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1. gestational hypertension
2. Pulmonary embolism 3. Hemorrhage |
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Ch. 9 - Types of antepartum testing and biophysical assessment
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1. Daily Fetal movement Count
2. Ultrasonography 3 MRI 4. Amniocentesis 5. Percutaneous umbilical blood sampling 6. Chorionic villus sampling 7. Maternal Assays 8. Nonstress test (NST) 9. Contraction stress test (CST) |
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Ch. 9 - Daily Fetal movement Count - when to notify doctor
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if fetal movements (FM) cease entirely for 12 hrs.
If fewer than 10 FM within 12 hrs |
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Ch. 9 - Ultrasonography - when gestational age is most accurately measured
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first 20 weeks due to consistent growth rates of fetuses
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Ch. 9 - Ultrasonography - uses by trimester
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1st trimester- Confirm pregnancy, determine gestational age
2nd trimester - Confirm dates, detect congenital anomalies, IUGR 3rd trimester - determine fetal position, amniotic fluid volume |
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Ch. 9 - Amniocentesis - Indications for use
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assessment of genetic disorders
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Ch. 9 - Percutaneous umbilical blood sampling (PUBS)- indications for use
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fetal blood sampling (blood type, RBC count)
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Ch. 9 - Chorionic villus sampling (CVS) - indications for use
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assessment of genetic disorders
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Ch. 9 - Coombs' test - Indication for use
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Sreening for Rh incompatability
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Ch. 9 - Contraction Stress Test (CST) - Contraindications
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rupture of membranes
previous classic incision for cesarean birth preterm labor placenta previa abruptio placentae multifetal pregnancy previous preterm labor hydramnios more than 36 wks of gestation incompetent cervix |
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Ch. 9 - Nonstress test (NST) - Interpretation
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two or more accelerations of 15 beats/min lasting for 15 seconds over a 20 min period
normal baseline rate moderate variability |
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Ch. 9 - Contraction Stress Test (CST) - interpretation
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negative - no late decelerations
positive - repetitive late decelerations |
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Ch. 9 - Normal Fetal Heart rate?
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110-160 bpm
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Ch. 6 - Amenorrhea
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Absence of menstrual flow
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Ch. 6 - Amenorrhea - causes
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Eating disorder/excessive exercise
endocrine disorders |
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Ch. 6 - hypogonadotropic amenorrhea - Causes
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Stress, weight loss, eating disorders, exercise
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Ch. 6 - Dysmenorrhea
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Pain during or shortly before menstruation
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Ch. 6 - Primary Dysmenorrhea - Causes
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increased uterine activity
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Ch. 6 - Secondary Dysmenorrhea - Causes
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pain r/t pelvic pathology
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Ch. 6 - Endometriosis
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presence and growth of endometrial tissue outside of the uterus
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Ch. 6 - endometriosis - S&S
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Pelvic pain
dysmenorrhea dyspareunia (painful intercourse) |
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Ch. 6 - Oligomenorrhea
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decreased menstruation:
amount or time |
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Ch. 6 - menorrhagia (hypermenorrhea)
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excessive menstruation
duration or amount |
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Ch. 6 - Bacterial STIs
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1. Chlamydia
2. Gonorrhea 3. Syphilis |
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Ch. 6 - Viral STIs
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1. HIV
2. Herpes Simplex 3. Viral hepatitis A and B 4. Human Papillomavirus |
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Ch. 6 - Most Common STI
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Chlamydia
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Ch. 6 - Viral Hepatitis - Types
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1. Hep A - Fecal-Oral
2. Hep B - STI 3. Hep C - Blood-borne |
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Ch. 6 - HIV - time to seroconversion
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within 6-12 wks
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Ch 11 - Barriers to obtaining care during pregnancy
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1. low # of healthcare providers
2. Unpleasant clinic/procedures 3. bad clinic location/hours 4. lack of transportation, 5. Finances |
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Ch 11 - Fundal height as a gestational age indicator
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Height of fundus in centimeters above the symphysis pubis = gestational age in weeks
(empty bladder) |
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Ch 11 - Discomforts r/t pregnancy 1st trimester
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1. Breast changes
2. Urinary urgency & frequency 3. N&V 4. Ptyalism (excessive saliva) |
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Ch 11 - Discomforts r/t pregnancy 2nd trimester
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1. Skin (oily skin & acne)
2. Angiomas (upper body) 3. Palpations 4. Supine hypotension 5. Constipation 6. Carpal tunnel & numbness |
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Ch 11 - Discomforts r/t pregnancy 3rd trimester
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1. Dyspnea
2. Insomnia 3. ankle edema 4. leg cramps |
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Ch 12 - Nutritional needs before conception
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1. Folate 0.4 mg / day
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Ch 12 - Nutritional needs during pregnancy & lactation
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Energy P=+81 kcal & 3rd tri=+108
L=+79 2nd 6m=+55 Protein P & L=+25 g; Water P=3 L ; Lac=3.8 L |
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Ch 12 - Optimal Weight gain per month
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Normal weight women=1-3 kg/m
Obese women= 0.5 kg - 3 kg/m |
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Ch 13 - Diabetes Mellitus - Blood sugar goals
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60-120 mg/dL
A1c= <6 |
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Ch 13 - Diabetes Mellitus - Insulin Needs by trimester
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1st = reduced
2nd & 3rd=Increased |
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Ch 13 - Diabetes Mellitus - Complications
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Preeclampsia
Hydraminios infetions ketoacidosis hypoglycemia Macrosomia (excessive growth) |
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Ch 13 - Mothers with PKU
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Discouraged from breastfeeding
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Ch 14 - Pregnancy induced Hypertension - Types
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gestational - high BP
Preeclamp - high BP, Proteinuria Eclamp - preeclamp + seizures |
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Ch 14 - eclampsia - Magnesium Sulfate
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uses - treatment/prevention of seizures
Evaluate - DTR |
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Ch 14 - Hyperemesis Gravidarum
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Excessive vomiting causing 5% weight loss
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Ch 14 - Miscarriage (Spontaneous Abortion) - Types
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1. Threatened - spotting with closed cervical os
2. Inevitable - Bleeding, cervical dialation 3. Incomplete - bleeding, delivery of fetus with retention of placenta 4. Complete - All fetal tissue is passed, closed cervix 5. Missed - fetus is dead, but fetal tissue are retained |
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Ch 14 - Incompetent Cervix - Causes
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Cervical Trauma, excessive cervical dilation for biopsy, short cervix (<25 mm)
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Ch 14 - Incompetent Cervix - Treatment
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Bed rest, tocolysis (inhibition of contractions),
Prophylactic cerclage |
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Ch 14 - Placenta Previa
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Placenta is implanted in the lower uterine segment near the cervical os
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Ch 14 - Placenta Previa - Types
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Low-lying - implanted in lower uterus but doesn't reach the os
Complete/total/central - internal os is entirely covered Partial - incomplete coverage of internal os |
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Ch 14 - Placental Abruption
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Premature separation of the placenta
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Ch 14 - Placental Abruption - S&S
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Sudden onset of intense, localized uterine pain
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Ch 19 - PROM and PPROM
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Premature Rupture Of Membranes beginning at least 1 hour before onset of labor
Preterm PROM - before 37 wks |
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Ch 19 - Preterm Labor - Tocolytics
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Indocin - Discontinue @ 32 wks
Magnesium Sulfate Procardia |
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Ch 19 - Promotion of fetal lung maturity - Glucocorticoids r/t gestational age
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given between 24-32 wks
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Ch 15 - Factors Affecting Labor - 5 P's
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Passenger
Passageway Powers Position of women Process of labor |
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Ch 15 - Factors affecting Labor - Passenger - Presentation
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Part of the fetus that leads through the birth canal:
Cephalic (Vertex) Breach(Butt or feet first) Shoulder |
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Ch 15 - Factors affecting Labor - Passenger - Fetal Position
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Three letter abbreviation
1. Right or Left of pelvis(R or L) 2. Presentation (Occiput, Sacrum, Mentum(chin), (Sc)apula) 3. Relation to pelvis (Anterior, Posterior, Transverse) |
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Ch 15 - Factors affecting Labor - Passageway - Types of Pelvis
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1. Gynecoid (Best for delivery)
2. Android (Male pelvis) 3. Anthropoid (Ape pelvis) 4. Platypelloid (Flat Pelvis) |
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Ch 15 - Factors affecting Labor - Powers - Primary and Secondary
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Primary - Effacement, Dilation, Contractions
Secondary - Bearing Down |
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Ch 15 - Factors affecting Labor - Process - Signs Preceding Labor
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Surge of energy
Weight loss 0.5-1.5 kg Bloody show |
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Ch 15 - Factors affecting Labor - Process - Stages Of Labor
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1. Onset of regular contractions to full dilation of cervix
2. Full dilation to birth of fetus 3. Birth to delivery of placenta 4. 2 hours post delivery of placenta |
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Ch. 16 - Pain During Labor - Neurologic
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1. Visceral - Cervical/Uterine ischemia (1st Stage)
2. Somatic - Sharp, burning, well localized (2nd Stage |
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Ch 18 - How to distinguish true or False labor - Contractions
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True - Regular, intensifying, lasting longer, closer together; become more intense with walking
False - Irregular, stop with walking |
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Ch 18 - How to distinguish true or False Labor - Cervix
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True - Shows progressive change (Softening, effacement, dilation)
False - No significant change in effacement / Dilation |
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Ch 18 - How to distinguish true or false labor - Fetus
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True - Presenting part engages in the pelvis ( Increased ease of breathing & urinary frequency)
False - Presenting part is not engaged in the pelvis |
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Ch 23 - Postpartum Hemorrhage - Normal Amounts
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Vaginal - <500 ml
C-sec - < 1000 ml |
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Ch 23 - Retained Placenta - Types
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1. Placenta accreta - slight penetration of myometrium
2. Placenta increta - Deeop penetration of myometrium 3. Placenta percreta - Perforation of uterus |
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Ch 23 - Inversion of the uterus - Prevention
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Umbilical cord should not be pulled unless placenta has definitely separated
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Ch 23 - Mastitis - Antibiotic treatment r/t breastfeeding
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Breastfeeding is contraindicated while taking Tetracycline
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Ch 24 - Jaundice - Bilirubin levels
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Greater than 5 mg/dl
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Ch 25 - APGAR - what it stands for,
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Appearance (Degree of cyanosis)
Pulse (absent, <100, >100) Grimace (reflex irritability) Activity (Flexion, Movement) Respiration |
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Ch 25 - APGAR - How to score
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score of 0, 1, or 2
Total score of 10 Norm 7-10 |
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Ch 25 - APGAR - Timing of evaluation
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1 min after birth
5 min after birth |
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Ch 25 - Heel stick location
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Lateral aspect of heel
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Ch 26 - Breastmilk - Storage
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Room temp - 6-8 Hrs
Refrigerated - 5 days Freezer - 6 months < -18 C - 1 year |
