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72 Cards in this Set

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Prenatal period
Time from conception until delivery of the fetus
Ovulation
release of an egg from the ovary
Ovulation to menses is how many days
14
where does fertilization usually take place
the distal 3rd of the follopian tube
what is a blastocyst
a hollow ball of cells that implant in the wall of the uteris
when does the plecents develope
3 weeks into pregnacy
functions of the placenta
life line and endocrine gland for hormones
describe the umbilical cord
two arteries and one vein 2ft in length the vein transports O2
volume of amniotic fluid after 20 weeks
500 to 1000 cc
what % of blood does a uteris contain
16% of the mothers blood
what is a mucous plug
it covers the cervix to protect the fetus
describe respiratory changes in the pregnant mother
Progesterone causes a decrease in airway resistance
40 % increase in tidal volume
Diaphragm is pushed up
how much is the maternal blood volume increased
45%
how much does cardiac output increas in a pregnant female
6 to 7 liters a min by the time the fetus is fully developed
how much blood loss will cause a change in vital signs in a pregnant female
30 to 35 %
describe blood pressure in pregnant femal
decreases slightly during the first two trimesters then returns to normal in third trimester
what is Supine hypotensive syndrome
it is when the mother lies on her back and compresses the inferior vena cava causeing decreased venous return to th right atrium which lowers blood pressure
describe GI problems with the pregnant female
N/V because of hormonal levels and change in carbohydrate needs also peristalsis is slowed which causes constipation
Describe renal changes in the pregnant femal
filtration rate increases 50%
because of the kidneys inability to absorb all the extra glucose gestational diabetes may develope
what is the average heart rate increas during pregnancy
10 to 15 BPM
what is the normal duration of pregnancy
40 weeks from last period
10 luner months
9 calender months
when can fetal heart tones be heard
20 weaks
when is it possible for the baby to survive if born premature with extreme supportive care
24 weeks
when can you determine the sex of the baby
16 weeks
when does the fetal heart begin to beat
4 weeks
when are all body systems and external structures formed
8 weeks size is about 1.2inch
when does a premature baby have a very good chance of survival and why
28 weeks because the surfactant neessary for lung function is formed
what is the ductus venosus
it is where the umbilical vein connects directly to the inferior vena cava
What is the foramen ovale
allows mixing of the oxygenated blood in the right atrium and then going to the left ventricle
What is the ductus arteriosus
this connects the pulmonary artery wiht the aorta which causses blood to bypass the uninflated lungs
what is the normal fetal heart range
140 to 160
when the fundal height reaches the umbilicus about 20 cm how many week along is the mother
20
how should you position the mother for vitals
on her left side to aleviate the presure on the inferior vena cava
what is ectopic pregnanacy
abnormal implantation of the fertilized egg outside of the uterus
how does ectopic pregnanacy present
abdominal pain that starts out diffuse and then localizes to sharp pain in the lower abdominal. LMP occurred 4 to 6 weeks and was shorter than usuall and brown in color. As intra abdominal bleedinng continues the abdomen becomes rigid and the pain intensifies and is often referred tothe shoulder on the affected side. watch for shock
what is placenta previa
abnormal implantation of hte placenta on the lower half of the uterin wall, may completely or partially cove the cervix
what is the sign of plecenta previa
the onset of painless bright red vaginal bleeding usually in the last trimester or during birth
what is Abruptio Placentae
premature separation of a normally implanted placenta from the uterine wall could be marginal (partial) or Central (severe) or Complete
signs of abruptio placentae
include
Marginal abruption, there will be bleeding but no pain

Central abruption, there will be sharp, tearing pain and a stiff board like abdomen

Complete abruption, will result in massive hemorrhage
What is Preeclampsia
hypertensive disorder of pregnancy defined as an increase of systolic of 30 and a diastolic of 15 over baseline
What is eclampsia
it is the moste severe of the hypertensive disorders of pregnancy characterized by generalized tonic clonic seizure activity
treatment of eclampsia may include what
a bolus of Mag sulfate of 2 to 5 g diluted in 50 to 100 ml
slow iv push
also valium may be in order for controling seizures
be sure to have calcium glutimate available to reverse mag sulfate effects
what is supine hypotensive syndrome
drop in blood pressure because of laying supine for too long, place in latteral recombent position and elevate her right hip
what is the likely cause of a pregnant patient with altered mental status
gestational diabetes
what are braxton hick contractions
contractions felt by the mother as early as 13 weeks, these enhance placental circulation and condition the abdominal muscles for labor also called false labor
when is the fetus considered to be full term
38 weeks
what is effacement
the thinning and shortening of the cervix during labor
what is tocolysis
the process of stopping labor
what are the ways that tocolysis is done in the field
sedation with narcotics or barbiturates
or administration of approximately 1 liter of fluid
what is the Puerperuum
this is the time period surrounding the birth of the fetus
what is the imminent sign of labor
bloody show the pink tinged secretions that is released from the opening of the cervix
how long after the bloody show will labor start
12 to 24 hours, if not labor will be induced because of the risk of infection
how do you asses the frequency and duration of contraction
by placing your hand on the fundus of the uterus
what are the 3 stages of labor
Dilation
expulsion
placental
what is the dilation stage
it begins with the onset of contractions and ends with the cervical opening at 10 cm
usually lasts about 5 to 10 hours
what is the Expulsion stage
begins with complete dialation and ends with the delivery of the fetus lasting about 30 to 60 min
what is the Placental stage
begins after the birth and ends with the delevery of the placenta last about 5 to 20 min
what factors should prompt immediate transport despite the threat of delivery
Prolonged rupture of membranes
abnormal presentation
prolapsed cord or fetal distress as evident by meconium staining or fetal brady, the presence of multiple fetuses.
what should you do if the fetal heart rate is less than 90 or if the baby has not delivered after 20 min with contractions every 2 to 3 min
transport immediately with mother on her left side
what are the elements of the APGAR score
Appearance
Pulse rate
Grimace
Activity
respiratory effort
what is cephalopelvic disproportion
usually associated with diabetes, multiparity or postmaturity. Transport immidiately
what is precipitous Delivery
delivery that occurs after less than 3 hours of labor. associated with fetal trauma and tearing of the umbilical cord and multiple lacerations
What is meconium staining
when the fetus passes feces into the amniotic fluid it is always indicative of a fetal hypoxic incident
What is shoulder Dystocia
a condition of diabetes and obese mothers. the baby has shoulders bigger than his head. have the mother drop her buttocks off the end of the bed then flex her thighs upward to facilitate delivery and apply firm pressure with and open hand immediately avove the symphysis pubis to assist
what is postpartum hemorrhage
when there is more than 500cc of blood loss after delivery, try fundal massage and administer oxytocin, replace fluids as needed
What is uterine Rupture
usually associated with trauma, it will cause extreme pain and shock. it usually occurs with the onset of labor and is always associated with the cessation of labor contractions
What is Uterine Inversion
when the uterus turns inside out after delivery and extends through the cervix, in this case make one attempt to replace the uterus
Describe how a pulmonary embolism relates to pregnancy
it acna occur after pregnancy, usually as a result of venous thromboembolism, it is one of the most common maternal deaths. it presents with suddon onset and sharp chest pain patients also report impending doom
What do you do for PEA
ask Dusty :)
A woman who has given birth to her first child is termed
Primipara
What is the preferred analgesic in pregnancy
nitrous oxide
An APGAR scoring 4-6 indicates what
the need for Oxygen and stimulation to breath