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Mom/Baby Exam 2
Chs: 8, 9, 13-16
| Question | Answer |
|---|---|
| Nutrients important during pregnancy | calcium, protein, iron, B-complex vitamins, vitamin C, magnesium |
| Birth preference plan | writing down preferences; prospective parents can identify aspects of the childbearing experience that are most important to them |
| Doula | specialized childbirth support person; caters to mother; cannot facilitate birth, may assist in breathing techniques |
| Prenatal education | provide important opportunities to share information about pregnancy and childbirth and to enhance the parents' decision-making skills |
| Early prenatal classes (First trimester) | early gestational changes, self-care, fetal development, environmental dangers, sexuality, birth settings and types of HCPs, nutrition, rest, or exercise suggestions, relief measures, psychologic changes, danger signs, feeding choices/breastfeeding |
| Later prenatal classes (Second and Third trimester) | prep for birth, post self-care, birth choices, relaxation techniques, breathing techniques, alt. therapies, infant stimulation/massage, safety issues (car seats, sleeping position, etc), sibling prep |
| Adolescent Preparation classes | how to be a good parent, newborn care, health dangers, weight gain issues and nutrition, how to recognize that baby is ill, baby care (physical and emotional), sexuality, peer relationships |
| Breastfeeding programs | advantages/disadvantages of breastfeeding, maternal nutrition, techniques, methods of storage, involvement of fathers, returning to work, cultural considerations |
| Abdominal effleurage | a light stroking movement made over the abdominal wall with the fingertips; provides TACTILE stimulation to fetus |
| La Leche League | nonprofit organization that promotes breastfeeding |
| Pelvic-tilt exercises | rocking in a rocking chair or actually exercising; provides VESTIBULAR stimulation to fetus |
| Auditory stimulation | speaking to fetus; causes heart rate accelerations and a motor response |
| Vaginal birth after cesarean (VBAC) | supply information about vaginal births; parents should prepare 2 birth plans in the event of c-section again; |
| Bradley method | "best, safest, and most rewarding birth experience possible"; goals: natural, active participation of husband as coach, excellent nutrition, breastfeeding; work in harmony c body using abdominopelvic breathing; relaxation |
| Lamaze method | "childbirth education empowers..."; goals: normal, natural, healthy birth, experience profoundly affects, inner wisdom guides thru birth, women have right to no meds; disassociation, muscular relaxation, breathing patterns, positioning |
| Kitzinger method | "information to make decisions; home birth for those not at risk"; sensory memory to help prepare body; chest breathing & ab relaxation, Stanislavsky method for relaxation |
| Hypnobirthing method | "eliminate fear; stress-free, calm, and gentle environment"; mind and body relaxed, endorphins are body's natural anesthesia; deep, slow breathing, relaxation, breathing baby down, comfort and eliminate pain |
| Changes: uterus | increased amounts of estrogen and progesterone; enlargement in size; increase in weight, strength, elasticity, and vascularity |
| Changes: cervix | increased estrogen levels; hyperplasia; formation of mucous plug - prevents organisms from entering; discharge may increase - thick and sticky |
| Goodell's sign | softening of cervix |
| Chadwick's sign | bluish discoloration of cervix |
| Braxton Hicks contractions | irregular, generally painless contractions of the uterus; occurs intermittently throughout pregnancy; may be felt around the 4th month |
| Changes: vagina | increased estrogen levels; increased thickness of mucosa; increased secretions to prevent infections; connective tissue relaxes; pH becomes more acidic; increased blood flow - darker pigmentation |
| Changes: breasts | increased estrogen and progesterone levels; increased in size and number of mammary glands; nipples more erectile and areolas darken; colostrum produced during 3rd trimester - rich in antibodies and nutrients; superficial veins more visible; stretch marks |
| Montgomery's tubercles | sebaceous glands on breasts; enlarge during pregnancy |
| Changes: respiratory system | increasing levels of progesterone causes: increased volume of air, decreased airway resistance, increased anteroposterior diameter, thoracic breathing occurs as uterus enlarges; some hyperventilation may occur; nose bleeds and stuffy nose |
| "lightening" | baby "drops" into pelvic area allowing for easier breathing |
| Changes: cardiovascular system | increased levels of estrogen and progesterone; cardiac output and blood volume increases; swelling in lower extremities (edema); increased levels of RBC (40-50%), increase O2; clotting factors increase; pulse incre by 10-15 BPM |
| Changes: GI system | rising levels of progesterone cause: delayed gastric emptying and peristalsis (consti, naus, vomit); change in carb metabolism; may bleed from gums easier; smooth muscle relaxation |
| Changes: GU system | increased blood volume; glomerular filtration rate increases; urinary frequency in 1st/3rd trimester; renal tubular reabsorption increases; |
| Changes: skin and hair | increased skin pigmentation caused by increased estrogen and progesterone; areola, vulva, and linea nigra; "mask of pregnancy" on face - should fade post; vascular spider nevae; increased nail strength |
| Changes: musculoskeletal | relaxation of joints caused by increased estrogen and progesterone; no changes to teeth - bleeding gums; waddling gait, center of gravity changes, lordosis, lower back pain, separation of muscle in abdomen |
| Changes: CNS | decreased attention, concentration, and memory at tail end of pregnancy and early post; headaches - BAD |
| Changes: metabolism and weight gain | increased during pregnancy; baby takes what it needs, left overs to mom; average = 25-35 lbs, overweight = 15 lbs, underweight = up to 40 lbs |
| Changes: endocrine system | thyroid: enlarges, inc serum protein, inc bound iodine, Basal M rate inc; pituitary: makes preg possible, maintains, prolactin; adrenals: cortisol reg carb/protein metabolism; pancreas: inc insulin needs |
| Supine hypotensive syndrome | enlarging uterus may also press on the aorta and its collateral circulation; AKA - vena caval syndrome or aortocaval compression; have woman lie on side or pillow under right hip |
| cholasma (melasma gravidarum) | "mask of pregnancy" |
| diastasis recti | pressure on enlarging uterus on the abdominal muscles may cause the rectus abdominis muscle to separate |
| Water retention is caused by... | increased level of steroid sex hormones; affects sodium and fluid |
| Human chorionic gonadotropin | stimulates progesterone and estrogen production by the corpus luteum to maintain pregnancy until placenta takes over |
| Human placental lactogen | antagonist of insulin; decreases fetal metabolism of glucose |
| Estrogen | produced primarily by the placenta as early as the 7th week; stimulate uterine development; helps develop ductal system of the breasts in prep for lactation |
| Progesterone | greatest role in maintaining pregnancy; inhibits spontaneous uterine contractility; helps prep for lactation |
| Relaxin | inhibits uterine activity, diminishes strength of uterine contractions, aids in the softening of cervix, long-term effects of remodeling connective tissue |
| Hegar's sign | softening of the isthmus of the uterus; area between the cervix and the body of the uterus |
| McDonald's sign: | ease in flexing the body of the uterus against the cervix |
| Ballottement | passive fetal movement elicited when the examiner inserts two gloved fingers into the vagina and pushes against the cervix |
| Rubin's Four Tasks | ensuring safe passage thru pregnancy, labor and birth; seeking acceptance of child by others; seeking commitment and acceptance of herself; learning to give oneself on behalf of child |
| Early adolescence pregnancy | age 14 and under; still sees authority in his/her parents; gains independence by spending more time c friends; egocentric and concrete thinker; minimal ability to see future or consequences of actions |
| Middle adolescence pregnancy | ages 15-17 years; time for challenging and experimenting; begin to move from concrete to formal operational thought; still struggles with consequences |
| Late adolescence pregnancy | ages 18-19 years; more at ease c individuality and decision-making ability; think abstractly and anticipate consequences; formal operational thought; accept consequences |
| Nursing care for the pregnant adolescent | provide info: regular prenatal visits, signs of complications, STIs, substance abuse |
| Ultrasound | early identification of preg (week 5-6);fetal heartbeat (11 wks);ID of multiples;measure head to assess growth;estimation of birth weight;fetal/facial abnormalities;location of placenta and grading;fetal death;position |
| Nuchal translucency testing (NTT) | 11-13 weeks gestation; screening for trisomies 13,18,21; looks at clear area on back of neck and measures diameter |
| Umbilical velocimetry | noninvasive ultrasound test; measures blood flow changes that occur in maternal and fetal circulation in order to assess placental function |
| Nonstress test (NST) | evaluates fetal status; based on the knowledge that when the fetus has adequate oxygenation and an intact CNS, there are accelerations of the fetal heart rate with fetal movement |
| Biophysical profile (BPP) | fetal breathing and movement; fetal movements of body or limbs; fetal tone (extension and flexion of extremities); amniotic fluid volume; reactive FHR with activity; combines ultrasound c NST |
| Contraction stress test (CST) | means of evaluating the respiratory function of the placenta; contraindicated in 3rd trimester bleeding, and many others; contractions must be present; do not overstimulate; negative is normal; positive means the fetus may not be able to handle labor |
| Amniocentesis | procedure used to obtain amniotic fluid for genetic testing for abnormalities or fetal lung maturity in 3rd trimester; early or 15-16 wk; 22 gauge needle to take 15-20 mL |
| Quadruple screen | used to screen for Down syndrome (trisomy 21), trisomy 18, and neural tube defects; amniocentesis required |
| Chorionic villus sampling (CVS) | obtain a small sample of chorionic villi from the developing placenta; 1st trimester; diagnosis of genetic, metabolic, and DNA studies; 10-12 weeks; cannot detect neural tube defects; higher risk of fetal loss |
| Alcohol | CNS depressant and potent teratogen; 3-8 weeks is crucial time - alcohol does most damage; fetal alcohol spectrum disorders - physical and psychological deformities; excreted in breast milk - "pump and dump" |
| Drug abuse (cocaine/crack and marijuana) | cocaine and crack: maternal hypotension, small head and shorter babies, dilated pupils, crosses into milk; marijuana: no evidence of teratogenic effects, withdrawal |
| Drug abuse (Ecstasy and Heroin) | Ecstasy: little is known, may cause death; heroin: malnutrition, intrauterine growth restriction, inc risk of HIV, hypoxia, shrill cry, withdrawal occurs within 72 hrs, given valium and methodone |
| Methadone | given to mothers who are suffering from withdrawal from heroin; crosses placenta; blocks symptoms of withdrawal; low incidence of tolerance |
| Diabetes mellius during pregnancy | endocrine disorder; maternal risks - hydraminos, pre/eclampsia, ketoacidosis, infections; fetal risks - macrosomia, IUGR, resp distress syn, polycythemia, jaundice; CONTROL! |
| Anemia | hemoglobin of less then 11 g/dL in the 1st trimester, 10.5 g/dL in 2nd, 11 g/dL in 3rd; fatigue, pallor; low birth weight, premature, stillbirth; iron, folic, sickle, thalassemia |
| Human Immunodeficiency Virus (HIV) infection | can pass HIV to baby - transplacental, breastmilk, or vaginally; three-part ZDV prophylaxis regimen; c-section and no breastfeeding |
| Heart disease during pregnancy | decreased cardiac reserve and diminished capacity to handle pregnancy workload; rheumatic fever - untreated group A beta-hemolytic strep infections; mitral valve prolapse -usually tolerate well; peripartum cardiomyopathy-not well |
| Hepatitis B during pregnancy | does not affect course of pregnancy but can be transmitted; routine vaccinations of all infants at birth |
| Thyroid medications during pregnancy | breastfeeding is contraindicated; not medicated - fetal loss is great |
| Maternal phenylketonuria (PKU or hyperphenylalaninemia) | low phenylalanine diet is mandatory at conception and during pregnancy; fetal levels are generally 50% higher than mother; can cause mental retardation, microcephaly, heart defects, IUGR |
| Multiple sclerosis during pregnancy | in remission - okay; rest is important; labor may be almost painless; voluntary pushing may be hindered; genetic predisposition |
| Systemic lupus erythematosus (SLE) | remission, okay; plan pregnancy because meds are teratogenic; prenal visits and testing are more frequent; prognosis of infant varies, may need pacemaker |
| Tuberculosis (TB) | supplemental B6 vitmains; extra rest and limited contact with others; if maternal TB is inactive, breastfeed; newborn cannot have contact until mother is healthy |
| Abortion (or miscarriage) | expulsion of the fetus prior to viability; spontaneous - occurring naturally, induced - result of a medical or surgical means; pelvic cramping and backache |
| Ectopic pregnancy | implantation of the fertilized ovum in a site other than the endometrial lining of the uterus; cannot growth and thrive; may cause infertility |
| Hydatidiform mole (molar pregnancy) | disease in which abnormal development of placenta occurs, resulting in hydropic vesicles (fluid-filled, grapelike cluster) and the trophoblastic tissue proliferates; loss of pregnancy; complete-empty egg, can lead to cancer; partial-69 chromosomes, miscar |
| Incompetent cervix | premature dilation of the cervix in 4th or 5th month; purse string suture of cervix and planned c-section |
| Hyperemesis gravidarum | excessive vomiting during pregnancy; woman vomits everything she eats and retches between meals; dehydration may occur, metabolic acidosis, low potassium |
| Preeclampsia | most common hypertensive disorder; increase in blood pressure after 20 weeks gestation accompanied by proteinuria; mild or severe; eclampsia - most severe form; generalized seizures or coma can develop; only cure is birth and removal of baby and placenta |
| HELLP syndrome | hemolysis, elevated liver enzymes, and low platelet count; sometimes associated with severe preeclampsia; |
| Pre/eclampsia (maternal risks) | CNS changes: hyperreflexa, headache, and seizures; increased risk for: thrombocytopenia, renal failure, abrupto placentae, DIC, ruptured liver, and pulmonary embolism |
| Rh alloimmunization | fetus is incompatible with the Rh of the mother; if Rh negative woman carries an Rh positive baby; the mother's body begins attacking fetus; RhoGAM is given to prevent the attack |
| Surgery during pregnancy | early second trimester is the best time; place a wedge under hip during and after surgery; catheter and NG tube placed; endotracheal tube required during surgery |
| Trauma during pregnancy | save mom - saves baby; turn on left side, oxygen, IV fluids, control bleeding, ABCs; fetal monitoring for at least 4 hours; fetus born after 5 minutes of maternal death is okay |
| Abused pregnant woman | if violence in a relationship is to occur, more likely during pregnancy; may result in loss of pregnancy, preterm labor, low birth weight, c-section; delay in starting prenatal care and higher rates of complications; safe environment |
| Rubella during pregnancy | AKA German Measles; period of greatest risk is 1st trimester; congenital cataracts, sensorineural deafness, congenital heart defects; isolated at birth (elevated IgM titer); prevention!; abortion |
| Placenta previa | placenta's position is slightly turned; may cover cervical os partially, completely or just near the os |
| Abrupto placentae | the placenta separates from the uterine wall |
| Magnesium sulfate | anticonvulsant; given during preeclampsia and eclampsia to avoid seizures; given as a bolus |
Created by:
jodybreeze2013
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