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Antepartal Care

Amennorrhea, nausea, vomitting, breast/skin changes, cervical color changes & quickening are signs of? Presumptive indications
Abdominal enlargement, Goodell's sign, ballottement, Braxton Hicks contractions, palpation of fetal outline & positive pregnancy test are signs of? Probable indications
Define Hegar's sign softening of isthmus of uterine cervix, occurs early in pregnancy
Define Goodell's sign softening of the cervix
Define ballottement fetal head movement on exam
Define Braxton Hicks contractions irregular contractions or false labor
When is doppler used in ausculation of the FH sounds? 10-12 weeks
When is the fetoscope used in ausculation of the FH sounds? 18-20 weeks
When is the embryo seen using ultrasound? 5-6 weeks
When is the embryo seen using transvaginal technique? 10 days
Define gravida total # of pregnancy including the one in progress
Define para birth given at least 20 weeks
Define term births 38 weeks or later
Define preterm births before 38 weeks
What are some complications in pregnancy history that may affect labor? HTN, DM, infx or bleeding
What is Nagel's rule? Last normal menstrual period minus 3 months plus 7 days
What are some complications in medical history that may affect labor? Age, blood diseases, hepatitis, std, tb, gbs, anemia
Capacity of uterus? 5000 ml
Weight of uterus during pregnancy? 2.2 lb or 1000gm
How many weeks when uterus is in abdominal cavity or above symphysis pubis 12 weeks
How many weeks when uterus is midway symphisis & umbilicus 16 weeks
How many weeks when uterus is in xiphoid process 36 weeks
How many weeks when uterus is lightening? 40 weeks
When is uterine contractility (Braxton Hicks) infrequent? 1st & 2nd trimester
When is uterine contractility (Braxton Hicks) more frequent & cause discomfort? 3rd trimester
What happens to the uterine blood flow? increases dramatically
What happens to the myometrial artery? enter intervillous space
What is the reason for the myometrial artery entering the intervillous space? exchange of O2 & CO2 from ; provide nutrients & eliminate wastes to venous system
What is the fx of mucus secretions? and where is the location? What is the name of the ends of the mucus? protection from bacteria and protects baby from infx; canal of the cervix; internal & external OS
Define Chadwick's sign bluish color of the vagina & labia
What causes bluish color? increase level of estrogen
Vagina & Vulva changes - what causes the thick, white discharge? increase glycogen=increase sloughing
Vagina & Vulva changes - describe acidity discharge acidic (pH 3.5-6.0) due to increase lactic acid
Vagina & Vulva changes - what happens to bacteria? bacterial growth decreases but increase in yeast infx
Vagina & Vulva changes - increased edema & vascularity causes? orgasmic experience
Changes in ovaries - after conception, what is secreted and how many weeks? progestrone the first 6-7 weeks
What does progesterone do within the uterus? suppresses contraction of uterus & prevent tissue rejection of the fetus
After 7 weeks, what happens to the progesterone? The placenta will secrete it the rest of the pregnancy.
Main fx of progesterone? relaxes everything
What happens to the ovulation when pregnant? It stops because of high estrogen and progesterone levels which inhibits FSH & LH
When does quickening occur? 16 and 20 weeks gestation
When does backache develop? 2nd trimester
When does dyspnea develop? 3rd trimester
When does fatigue develop? 1st trimester
Normal weight gain for a pregnant woman? 25-35 lb
When (# weeks) does leg cramping occur? 22
What causes leg cramps? low Ca+ and or high Phosphorus
High levels of progesterone decrease contractility of the smooth musculature throughout the body resulting in an increase in? Pulse Rate and Temperature
When (# weeks) is vaginal and rectal cultures done? Purpose? 36 weeks, GBS (group B streptococcal)
At what position of the fetus is when urinary frequency happens? descent of the fetus into the pelvis or once lightening occurs
Anemia is a normal finding at how many weeks of gestation? 36 weeks
What promotes growth of lobes, lobules and alveoli? progesterone
What stimulates mammary ductal tissue? estrogen
When (timeframe) is heart pushed upward and left? 3rd trimester
When (# weeks) is systolic murmur heard? What sound is normal? after 12-20 weeks until 2 weeks PP; 3rd sound due to rapid filling of diastole
When (# weeks) does total blood volume increase by 45%? 6-8 weeks of pregnancy
When (# weeks) does plasma volume increase? How many mL? 32 weeks; 4700-5200 mL
Reason for plasma volume increase as it relates to protection? but risk in? protects from hemorrhage but increase risk of thrombus formation
Reason for plasma volume increase as it relates to other body growth? meet demands of increase uterine and breast tissues
What physiological changes causes plasma volume to increase? due to vasodilation from estrogen, progesterone & prostaglandins
Reason for plasma volume increase as it relates to respiratory and health? necessary to provide nutrients & O2
What is the reason for more blood volume as it relates to the fetus? more blood must circulate through the mom's kidneys to remove waste from mom & fetus
RBC mass increase to how many mL or %? 250-450mL (20-30%)
HCT decreases causing? physiologic anemia
Normal range for Hgb and Hct Hgb <10.5g/dl Hct <33%
When (# weeks) does cardiac output increase and by what %? 20-24 weeks (5-6 months), increase by 40%
What happens to the stroke volume and HR when CO increases? both increases, HR increases 15-20 bpm
What happens to the peripheral vascular resistance (PVR) when CO increases? PVR dialates or decreases
What changes happen to the respiratory at 10 weeks r/t O2, breathing, TV, & pH? O2 consumption inc. 20%, breathes deeper, tv inc., pH inc. more alkaline
What does progesterone do to the airway, CO2, ventilation? decreases airway resistance, inc sensitivity to CO2, inc. minute ventilation
What does estrogen do to the respiration as it r/t upper respiratory tract & congestion inc vascularity of URT, inc. congestion & stuffiness
What does progesterone do to the GI tract? relaxes GI tract muscles, slows emptying of stomach & sm. intestine
What does progesterone do to the colon as it r/t constipation? dec. motility leading to constipation & making hemorrhoids worst
What happens to the liver & uterus at 3rd semester? uteres lift diaphragm 4cm, prevents full lung expansion,
What semester has most frequency & urgency to urinate? 1st
Because kidney is working so hard, what declines? plasma creatine & urea
Define creatine creatinine is broken down by the body to make energy
What semester does waddling gait begin? 2nd
What semester stores extra Ca in bones? 1st
What semester does the fetus begin using Ca? 3rd
Abdomen separation is? Diastasis Recti
What hormone prepares breasts for lactation? prolactin
What hormone enlarges gland & BMR at 1st trmester? thyroid gland
What hormone dec. but able to meet fetal demands for Ca & Phos? parathyroid glands - regulates Ca & Phos
What does Ca & Phos do? inc, absorption offrom GI
What happens to the pancreas at 1st trimester? insulin production inc. due to glucose levels
What happens to the insulin at 3rd trimester? inc. 30%
What happens if there is too much resistance to insulin at 3rd trimester? hperglycemial
Fx of aldosterone? overcome Na wasting & maintain Na level with large blood volume
Define chorion outer layer of the placenta
When does heart develop? 5-8 weeks
When is fetal stage? `9-12 weeks
When does fetus begin to move and what oocurs with the fetus? 13-16 weeks; makes urine & mec
When can you hear FHT? 17-28 weeks
When is surfactant produced? 20 weeks
When does vernix & laguno occur? 21-24 weeks
Least amount of weeks that a fetus can survive? 29-32
How many grams by 33-36 weeks? 2-2.5g
What week 2 plus lbs, first viable? 28
What week 2mm tubular heart 2
What week resembles a human being? 8
What week lung maturity? 36
What week 1 plus lbs, lanugo, quickening 20
When does increased vaginal discharge occur? 1st
When does dyspnea, constipation, hemorrhoids occur? 2 & 3
When does heartburn occur? 2 & 3
When does nasal stuffiness and epistaxis occur? why? 2 & 3; due to blood excess
When does faintness occur? is it dangerous or discomfort? cause? 2 & 3; discomforts; low BG
What are danger signs r/t head? severe headache, dizziness, blurred vision, double vision, elevate temperature
What are danger signs r/t extremities? edema of hands, face, legs & fee
What are danger signs r/t abdominal? abdominal pain; persistent vomiting,
What are leg cramps r/t? xchange of electrolytes
What are danger signs r/t urinary system? oliguria, dysuria
What are danger signs r/t preclamsia? muscular irritability, convulsions
What are danger signs r/t digestive system? epigastric pain
What are possible causes of danger signs r/t placenta placenta previa, abruptio
What are possible causes of danger signs r/t BP? preeclampsia or PIH, pregnancy induced hypertension, eclampsia
What are possible causes of danger r/t kidney? UTI, pylonephritis (back pain that goes up)
What are possible causes of danger r/t fetus? SROM, premature labor
What type of spontaneous abortion when vaginal or spot bleeding occurs? threatened
What type of spontaneous abortion when membranes rupture and cervix dilates? inevitable
What type of spontaneous abortion when some products of conception have been expelled but some remain? incomplete abortion
What type of abortion when products of conception die and no spontaneous bleeding or evacuation occurs? Missed abortion
What may need to be done for a missed abortion? may need dilation & curettage
What type of abortion when all products of conception & tissue is passed complete abortion or miscarriage
What are s/s of ectopic pregnancy? pain, bleeding, low BP, shock
When is ultrasound best done? determines? 14-16 weeks; size and dates
When is the placenta assessed during pregnancy and why? later in pregnancy to detect location if she's bleeding
What does modes B in ultrasound show? brightness shows density
What does modes M in ultrasound show? movement, can see fetus swallowing, hear valves closing
What does CST - Contraction Stress Test measure? aka? ultrasound for FHR and toco for uterine contractions, late decels with contractions; Oxytocin Challenge Test
When is daily movement log test performed? after 20 weeks
What test is performed for Rh disease or pH? cordocentesis
What test is performed for high risk pregnancy or genetic? chorionic villus sampling
Total weight gain in pregnancy? 25-35 lbs
How much weight gained 1st trimester? Then 2nd & 3rd? 2-3 lbs; 1lb/wk
Intrauterine Growth Restriction is associated with? preeclampsia
What is an example of a prenatal high risk factor? multiparity >3
Which semester is uncertainty & ambivalence? 1st
What occurs psychologically at 2nd trimester fetus as primary focus, body image, changes in sexuality
What occurs psychologically at 3rd trimester Vulnerability, increasing dependence, preparation for birth
s/s of recent cocaine use r/t skin, blood, respiratio diaphoresis & cellulitis (red patches-dirty needles being used), high BP, irregular respirations
s/s of recent cocaine use r/t uterus and fetus sudden onset of severely painful contractions, fetal tachycardia,
Anxiety, depression, panic attacks, sleeplessness, anorexia is defined as?
Created by: jjcarmelbeach