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MVCTC Maternity sec

MVCTC Maternity sec 1

What is Maternity Nursing Care? Quality Nursing Care expirence for whole family for each patient .
The birthing setting where the room is a homelike room, but their postpartum room is in another room, both on Hospital grounds? {LDR} Labor Delivery recovery Room
In collaborative Care who is athorized to deliver in a uncomplicated births of low risk women? 1. Certified Nurse Midwife 2.) Obstericians and Gynecologists
TIMELINES for specific patients diagnosis ? Clinical Pathways
Government Health Influences Title V Public Health Clinics for mom and newbornTitle XIX Medicaid ie: caresourceWIC food for Women Infant and Children
Birth Rate Statistics # OF live Births per 1000 year
Infant Mortality Rate # OF DEATHS < 1 year old/ 1000 live births
Neonatal mortality Rate # of deaths <28days old/ 1000 live births
Family types Nuclear-RegularBlended- 2+ familiesCommunal-several families live together
Legal Liability Professional negligence to cause injury or death - to prevent remember to do both consent forms and documentation
Low Risk Pregnancies Fetal HR, Activity, VS, urine activity, etc
High Risk Pregnancies Kick Counts 10 kicks in 12 hours or 3 kicks in 1 hour
Allows passage of the baby by Stretching Rugae
The muscular layer of the uterus that is functional unit in pregnancy and labor Myometrium
Fallopian tube 1.)carries the ovum from the ovary to the uterus2.) Site for fertilization3.) passage way for sperm to get to the ovum
The ovaries secrete what? Estrogen and Progesterone
Progesterone does what? Prepares and maintains uterine lining for implantation of zygote/ ovum
The pelvis is divided into true and false pelvis by the imaginary line the? Linea Terminalis
Ischial Spines Represents the shortest diameter of the pelvic cavity(the width)
Diagonal Conjugate distance between the symphysis pubis and the sacral promontory
Pelvic type: Gynecoid normal round female pelvis
Ovulation occurs 14 days before the beginning of the next cycle
Ovum is fertile for approx 24 hours
Sperm can survive up to? 5 days
Uterine layer involved in implanation? Endometrium
A decrese in estrogen and progesterone during menstrual cycle is responsible for Shedding of the endometrium
Ovarian follicles matures under influence of Anterior pituitary horomones FSH and LH
What helps maintain the pregnancy:? Progesterone
The milk secreting cells? acini cells in the alveoli
Montgomery's tubercles small raised areas around the areola they are sebaceous glands.
When newborn sucks at breast what horomone releases to stimulate milk Production to fill boobs? Prolactin (Ant. pituitary)
The ejection of milk into the ducts for release through the nipples "the let down" Oxytocin(contractile)posterior pituitary
The Scrotum suspends outside the body for Allow for cooling that is necessary for Spermatogenesis (FSH helps production) (sperm production)
Testosterone functions 1.) Secondary sex characteristics 2.) formation of sperm 3.) Bones and muscle-thicker and longer 4.) Larynx-enlarged: lower voice 5.)Enhancing production of RBC's
Mitosis Contain the same number of chromosomes as parent - 46 chromosomes- 46 chromosomes
Meiosis ( Reproductive cells) Contain half the number of chromosomes as parent- 46 chromosomes- 23 chromosomes
The sex of the baby is xx or xy What is XY and XX? X Of sperm and X of ovum= female Y of sperms and X of ovum= male
In fetal development what weeks is it considered a Fetus? 9th week of gestation
Chorion the thick outermost layer
Amnion Inner layer- prtects the eymbro
Amniotic Fluid an excess that greater than 2 L Hydramnios- Polyhydramnios
Amniotic Fluid less than 30cc Oligohydramnios
Function of the Amniotic Fluid 1.) Free movement 2.) Cushion
Progesterone Reduces uterine contractions to prevent spontaneous abortion
Estrogen Stimulates uterine growth
hCG Detects in a home pregnancy test within 7-9 days after fertilization
Human Placental Horomone Increases resistance to insulin causing more protein, glucose and minerals to be available for baby
The Duncan's Placenta Maternal Side, Rough, have to watch for hemmorrhage on this side
The Schultze's Placenta Fetal Side, Smooth, you want this side first.
2 arteries there are 2 arteries so 2 to carry away so they are deoxygented blood and waste away from baby to placenta 2 dirty so away from baby.
1 vein 1 vein that is oxygenated
Ductus Venosus V= vein (bypass liver) extra help= your have one liver and one vein [connects vein with the inferior vena cava]
Foramen Ovale (Bypass lungs) {extra help}= you have 2 arteries and 2 lung [opening between the R and L atria of the heart bypass' lungs]
Ductus Arteriosus (bypass lung) {extra help} = you have 2 arteries and 2 lungs [Connects the pulomary artery and aorta]
Purpose of the Foramen Ovale to reduce blood flow to the lungs
Monozygotic Identical twins{have to be same sex} splitting of 1 sperm and 1 egg
Dizygotic Faternal Twins { 2 ova and 2 sperm}
Gravida any pregnancy, regardless of duration, includes the present one,
Nulligravida nulli= never, so never been prego
multigravida have been pregnant before
primagravida prima = 1, so first time she's been pregnant
para a woman who has given birth to one or more children who reached 20 weeks dead or alive,para= parent
nullipara women who has not given bith to a baby who's reached 20 weeks,so nulli= never and para=parent
Preterm and Post term Preterm pregnancy that ends at 20 weeks and before 38 weeksPostterm- a pregnancy that goes beyond 42 weeks
EDD, EDB, EDC ALL same thing- EDD estimated date of deliveryEDB estiamted date of birthEDC estimated date of confinement
Gestational Age number of completed weeks of fetal development calculated from the first day of the LMP
Fertilization Age number of completed weeks of fetal develpment calculated from the date of conception approx. 2 weeks shorter than gestational age
Nagele's Rule 1st day of your LNMP + 7 days - 3 months examples LNMP=july 10th2006+ 7days= july17-3 months = april 17, 2007 watch your year!
S/S OF Presumptive Pregnancy= may suggest pregnancy 1.)Amenorrhea 2.) N with or without V 3.) Urinary Urgency 4.)Breast changes 5.)Quickening 6.)Fatigue and Drowsiness
s/s of Probable pregnancy= strong indicate pregnancy 1.) uterine enlargement 2.)pigment changes{linea nigra-abd} areola on breast 3.) + PREGO TEST 4.) Hegar's sign= sofetning of Uterus 5.) Goodell's sign= softening of the Cervic 6.) Chadwick's sign= bluish Discoloration 8.) Braxton Hicks Contactions
s/s of Positive pregnancy=confirm pregnancy Fetal Heartbeat. Ultrasound. active fetal movement palpated by examiner
Relaxin Symphysis pubis more moveable: cervix to soften
Cardiovascular system -Increase Cardiac Output-BP does NOT increase-Increase WBC -Increase HEART rateIncrease clotting factors -Increase maternal blood
Due to pressure of enlarged uterus causing decrease venous return what is cause by this ? Varicosities and Hemorrhoids
Supine Hypotension syndrome due to compression on IVC when lying supine as pregnancy advances
Treatment and Signs and Symptoms of Supine Hypotension S/S dizziness, lightheaded, nausea, pallor, diaporesis , syncope tx= position on left side
Increased Relaxin and Progesterone causes? constipation
Chloasma "mask of pregnancy" pigmentation changes on face
Preconception what vitamin do you need? Folic acid 0.4 mg
carries blood with lowest level of 02 umbilical artery(deoxygenated)
what horomone helps maturation of ovarian follicle? FSH
Takes oxygenated blood to the fetal liver and diverts most blood to interior vena cava Ductus Venous
Connects pulmonary artery with aorta Ductus Arteriosus
When is Amnicentesis performed Done at 16-18 week gestation worry about infection, pregnancy loss an needle injury to fetus
What occurs with the Alpha Fetoprotein? Increase=neural tube- spinal bifidadecrease+chromosomal- Down's
nonstress test looks for? adequate oxygenation/ placenta function
normal weight gain 25-35 pounds
when Pregnant how many extra calories? 300/day
during lactation how many extra calories 500/day---- thats with the 300 already included
Slow paced breathing early stages breathing at half the usual rate
Modified Paced Breathing 2 times normal amount danger for hyperventilation breaths are rapid and shallow
Bleeding EARLY in pregnancy Abortion
s/s of spontaneous abortion Bleeding and cramping
Threatened Abortion -slight to moderate bleeding with or without cramps- Cervix closed- NO tissue passed
Inevitable Abortion Moderate to severe bleeding with modoerate cramps- open cervis- no tissue passed
Incomplete abortion Severe cramps with severe bleeding-cervix open - passage of tissue/part of tissue
Complete bleeding cervix bleeding - cervix closed- loss of placenta
Missed abortion No cramps, cervix closed, brownish discharge, retention of tissue
Etopic pregnancy abnormal implantation of fertilzed ovum outside uterus can lead to hemorrhage or shock
Sign and Sympoms of etopic pregnancy 1.) sudden stabbing abd pain 2.) shoulder pain
Treatment of Etopic Pregnancy Methhotrexate (Folex)- chemo agent used to inhibit cell reproduction, inhibits cell division
Hydatidiform mole takes on apperance of grapelike clusters and fluid filled
Hydatidiform mole complete and partial Complete is all genetic material is paternal no embryopartial is fetus is abnormal: usually aborts
s/s of hydatidiform rapid uterine growth, vaginal bleeding, n/v and high hCG levels
Bleeding LATE in pregnancy= Placenta Previa causes PAINLESS vaginal bleeding after 24 weeks- abnormal implantation of placenta
Abruptio Placenta Premature seperation of placenta from uterine wall PAIN with bleeding
RhoGam give at 28 weeks and then 72 hours after delivery
Gestational Hypertension one of the leading cause of maernal death and perinatal death
Preeclampsia renal involvement leading to protinuria
Eclampsia CNS involvement leading to seizures, chronic HTN AND HELLP
Gestational Hypertension Assessment BP, URINE- protein,edema, weight gain,blood work and fetal well being
Gestational Hypertension treatment Mag Sulfate to prevent seizures if resp rate is < 12 you give calcium gluconate to counteract
Pulmonary Embolism one of the leading cause of maternal death
What risk factors can cause a Pulmonary Embolism Venous Statis, vessel wall injury, use of oral contraceptives, >30 years old, obesity
Maternal pushing does what Taxis the heart and isn't good for a cardiac week patient
Anemia s/s tire easy, suseceptible to infection, increase risk of pregnancy complications
Iron deficiency anemia dietary management Iron supplement/ Vit CGive MEATS AND DARK GREEN LEAFY VEGGIES
Folic Acid Deficiency Anemia increse intake of folic acid to decrease risk of neural tube defects
Hyperemesis Gravidarum (early pregnancy) fetus at risk for Inner uterine growth restriction which will cause a smaller than expected birth weight
Hyperemesis Gravidarum diet Low fat, avoid dairy, small frequent meals EAT CRACKERS BEFORE YOU GET UP IN THE MORNING
When is Gestational Diabetes Mellitus checked? Checked at 24 to 28 weeks gestation
S/S of gestational Diabetes excessive thirst, hunger urination and weakness
What was the puropse of the Title V amendment of the Public Health Service Act establish infant- maternity care centers in public clinics
Documentation of assessment made during a home care visit reduces? reduces legal liability for the nurse and increases the quality of patient care
A common therapy performed at home for high risk newborns Phototherapy
What are functions of the uterus? menstruation, pregnancy, labor and birth
Where does fertilization normally occur? the fallopian tubes
Which position best facilitates placental circulation side lying
Where is Testosterone releses? Testes
Where is estrogen releases The ovary and the placenta
Progetsterone is released in the Overy and corpus luteum and Placenta
Which horomones are released in the Ant. Pituitary LH, FSH, and Prolactin
Which horomone is released by the posterior pit Oxytocin
(NCLEX) A pregnant client asks the nurse about the horomone that causes milk production. The nurse tells the client that the primary hormone that stimulates the secretion of milk is? Prolactin
(NCLEX) The LPN tells the adolescents that the normal duration of the menstrual cycle is about? 28 days
(NCLEX) A maternity nursing instructor asks a nursing student to identify the horomones that are produced by the overies? Estrogen and Progesterone
(NCLEX)The nursing instructor ask the student about the Function of Progesterone. Which would be a correct understanding on the function of progesterone? It maintains the uterine lining for implantation and relaxes all smooth muscle including the uterus
(NCLEX) Teaching to a preganant woman the physiological effects and horomone changes that occur in pregnancy. What about the purpose of estrogen? It stimulates uterine development to provide an environment for the fetus and stimulates the breasts for lactation.
(NCLEX) A client asks the nurse about the purpose of the placenta. The nurse plans to respond to the client, knowing that the placenta; Provides an exchange of nutrients and waste products between the mother and fetus
(NCLEX) The structure of the ductus Venosus Connects the umbilical vein to the inferior vena cava
(NCLEX) A nurse is collecting data during an admission assessment on a client who is pregnant with twins. The client also has a 5 year old child. The nurse would document which gravida and para status on this client? Gravida II, Para I
(nclex) The physician has just documented the presence of Goodell's sign. The nurse determines that his sign is indicative of: A softening of the cervix
(nclex) A nursing instructor ask the nursing student to describe the process of quickening. What determines a understanding of this term? It is the fetal movement that is felt by the mother
(NCLEX) The nurse determine that the patient is having Braxton Hicks contrations. What nursing action is appropriate? Intruct the client that these are common and may occur through out the pregnancy.
(NCLEX) A nurse is providing instructions to a pregnant client with genital herpes about the measures that need to be implemented to protect the fetus. The nurse tells the client that: A cesarean section will be necessary if vaginal lesions are present at the time of labor
Created by: sarahe