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Ch 32 OBGYN

106 Obstetric and Gynecologic

TermDefinition
External genitalia labia, perineum, mons pubis
perineum soft tissue and muscle between vagina opening and the anus, prone to tearing during birth
mons pubis layer soft tissue that covers and protects pubic symphysis, where hair grows
internal genitalia vagina, fallopian tubes (oviducts), ovaries
vagina birth canal, smooth muscle
ovaries small, round organs producing ova
fallopian tubes (oviducts) ovum travels through to the uterus. fertilization most likely happens in the oviducts
Ectopic pregnancy if the ovum implants in the oviducts and not the uterus, which will rupture
uterus muscular, hollow organ at the midline
fundus top of the uterus is as high at the xiphoid process
cervix muscular ring separating the uterus and vagina, thins and dilates during birth
Hormones released every 28 days estrogen and progesterone
peristalsis waves of muscular contractions of the fallopian tubes that push the ovum to the uterus
ovulation process of the ovaries releasing an ovum, and the walls of the uterus thicken
menstruation ovum is not fertilized, releasing hormones that slough off the thickened inner walls of the uterus (vaginal bleeding)
Duration of menstruation, and how much blood is lost? 3-5 days, and 50 mL
When an ovum combines with sperm, it becomes a(n)? embryo, embryonic stage begins
What is the embryonic stage, and how long does it last? 8 weeks, when the ovum combines with sperm, and the embryo attempts to implant in the uterus and develops basic connections with the mother
Fetal Stage after the 8 weeks of the embryonic stage, 32 weeks long
First trimester fetus is being formed, little uterine growth
Second trimester uterus grows rapidly reaching umbilicus by the 5th month, and the epigastrium by the 7th month
epigastrium upper abdomen
placenta attached to the wall of the uterus and exchanges O2 and nutrients
umbilical cord and its measurements where diffusion takes places, 1inch wide and 22 inch long at birth
amniotic sac 1 quart of amniotic fluid that allows baby to float, and acts as a cushion and maintains fetal body temp
Cardiovascular System changes during pregnancy increases blood volume, cardiac output, and heart rate. number of red blood cells stays the same, this dilution is anemia. usually a slightly lower blood pressure, sometimes higher
Respiratory System changes during pregnancy increasing O2 demand and consumption, pressure on diaphragm and decrease in volume of air in the lungs
GI System nausea and vomiting due to pressure on the stomach and intestines slowing digestion, dehydration and hypovolemia if severe
Muskuloskeletal hormones released makes ligaments more elastic and vulnerable, also weight effects posture and back pain
2 Diseases that can become worse during pregnancy? diabetes and asthma
Supine Hypotensive Syndrome 22-24 lbs (uterus, placenta, fetus, amniotic fluid) compresses the inferior vena cava, reducing blood return to the heart -> decreases cardiac output, causing dizziness and drop in BP
Vena Cava Compression Syndrome same as Supine Hypotensive Syndrome, contracts the uterine arteries to return blood flow to the major organs, severely affects fetus
How to treat Supine Hypotensive Syndrome? take weight off vena cava, place patient on left side and place towels rolled up behind back to support
3 stages of Labor 1st Dilation Period, 2nd Baby enters birth canal, 3rd after baby is born until the afterbirth
Dilation Period cervix shortens and thins, Braxton-Hicks (mild contractions days or weeks before actual labor), Lightening (baby moves from high abdomen to lower into birth canal)
Contractions cycle durations 30 mins to 3 mins or less, when contractions are 2/3 mins apart and last 30 seconds long - baby is imminent
What should you keep track of regarding Labor pains contraction time/duration (from start to end), contraction interval/frequency (start to start)
On average, how long will a woman remain in the dilation period if its the first time giving birth? If not their first? 16 hours ; 4 hours
What happens when the water breaks amniotic sac breaks and the clear fluid discharges
Term referring to amniotic fluid that is greenish or brownish yellow colored? meconium staining
What is "the bloody show"? the mucus plug that helped keep the cervix closed
Urge to push/move their bowels? Second stage of labor, after the full dilation of cervix, when the baby moves downward and pushes on the rectum
Third Stage of Labor after baby is born up until the afterbirth, when the the uterus continues to contract and the placenta sloughs off the wall and is expelled, lasting 10-20 minutes
8 steps of assessing a Woman in Labor 1 ask name, age, due date 2 1st preg? 3 prenatalcare? 4 when pains start and how long, water break? 5 urge to push? 6 examine crowning 7 feel uterine contractions 8 vital signs
Name of the normal head first birth? Cephalic Presentation
3 signs its okay to transport? 1st delivery, not straining, and no crowning
Signs indicating possible neonatal resuscitation no prenatal care, premature delivery, labor induced by trauma/medcon pr drugs, multiple births, history of problems palcenta previa or breech pres, meconium staining
Contents of Obstetrics Kit several pairs of surgical gloves, towels/sheets, 1 dozen gauze pads, 1 rubber bulb syringe (3oz.), cord clamps, umbilical cords tape, scissors, baby blanket, individually wrapped napkins, plastic bag
Term used for newly born baby and less than one month old neonate
APGAR Score used to evaluate neonate, appearance, pulse, grimace, activity, respiratory effort 0-10
Appearance blue all over, trunk pink, all pink
Pulse no, <100, >100
Grimace no, facial grimace, sneezecoughcry
Activity none, slight flexing extremities, moving normally
Respiratory Effort none, slow or irregular weak cry, good breathing strong cry
When should the APGAR Score be determined? 1 minute and 5 minute mark after birth
Cutting the cord necessary if (3) cord wrapped and cant be slipped over head, attachment impedes resuscitation effort, attachment interferes with urgent need to transport
When and how to cut? no less than 1 min after birth, then palpate for pulsation, apply clamp/tie 10 inches from baby and 7inches from baby
TorF: If there is still bleeding occuring through a clamped/tied umbilical cord, you should remove/retie False, add another clamp or tie
Depth and Order of suctioning? mouth 1-11/2 inches, the nostrils 1/2 inch
after 30 seconds of not breathing, how do you encourage breathing? rubbing bag, and snap finger against sole of foot
If shallow, slow, gasping, or absent respirations? ppv at rate of 40-60/min "breath baby Breathe"
If HR is <100? ppv at rate of 40-60/min
If HR is <60? ppv and compressions, 3:1 ratio 120/min (90 to 30 ventilations)
If cynosis or low OSat for longer than 10 mins? apply O2 via nonrebreather at 15 L/min
Afterbirth consists of: placenta with umbilical cord, membranes of amniotic sac, and tissues lining the uterus (few minutes after baby is born), can wait up to 20 minutes before transporting
what to do with placenta? container, then wrap in plastic bag, include name and time of expelled
how much blood is loss during delivery of baby and placenta about 500cc
3 Complications of Delivery breech presentation, limb presentation, prolapsed umbilical cord
Breech Presentation butt or two legs first, increased risk of prolapsed cord and meconium staining is common
Limb Presentation limb of infant
Prolapsed Umbilical Cord cord squeezes through vaginal wall and baby's head and is life threatening to neonate, use finger to lift head off cord and feel it pulsating
ToF second baby of a multiple birth is ALWAYS born before the placenta is delivered
Define a premature infant? weighs less than 5 1/2 lbs, or born before 37th week of pregnancy
Desired temperature of room? 90 -100 degrees
Meconium Staining sign of fetus and maternal stress, fetus defacating inside the amniotic sac
Bleeding in early pregnancy? miscarriage
2 types of excessive bleeding in late pregnancy Placenta previa (formed low in the uterus near or over cervical opening, tears as cervix dilates), Abruptio placentae (detaches from uterus wall, typically from trauma)
A condition that causes seizures in pregnancy, and how can it be recognized? Eclampsia and preeclampsia - woman retains large amount of fluid, recognized by alt ment status, swollen feet, hands, face, and high BP
Two types of abortion spontaneous, induced
How much faster is a typical pregnant pulse when compared to a nonpregnant pulse? 10-15 bpm faster
Actions during CPR? manually displace uterus to the left, compressions 1-2 inches higher on sternum than normal, ventilations may require low volume, immediate transport
Main concern with excessive vaginal bleeding? hypovolemic shock
Created by: jon.kowalski
 

 



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