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Ch 32 OBGYN
106 Obstetric and Gynecologic
| Term | Definition |
|---|---|
| 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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