Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
OB Tutoring
Before Conception
| Term | Definition |
|---|---|
| Cultural Competence | Understanding and respecting all persons' values, attitudes, and beliefs. As a future RN we need to emphasize the importance of good communication and having an open mind. |
| Cultural Competence | Culture includes: ○ Religion ○ Language ○ Profession ○ Age ○ Gender identity ○ Disability ○ Sexual orientation ○ Beliefs ○ Tradition |
| Things that can contribute to health disparities | ○ Geography ○ SES ○ Religion ○ Race ○ Ethnicity ○ Identity ○ Sex ○ Sexual Orientation ○ Immigration Status ○ Language Proficiency ○ Education ○ Eligibility for insurance (including Medicaid/Medicare) |
| Health Disparities | ● Be aware of the ways that you, as a nurse, can perpetuate health disparities due to implicit bias ● Sometimes a person’s pregnancy will be the first time in their life that they are receiving regular, primary care |
| Health Disparities | ○ Insurance or lack of it affects patients, their care, and options ○ Most insurances do not cover preconception care, despite the first weeks of pregnancy being a very critical period ○ In the US, costs are astronomically high, yet outcomes are worse |
| Health History | ○ Sexual history ○ Gender identity ○ Questions about self-care and health promotion ○ Review of systems ○ Biographic data ■ Is the patient is under age 20 or over age 35? (High Risk) |
| Health History | ○ Allergies ○ Diet ○ Sleep patterns ○ Immunizations ○ Workplace and environmental habits ○ Eating habits ○ Family history |
| Gynecological history includes | ○ Age of menarche (menses) ○ Date of last menstrual period (LMP) ○ Cycle length and regularity ○ STIs ■ Including STI history ○ Gynecological surgeries ○ Gynecological conditions ○ # of sexual partners and their numbers |
| Obstetric history includes | ○ Dates of prior births ○ Gestational age at birth ○ Mode of birth ○ Type of anesthesia ○ Location of birth ○ Pregnancy outcome |
| Obstetric history includes | ○ Sex of the child ○ Length of labor ○ Birth weight and percentile according to gestational age ○ Length of labor ○ Complications |
| GTPAL | G-TPAL is an acronym used to describe a person's pregnancy history. It's a shorthand way to communicate important obstetric information. KEEP IN MIND: Twins/Triplets count as “one” in every section EXCEPT “L” |
| GTPAL | G (Gravidity): The total number of times a person has been pregnant, including current pregnancy. T (Term): The number of pregnancies that reached full term (37 weeks or more). L (Living Children): The number of living children the person has |
| GTPAL | P (Preterm): The number of pregnancies that ended in preterm birth (between 20 and 36 weeks of gestation). A (Abortion/Miscarriage): The number of pregnancies that ended in miscarriage or abortion before 20 weeks. |
| Naegele’s Rule | method for calculating the estimated delivery date (EDD). It's based on the idea that a pregnancy lasts 280 days, or 40 weeks. |
| Naegele’s Rule | Calculations: ○ First day of the last normal menstrual period (LNMP) + 7 days – 3 months + 1 year = EDD. ○ OR Add 9 months to LNMP + 7 days = EDD |
| Confirmation of Pregnancy: Presumptive Signs | These are subjective signs that a person experiences that might indicate pregnancy but could also be caused by other conditions. These are the least reliable signs. |
| Confirmation of Pregnancy: Presumptive Signs Examples | ○ Amenorrhea (absence of menstruation) ○ Breast Tenderness ○ Nausea and Vomiting ○ Fatigue ○ Urinary Frequency ○ Hyperpigmentation of the Skin ○ Fetal movements (quickening) ○ Uterine Enlargement ○ Breast Enlargement |
| Confirmation of Pregnancy: Probable Signs Examples | These are objective signs that a healthcare provider can detect during a physical exam, but other conditions can still cause them. |
| Confirmation of Pregnancy: Probable Signs Examples | ○ Braxton Hicks Contractions ○ Softening of the Cervix (Goodell's sign) ○ Bluish Discoloration of the Female Genitalia (Chadwick's sign) ○ Abdominal Enlargement ○ Ballottement ○ Softening of the Lower Uterus (Hegar's Sign) |
| Confirmation of Pregnancy: Probable Signs Examples | ■ hCG (Human Chorionic Gonadotropin): This hormone is produced at the time of iimplantation and doubles every 48 to 72 hours in early pregnancy. Home pregnancy tests detect hCG in the urine, and false negatives can occur. |
| Confirmation of Pregnancy: Probable Signs Examples | ○ Positive Pregnancy Test (detects hCG) |
| Confirmation of Pregnancy: Positive Signs | These are definitive signs that can only be attributed to a pregnancy. |
| Confirmation of Pregnancy: Positive Signs Examples | ○ Fetal Heartbeat Obtained via Doppler ○ Fetus Visualized on Ultrasound ○ Fetal Movement Felt by an Experienced Clinician (RN/MD/PA/NP/DO) NOT BY THE PATIENT* |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ● Hypothalamic-Pituitary-Ovarian (HPO) Axis ● The hypothalamus is constantly monitoring hormone levels and notices when there is a drop in estrogen and progesterone levels. |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ● In turn, the hypothalamus is then stimulated to release GnRH (gonadotropin-releasing hormone), which signals the anterior pituitary to release the gonadotropins LH (luteinizing hormone) and FSH (follicle-stimulating hormone) |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ○ LH: responsible for the final maturation and release of the egg from the follicle (triggers ovulation) ○ FSH: responsible for the maturation of follicles of the ovary that release eggs for fertilization (think about it nourishing the egg!) |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ○ Corpus luteum produces large amounts of progesterone and a smaller amount of estrogen, which maintain the uterine lining for implantation. (This is the hormones getting ready for a baby.) |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ● After ovulation (follicle rupture) occurs, the ovarian follicle is called a corpus luteum. |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ● If implantation does not occur, the corpus luteum begins to lose its secretory function after about a week. ● Hormone levels will drop again, starting the cycle over |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ● Estrogen ○ Secreted by the ovaries and the corpus luteum after ovulation ○ Dominant hormone in the first half of the menstrual cycle ○ “Prepares the body for pregnancy” |
| Female Reproductive Hormones (GOOD BACKGROUND KNOWLEDGE) | ● Progesterone ○ Produced by the corpus luteum after the rupture of the ovarian follicle ○ Progesterone, in the second half of the menstrual cycle, maintains the uterine lining and relaxes the smooth muscle of the uterus ○ “Maintains the Pregnancy” |
| Ovarian Cycle: Follicular Phase | ○ The phase associated with the maturation of the follicles and oocytes ○ As the follicles mature (from FSH) they secrete estrogen causes the uterine lining to proliferate (thickens) |
| Ovarian Cycle: Luteal (Secretory) Phase | ○ Ovulation marks the transition from the follicular to the luteal phase ○ LH stimulates the ruptured follicle (becoming the corpus luteum) |
| Ovarian Cycle: Luteal (Secretory) Phase | ○ Corpus luteum releases progesterone (& some estrogen) to create a hospitable environment for the implantation of a fertilized egg ■ Thickening of the endometrium ○ Without fertilization, the corpus luteum loses secretory function after about one week |
| Ovarian Cycle: Luteal (Secretory) Phase | ○ Drop in levels of progesterone and estrogen signal the hypothalamus to produce GnRH ○ As a result FSH and LH increase and the cycle restarts |
| Menstrual Cycle: Menstrual Phase | ○ Endometrium sheds due to corpus luteum losing secretory function when an ovum is not fertilized ○ Low levels of progesterone cause the uterine lining to shed because the progesterone maintains the lining |
| Menstrual Cycle: Secretory Phase | ○ Endometrium is maintained by progesterone post-ovulation ○ Increased blood flow and secretions to the endometrium |
| Menstrual Cycle: Secretory Phase | ○ Progesterone reduces uterine smooth muscle contractility of the uterus ■ These changes help support the implantation of a fertilized ovum |
| Menstrual Cycle: Ischemic Phase | ○ Begins as the corpus luteum begins to disintegrate ○ Progesterone/estrogen levels are decreasing ○ Vascular changes (ischemia) leads to necrosis of the endometrial lining and menstruation begins |
Created by:
getit