maternity exam 1 study guide
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| Process that takes place in the seminiferous tubules of the testes | Spermatogenesis: (key word sperm)
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| The process of producing gametes or sex cells(key word: sex cells) | Gametogenesis:
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| Process that gives rise to eggs. Takes place in the ovaries. | Oogenesis:(key word: ovaries)
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| For conception to occur, a(n) _______ must be available and _______ must take place | ovum; ejaculation
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| Sperm anatomy: (3) parts and their relevance | 1. Head=DNA, 2. Mitochondria in mid piece for energy, 3. Tail for movement
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| *Embryonic Development -Weeks 2 through 8 = -Weeks 8 through 40 = | -Weeks 2 through 8 = embryonic
-Weeks 8 through 40 = fetus
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| Until when is baby considered a fetus? | Until the time he takes first breath and is viable.
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| *Fetal Development by Weeks (name what weeks this happens) The most critical part of the fetus is | 9 – 12 weeks
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| *Fetal Development by Weeks (name what weeks this happens) Nearly all structures and organs are formed and begin to function; wt I ~0.25 ounces | 9 – 12 weeks
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| *Fetal Development by Weeks (name what weeks this happens) Only need growth for most structures/organs | 9 – 12 weeks
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| *Fetal Development by Weeks (name what weeks this happens) All nourishment is rec’d from placenta. | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Alveoli forming | Weeks 13-20
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| What is the survival rate at week 20? | 25-35%
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| Weeks 20-30 _____are under production _____ is no longer translucent Infant can ____ mom and dad, recognize voices The _____ has entered rapid-growth stage _____ is starting to breakdown bilirubin | WBC,skin, hear, brain. liver
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| Weeks 20-30 _____ are moving down; testosterone is being produced Blood vessels in _____ develop, lungs secrete surfactant, 1.5 pts of _____ surround her ____ produces RBCs | Testes, lungs, amniotic fluid, Bone marrow
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| *What organ matures last? Why? | Lungs mature last=has to do with surfactant production
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| Fetal Development by Weeks (name what weeks this happens) Accumulation of fat is constant | Weeks 31-40
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| Fetal Development by Weeks (name what weeks this happens) May hear heartbeat @ next appt. | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Fluttering movements; | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) liver is fx; | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Sex glands begin to migrate to correct position; | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) brain is fully developed. | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Skeleton is transforming from cartilage to bone. | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) kidneys making urine. | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Immunities being transferred from mom | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) wt ~ 10.58 oz | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Lungs are ONLY major organ left to mature | Weeks 31-40
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| Fetal Development by Weeks (name what weeks this happens) Fetus turns towards light outside uterus | Weeks 31-40
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| Fetal Development by Weeks (name what weeks this happens) Periods of dream sleep (REM) begin | Weeks 31-40
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| Fetal Development by Weeks (name what weeks this happens) Amniotic fluid is at its highest level | Weeks 31-40
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| Fetal Development by Weeks (name what weeks this happens) Antibodies are being transferred | Weeks 31-40
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| Fetal Development by Weeks (name what weeks this happens) All 5 senses are working | Weeks 31-40
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| The sperm head contains: a. Mitochondria b. Genetic material c. Energy for movement d. Axial filament | b. Genetic material
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| T/F: Weeks 2 through 16 = the embryonic phase? | False. 2-8 weeks
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| T/F: By week 12, nearly all structures and organs are formed and begin to function | True
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| T/F: Kidneys are the last major organ left to mature | False. Lungs
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| Fetal blood vessel connecting the umbilical vein to the inferior vena cava (IVC) | Ductus Venosus
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| Ductus Venosus is the featal blood vessel that connects the ___ vein to the _____ | umbilical vein to the inferior vena cava (IVC)
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| Protects lungs against circulatory overload. Allows the rt. ventricle to strengthen. Increases pulmonary vascular resistance, decreases pulmonary blood flow. Carries mostly oxygen saturated blood | Ductus Arteriosis
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| Ductus Arteriosis: Protects ___ against circulatory overload. Allows the ____ to strengthen. __ pulmonary vascular resistance, ___ pulmonary blood flow. Carries mostly ___ saturated blood | lungs; rt. ventricle; Increases; decreases; oxygen
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| *Shunts highly oxygenated blood from the rt. atrium to lt. atrium – right to left shunting | Foramen ovale
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| *Foramen ovale:Shunts highly oxygenated blood from the ____ to ____ – | rt. atrium to lt. atrium - right to left shunting
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| Changes at Birth Foramen ovale, ductus arteriosus and ductus venosus and umbilical vessels are ___ | No longer needed
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| Changes at Birth Ductus venosus ____ forcing blood entering the liver to go through _____. Occlusion of the placental circulation causes an immediate fall in ___ in ___ and ___ | Constricts; hepatic sinusoids. BP in IVC; rt. atrium
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| Maternal CV system responds to ___ metabolic demands of mother and fetus. Blood volume ___ beginning 6-8 weeks and continued until 32-34 weeks w/few changes after that. Increase in plasma volume is greater than RBC mass = decrease iron supplies = | Increased; increases; physiological anemia
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| Verbalize: What is physiological anemia? | means plasma volume is up but iron does match up to iron. seen around 4th month.
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| CV System Heart murmur is common R/t _____ blood volume Heart enlarges and is pushed upward to the ___ | increase; left
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| CV System *Peripheral vascular resistance ____ r/t progesterone/ prostaglandins causing smooth muscle relaxation | decreases
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| CV System B/P: Readings remain mostly unchanged r/t _____ PVR Affected by ____. ____ hypotension Mom in ___ (2nd/3rd tri) causing occlusion of vena cava resulting in dizziness, syncope, nausea, agitation. Solution? | decrease; position; Supine; supine,Change mom to rt. lateral position
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| sign of hypoxic patient | restlessness; fixed by switching position
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| T/F. The chorion villi are used for genetic testing because they contain the same genetic material as the mother. | False. Contain same genetic material as the fetus.
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| The normal umbilical cord should have 2 veins and 1 artery | False. 2 arteries and one vein.
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| Wharton jelly protects the mother’s vaginal canal during birth | False. Protects umbilical cord
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| Which shunt protects the lungs against circulatory overload? | ductus arteriosus
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| Supine hypotension is a result of a mother rising too quickly from a sitting position | False. Supine means lying down.
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| *What are the two major placental hormones? | Estrogen and Progesterone
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| *What's responsible for uterine growth, blood supply, uterine contractions (near term), glands/ducts for breast feeding, hyperpigmentation? | Estrogen
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| Verbalize *What maintains endometrium for fertilized ovum, *prevents spontaneous abortion? | Progesterone
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| Confirmation of Pregnancy Presumptive, Probable, or Positive indicators? Amenorrhea, N&V, Fatigue, movement, etc. | Presumptive Indicators
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| Confirmation of Pregnancy Presumptive, Probable, or Positive indicators? Abd enlargement, Cervical softening (Goodell sign, r/t vasocongestion) Uterine consistency changes (Hegar sign) | Probable indicators
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| Confirmation of Pregnancy Presumptive, Probable, or Positive indicators? Auscultation of fetal heart tones Fetal movement felt by examiner Visualization of the fetus | Positive indicators (only 3)
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| *What's the proper term for cervical softening and what type of confirmation of pregnancy indicator is it? | Goodell sign; Probable indicator
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| *What's the proper term for uterine consistency changes and what type of confirmation of pregnancy indicator is it? | Hegar sign; Probable indicator
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| T/F Mothers experience a slight decrease in lunch capacity r/t the diaphragm being displaced by the fetus. | True
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| T/F Maternal renal blood flow decreases during pregnancy in response to the demands of the fetus | False. Increases
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| Palmer Erythema is a common occurrence for pregnant women | True.
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| Oxytocin decreases during pregnancy r/t progesterone levels | True
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| Pregnant women’s complaints about hearing loss are considered normal during pregnancy | True
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| During pregnancy women are more susceptible to viral and fungal infections | True
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| Cervical softening is called Goodell or Hegar sign? | Goodell
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| what should you tell pregnant women about immunization? | NO live viruses- MMR, oral polio, smallpox
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| Name some common discomforts of pregnancy | N&V; Heartburn, Backache; Round ligament pain, Urinary frequency, Varicosities, Hemorrhoids, Constipation, Leg Cramps
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| Common Questions Bathing Hot tubs/sauna Douching Breast care Clothing Exercise Sexual activity | (yes, please)
(maybe, if not too hot/too long)
(No, no, no!)
(no soap on nipples, wear a bra)
(be comfortable)
(yes, 30 minutes qd, be careful)
(yes, unless water has broken)
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| Questions (Cont’d) Nutrition Employment Travel Immunizations: Everything else is OK and recommended , as needed: | (healthy, but no double portions)
(yes, but watch lifting, being on feet continually)
(yes, up until 36 wks by air; in a car, stop q2hrs to walk)
NO live viruses – MMR, oral polio, smallpox
(see chart in doc sharing)
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| Maternal Psychological Responses:name the trimester -Uncertainty -Ambivalence (~51% are unintended!!) -Permanent life change -It’s all about ME | First trimester
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| Maternal Psychological Responses:name the trimester Beginning to “show” -Fetus (baby) is primary focus now -Narcissism & introversion | Second trimester
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| Maternal Psychological Responses:name the trimester -Vulnerability -Worry about their child -Fantasies, nightmares -Increasing dependency -Surprising to some partners Concentration trouble Preparation for birth -Fear/dread labor -Nesting about 2 | Third trimester
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| T/F A high MSAFP indicates multiple births. | False. It indicates Open neural tube defects; Trisomy 21 (Downs)
Ultrasound
Further testing is needed
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| T/F Sexual intercourse can continue up until a women goes into labor | True
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| Name an immunization not recommended for a pregnant woman. | NO live viruses- MMR, oral polio, smallpox
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| Some women go through a period of grief when they find out they’re pregnant | True
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| What blood loss is considered normal for a vaginal delivery?For a C-section delivery? | ≤ 500 ml (or less) normal blood loss for vaginal delivery
≤ 1000 ml for c-section
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| Name Barriers to Prenatal Care** (8) | -Financial
-Systemic
-Attitudinal
-Inability to pay
-Don’t want to know
-Lack of child care
-Loss of wages
-Lack of transportation
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| Name 3 barriers to obtaining prenatal care | -Financial
-Systemic
-Attitudinal
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| Culturally competent care will combine _______ with _______ | assessment with negotiation
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| Cultural Influences on Childbearing Differences within cultures Divergent groups – especially in this area | Women may go back to old ways when pregnant
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| Name Application of the Nursing Process: Psychosocial Concerns | -Assessment – Is family adapting?
-Analysis – Look at your data with fresh eyes
-Planning – What are your expected outcomes?
-Intervention – Give them information with participatory guidance
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| What is the folic acid intake recommendation for women and why | 0.4 mg in fortified foods recommended
Neural tube defects can occur with poor intake
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| Patterns of gaining weight | ◦~1 – 4 lbs, 1st trimester;
◦ then ~ 1 lb/weekly
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| Name Nutritional Risk Factors ****On exam as fill in the blank (12) | SES, adolescence, vegetarianism, lactose intolerance, nausea and vomiting of pregnancy, anemia, eating disorders, food cravings and aversions,abnormal pregnancy weight, substance abuse, multiparity and multifetal pregnancy, other risk factors
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| Factors That Influence Nutrition | Age
Nutritional knowledge
Exercise
Food precautions
Culture
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| Nutrition After Birth **How many cal/day should lactating mothers consume? What else should she do? | =300-500 cal/day
=Adequate fluid intake
=Avoid smoking, alcohol, and excessive caffeine
=Irritating foods to baby
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| Nutrition After Birth what does a nonlactating mother's nutrition consist of? | Return to pre-pregnancy diet. Multi-vitamin
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| *Pyrosis is related to what in pregnancy? | Heart burn
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| ** Verbalize: Types to prevent N/V (name 2 out of 10) | Don’t skip meals and become hungry,Get out of bed slowly—eat starchy food before getting up,Avoid fluids early in morning (watch out for coffee!),Avoid sudden movements, Avoid fat/fried foods, Cool temp foods – No aroma,
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| ** Verbalize: Types to prevent N/V (name 2 out of 10) (cont.) | Don’t brush teeth immediately after eating (gag reflex),Salty/tart foods are best, Exercise/fiber good for constipation (too much can prevent calcium absorption), Pyrosis
Eat small, frequent meals)
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| *When do we treat anemia in pregnant women? | Hgb level is <11g/dl during 1st/3rd Tris
<10.5g/dl during 2nd Tri
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| T/F The Nursing Process in OB is: Assessment, Diagnosis, Planning, Intervention & Evaluation | False. Analysis after assessment
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| T/F Women should plan on gaining 2 lbs/weekly after the first trimester | False. 1 lb
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| Name 3 tips for preventing N&V | Don’t skip meals and become hungry,Get out of bed slowly—eat starchy food before getting up,Avoid fluids early in morning
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| T/F Anemia during the 1st & 3rd trimesters is defined as a Hgb level <11g/dl | True
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| Lactating mothers should consume how many extra calories a day? | 300-500 cal/day
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| What is considered a pre term pregnancy? | 20-36 weeks
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| What is considered wnl pregnancy? | 37 weeks
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| What is considered a late preterm infant? | 37-38 weeks
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| *Term for time between conception and onset of (true) labor | Antepartum
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| *Term for time from onset of labor until the birth of the infant and placenta | Intrapartum
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| *Term for Time from birth until the woman’s body (uterus*) returns to essentially pre-pregnant condition (size*) | Postpartum
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| *Term for the number of weeks since the first day of the LMP | Gestation
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| *Term for birth that occurs *before 20 weeks* gestation or birth of fetus-neonate weighing *less than 500 grams* | Abortion
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| *Term for normal duration of pregnancy 38-42 weeks | Term
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| *Term for *after 20 weeks* BUT *before 37 weeks* | Preterm/premature labor
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| *Term for any pregnancy regardless of duration including current pregnancy | *Gravida
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| Term for a woman who has never been pregnant | Nulligravida
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| Term for first time pregnant | Primigravida
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| Term for birth after *20 weeks* gestation, regardless of whether infant is born alive or dead | Para
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| Term for a woman who has *not* given birth at more than 20 weeks | Nullipara
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| Term for one who has had *one* birth at more than 20 weeks | Primipara
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| Term for a woman who has *not* given birth at more than 20 weeks | Nullipara
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| Term for one who has had *one* birth at more than 20 weeks | Primipara
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| Term for a woman who has had *two or more* births at more than 20 weeks | Multipara
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| Term for fetus born dead *after 20 weeks* gestation | Still birth
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| Components Labor- The 4 "P"s | Passage, passenger, power, psyche
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| What makes up the passage of labor? | Maternal pelvis
Soft tissue
Hormones
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| *Which one is the narrowest in the pelvic inlet? | AP
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| *Which is the narrowest in pelvis outlet? | Transverse
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| *What is the best shape for vaginal birth? | Gynecoid
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| What is the worst shape for vaginal birth | Platypelloid – Worst for vag birth
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| Fetal head shapes to mom's pelvis? | Molding
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| Is the passenger better flexed or extended? | Flexed
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| Relationship of fetal parts to one another | Attitude
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| **Point on fetal part in relation to MOM's pelvis | Position
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| The overlap of these vault cranial bones during the powers of labor | Molding
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| **What shape is the anterior fontanelle? | Diamond shaped (2-3cm)
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| **What shape is the posterior fontanelle? | Smaller triangle shape
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| *The area *between* the anterior and posterior fontanelles | Vertex
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| The area of the fetal skull occupied by the occipital bone, beneath the posterior fontanelle | Occciput
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| **Best, safest, fastest birth position | Vertex presentation, complete flexion
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| What part is born last in breech presentation? | Head
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| The 4 Ps of labor are: | Passage, Passenger, Power, Psych (presentation- tired; not right state of mind
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| T/F The True Pelvis is the best measurement for pelvic girth | True?
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| T/F Anthropoid is the best pelvic type for a vaginal birth | False. Gynocoid
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| T/F The anterior fontanelles is diamond shaped | True
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| Molding of the fetus’s head during birth will go away on its own | True
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| A Frank Breech presents with the legs crossed and tucked under the buttocks | False
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| In false labor contractions increase with walking | False. They go away
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| **Physiologic Maternal Effects CV: Blood flow to placenta ______ with contraction, maternal blood vol _____. Supine hypotension. | decreases; increases;
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| Stages of Labor and Birth | =First stage = longest
-Latent phase (1-3 cm dilation)
-Active phase (4-7cm dilation)
-Transition phase (8-10 cm dilation)
AFTER transition comes Stage 2
=Second stage – Birth
=Third stage - Placenta delivered
=Fourth stage - Hemodynamic changes
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| **When is stage 4 of labor? | from delivery of the placenta through the first 1-4 hrs after birth
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| T/F Blood flow to the placenta decreases with contractions | True
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| T/F Maternal blood flow increases during contractions | True
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| Active phase is in which stage? | First Stage
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| Transition phase results in the cervix being totally dilated | True
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| During stage 4, the placenta is delivered | False. Third stage
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| Stage 2 begins when the cervix is completely dilated | True
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| The fetal side of the placenta is called “Shiny” Schultze | True
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| Uterine contractions can continue after the third stage of labor | True
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| During the 4th stage of labor the uterus can be palpated at the level of the umbilicus | True
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| Compare and contrast true vs false labor. List true labor | -Regular contractions; getting closer together
-CTX begin in back; radiate around abd
-Increased intensity with walking
-Progressive dilation & effacement
-Persistent contractions even with rest or warm bath
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| Compare and contrast true vs false labor. List false labor | =Irregular contractions
-No Δ in interval/ duration
-Sensation in abdomen
-Walking has no effect
-No dilation/ effacement
-Rest and baths lessen ctx
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| When does preterm labor occur? | Prior to 37 (completed) weeks gestation
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| First labor stage: early or latent phase contractions | 5 min intervals and 30-40 sec duration by end of early stage
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| First labor stage: latent phase contractions | Contacting every 3-30 min lasting 20-40 sec
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| First labor stage: active phase contractions | Contractions more intense: 2-5 min apart x 40-60 secs
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| First labor stage: transitional phase contractions | 3 hr long
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| Second labor stage contractions | 3 hr
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| What if mother doesn't want fetal monitoring machine? What do you do? What's nurses concern | Explain fetal monitor machine, Explains benefits, Explain importance, Compromise-intermittent monitoring, Ask to express her concerns, Fetoscope as an alternative(oscultate), Use manual techniques like palpation. COW to how device Concern? miss full pic
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| Compare and contrast genetic testing. | CVS- CVS is done at 10-12 weeks' gestation
Amnio- adv of early diagnosis, amniocentesis is done at 15-20 weeks' gestation, do AFP first
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| Fetal surveillance tests and when they are done. | US- anytime and frequently
Doppler- anytime
FKT- 20 wks
AFP- 16-18 wks
Modified Biophysical Profile
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| Birthing teaching | Childbirth classes
Teach about diff options for meds/natural
Vaginal/C-section (risk)
Diet, exercise, lifestyle changes (smoking, drugs)
Kegels
Mom smokes- concerned about low birth weight, no O2, vasoconstrictions (preeclampsia prob)
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| Normal heart rate: | 110-160bpm in the base line
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| HTN= bp Infection = | > 140/90
> 100.4
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| GTPAL stands for | Gravida, Term (# of term babies), Pre term (# of preterm babies <37 completed weeks), Abortion (spontaneous/ elective), living children
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| Why do you do leopold's maneuvers? | To decide where to place the probe for the FHR
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| Comfort measures | Lighting:
Soft, indirect lighting is soothing
Temperature - Cool damp washcloths, socks, electric fans
Cleanliness:
Change sheets, offer change of gown as needed
Mouth care:
NPO, offer ice chips to reduce discomfort
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| Comfort measures continued | Bladder: A full bladder intensifies pain and interferes w/dilation during labor,
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| Comfort measures continued | Positioning: Encourage position changes to promote comfort, Change positions frequently, Use pillows, sheets to help move mom, Allow walking sitting if ROM has not occurred, Teachin: NOW’s the time!
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| transitory gradual decrease in FHR below baseline rate in contracting phase is called | Late decelerations
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| Transitory, gradual decrease in FHR below baseline rate in contracting phase | Late decelerations
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| Onset is late in contraction phase, after peak of contraction; & ends after the contraction ends. | Late decelerations
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| Uniform shape; mirror image of contraction; deep or shallow | Late decelerations
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| Due to uteroplacental insufficiency (UPI) = Nonreassuring; r/t fetal hypoxemia, acidemia (low Apgar) scores = Interventions needed!! | Late decelerations
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| **Verbalize causes of UPI | Uterine hyperactivity or hypertonicity,Maternal supine hypotension, Epidural or spinal anesthesia,Placenta previa,
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| **Verbalize causes of UPI continued | Diabetes mellitus, Intraamniotic infection, Abruptio placentae, Hypertensive disorders, Postmaturity, Intrauterine growth restriction (IUGR)Interventions needed!!
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| Chronic Villus Sampling: Purpose, Procedure, Advantages, and risks | Purpose
Genetic disorders; moms over age 35 yrs
Procedure
Thin tube – biopsy of villus
Usu done at 15-20 wks GA
Advantages
Identifies Tay-Sachs; hemophilia; Downs, faster/ more efficient
Risks
Infection; early labor; bleeding
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| Amniocentesis: Purpose, Procedure, Advantages, Disadvantages | Purpose
Ck for genetic disorders
Procedure
Belly tap
Advantages
Early diagnosis
Disadvantages
Risks to mom/fetus
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| Non-stress test: Purpose, procedure, and risk | Purpose
Ck fetal health
Not moving much
Mom is overdue
Suspected placental insufficiency
High risk pregnancy
Procedure
Toco & transducer to measure contractions FHR x 20-30 minutes
Risks
Negligible
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| NON-stress test continued: interpretation | Interpretation
Reactive is good; NONreactive is concerning
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| Biophysical profile: | Purpose
Measures health of fetus during pregnancy
Procedure
Nonstress/Contraction Stress test
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| **Biophysical profile interpretation: | Interpretation
HR; muscle tone; movement; amt of amniotic fluid
0-10;
8-10 = healthy; 6-8 retest; <4 = fetus has problems;
Helps health provider decipher health of fetus and whether the infant is strong enough to survive the trauma of birth
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| Complete BPP | 5 Components:
-Non stress test (NST)
-The amniotic fluid volume
-Fetal breathing movements
-Fetal gross body movements
-Fetal extremity tone
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| Dysfunctional Labor: Problems of Powers- Passenger- Passage- | Powers
Ineffective contractions
Ineffective maternal pushing
Passenger
Fetal size
Abnormal fetal presentation/position
Multifetal pregnancy
Fetal anomalies
Passage
Blockages
Shoulder dystocia
Soft tissue
Pelvis
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|
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| Dysfunctional Labor: Problems of Psyche | Psyche
Abnormal labor duration
Prolonged
Macrosomia
Malpresentation
Precipitous labor
≤4 hrs from beginning of labor to delivery
Precipitous birth
Takes place w/o medical assistance
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|
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| Breech baby concern | Cord, Lack of O2
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|
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| Prolonged Pregnancy- Complications, Precipitous, Therapeutic Management, Nursing considerations | Complications
Exhausted mom/fetus
Precipitous =
Damage to cervix/vaginal walls
PP hemorrhage
Damage to fetal head/body
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|
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| Intrapartum Emergencies | Placental abnormalities
Prolapsed umbilical cord
Uterine rupture
All FAST moving, deadly, but (thankfully!) rare
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|
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| Intrapartum Emergencies (cont’d) | Anaphylactoid Syndrome
Amniotic fluid embolism
Inflammatory response??
V. rare – not much data Mom goes to ICU
Hypoxia
Hypotension
Cardiac arrest
Pulmonary edema
80 units PRBCs
10 hrs in OR before ICU
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| Cord prolapse | If fully dilated; head at 0 or below: forceps
If not:
Knee-chest position
Steep Trendelenberg
Gloved hand in vagina
500-700 mL of saline in bladder
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|
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| Uterine Rupture: Etiology, S/S, Management | Etiology
Previous C-section
Instrument delivery
Improper use of Oxytocics
Manipulations/version
S/S
Abdominal pain; tenderness
Sudden hematuria
Hypovolemic shock
Fetal distress/death
Cessation of ctxs
Management
Surgery
Hysterectomy
TL
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|
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| Poly Hydramnios | Excess Fluid (H20)
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|
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| Oligo Hyramnios | Little Fluid (H2O)
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|
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| Problems associated with poly hydramnios | -Imbalanced water exchange among mother, fetus, and amniotic fluid
-Poorly controlled maternal diabetes mellitus
-Malformations of the CNC, Cardio, GI
-Chromosomal abnormalities
-Multifetal gestation
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|
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| Problems associated with Oligo hydramnios | poor placental flow, preterm membrane rupture, failure of fetal kidney development, blocked urinary excretion
🗑
|
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| What vaccines should not be given during pregnancy | HPV, Influenza LAIV, MMR, Varicella
🗑
|
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| Factors that (we think)Help Initiate Labor But we really don’t know why it starts! | -Fall in progesterone levels
-Increase in prostaglandins
-Increase in oxytocin
-Increase in # of oxytocin receptors
Fetal role
-Increase in prostaglandins from fetal membranes
-Large amts of cortisol from fetus
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|
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| Name this sign: In response to increasing levels of estrogen the cervix becomes congested with blood (hyperemic), resulting in the characteristic bluish purple color that extends to include vagina and labia. One of the earliest signs of pregnancy. | Chadwick sign
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|
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| Name this sign: Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion | Chadwick sign
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|
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| Formation of the placenta -Sections -Parts | “Shiny” Schultze – shiny fetal side usually presents 1st
“Dirty” Duncan –rough maternal side
on infant- corionic villi and umbilical cord
Parts umbilical 2 arteries 1 vein
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|
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| Genetic testing done 16 – 18 weeks and interpretation | -Maternal serum alpha-fetoprotein (MSAFP or AFP), hCG, Estriol
-Interpretation
-High = Open neural tube defects; Trisomy 21 (Downs)
-Ultrasound
-Further testing is needed
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|
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| Adequate amount of calcium during pregnancy | 1000mg
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|
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| Avoiding infection | Wash hands
Change pads
Sterile technique
Use bathroom often to empty bladder
Vaginal assessments are not done every ten minutes because the more vaginal assessment the greater the risk of infection
🗑
|
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| Fundus height at 20 weeks? At 36 weeks? | 20-fundus located approx at the umbilicus
36-xiphoid process-highest point
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|
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