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