nrtc OB chapter 4
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| ante | before
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| antepartum | time before delivery
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| Gravida | any pregnancy, regardless of duration, including the present one
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| prenatal | time before birth
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| Nulligravida | a woman who has never been pregnant
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| Para | # of births after 20weeks gestation, regardless of whether the infants were born alive or dead
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| Preterm | pregnancy that ends after 20weeks and before 37weeks gestation
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| Postterm | pregnancy that goes beyond 40weeks gestation
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| Primigravida | a woman pregnant for the first time
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| Multigravida | a woman who is in her second or subsequent pregnancy
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| Nullipara | a woman who has not given birth at more than 20weeks gestation
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| Primipara | a woman who has given birth to a fetus (dead/alive) that had reached at least 20weeks gestation
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| Multipara | a woman who has given birth 2 or more times to fetuses that had reached at least 20weeks gestation
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| Stillbirth | a fetus born dead after 20weeks gestation
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| EDD | estimated date of delivery
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| GTPALM | used for recording a woman's pregnancy history
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| Nagele's Rule | used to determine the woman's estimated date of delivery
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| how is Nagele's Rule done | identify the 1st day of the last normal menstrual period/count backwards 3months/add 7 days
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| lunar months are used for what | calculating pregnancy
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| abortion | pregnancy terminated before the fetus reaches 20weeks gestation- also can be referred to as a miscarriage
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| what are the 3 categories of signs of possible pregnancy | presumptive (suggest)/probable (probably)/ positive (definite)
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| how early in the pregnancy is the hormone hCG present in the woman's urine | as early as 1week after conception
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| pregnancy tests are considered what category of pregnancy signs | probable sign
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| name some presumptive signs of pregnancy | amenorrhea, N/V, frequent urination, fatigue, quickening, breast tenderness
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| name some probable signs of pregnancy | uterine enlargement, pigmentation changes, Goodell's sign, Hegar's sign. Chadwick's sign, Ballottement, Braxton Hicks contractions, positive pregnancy test
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| what is a positive sign of pregnancy | Ultrasound visualization
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| Goodell's Sign | softening of cervix
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| Hegar's Sign | softening of lower portion of uterus
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| Chadwick's Sign | bluish purple discoloration of vaginal mucous membrane caused by increased vascularity or pelvic congestion
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| Ballottement | rebounding of fetus in amniotic fluid felt by examiner during pelvic examination
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| Braxton Hicks Contractions | painless, irregular uterine contractions; may be felt by the woman as a tightening across the abdomen
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| signs & symptoms of the first trimester | positive pregnancy test, amenorrhea, fainting, morning nausea, heartburn, odor sensitivity, pigmentation deepens on the face/abdomen, weight gain, abdomen enlarges, frequent urination
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| signs & symptoms of the second trimester | occasional pain in groin, increased sexual pleasure/desire, white discharge, orthostatic hypotension, anemia, perineal itching, pressure on rectum, leg muscle spasms, abnormal labs, stress with exercise, mood swings, constipation, stuffy nose, gingivitis
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| more signs & symptoms of second trimester | leaking colostrum from nipples, tingling fingers, sensitivity to medications, DVT, fetus moves/kicks
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| signs & symptoms of third trimester | leaking colostrum from nipples, voice changes, easily tired, gestational hypertension, increased risk for carpal tunnel, decreased appetite, shortness of breath, varicose veins, lightening, delivery
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| lightening | fetal head engages and the uterus "drops"
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| what stimulates the growth of the uterus | estrogen & progesterone
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| name the hormones essential in pregnancy | estrogen, progesterone, thyroxine (T4), hCG, hPL, melanocyte-stimulating hormone, relaxin, prolactin, oxytocin
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| effacement | thinning of the cervix
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| dilation | enlargement of the opening to the cervix
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| what causes the softening of the cervix | hormonal influence that causes an increased blood supply, increase in secretions from the cervical glands
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| what is the mucous plug | barrier to prevent organisms from entering the uterus-formed by secretions from cervical glands-usually expelled during labor
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| what is the role of the hormone Relaxin | relaxes the symphysis pubis and other pelvic joints and ripening the cervix in preparation for labor
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| Montgomery's glands | lubricate/protect the nipple in preparation for breastfeeding
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| Striae | pinkish-white lines caused by stretching of the elastic tissues as the breasts enlarge
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| colostrum | thin, yellowish fluid excreted by the breasts as early as the 10th week of gestation-"pre-milk"
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| how is Lactation initiated | profound drop in estrogen/progesterone levels after delivery of the placenta-allows an increase in prolactin levels
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| supine hypotensive syndrome (aortocaval compression) | vena cava compressed when a pregnant woman lies flat on her back-decreases cardiac output
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| when is cardiac output best for the pregnant woman | lying on her side
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| the pregnant woman breathes more deeply for what reason | to maintain oxygen for herself and her fetus
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| oxygen consumption increases to what percent during pregnancy | 15-40%
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| normal Hemoglobin in pregnant women | 11-12
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| normal Hematocrit in pregnant women | 33-46
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| normal RBCs level in pregnant women | 4.5-6.5
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| normal WBCs level in pregnant women | 5000-15000-rises to 25000 during labor & postpartum
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| normal Fibrinogen levels in pregnant women | 300-600
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| why do pregnant women experience dyspnea | increased pressure the uterus places on the diaphragm
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| why do pregnant women experience epistaxis (nose bleeds) | increased vascularity from increased estrogen
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| gestational diabetes | periodic hyperglycemia occurring during pregnancy
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| why do pregnant women have an increased risk of UTI | because of stasis of urine in the bladder
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| asymptomatic bacteriuria | bacteria in the urine
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| why does Renal Plasma Flow increase by 75% | to remove metabolic wastes of the mother and fetus
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| pyelonephritis | infection of the upper urinary tract
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| fluid retention in pregnant women poses a major problem during labor for what reason | if she already has fluid retention and is given IV fluids containing oxytocin (Pitocin) it can result in water intoxication
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| "waddling gait" | fetal head settles into the pelvis and a slight separation of the symphysis pubis occurs-facilitates the passing of the fetus through the pelvis
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| diastasis recti abdominis | rectus abdominis muscles separate during pregnancy
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| why is carpal tunnel common in pregnant women | weight gain and edema cause compression of the medial nerve-particularly around the wrist
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| chloasma (melisma) | blotchy/brownish "mask of pregnancy"-linea alba darkens and becomes a darkened line in the abdomen-called linea nigra
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| striae gravidarum | stretch marks-pinkish or purple lines caused by a weakening of the elastic tissues
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| increased levels of estrogen & progesterone do what to the liver | alter hepatic functions and cause accumulation of drugs (medicines) in the body
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| Body image | a person's perception of his/her own body
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| the 4 aspects of body image | appearance, function, sensation, mobility
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| FDA Pregnancy Risk Category A | evidence of fetal harm is remote-no risk
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| FDA Pregnancy Risk Category B | animal studies have not shown a risk in second or third trimesters-no data on first trimester
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| FDA Pregnancy Risk Category C | animal studies show negative effect on the fetus but not yet proven on the pregnant woman-risk cannot be ruled out
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| FDA Pregnancy Risk Category D | positive evidence of fetal damage when the drug is used during pregnancy-need for drug should be carefully evaluated
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| FDA Pregnancy Risk Category X | human/animal studies show definite fetal risks-should NOT be used during pregnancy
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| what are the 4 developmental tasks the pregnant women goes through | pregnancy validation, fetal embodiment, fetal distinction, role transition
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| what are the 3 stages the expectant father goes through | announcement phase, adjustment phase, focus phase
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| elderly primips | mothers that become pregnant for the first time after 35yrs of age
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