exam 1
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| eptopic pregnancy | outside the uterus implantation
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| myomectomy | surgery for thyroids in the uterus
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| placentaprevia | implantation in the lower uterus covering the cervix
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| bony pelvis serves 3 primary purposes | protects the pelvis structures
accomodates the growing fetus during pregnancy
anchors the pelvic support structures
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| antropoid pelvis | very uncommon in the world. unable to deliver vaginally
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| platyelloid pelvis | very uncommon in the world. unable to deliver vaginally
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| gyneccoid pelvis | most common pelvis and able to have a baby vaginally
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| android pelvis | can possibly deliver baby vaginally but only very small baby
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| hormone ovaries release | estrogen
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| menarche | beginning of menstrual and reprodcutive function in the female
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| menstruation | periodic uterine bleeding that occurs about 14 days after ovulation. average cycle occurs every 29 days but varies 21-35 days
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| puberty | transition between childhood and sexual maturity.
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| ovulation | release of a mature ovum from the ovary usually at regular monthly intervals at around day 14 of the cycle
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| estrogen | controls female secondary sex characteristics
assists in maturation of ovarian follicle
causes endometrium to proliferate following menstruation
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| progesterone | secreted by corpus luteum and found in greatest amount during secretory phase of menstrual cycle
causes temperature rise that accompanies ovulation
production increases during follicular maturation
critical to follicular rupture
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| hypothalmic-pituitary cycle | hypothalamus -> with low ovarian hormones at end of normal menstrual cycle -> GnRH -> anterior pituitary -> FSH -> Graddian follicle (corpus luteum) estrogen stimulation -> estrogen fall -> hypothalmic GnRH -> anterior pituitary -> LH and some estrogen ->
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| ovarian cycle | 1. follicular phase: have follicles begin maturing under FSH with LH selecting a follicle -> oocyte maturation -> ovulation
2. luteal phase: begins immediately after ovulation and ends with menstration
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| endometiral cycle | 1. menstrual phase
2. proliferative phase- time of restoring endometrium (day 5 to ovulation)
3. secretory phase- from ovulation to 3 days before menstruation -> mature, enriched endometrium ready for fertilized ovum
4. ischemic phase: no implantation
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| S&S predicting ovulation | -BBT drops below 37C and rises after surge of progesterone. must check BBT q am before rising and chart it
-then BBT increases about .3-.6 C 24 to 48 hrs after ovulation time
-spinbarkeit-mucous-eleastic, stretches
-mittelschmerz-abdominal pain due ovu
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| scrotum | main purpose is to protect the testes and maintain a temperature that is lower than body temperature so spermatogenesis can occur
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| sperm head | contains prostagladins
prostagladins cause cervix to contract and pushes the sperm out. lube comes out of the penis before the sperm. it neutralizes acidity of vag
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| fertilization | takes place in ampulla (outer third of the fallopian tube)
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| implantation | occurs in the fundus betwee day 7-10 post fertilization. progesterone thickens the endometrium and vascularity in prep for implantation. at implantation have 2 fetal membranes :corion and amnion. once implantated, usually in the fundus
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| chorion | part of the protection for the baby wraps around the sac
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| placenta | development & circulation do not begin until 3rd week of embyronic development
expansion continues till 20th week, thereafter becomes thicker not wider
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| decidua basalis | dirty duncacn
maternal portion of placenta
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| chorionic villi | shiney schultz
fetal portion of placenta
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| umbilical cord | body stalk fuses with embryonic portion of placenta
body stalks elongates to become umbilical cord
3 vessels: 2 arteries and 1 vein
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| 2 arteries of umbilical cord | carries deoxygenated blood from fetus back to placenta
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| 1 vein of umbilical cord | carries oxygenated blood from placenta to fetus
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| oligohydraminos | not enough amniotic fluid
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| polyhydraminos | to much amniotic fluid
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| placental functions | fetal respiration
nutrition
excretion
nutrient production
hormonal production
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| pre-embryonic stage of human development | fetilization till day 14
cell multiplication and differentation
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| embryonic stage of human development | day 15 till 8th week
development of major organ systems and main external features develope
prenancy is MOST VULNERABLE to teratogens
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| fetal stage of human development | 8th week till birth
refining structures and perfecting function
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| 4 to 8 week gestation | heart beating and circulation begins
arms and leg buds are present
eyes and nose begin to form
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| general info | after 8 weeks embryo called a fetus
12 weeks fetus is moving wont see unless US
FHT 120-160 normal
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| 12 week gestation | spontaneoius movements made
fetal heart tones (FHT) audible
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| 20th week gestation | "quickening" (mother feels fetus move between 16-20 weeks)
respiratory movements
suck and swallow fluid
vernix
gender is clear
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| nullipareous | never had a baby before and pregnant now
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| primiparous | first time mother after giving birth to first baby
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| multiparous | had babies before
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| 24th week gestation | threshold of viability
mature brain
aveoli appear: gas exchange is possible
reddish, wrinkled skin with vernix
age of viability
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| 32 week gestation | eyes opening and closing for last month
subcutaneous fat being laid down
fingernails & toenails
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| 36 week gestation | lanugo disappearing
few sole creases
sebaceous glands producing vernix
scrotum descends/labia minor and majora equally prominent
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| 38-40 week gestation | lecithin-sphingomyelin (L/S) ratio approaches 2:1, indicating lung maturity (if greater 2:1 lungs considered mature for fetus of diabetic mother)
smooth, pink skin; vernix in skin folds, nails extend over tips
rugi at scrotum/labia maj more prominent
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| fetal circulation | o2 rich through umbilical vain bypassing liver via ductus venosus and flows to inferior vena cava to R atrium through foramen ovale to L atrium to flow to L ventricle to aorta
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| fetal cirulation con. | some blood from superior vena cava to R atrium goes through tricuspid valve to R vetricle to pulmoary artery to bypass lung, blood flows through ductus arteriosus into descending aorta
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| umbilical vein | o2 rich blood enters fetus
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| ductus venosus | allows blood to bypass liver
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| foramen ovale | allows blood to bypass pulmonary arteries and flow from R atrium to L atrium
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| ductus arteriosus | how blood returning to SVC and entering RV is able to bypass liver
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| preterm labor | labor occuring after 20 weeks but before 37 weeks. completed gestation
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| post-term labor | labor occurring after 42 weeks
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| gravida | any pregnancy regardless of duration including the present pregnancy
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| multigradvia | woman who is in her second or any subsequent pregnancy
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| multipara | a woman who has had 2 or more births at more than 20 weeks
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| stillbirth | a fetus born dead after 20 week gestation
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| nuligravida | woman who had never been pregnant
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| primigravida | woman who is pregnant for 1st time
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| bishops score | score to determin if woman is inducible
8/10 is inducible
very low score would have C-section
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| CPD | cephalopelvic disproportion
baby's head cannot fit through inlet
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| first stage of labor | 0-10 cm cevical dilation
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| second stage of labor | 10 cm to birth of baby
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| third stage of labor | birth of baby to birth of placenta
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| fourth stage of labor | first 4 hours after placental delivery
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| postpartum period (PP) | begins with fourth stage and ends at approximately 6 weeks after birth
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| first degree laceration | tear extends to skin and structures superficial to the muscles
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| second degree laceration | tear extends through muscles
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| third degree laceration | tear involves anal spincter
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| fourth degree laceration | tear extends through the rectal mucose to the lumen of rectum
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| involution | rapid reduction in uterine size following birth of placenta
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| involution process | placenta is delivered then posterior pituitary excretes oxytocin then uterine vessels contract (afterpains)then to hemostasis
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| lochia | uerine debris discharged after birht
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| lochia rubra | red first 2-3 days but may vary according to BF practice and parity-musty stale odor
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| lochia serosa | pink day 3 to 10
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| lochia alba | white continues until the cervix is closed which decreases chance of infection
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| diastasis recti | separation of the musculature after pregnancy.
usually in smaller woman
heal within first few months post delivery
no driving heavy lifting stairs
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| lactogenesis during pregnacy | elevated hormore (E&P) evels promote breast duct and lobules preparation for lactation
placenta's progeserone suppresses lactation
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| lactogenesis following delivery of placenta | placenta out leads to progesterone levels to fall then inhibition is removed and milk production begins
breast stimulation prolactin levels rise and milk production increases. oxytocin levels rise and milk ejects, uterus contracts
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| vital signs | temp may be elevated 38C(100.4F) up to 24 hours after birth and increased 24 hours after milk comes in
transient rise in BP early then normal
bradycardia first 6-10 days p
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| physiological adjustments taking in | seen during the first day or 2nd day: self centered, passive, dependent, takes care of "her" needs
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| physiological adjustments taking hold | seen durings the 2nd to 3rd day: resuming control and ready for self/newborn care
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| physiological adjustments letting go | seen during the 4th day on: new role to baby
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| BBUBBLE:HE | Brain
Breast
Uterus
Bladder
Bowels
Lochia
Episiotomy
Homans sign
Emotional
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| B: Brain | HA, blurred vision, sports before eyes are signs of preeclampsia
dizzy/lightheaded
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| B: Breasts | size, shape, consistency (full?filling?soft?)
nupples- abnormalities/ signs of damage (cracks, bleeding, blisters)
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| U:Uterus | position: horizontal (related to umbilicus) vertical (related to midline)
tone: firm, boggy
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| B:Bowels | flatus, BS, BM
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| B:Bladder | assess of distention
void at least 100 ml pp within 8 hr
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| E: Episiotomy | perineal assessment: REEDA
lochia
presence/state of hemorrhoids
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| H: Homans sign | look for redness swelling pain
if present do not do homans sign
searching for clots
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| E: emotional | how is she feelings, care-giving skills
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| postpartum blues | transient period of emotions depression; somtimes occues during first 10 days of postpartum
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| pp blues S&S | mood swings
anger
weepiness
anorexia
difficulty sleeping
feeling let down
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