406 3 Flashcards
Psychosocial: Whether pregnancy is planned or unplanned, ____ is normal in the First trimester
ambivalence
Some men experience pregnancy-like symptoms, such as nausea, weight gain, and other physical symptoms; this is known as ____ syndrome
couvade
____ phase, the period of adjustment to the reality of pregnancy
Moratorium
Gravida
the number of times one has been pregnant (regardless of the outcome)
Para
the number of pregnancies that have reached 20 weeks or greater of gestation and before birth
Any pregnancy loss occurring before 20 weeks is counted as an
abortion (whether spontaneous or elective termination)
only only count for a client’s gravidity, not parity.
abortion
When calculating parity, multiple births count as
1
GTPAL
Gravidity, Term Births, Pre- term Births, Abortions and Miscarriages, Living Children
number of pregnancies
Gravidity
Term
term births or pregnancies delivered
Preterm
pregnancy that has reached 20
weeks of gestation but ends before comple-
tion of 37 weeks of gestation
Abortions and Miscarriages
pregnancy that does not reach 20 weeks of gestation.
Antepartum: BP should rise no more than __ points systolic from previous baseline normal
30
Antepartum: BP should rise no more than __ points diastolic from previous baseline normal
15
Antepartum: Average respiration is
16 to 24 breaths per minute
At approx 28 to 32 weeks, plasma volume
increases by 25 to 40%, resulting in normal hemodilution.
At approx 28 to 32 weeks, plasma volume increases by 25 to 40%, resulting in normal hemodilution. Therefore high Hct values
are actually a bad thing and indicate gestational HTN
Check urine: normal albumin level is
trace
preeclampsia
pregnancy HTN
Glucose: no more than __ in a normal finding
1+
Check urine: normal protein level is
trace
how much weight gain in the first trimester is
recommended
2 to 4 lb
how much weight gain after the first trimester is
recommended
1 lb weekly
After the 1st trimester: if mother is gaining more than 1 lb weekly, watch out for
preclampsia
12 to 13 weeks: Fundus rises above
symphysis
From gestational weeks 18 to 32, the height of the fundus, measured in centimeters and with an empty bladder, is approximately
the same as the number of weeks of gestation
As pregnancy advances, the uterus presses on abd vessels. To relieve supine hypotension and increase perfusion to the uterus/fetus
teach the woman to lie on her side
Check fetal heart rate: 10 to 12 weeks: detectable by using
Doppler
Check fetal heart rate: 15 to 20 weeks: detectable by using
fetoscope
Check fetal heart rate: normal range
110 to 160 bpm
the first and most important indicator of compromised blood flow to the fetus
FHR
Discomforts such as nausea, fatigue, and urinary frequency subside after
13 weeks
Exercise is fine as long as woman is able to
converse easily while exercising. If not, she should slow down.
Bathing is acceptable until
membranes rupture (usually within hours of delivery).
maternal gum hypertrophy
is common
round-ligament pain
is normal
Instruct client to come to hospital when contractions
are occurring regularly 5 minutes apart.
Discharge from vagina (anything other than normal leukorrhea)
report immediately
Cracked lips can be a symptom of
malnutrition
You should increase protein by
30 g/day.
Drink a total of ___ glasses of fluid per day
8 to 10
prenatal vitamins can only be prescribed by
the provider
in order to get enough calcium and to help alleviate leg cramps, she should eat
3 cups of milk or yogurt daily
Maternal risk factors: Age
under 17 or over 34
Maternal risk factors: High parity
greater than 5
dystocia
shoulders can’t fit through the birth canal
Maternal risk factors: height
under 5 ft tall
in some states. screening for neural tube defects (AFP testing) is
mandated by law
US preparation: instruct the client to drink
3 to 4 glasses of water and don’t urinate
US preparation: Position the woman with pillows
under neck and knees to keep pressure off bladder
US preparation: late in the third trimester, place wedge under
right hip to displace uterus to the left.
US Complications
none. US can be done routinely
Gestational age is best determined by an early
sonogram rather than a late one
Chorionic Villi Sampling (CVS) cannot replace
amniocentesis completely because no sample of amniotic fluid can be obtained for AFP or Rh disease testing
Chorionic Villi Sampling (CVS): Removal of a small piece of villi during the period between
8 and 12 weeks
Chorionic Villi Sampling (CVS): Warn of slight sharp pain upon
catheter insertion
Chorionic Villi Sampling (CVS) complication that occurs 5% of the time
Spontaneous abortion
Fetal lung maturity is determined by which test
Amniocentesis
Amniocentesis: Performed only when uterus rises above the
symphysis (between 12 and 13 weeks)
the best predictor of extrauterine survival
Lung maturity
Meconium in amniotic fluid may indicate
fetal distress
Amniocentesis position
supine with hands across chest
bilirubin test: protect the samples from
light
Amniocentesis: for 1 hour after the procedure monitor
FHR
Amniocentesis: bladder, late verse early
in an early Amniocentesis, the bladder should be full for the test.
Late it should be empty
Within a contraction, the FHR slows at the very beginning:
this is a harmless thing; it’s because the head is compressed a little
Fetal anemia causes what change in FHR
increased rate
Nursing actions for variable decelerations: Discontinue ___ if infusing.
oxytocin
Nursing actions for variable decelerations: Administer oxygen at ___ by tight face mask.
10 L
Nursing actions for variable decelerations: Perform a vaginal examination to check for
cord prolapse
___ decelerations are a potentially disastrous sign
Late
Nursing actions for decelerations: position patient
on her left side
early decelerations (caused by head compression) usually happen between _ and _ cm
4 and 7 cm
if cord prolapse is detected,
put her in knee to chest position or push the cord until they can do a c-section
deceleration is especially ominous when when combined with
decreased variability or tachycardia
a decrease in uterus perfusion results in __ deceleration
late deceleration
Cord compression results in a pattern of ___ decelerations
variable
A healthy fetus will usually respond to its own movement by means of an FHR acceleration of
15 beats
Nonstress test: The fetus that responds with the ___ accelera- tion is considered “reactive” and healthy
15/15 (15 beat increase for 15 second)
The fetus is challenged with the stress of labor by the induction of uterine contractions, and the fetal response to physiologically decreased oxygen supply during uterine contractions is noted
stress test
stress test: Contractions can be induced by nipple stimulation or by infusing a dilute solution of
oxytocin (because you’re simulation labor)
stress test contraindication:
twins
stress test: To assess for fetal well-being, a recording of at least ___ contractions in 10 minutes must be obtained.
three
stress test: the danger of nipple stimulation is
you don’t know how much oxytocin will be released from the pituitary
Ultrasonography is used to evaluate fetal health by assessing five variables:
(1) Fetal breathing movements (FBM)
(2) Gross body movements (FM)
(3) Fetal tone (FT)
(4) Reactive FHR (nonstress test)
(5) Qualitative amniotic fluid volume (AFV)
Biophysical profile (BPP)
Fetal pH Blood Sampling: This technique is performed only in the ___
period
intrapartum
Fetal pH Blood Sampling: This technique is performed only in the intrapartum
period when the fetal blood from the presenting part
(breech or scalp) can be taken
(i.e., when membranes have ruptured and the cervix is dilated 2 to 3
The test is used to determine true acidosis when non- reassuring FHR is noted
Fetal pH Blood Sampling
