Ch.34 Obstetrics And Neonatal Care Flashcards
During puberty, the maturing female body undergoes multiple physical and hormonal changes, ultimately leading to__.
menarche
The first menstrual cycle or onset of the first menstrual bleeding in females
Menarche
The processes that the follicle goes through and the actual release of the egg (ovulation) are stimulated by the release of specific hormones in the female body. Ovulation occurs approximately 2 weeks prior to menstruation. Immediately following ovulation, the___ (the lining of the inside of the uterus) begins to thicken in preparation for the potential implantation of a fertilized egg. If the egg is not fertilized within 36 to 48 hours after it has been released from the follicle, it will simply die, and the thickened endometrium will be shed because it is not needed. This shedding is the menstrual flow that occurs on the first day of a woman’s cycle.
endometrium
Fertilization, which occurs when a sperm meets an egg, usually takes place when the egg is inside the fallopian tube. The fertilized egg then continues to the uterus where, if implantation occurs, the fertilized egg develops into an___ (the stage from 0 to 10 weeks after fertilization) and then a fetus (the stage from 10 weeks until delivery) and grows until the time of delivery at approximately 9 months (40 weeks) of . gestation (FIGURE 34-1).
embryo
The uterus is a muscular organ that encloses and protects the developing fetus. During labor, it produces contractions and ultimately helps to push the fetus through the__.
birth canal
The birth canal is made up of the vagina and the lower third, or neck, of the uterus, called the_.
cervix
During pregnancy, the cervix contains a mucus plug that seals the uterine opening, preventing contamination from the outside. When the cervix begins to dilate, this plug is discharged into the vagina as pink-tinged mucus, sometimes called__. This small amount of bloody discharge often signals the beginning of labor.
bloody show
Documentation of the last menstrual period (often noted as LMP) should be included in the history section of the patient’s chart. The last menstrual period is documented as the first day of the patient’s last menstrual bleeding. Documentation should also include the average number of days that the patient experiences bleeding and the average number of days between the start of each cycle. For women who have experienced__, the month and year of the last known menstrual period should be charted, if possible, particularly when relevant to the chief complaint (eg, vaginal bleeding, abdominal pain).
menopause
The vagina is the outermost cavity of the female reproductive system and forms the lower part of the birth canal. It is about 3 to 5 inches (8 to 12 cm) in length, beginning at the cervix and ending as an external opening of the body. The vagina completes the passageway from the uterus to the outside world for the newborn. The area between the vagina and the anus is called the___.
perineum
The____ is a disk-shaped structure attached to the uterine wall that provides nourishment to the fetus through the umbilical cord. Blood normally does not mix between the fetus and the pregnant woman because of the placental barrier (FIGURE 34-2). This barrier consists of two layers of cells, keeping the circulations of the woman and the fetus separated but allowing nutrients, oxygen, waste, and carbon dioxide to pass between the fetus and woman. Many drugs and toxins are also able to pass through this barrier.
Anything ingested by a pregnant woman therefore has the potential to affect the fetus. After delivery of the newborn, the___ separates from the uterus and is delivered.
placenta
The____ connects the woman and fetus through the placenta.
Oxygenation, nutrition, and waste removal all rely on this connection remaining intact. The ___contains two arteries and one vein.
umbilical cord
The umbilical vein carries oxygenated blood__,
from the placenta to the heart of the fetus
and the umbilical arteries carry deoxygenated blood from___
the heart of the fetus to the placenta.
Oxygen and other nutrients cross from the woman’s circulation through the___ and then through the umbilical cord
placenta
The fetus develops inside a fluid-filled, bag-like membrane called the__, or bag of waters. The sac contains approximately 500 to 1,000 mL of amniotic fluid, which helps insulate and protect the fetus. When the sac ruptures, usually at the beginning of labor, the amniotic fluid is released in a gush. It is typical for the patient to tell you that her “water broke.” Some women may experience a small leak rather than a gush of fluid. This fluid helps to lubricate the birth canal and remove any bacteria
amniotic sac
A pregnancy is considered full term when it reaches 39 weeks but has not gone beyond 40 weeks, 6 days. A pregnancy
that has reached full term is referred to as___.
term gestation
A baby’s “due date” is the predicted date of delivery based on the first day of a pregnant woman’s last menstrual period. Although many women have a general idea of the date their last menstrual cycle began, young women, women who have irregular cycles, and women who did not know they were pregnant may have difficulty determining when their last menstrual period started. Also, some women calculate their due date based on the number of weeks from conception rather than last menstrual period. It is important to remember that the due date is only a prediction of when a woman is likely to deliver her baby, and many factors can cause the actual date of delivery to be earlier or later than anticipated.
Words of wisdom :)
Four body systems-___systems undergo major physiologic and anatomic changes during pregnancy. Understanding these changes is important when assessing and treating a pregnant patient
the reproductive, respiratory, cardiovascular, and musculoskeletal
In the___ system, hormone levels increase to support fetal development and prepare the body for childbirth.
These increased hormone levels also put the pregnant woman at an increased risk for complications from trauma, bleeding, and some medical conditions. As the fetus develops, the uterus grows, stretching to accommodate a full-term fetus. As the size of the uterus increases, so does the amount of fluid it contains. These factors eventually result in displacement of the uterus out of its well-protected position within the pelvic area and may expose it to injury. By the 20th week of pregnancy, the top of the uterus is at or above the belly button. This increases the chance of direct fetal injury in trauma.
reproductive
In the second trimester of pregnancy, the rapid growth of the uterus leads to changes in the___ system. As the uterus grows, it pushes up on the diaphragm, displacing it from its normal position and leading to reduced tidal volume with each breath. To make up for this, the pregnant female’s respiratory rate must increase. Pregnancy also increases the patient’s overall demand for oxygen as her metabolic demands and workload increase to support the developing fetus.
These changes lead to an overall reduction in respiratory reserve and decreased ability to compensate during times of respiratory distress
respiratory
