Chapter 33- Obstetrics And Neonatal Care Flashcards
Endometrium
The lining inside the uterus
Embryo
The stage from 0 to 10 weeks after fertilization
Fetus
The stage from 10 weeks until delivery
Birth canal
Made up of the vagina, and the cervix
Cervix
The lower third, or neck, of the uterus
Bloody show
When the cervix begins to dilate, this plug is discharged into the vagina as a pink-tinged mucous
Perineum
The area between the vagina and the anus
Placenta
A disk-shaped structure attached to the uterine wall that provides nourishment to the fetus
Umbilical cord
Is the lifeline of the fetus, connecting to the woman and fetus through the placenta
Amniotic sac
Bag of waters, the fetus develops inside this
Term gestation
A pregnancy that has reached full term
The primary systems involved in pregnancy are:
Respiratory
Cardiovascular
Musculoskeletal
Anemic
A condition in which a person has too few red blood cells
Increased hormones affect the musculoskeletal system by…
Making the joints “looser” or less stable
Gestational diabetes
Diabetes that develops during pregnancy in many woman who have not had diabetes previously
Preeclampsia
Pregnancy-induced hypertension
Signs and symptoms of preeclampsia
- Severe hypertension
- Severe or persistent headache
- Visual abnormalities such as seeing spots, blurred vision, or sensitivity to light
- swelling in the hands and feet (edema)
- anxiety
Eclampsia
Characterized by seizures that occur as a result of hypertension
Supine hypotension syndrome
This condition is caused by compression of the inferior vena cava by the pregnant uterus when the patient lies supine, reducing the amount of blood that is returned to the heart
How do you avoid supine hypotensive syndrome?
By transporting the patient on her left side (left lateral recumbent
Ectopic pregnancy
When an embryo develops outside of the uterus, most often in the Fallopian tube
Miscarriage
Spontaneous abortion
Abruptio placenta
When the placenta separates prematurely from the wall of the uterus
May present with signs of shock
Placenta previa
The placenta develops over and covers the cervix
When early labor begins and the cervix begins to dilate, the pregnant woman may experience heavy vaginal bleeding, often without significant pain
Abortion
Passage of the fetus and black at before 20 weeks
Fetal alcohol syndrome
A condition seen in infants born to women who have abused alcohol.
The effects of the addiction on the fetus can include prematurity, low birth weight, and severe respiratory depression.
What is one of the leading causes of abruptio placenta?
Trauma
Guidelines when treating a pregnant trauma patient
- ) Maintain an open airway
- ) administer high-flow oxygen
- ) ensure adequate ventilation
- ) assess circulation
- ) transport considerations
Meconium
Fetal stool (green)
When gathering the history of a pregnant patient, ask this:
Whether the woman has taken any drugs or medications during the pregnancy
If her water has broken, ask whether the fluid was green
Determine the due date, fetal movement, frequency of contractions, and history of previous pregnancies and deliveries and their complications
Secondary assessment
- assess for fetal movement by asking the patient whether she can feel the fetus moving
- assess the length and frequency of contractions by asking the patient and by placing your hand on the abdomen
- if at any point you suspect imminent delivery, check for crowning (only done when appropriate and per local protocol)
- vital signs: pulse, respirations, skin color temp and condition, and blood pressure
- hypertension, even when mild, may indicate more serious problems
Stages of labor
- ) dilation of the cervix
- ) delivery of the fetus
- ) delivery of the placenta
First stage of labor begins with…
The onset of contractions and ends when the cervix is fully dilated.
Signs of the beginning of labor
Bloody show
Water breaking
Primigravida
Woman who is experiencing her first pregnancy
Multigravida
A woman who has experienced previous pregnancies
Lightening
The movement of the fetus down into the pelvis
The second stage of labor begins when… and ends when…
When the fetus enters the birth canal
With the delivery of the newborn
Pressure on the rectum may make the woman feel…
As if she needs to have a bowel movement
Never allow her to sit on a toilet
When the top of the fetus’s head begins to appear at the vaginal opening is called
Crowning
The third stage of labor begins with…. and ends with…
With the birth of the newborn
And ends with the delivery of the placenta.
Answers to these questions will help determine whether delivery is imminent:
- how long have you been pregnant?
- when are you due?
- is this your first pregnancy?
- are you having contractions? How far apart are they? How long do they last?
- have you had any spotting or bleeding
- has your water broken?
- do you feel as though you need to have a bowel movement?
- do you feel the need to push?
Asking these questions will help determine any potential complications:
- were any of your previous deliveries by C section?
- have you had any problems in this or any previous pregnancy?
- do you use drugs, drink alcohol, or take any medications?
- is there a chance you will have multiple deliveries
- does your physician expect any other complications?
Immediately prepare for delivery and consider calling for additional resources is the patient says:
- that she is about to deliver
- she has to move her bowels
- or feels she needs to push
Nuchal cord
If the cord is wrapped around the neck of the infant as its being delivered
Vernix caseosa
White, cheesy substance that may be covering the newborn
After cutting the cord, now is the time to evaluate the newborn for:
Term gestation, good muscle tone, and breathing/crying: also obtain the 1-minute agar score
To help slow bleeding, you can massage the..
Woman’s abdomen with a firm, circular, kneading motion
Fundus
A firm, grapefruit-sized mass in the lower abdomen
Algae score
The standard scoring system used to assess the status of a newborn
Altar scoring is based off of:
- appearance
- pulse
- grimace or irritability
- activity or muscle tone
- respiration
The algae score should be calculated at ____ and ____ after birth
1 minute and again at 5 minutes after birth
Presentation
The position in which an infant is born or the body part that is delivered first
Vertex presentation
Normal birth, born head first
Breech presentation
When the buttocks are delivered first
Limp presentation
When the presenting part of the fetus is neither the head nor the buttocks but a single arm or leg
Prolapse of the umbilical cord
A situation in which the umbilical cord comes out of the vagina before the fetus
Spina birdie
A developmental defect in which a portion o the spinal cord or meninges may protrude outside of the vertebrae and possibly outside of the body.
It is important to cover the open area of the spinal cord with a moist, sterile dressing and then an occlusive dressing to seal the area immediately after birth
A normal, full term, single newborn will weigh approximately…
7 pounds at birth
