EXAM 1 Flashcards
Define anteversion
the entire uterus tips far forward
define retroversion
the the entire uterus tips far back
define anteflexion
the top of the uterus is bent sharply forward
define retroflexion
the top of the uterus is bent sharply back
define couvade syndrome
the partner of the mom begin showing similar signs that the mom experiences during pregnancy. EX: back pain, gaining weight, cramps
This is normally due to stress or empathy for the pregnant partner.
Define and give example of presumptive (subjective) symptoms
Symptoms experienced by patient but cannot be documented by examiner
EX: breast tenderness, nausea, fatigue, quickening
Define and give example of probable signs
objective and can be verified by examiner
EX: goodell sign, hegar sign, chadwick sign, braxton hicks
What are the 3 documented or “positive” signs of pregnancy?
- demonstration of a fetal heart separate from mother’s
- fetal movements felt by examiner
- visualization of fetus via ultrasound
define Hegar sign
extreme softening of lower uterus indicating possible early pregnancy
define ballottement
Positive test indicates the presence of a floating object in the cavity
define vulvovaginitis
inflammation of the vulva or vagina accompanied by pain, odor, pruritus, and vaginal discharge
define pelvic inflammatory disease (PID)
refers to various inflammatory conditions of the uterus, fallopian tubes, ovaries, and their supporting structures.
Take good notes on this. pg. 1348
define dyspareunia
painful sex
define dysmenorrhea
painful menstrual cramps
define a laparoscopy
a surgical procedure in which a fiber-optic instrument is inserted through the abdominal wall to view the organs in the abdomen or to permit a surgical procedure
define quickening
first movement mom feels fetal movement
define pica in pregnancy
when the pregnant person eats non food items like ice cubes, dirt, paint chips. Possibly due to low iron
define lordosis
exaggerated inward curving of the spine, usually lower back
when experiencing lightning, what will the patient most likely experience often
urinary frequency
what hormone causes the cervix to relax
relaxin
define melasma
also known as cholasma -“mask of pregnancy”
increased pigmentation of the pregnant person’s face
what are the bumps that appear on the areola called?
montgomery glands
define teratogen
any factor that may adversely affect the fetus
define tocophobia
feeling frightened at the idea of childbirth
Regarding pregnancy status, define para
the number of pregnancies that have reached viability, regardless of whether the infants were born alive
Regarding pregnancy status, define gravida
of times a woman has been pregnant
Regarding pregnancy status, define primigravida
a person who is pregnant for the first time
Regarding pregnancy status, define primipara
a person who has given birth to one child past age of viability
Regarding pregnancy status, define multigravida
a person who has given birth past the age of viability previously
Regarding pregnancy status, define grand multipara
a person who has carried five or more pregnancies to viability
Regarding pregnancy status, define multipara
a person who has carried two more more pregnancies to viability
Regarding pregnancy status, define nulligravida
a person who has never been and is not currently pregnant
define cytomegalovirus
type of HSV that is another teratogen causing intense damage to fetus. spreads via droplet infection. if fetus is infected, they may be born with severe neurologic challenges
define fetal alcohol syndrome
effects on fetus due to mother drinking alcohol
define leukorrhea
whiteish vaginal discharge that occurs in response to the high estrogen level and the increased blood supply to the vaginal epithelium and cervix in pregnancy
define malaria
mosquito-borne infectious disease
define sims position
pregnant person laying on their right side in bed with left leg bent. This allows good circulation and takes pressure from fetus off mom
how often should a pregnant person exercise?
3x/week, 30 min
While driving, how often should a pregnant person stop to walk or move around?
at least every 2hrs, preferably every 1hr.
-wear seatbelt! It is safe for baby
explain supine hypotension for a pregnant woman
this occurs when a pregnant person lies on her back and the uterus presses on the inferior vena cava, impairing blood return to the heart. They may have a irregular HR and feel apprehension.
How to relieve it? turn on side
define lumbar lordosis
excessive curve of lower spine
examplain teratogenic maternal infections
viral or bacterial organisms that cross placenta from mom to fetus. This could be a mild flulike symptom for mom, yet serious for fetus
what is TORCH?
test that tests for toxoplasmosis, rubella, cytomegalovirus, herpes.
-“O” may mean other infections
-“S” is sometimes added for Syphilis
what is toxoplasmosis?
a protozoan infection spread commonly via uncooked meat or sometimes handling cat stool in soil or litter box
what is rubella?
virus causing mild rash for adult, but can cause devastating affects for fetus like hearing impairment, cognitive and motor challenges, cataracts, and cardiac defects
What is herpes simplex virus?
STI spread by intimate contact. it can spread through the blood stream and cross the placenta to fetus
True or false:
Abortions and miscarriages before 20 weeks both fall under the “A” in the 5-digit system of gravidity and parity
True. It is considered a abortion even if it was a miscarriage
What does the G represent in GTPAL?
total # of pregnancies
What does the T represent in GTPAL?
of full term pregnancies (37-40 weeks)
what does the P represent in GTPAL?
preterm deliveries (20-36 weeks)
what does the A represent in GTPAL?
of abortions or miscarriages (before 20 weeks)
what does the L represent in GTPAL?
of living children
what does Gravida and Para mean?
Gravida: # of pregnancies
Para: # of births after 20weeks
what are the 3 laying positions of the fetus in pregnancy?
Cephalic: head towards cervix, ready for birth
oblique: head down, diagonal
transverse: baby’s spine is perpendicular to mom’s spine
breech: feet towards cervix
what is the point of Leopold’s Manuver?
to feel the position of the baby. Nurse places hands on mom’s belly and applies light pressure to identify baby’s position
define hypovolemia
body has low amount of fluids
is low BP common in early stages of pregnancy?
yes. not majorly concerning
what is the normal measurment of fundal height at 20 weeks?
20cm
linea nigra
dark vertical line appearing on pregnant belly caused from hormonal changes, will go away after pregnancy
what is cullen’s sign?
blueish coloring or bruising over umbilicus
if a pregnant mom finds taking prenatal vitamins to make them have an upset stomach you can suggest…
they take the pills at night, or with orange juice which may help
why check pregnant mom’s urine for protein?
to check for pre-eclampsia
what is pre-eclampsia?
hypertension during pregnancy
should physical activity stop when pregnant?
no. continue doing usual activities. mild-moderate exercise can be very beneficial
what happens when a women feels lightening?
it is the descent of the fetus into the pelvis. Usually occurs 10-14 days before labor begins. This process positions the uterus lower and gives patient relieve from symptoms like SOB and pressure giving it the name “lightening”
what is polyhydramnios?
-Too much amniotic fluid
-when there is excess amniotic
fluid or an amniotic fluid index above 24cm.
what is amniotic fluid formed by?
combination of the cells of the amniotic membrane and fetal urine
how is amniotic fluid evacuated?
- by being swallowed by the fetus
- absorbed across the intestinal membrane into the fetal bloodstream
- transferred across the placenta
what is oligohydramnios?
a pregnancy with less than the average amount of amniotic fluid. often caused by a bladder or renal disorder of fetus
what is isoimmunization (Rh incompatibility)?
this occurs when an Rh-negative pregnant patient carries a fetus with an Rh-positive blood type.
ovum
from ovulation to fertilization
zygote
from fertilization to implantation
embryo
from Implantation to 5-8 weeks
fetus
from 5-8 weeks until term
conceptus
developing embryo and placental structures throughout pregnancy
age of viability
The earliest age at which a fetus survives if they are born is generally accepted as 20-24 weeks
fertilization
can be described as conception, impregnation, or union of ovum and sperm
Implantation
contact between growing structure and and uterine endometrium
the zygote traveling to the uterus to develop into a fetus
When does implantation occur?
8-10 days after fertilization
Measurements of placenta:
cm diameter & cm depth
15-20 cm in diameter
2-3 cm in depth
covers half surface area of internal uterus at term
what is the chorionic membrane
outermost fetal membrane
define hydramnios (also known as polyhydraminos)
KNOW THIS
excessive amniotic fluid caused by fetus being unable to swallow fluid in womb. May occur in people with diabetes
define oligohydramnios
reduction in the amount of amniotic fluid. This can be detected via ultrasound
what is the total amniotic fluid at term?
800-1,200mL
How many veins and arteries does a umbilical cord have?
1 vein and 2 arteries. This is always assessed and recorded at birth some infants only have 1 of each which causes chromosomal disorders.
what is the rate of blood flow in an umbilical cord?
350mL per minute
define surfactant
phospholipid substanced formed by alveolar cells of lungs at 24th week to decrease alveolar surface tension during expiration. This prevents alveolar collapse
a liquid in the alveoli spaces of the lungs to help inhalation and prevent sticking during exhalation.
define a neural plate and when does it develop?
a thickened portion of the ectoderm. Develops by 3rd week of gestation.
describe rhythm strip testing
Assessment of fetal well-being with fetal heart rate monitor on mother’s abdomen. record fetal HR for 20 min
nonstress test
measures response of fetal HR to fetal movement
what are the 5 parameters of the biophysical profile?
- fetal reactivity
- fetal breathing movements
- fetal body movement
- fetal tone
- amniotic fluid volume
8-10 score is normal
in the biophysical profile, what does the fetal heart and breathing record measure?
short-term CNS function
in the biophysical profile, what does the amniotic fluid volume measure?
long-term adequacy of placental function
define cervical insufficiency (premature cervical dilation)
expulsion of products of conception occurs
(however big embryo is, it is rejected and body births it. possibly related to tissue changes and alterations in the length of the cervix)
hyperemesis gravidarum
excessive nausea and vomiting prolonged through pregnancy
RISK FACTORS
-diabetes
-multifetal pregnancy
-gestational trophoblastic disease
gestational diabetes mellitus
impaired tolerance to glucose during pregnancy
RISK FACTORS
-maternal age 25yrs+
-previous birth of infant that was large or stillborn
gestational hypertension
occurs after 20th week of pregnancy, elevated BP at 140/90 or more on two different occasions. BP then returns to normal 12 weeks postpartum
RISK FACTORS
-maternal age 40yrs+
-chronic renal disease
Dont get this mixed with preeclampsia (hypertension with protein in urine)
define amniocentesis
a test you may be offered during pregnancy to check if your baby has a genetic or chromosomal condition, such as Down’s syndrome, Edwards’ syndrome or Patau’s syndrome. It involves removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the baby in the womb.
-testing L:S ratio
-When do we do this test? 15-20 weeks!!!
if a patient has oligohydramnios, nurse would be worried about …
placental insufficiency
term for fertilized egg
zygote
goodell’s sign
softening of cervix during pregnancy
Define phenylketonuria (PKU)
inherited disorder where a person cannot convert phenylalanine, an essential amino acid, into tyrosine
Phenylalanine is a protein building block (an amino acid ) that is obtained from eating certain foods (such as meat, eggs, nuts, and milk) and in some artificial sweeteners.
Without treatment, PKU can damage the brain and nervous system, which can lead to learning disabilities
Define hyperemesis gravidarum
persistent vomiting and nausea of during pregnancy past 16 weeks
striae gravidarum
stretch marks
what is RhoGAM
injection given to Rh-negative pregnant women to prevent Rh incompatibility
coombs test
blood test checking for antibodies that attack RBCs
Explain this hormone: hCG
-Human Chorionic Gonadotropin
-Very important for early pregnancy development for implantation off egg and production of progesterone
Explain this hormone: Relaxin
Prepares the body for birth by relaxing muscles, joints, pelvic floor, etc
Explain this hormone: Estrogen
this hormone supports the growth of the fetus and placenta, and maintains uterine lining
Explain this hormone: Progesterone
This hormone thickens uterus lining, and prevents contractions so body does not miscarriage
define a “ripe” cervix
a cervix that has softened, thinned, and opened in preparation for delivery
what is in a monophasic pill
fixed doses of both estrogen and progestin
what is in a biphasic pill
constant estrogen but various amounts of progestin
what is in a triphasic and tetraphasic pill
variation of how much estrogen and progestin is released
how does a mini pill work
they are progestin ONLY. since there is no estrogen, ovulation may occur. however fertilization will not take place
what is DMPA
a IM injection of progesterone given every 12 weeks inhibiting ovulation, altering the endometrium, and thickening mucous
Side effect: osteoporosis… take calcium
Can DMPA (depot medroxyprogesterone acetate) be used as a contraceptive while breast feeding?
YES
How does plan B or morning after pill work?
it inhibits ovulation. must be taken within 72 hours of unprotected sex to work
multigravida
woman has been pregnant 2+ times
primigravida
woman’s first pregnancy
nulligravida
woman has never been pregnant before
nullipara
zero pregnancies beyond viability (20 weeks)
primipara
one pregnancy that has reached viability
multipara
2+ pregnancies that have reached viability
how are gestational hypertension and pre-eclampsia different?
pre-eclampsia is more serious and is found by excess protein in urine. Both are hypertension
chadwick sign
bluish-purple discoloration of the vagina, vulva, or cervix
At what week is the maternal serum alpha-fetoprotein tested?
15-20 weeks
at what week is the chorionic villi sampling tested?
10-13 weeks
at what week is the amniocentesis tested?
15-20 weeks
at what week is an ultrasound used
starting at 12 weeks, also at 20 weeks
at what week is the non-stress test used?
28 weeks
at what week is the BPP tested?
28-32 weeks
when should a pregnant woman be scanned for gestational diabetes?
24-28 weeks
how much folic acid should a woman intake per day in pregnancy?
400mcg/day
What does AFP (alpha-fetoprotein) test for in a fetus?
spinal defects
Amniocentesis determines…
- Abnormalities in fetal chromosomes
- Neural tube defects
- Gender of fetus
what med treats chlamydia?
one dose of Azithromycin
what is the prolactin hormone for?
initiation of lactation and production of breastmilk
what is the oxytocin hormone for?
letdown of milk and uterine contractions. Also main hormone in orgasm
