Exam 1 Flashcards
Graviditiy
Pregnancy
Gravida
A woman who is pregnant
Multigravida
A woman who has had two or more pregnancies
Multipara
A woman who has completed two or more pregnancies to 20 or more weeks
Nulligravida
A woman who has never been pregnant
How long does pregnancy last?
Pregnancy lasts about 280 days after the last menstrual period, or 266 days (or 38 weeks) after conception.
How long is the ovum stage?
The ovum stage lasts from conception until day 14 and includes the development of the primary germ layers
How long is the embryo stage?
The embryo stage lasts from day 15 until about 8 weeks after conception, when the embryo measures 3 cm from crown to rump.
• ♣ This stage is the most critical time in the development of the organ systems and the main external features. Developing areas with rapid cell division are the most vulnerable to malformation caused by environmental teratogens, which are substances or exposures that cause abnormal development.
How long is the fetal stage?
The fetal stage lasts from 9 weeks after conception until the pregnancy ends.
When is a fetus considered viable?
Viability refers to the ability of the fetus to survive outside the uterus. Infants who are at 22 to 25 weeks of gestation are now considered to be on the threshold of viability.
What are the types of signs a women sees during pregnancy ?
Presumptive signs are those noticed by the woman, such as amenorrhea, fatigue, nausea, vomiting, and breast changes.
• o Probable signs are those noted by the examiner, such as Hegar sign, ballottement, and pregnancy tests.
• o Positive signs are those that are attributable only to the fetus, such as hearing fetal heart tones, visualizing the fetus, and palpating fetal movements. Only positive signs can establish the diagnosis of pregnancy.
What changes occur in the uterus/vagina during pregnancy/
The uterus enlarges greatly and changes in shape and position.
• ♣ Although the pH of vaginal secretions becomes more acidic, the pregnant woman is more vulnerable to some vaginal infections, especially yeast infections.
• ♣ Increased vascularity and sensitivity of the vagina and other pelvic viscera may lead to a high degree of sexual interest and arousal
What changes occur in the breasts during pregnancy?
Fullness, heightened sensitivity, tingling, and heaviness of the breasts begin in the early weeks of gestation. Colostrum may be expressed from the nipples as early as 16 weeks of gestation.
Supplements during pregnancy?
Iron supplementation is usually recommended routinely during pregnancy. Other supplements may be recommended when nutritional risk factors are present. Even with supplementation, the woman should consume a nutritious, well-balanced diet.
• o Nutritional needs during lactation are similar to those during pregnancy.
• o Needs for calories, protein, calcium, iodine, zinc, B vitamins, and vitamin C remain greater than nonpregnant needs.
• o However, during lactation the need for iron and folic acid is usually less than that during pregnancy.
What is couvade syndrome?
In accepting the pregnancy, some men experience couvade syndrome, developing pregnancy-like symptoms, such as nausea and weight gain.
What is amniocentesis done for?
Amniocentesis is performed to obtain amniotic fluid, which contains fetal cells. Indications for amniocentesis include prenatal diagnosis of genetic disorders or congenital anomalies, assessment of pulmonary maturity, and diagnosis of fetal hemolytic disease.
♣ CVS offers earlier diagnosis and fast
CVS
CVS offers earlier diagnosis and fast results, which makes it a popular technique for genetic studies in the first and second trimesters. Indications for CVS are similar to those for amniocentesis, except that CVS cannot be used for maternal serum marker screening because it does not obtain fluid.
What is PUBS?
PUBS allows direct access to the fetal circulation in the second and third trimesters, and is widely used for fetal blood sampling and transfusion. Indications for PUBS include prenatal diagnosis of inherited blood disorders, karyotyping of malformed fetuses, detection of fetal infection, and assessment and treatment of fetal isoimmunization and thrombocytopenia.
Child vs. adult resp. system
Respiratory System:
Cartilage in airway of an infant is soft
The trachea of an infant is 1/3 that of an adult
At birth, there are 25-40 million alveoli and 300-400 million alveoli by age 8-10
The size of alveoli does not change
Children generally have cardiac arrests secondary to primary respiratory arrests
Childs cardiac and neuro system
Cardiac System
Heart is fully developed and pumping by week 7
Neurological System
Myelination of neurological system is greatest in the last trimester and the first two years of life
Babys water content
Higher Body Water Content
At birth: 90%
Within 24-48 hours: 70%
12 months of age (comparable to that of an adult): 61%
Differences between children and adults
Less able to concentrate urine
Increasing risk for fluid imbalance, specifically dehydration which leads to hypovolemia
Lower glycogen stores
Increasing risk for hypoglycemia
Rapid metabolism
Increasing risk for hypoglycemia and hypoxia
Trust vs. Mistrust
Erickson: Trust vs. Mistrust
Piaget: 0-2 Years of Age,
Sensorimotor
Development of routines
Transitional items represent absent parents/caregivers
Huge developmental strides
Social skills-cooing, smiling, laughing, verbal
Stranger anxiety
Stranger anxiety- peaks 7-8 months and 18-20 months
Gross motor skills
Prefer upright position vs. horizontal
Lack of object permanence – what I cannot see is not there
Gross motor: creeping by 4-5 months, sitting by 6-8 months, walking by 12-15 month (These are typical times, but there are individual variations)
Autonomy vs. shame and doubt
Erickson: Autonomy vs. Shame and doubt
Allow to “do it myself” whenever possible
Piaget: 2-6: Preoperational
Everything is concrete and direct (“little stick in your arm”, “coughing your head off”, “two faced”, etc)
Egocentric, inability to delay gratification
Intiative vs. guilt
Erickson: 3-6 years (Initiative vs. guilt)
Piaget: : 2-6 years (Preoperational)
Everything is concrete and direct (“little stick in your arm”, “coughing your head off”, “two faced”, etc)
Are magical thinkers
Everything that happens is because of this little person, whether it is good or bad
Industry vs. inferiority
6-11 years (Industry vs. inferiority)
Piaget: 6-11 years (Concrete operational)
Want basic explanations and reasons for everything
Big learners – interested in the functional aspects of all procedures, objects, and activities
Heightened concern about body integrity
Regression common in stressful situations
Family assessment scale
Family APGAR Adaptation Partnership Growth Affection Resolve
3 basic principles of atraumatic care
Prevent/minimize separation from family
Promote child’s sense of control over situations
Prevent/minimize bodily pain or injury
Infants with a fever
Fever: Defined as: Rectal 101.4 or above Oral or tympanic 100.4 or above Axillary 99.4 or above Standing orders for fever reduction ALWAYS recheck temps within ½ hour after treatment if elevated
Hyperthermia in kids
Hyperthermia:
Can be because of fever
Can be a result of a traumatic brain injury, brain tumor, or exposure to higher than acceptable external temperatures
Will lead to Hypoxia and Increased Intracranial Pressure
Can result in damage to the brain and/or death
Important levels in infants
Potassium (3.4-5) , sodium (135-145) , chloride (96-111), glucose, and hematocrit (32-42)….IMPORTANT levels in infants
Urine output for infants
Urine (1-2cc/kg/hr)
Iv maintenance on kids
Check ivs every hour
Bag changes every 24 hours
Tubing changes every 72 hours
Monitoring elimination
Level Of Consciousness
Monitoring urine output: 1-2cc/kg/hour
Skin Turgor: Skin should not tent
Capillary Refill: Under 3 Seconds, but best if under 1 ½ seconds
Heart rate will increase with low fluid volume
Monitoring elimination cont.
Newborns/Infants: wet 6-10 times per day Weigh diapers and record output Zero out weight of diaper 1 gram=1ml Document on computer Stooling patterns vary Breastfed babies often have mustard stool with each diaper change Usually stool at least once every 3 days Significant findings: hard, pebble-like stools
The trimesters of pregnancy
Pregnancy divided into trimesters:
1st trimester: week 1-13, -embryonic plus 2 weeks as fetus.
2nd trimester : week 14-27
3rd trimester: week 28-40. (end of pregnancy)
Pregnancy
Length of pregnancy and development
LMP: First day of last menstrual period,
Fertile: generally about 2 weeks after first day of LMP (if 4 week cycles)
Ovulation and most fertile time: About 14 days before start of next menstrual cycle.
Pregnancy considered 40 weeks, but first 2 weeks, not actually pregnant, so pregnancy is actually 38 weeks.
Pregnancy development
In that 40 weeks the development is divided into the three stages:
Ovum or preembryonic: Conception until day 14
Cellular replication, blastocyst formation, embryonic membranes, primary germ layers
Embryo: day 15 -8 weeks after conception (3 cm- 1 inch in length)
greatest vulnerability to teratogens-organ systems and external structures are present.
Fetus: 9 weeks- end of pregnancy
Placenta structure and function
Placenta Structure Begins at implantation Maternal/placental/embryo circulation by day 17 Structure complete in first trimester, getting larger through week 20 Placenta Function Endocrine hCG hCS or hPL Progesterone Estrogen Metabolic Oxygen, CO2 Nutrient Stores No blood transport –only nutrients and waste
