exam 1 different flashcards

1
Q

what does the VEAL/CHOP acronym describe?

A

v - variable decels occur because of cord compression
e- early decels occur because of head compression
a - accelerations are ok
l- late decels occurs because of placental perfusion problems

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2
Q

how long after conception is there a fetal heartbeat?

A

28 days or 6 weeks

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3
Q

when does gender differentiation occur?

A

at 4-6 weeks, however it is not detectable on U.C. until 16-20 weeks gestation

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4
Q

when are all the organ structures formed?

A

by 10 weeks gestational age

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5
Q

when does fetal breathing and hearing develop?

A

16 weeks

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6
Q

what is the youngest preterm survivor?

A

21 4/7 weeks

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7
Q

what hormone is dominant in the follicular phase?

A

estrogen

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8
Q

what hormone is dominant in the luteal phase?

A

progesteron

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9
Q

what days of the cycle is the follicular phase?

A

1-14, but it is variable

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10
Q

what days of the cycle is the luteal phase? what is it also known as?

A

15 -28, this is fixed, aka secretory phase

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11
Q

how do you calculate when ovulation would most likely occur?

A

subtract 14 from the length of the cycle

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12
Q

In a 28 day cycle, when does conception occur?

A

two weeks after the 1st day of the LMP

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13
Q

what happens in the first trimester? how long does it last?

A

0-12 6/7 weeks, organogenesis and cellular hyperplasia

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14
Q

what happens in the second trimester? how long does it last?

A

13 weeks to 27 6/7 weeks,
cellular hyperplasia and hypertrophy

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15
Q

what happens in the third trimester?

A

cellular hypertrophy, this is from 28 weeks to delivery

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16
Q

how long does the egg survive?

A

12-24 hours but the fertile period is only 6-12 hrs

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17
Q

how long does the sperm survive?

A

72 hrs

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18
Q

where do the sperm and the egg meet?

A

in the ampulla, which is the outer 3rrd of the fallopian tube

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19
Q

how do the different category drugs work?

A

A is fine, B is no risk in animals, C is unknown risk, D is evidence of risk and X is definite risk

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20
Q

how does fetal circulation work?

A

there are 2 arteries that carry waste away from the fetus , there is 1 vein that carries oxygenated blood to the fetus

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21
Q

what are fetal circulation adaptations?

A

1) ductus venosus is the liver bypass
2) ductus arteriosus is the lungs bypass
3) foramen ovale connects the two atria in the fetal heart

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22
Q

what are positive signs of pregnancy?

A

fetal heartbeat per doppler or fetoscope
fetal movement palpated or visualized by provider
visualization of fetus on U.S.
delivery

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23
Q

what are probable signs of pregnancy?

A

objective things the provider can observe and measure, such as chadwick signs, positive pregnancy test

24
Q

what are presumptive signs of pregnancy?

A

subjective things the woman experiences and reports

25
what is partner couvade?
when someone unintentionally takes on the physical symptoms of the pregnant partner
26
what is chadwicks sign?
bluish purple discoloration of the cervix, triggered by an increase in hormone levels (H & P)
27
what is Goodell's sign?
the softening of the cervix triggered by an increase in hormone levels ( H & P)
28
what is Hegars sign?
the softening of the lower uterine segment caused by hormones (H and P)
29
what are the effects of pregnancy on HEENT?
ptyalism (hyper salivation) bleeding gums & nose(estr & proges) stuffy nose heightened taste and smell
30
what are the effects of pregnancy on skin and hair?
linea nigra, melasma (patches and spots that are darker), darkening areolae, vulva, and axilla acne vulgaris, spider nevi (progesteron), striae increased hair and nail growth (estrogen), and palmar erythema (estrogen)
31
what are pregnancy effects on the endocrine system?
-the thyroid increases in size and activity -TSH decreases in the first trimester there is an increase in -increase in basal body temp
32
pregnancy effects on cardiovascular system
lateral displacement of the heart, -increased stroke volume, HR, CO -vasodilation with drop in BP -increase in resting HR by 10-15 bpm -stystolic murmur up to 90% -increase in blood volume (max at 32 weeks, 50% increase in plasma) -increase in clotting factors puts the pt at risk for clotting cascade
33
pregnancy effects on the GI system
decreased motility and emptying (delay to absorb all nutrients possible) nausea and vomiting (hCG) risk for gall stones b/c of progesterone the lower esophageal sphincter softens -dilated vessels -hemorrhoids
34
preggy effects on renal system
-increased renal perfusion -increased but sloppy GFR so glucose and protein spilled into urine -increased urine output of 200 + ml/da.y
35
pregnancy effects on muscoskeletal system
-loosening of joints (relaxin, prog, estr) -widening of pubic symphesis, sacroiliac joints -postural changes = lumbago -kiphosis is the increased curvature of the spine
36
preterm
before 34 weeks
37
late term
41 weeks to 41 weeks 6days
38
post term
after 42
39
28 week labs
CBC glucose tolerance test ABS (if Rh neg) syphilis
40
36-37 week labs
GBS testing
41
desirable weight gain in pregnancy for underweight: normal weight: obese : morbid obesity:
underweight: 28-40lbs normal weight: 25-33 lbs obese : 11-20lbs morbid obesity: none
42
what does SROM increase the risk of?
infection, prolapsed cord, cord compressions (variable decels)
43
how would you confirm SROM?
nitrazine/ph paper ferning pooling valsalva
44
fetal lie
relationship of the long axis of the fetus to the long axis of the mother (longitudinal vs transverse)
45
fetal presentation
vertex (cephalic) breech - booty first shoulder
46
attitude
relationship of the fetal parts to one another flexed, military, brow, face complete, frank, footling
47
nursing care in the 3rd stage of labor
promote bonding and breastfeeding prevent hemorrhage five pitocin 10-40 units in IV 500-1000 ml LR pitocin 10 units IM -fundal massage after the placenta is out
48
drugs to treat hemorrhage: methergine
0.2 mg IM *contraindicated in hypertension*
49
drugs to treat hemorrhage: cytotec (misoprostol)
800-1000 mcg sublingual, buccal, rectal
50
drugs to treat hemorrhage: hemabate
250 mcg IM, intracervical intruterine *asmtha is contraindication* *can cause explosive diarrhea
51
drugs to treat hemorrhage: TXA
1 gm in 100ml NS IV over 10 min, this is used in the first 3 hrs after birth
52
2nd degree laceration
1st degree (vaginal mucosa or perineal skin), and bulbucavernosus muscle, transverse and deep transverse muscles and fascia
53
3rd degree laceration
includes the anal sphincter
54
4th degree
includes the anterior rectal mucosa
55
how do contractions change in the second stage of labor?
likely will decrease slightly but still occurs Q2 minutes and last 60-90 seconds
56
signs of fundal detachment
uterus changes shape and becomes more globular -fundus rises in the abdomen -sudden gush or trickle of blood -cord lengthens