lecture 10 maternity Flashcards
nageles rule
add 7 days and subtract 3 months
how long is a trimester
12 weeks (3 months)
how many trimesters are there
3 trimesters (36 months)
how much weight should pt gain per month in the 1st trimester (12 weeks)
1 lb/month
how many lbs should the pt have gained in the 1st trimester
3 lbs
how many lbs should pt gain after 1st trimester
1 lb/week
what is the ideal weight gain during pregnancy
28 lbs
how to quickly tell ideal weight gain if they give u how many weeks preg
subtract 9 from the weeks preg
how many lbs within ideal weight is normal for preg pts
2 lbs
how many lbs within ideal weight should u assess the pt
3 lbs
how many lbs within ideal weight gain is concerning and u need to do a biophysical profile
4lbs or more
what should u do if pt is over or under 3 lbs over ideal weight
assess the pt
what should u do if pt is 2 lbs over/under ideal weight
nothing
what should u do if pt is 4 lbs over/under ideal weight
get biophysical profile on fetus
31 wk preg pt gained 15 lbs what should u do
get biophysical profile (they are 7 lbs underweight)
31-9=22 lbs
22 lbs- 15 lbs = 7 lbs
what week can fundal height be palpated
week 12
where is the fundus at week 12
midway between umbillicus and pubic symphysis
where is the fundus in the 1st trimester
under umbillicus by pubic symphysis
where is the pubic symphysis
between your pelvis
when can u palpate the fundus at the umbillicus
20-22 weeks
where is the fundus
on top of uterus (top head part of the pussy by the fallopian tubes)
why do u palpate the fundus
to tell how many weeks preg the pt is
what does it mean if a pts fundus is bigger than normal
a molar pregancy
when can fetal hr be heard first
8-12 weeks
what trimester can u hear fetal HR
1st trimester
when can quickening be felt
16-20 weeks
what trimester do u feel quickening
2nd trimester
what is quickening
baby movement
blue cervix is what preg sign
chadwicks
soft cervix is what preg sign
goodell
how many weeks of preg do pts go once a month for prenatal visits
until 28 weeks
how many weeks preg do pts go for prenatal visits every other week
28-36 weeks
what trimester do u have monthly prenatal visits
1st trimester until middle of 2nd
what trimester do u have every other week prenatal visits
middle of 2nd until 3rd trimester
when do u have weekly prenatal visits
3rd trimester until delivery
when is a 12 wk pregnant pts next prenatal visit
in a month
what happens to hemoglobin during pregnancy
it falls
what hemoglobin is anemia in preg pts
anything under 9
what trimester does morning sickness happen
1st trimester
how do u treat morning sickness
dry carbs before the pt gets out of bed
what trimester has urinary incontinence
1st and 3rd
how do u treat urinary incontinence in pregnancy
urinate every 2 hrs until 6 weeks post partum
when can u stop urinating every 2 hrs for urinary incontinence
6 weeks post partum
when will preg pt have difficulty breathing
2nd and 3rd trimester
how to treat difficulty breathing for preg pt
tripod position (leaning forward)
when do pts have back pain during preg
2nd and 3rd trimester
how to treat back pain during preg
pelvic tilt exercises
thinning of the cervix is called
effacement
opening of the cervix is called
dilation
what to do if baby cant get past negative station numbers
do a c-section it cant go through vaginally
what does oxytocin do to the uterus
makes it contract (love hormone)
what does estrogen do to the uterus
makes it more sensative to oxytocin
what do prostaglandins do
softens the cervix (opens that pussy up)
what does relaxin do
relaces the cervix and allows baby to pass through pelvis
traverse lie equals
trouble
what to do if baby is traverse
c-section
what to do if baby is vertical lie
nothing its good
which is the most common baby presentation
right occiput anterior (ROA)
what should u choose between right occiput anterior vs left occiput anterior
ROA before LOA
0-4 cm dilated cervix is what phase of labor
latent (phase 1)
contractions 5-30 mins apart that last 15-30 secs is what phase of labor
latent (phase I)
mildly intensive contractions are what phase of labor
latent (phase I)
5-7 cm dilated cervix is what phase of labor
active (phase 2)
contractions 3-5 mins apart that last 30-60 secs are what phase of labor
active (phase 2)
moderate intensity contractions are what phase of labor
active (phase 2)
8-10 cm dilated cervix is what phase of labor
transition (phase 3)
contractions that are 2-3 mins apart and last 60-9- secs are what phase of labor
transition (phase 3)
strong contractions are what phase of labor
transition (phase 3)
when does post partum begin
2 hrs after placenta delivery
what is the priority of 2nd phase of labor (active phase)
pain management
what is the priority of 2nd stage of labor (baby delivery)
clearing babys airway
what is the priority of the 3 rd phase
checking cervical dilation
what is the priority of 3rd stage
assess placenta and umbiical cord
how should a normal placenta be
smooth and intact
how should an umbilical cord be
3 veins
uterine contractions should not be longer than
90 secs
uterine contractions should not be closer than
2 mins
what is a sign of uterine tetany
contraction longer than 90 secs
what is tetany
muscle spasms
what about uterine contractions would make u stop pitocin
contractions longer than 90 secs
what is uterine hyperstimulation
contractions longer than 90 secs
how to treat painful back pain during labor
counter pressure on sacrum while pt is in knee chest position (back shots)
where is the sacrum
above the butt
how to treat prolapsed cord
push baby head off cord and have preg pt in knee chest or trendelenburg
how treat preg complications that arent prolapsed cord or back pain (P LION)
pitocin stopped
left side
IV
oxygen
notify HCP
what to follow if theres a preg complication
P LION
whats the first thing to stop during preg complication
pitocin
when would u not give systemic pain med to labor pt
if baby will be born when med is at peak
You have a primagravida at 5-cm dilated who wants her IV push pain med. What is the nursing intervention?
hold the pain meds because she will deliver in 15-30 mins
when should u give pain meds for labor pt
in latent phase
