maternal health packet Flashcards
how long does the menstrual cycle take
26-35 days
when is an egg released before menstruation occurs
14 days
the shedding of the outer 2/3 of the endometrium with bleeding is called?
menstruation
how many phases of menstrual cycle are there?
4
site of oxygen, nutrient and waste exchange between the fetal and maternal blood supplies
placenta
when is a placenta fully developed
14 weeks
what is pinocytosis
large bacteria passing through the placental barrier
what is human chorionic gonadotropin (HCG)?
hormone that triggers body to make estrogen and progesterone
what is the original source of steroid hormones
estrogen and progesterone
what are the 3 categories of signs of pregnancy
presumptive
probable
positive
amenorrhea is considered what kind of sign of pregnancy
presumptive
a pregnancy test is considered what kind of sign of pregnancy
probable
auscultation of fetal heart beat is considered what kind of sign of pregnancy
positive
nausea/vomiting is considered what kind of sign of pregnancy
presumptive
a pregnancy test tests for the presence of what? (reason why athlete steroid users test pregnant)
HCG
What is Hegars sign?
softening of uterine isthmus
Hegars sign is considered what kind of sign of pregnancy
probable
ultrasound imaging of fetal heart motion by week 7 is considered what kind of sign of pregnancy?
positive
breast sensitivity and increased size is considered what kind of sign of pregnancy
presumptive
what is goodell’s sign
cervical softening
goodell’s sign is considered what kind of sign of pregnancy
probable
ultrasound confirmation of gestational sac by week 6 is considered what kind of sign of pregnancy
positive
fatigue is considered what kind of sign of pregnancy
presumptive
palpating fetal contours is considered what kind of sign of pregnancy
probable
fetal movements palpated by the provider by week 20 is considered what kind of sign of pregnancy
positive
abdominal enlargement is considered what kind of sign of pregnancy
presumptive
tightening in your abdomen that come and go are called?
braxton hicks contractions
braxton hicks contractions is considered what kind of sign of pregnancy
probable
bluish discoloration of the cervix, vagina, and vulva is called
chadwicks sign
chadwicks sign is considered what kind of sign of pregnancy
presumptive
skin pigmentation changes is considered what kind of sign of pregnancy
presumptive
the “before birth” period of pregnancy is called
the antepartum period
what does the prefix “ante-“ mean
before
when does a woman enter the antepartum period
after fertilization (once u nut in her u upped the ante)
changes in uterus during antepartum period
gets bigger from fetus enlargement and steroid secretion
changes in cervix during antepartum period
chadwicks sign
goodells sign
changes in vagina during antepartum period
smooth muscle hypertrophy causes vaginal vault length to increase (pussy vault get big)
changes in breasts during antepartum period
increased sensitivity
nipple/areola pigmentation
mammary gland growth
colostrum expressed from nipples at termination of pregnancy
white yellow fluid that comes out at termination of pregnancy
colostrum
changes in cardiovascular system during antepartum period
increased blood volume
physiological anemia
what causes increased blood volume during the antepartum period
increased metabolic demands
sodium and water retention
what causes physiological anemia during the antepartum period
dilution of red blood cells in increased plasma volume
changes in respiratory system during antepartum period
diaphragm pushed up
increased oxygen demand
why is the diaphragm pushed up during the antepartum period
enlarged fetus
changes in basal metabolic rate during antepartum period
increased to meet increased demands for energy and oxygen during pregnancy
when will basal metabolic range return to normal
days after delivery
changes in renal system during antepartum period
urinary frequency
increased glomerular filtration rate
why is there urinary frequency during antepartum
fetal pressure on bladder
what is nagelle’s rule and what is it used for
to determine estimated delivery date
how to calculate estimated delivery date
1st day of LMP + 7 days - 3 months + 1 year
what labs to obtain after performing physical of preg pt
rubella
blood type
Rh factor
HIV status
Hepatitis B screen
how to obtain HIV status
toxoplasma
what tests to perform for pregnant pt
TB
gonorrhea
chlamydia
pap smear
urinalysis
urine culture
what to assess at later prenatal visits
blood pressure
fundal height
fetal heartbeat
pt’s sensation of fetal movement and contractions
signs of infection
gestational diabetes
what type of diabetes should be checked for at prenatal visits
gestational diabetes
how many bpm should a fetal heartbeat be
120-160 bpm (metro & sizzle bpm)
when should one-hour glucose tolerance test be done
24-28 weeks
when should maternal serum and fetoprotein be done
15-18 week s
is a woman with a positive Rh factor a concern in pregancy?
no
is both parents are positive for Rh factor is that a concern>
no
if mother is Rh negative and father is Rh positive is that a concern?
yes may be incompatible (positive guys cant fw negative girls)
why is a rh negative mother and rh postive father a concern
may affect future pregnancies (positive guys should only have make a negative girl their bm once)
how will rh factor entering mothers circulatory system a concern for future pregnancies?
body builds antibodies against rh factor which will attack any future fetal RBC in future pregnancies and cause fatal anemia
what prevents development of Rh antibodies in Rh incompatibility and when is it given?
RhoGAM (Rh immune globulin) given in 28th week of pregnancy
what should be discussed for the post partum period
birth control options
Psychosocial support
diagnostic test used to diagnose potential geneteic problems in fetus, fetal hemolytic disease and estimate fetal lung maturity,
amniocentesis
needle inserted through abdomen and uterus into amniotic sac to withdraw amniotic fluid for evaluation is called
amniocentesis
who is amniocentesis indicated for
women over 35
familial hx of diseases
pt/spouse w chromosomal abnormality
how is fetal lung maturity determined in amniocentisis
lecithin/sphingomyelin (L/S) ratio determined after amniotic fluid is aspirated
normal L/S ratio
2/1
high frequency sound waves that resonate between ultrasound wand to fetus is called
ultrasonography
used to confirm fetal viability, gestational age/growth, fetal anatomy and placental location
ultrasonography
is being under what age a risk factor for complications
17 y/o
parity of what is a risk for pregnant complications
5 or more (multiparity)
risk factors for pregnancy complications
under 17 y/o
AIDS
diabetes
drug abuse
nullipara over age 35
parity of 5 or more
T.O.R.C.H. infections
previous hemorrhage
heart disease
history of premature labor
hypertension
malnutrition
rh negative
sickle cell
thyroid disease
massive obesity
what are T.O.R.C.H infections
Toxoplasmosis
Others (syphilis, hepatitis B)
Rubella
Cytomegalovirus
Herpes simplex
risk factors that can be discovered during antepartum
abnormal fetoprotein values
anemia
elevated glucose levels
perinatal infection
preeclampsia/eclampsia
premature labor
Rh immunization problems
TORCH infections
placenta development within lower uterine segment and covers cervix
placenta previa
risk factors for placenta previa
multiparity
older age
previous uterine surgery
hx of placenta previa
signs of placenta previa risk factors
painless bright red vaginal bleeding (gushing or intermittently)
soft non tender uterus
should you perform a vaginal exam on a pt with hx of placenta previa?
no
how should you measure blood loss in pt with hx of placenta previa
through perineal pad counts
what type of delivery is indicated for pt at risk for placenta previa
cesarean
what should be done with pt at risk for placenta previa
hospitalize and put on bed rest
premature separation of placenta from implantation site
abruptio placentae
how will hemorrhage from abruptio placentae be
external or concealed
how is concealed hemorrhage in abruptio placentae is diagnosed
sonogram
signs of abruptio placentae
-dark red blood
-intense, continuous cramping abdominal pain
-uterine tenderness
- absent/slow fetal heart rate
how to prevent supine hypotension in abruptio placentae pt
bed rest in wedge position
termination of pregnancy before viability of fetus is called
abortion
when is an abortion generally performed
before 20 wks gestation
involuntary delivery of fetus or miscarriage is called
spontaneous abortion
voluntary termination of pregnancy is called
elective abortion
signs of abortion
vaginal bleeding
frequent intense contractions
passage of conception products
what to do if abortion is threatened?
bed rest
pelvic rest
stress reduction
assist with hemostasis
surgical intervention
provide emotional support
what is hemostasis
stopping bleeding
pathological clotting disorder that is diffuse and causes injury rather than protecting coagulation sites is called
disseminated intravascular coagulation
consumption of clothing factors (platelets/fibrinogen) resulting in widespread bleeding
disseminated intravascular coagulation
signs of disseminated intravascular coagulation
spontaneous/uncontrolled bleeding
decreased platelets/fibrinogen
increasing prothrombin time
tachycardia
anxiety
restlessness
what to do for spontaneous/uncontrolled bleeding in disseminated intravascular coagulation
deliver fetus
remove abrupted placenta
treat preeclampsia
what to do if platelets/fibrinogen decrease and prothrombin time increases in D.I.C pt
replace blood/blood products
give heparin to prevent clots
hypertension in normotensive preg pt without proteinuria is called
gestational hypertension
when does gestational hypertension resolve
by day 10 of postpartum
signs of gestational hypertension
increased bp
no proteinuria
facial/hand edema
acute hypertension in pregnancy with proteinuria is called
preeclampsia
how is preeclampsia graded
from mild to severe
onset of preeclampsia
after week 20
signs of preeclampsia
increased bp
proteinuria
sudden weight gain
transient headache
signs of severe preeclampsia
oliguria
visual disturbances
abdominal pain
hyperreflexia
epigastric pain
seizures in preeclamptic women is called
eclampsia
signs of eclampsia
increased bp
severe putting edema
oliguria
visual disturbances
severe abdominal pain
hyperreflexia
change in LOC
how many of the four symptoms must be present to diagnose preeclampsia
2 out of 4
what are the 4 sxs of preeclampsia that 2/4 must be present for diagnosis
elevated bp
proteinuria
facial/hand edema
weight gain of more than 4.5/week
what position should eclampsia pt be maintained in during bed rest to prevent it
left lateral position
what kind of environment should pt at risk of eclampsia be kept in
quiet environment
can a pt at risk of eclampsia have a bunch of visitors
no
what precautions should pt at risk for eclampsia be on
seizure precautions
when can hcg be detected in urine
7-8 days