maternity Flashcards
presumptive signs of pregnancy
amenorrhea
tired
enlarged breast
sore breast
increased urination
movement perceived
emesis and nausea
Probable signs of pregnancy
positive pregnancy test
return of fetus when tapped
online of fetus palpable
Braxton kids contractions
softening of cervix (goodells signs)
bluish color to cervix (Chadwicks sign)
lower uterine segment softens (hegar’s sign)
enlarged uterus
positive sign of pregnancy
fetal movement felt by HCP
electronic device detects hear sounds
delivery of the fetus
ultrasound detects fetus
HCP sees movement by fetus
Exams done for all pregnancies
blood type/rh factor
STI testing
glucose challenge
urinalysis
ultrasound
non stress test
group b strep
kick counts
When does a glucose tolerance test take place
28 weeks
what happens during a glucose tolerance test
drinks 50g of glucose
bs checked 1 hour later
if greater than 140 3 hour glucose test in performed
what happens in a 3 hour glucose test
done fasting
fasting sugar is checked
drink 100g of glucose
BS checked every our for 3 hours
sugar over 140 is gestational diabetes
What does a non stress test assess
fetal well-being and oxygenation of placenta
evaluates if there are changes in real heart rate wit movement
what indicates a fetus will not tolerate labor
decrease in feta heart rate with movement
what is considered a reactive result for a NST
there are at least two accelerations of 15 beats per minutes for 15 seconds in a 20 minutes period
what is gravidity
number of pregnancies including current one
what is term
number of pregnancies carried to 27 weeks
what is Preterm
number of preterm births between 20 and 36+6 weeks gestation
what is abortion
number of pregnancies ending prior to 19+ 6
includes abortion and miscarriage
what is hyperemesis gravidarum
intense morning sickness with intractable nausea and vomiting during pregnancy
when to be concerned about hyperemesis gravidarum
weight loss
dehydration
hypernatemia (dehydration)
hypokalemia (vomiting)
hypochloremia (vomiting)
management of hyperemesis management
dietary changes
medications
ivf
tan/il
dietary changes for hyperemesis gravidium
sit up after meals
few crackers before getting out of bed
small portions
no liquids with meals
nothing spicy, too hot, too cold
what is preeclampsia
> 20 weeks gestation
blood pressure >140/90 2 times 4 hours apart
protein in urine
leads to seizures
signs of preeclamsia
edema
weight gain
headache
abdominal pain
blurry vision
proteinuria
management of preeclampsia
delivery
antihypertensives
prepare for a preterm baby
how do you prepare for preterm baby
magnesium sulfate to prevent seizures in mom
betamathasone to help babies lungs
what antihypertensives can be given during pregnancy
labetalol
nifedipine
hyralazine
What is gestational diabetes
diabetes diagnosed during pregnancy
pancreas can’t handle increased insulin requirement
change in carbohydrate metabolism
complications of gestational diabetes
higher birth weight
preeclamsia
low blood sugar
how to manage gestational diabetes
control with diet and exercise
monitor blood glucose
-baby at risk for hypoglycemia
symptoms of an ectopic pregnancy
dizziness or fainting
nausea or vomiting
loss of appetite
abdominal or pelvic pain
management of ectopic pregnancy
prevent rupture
methotrexate
rh retus
what does methotrexate do
stops embryo from growing
aborts fetus
What is station
how far down in the birth canal the baby is in relation to ischial spine (most narrow spot) =0
above is negative below is positive
Interventions for non-reassuring fetal heart rate
lay mother on left
increase IV fluids
O2
notify provider
discontinue Pitocin
reassuring labor signs
normal fetal heart rate
moderate variability
accelerations
non-reassuring labor signs
fetal tachycardia
fetal bradycardia
decreased variability
variable decelerations
late decelerations
What is placenta previa
placenta fully covers cervix
assessment of placenta previa
painless bright red bleeding
pad counts (amount)
observe clots or color
ultrasound
placenta previa interventions
don not perform vaginal exam
monitor for blood loss
weigh pads
bed rest
monitor baby
c-section indicated in most cases
Types of placenta abruptia
complete
incomplete
what is found in incomplete placenta abruptia
partial separation of placenta
causes internal bleeding
blood backs up behind placenta
what is found with complete placenta abruptia
causes massive external bleeding
very painful
Assessment finding placenta abruptia
dark red bleeding
intense abdominal pan
board like abdomen
rigid uterus
hypotension
maternal tachycardia
fetal bradycardia (fetal distress)
interventions for placenta abruptia
monitor for fetal distress
monitor maternal bleeding
keep BP up with IVF or blood products
prepare for delivery most likely C-section
what is a prolapsed cord
cord slips through the cervix and into the vagina after rupture of membranes and before baby descends into the birth canal
what happens to a prolapsed cord during delivery
it becomes compressed by presenting part of fetus cutting of oxygen
assessment of prolapsed cord
can visually see it
in exam something is squishy, pulsing or mom feels something
nursing intervention for prolapsed cord
elevate presenting part of fetus off the cord
keep your hand on the baby head lifting it up and call for help
knees to chest (opens pelvis)
trendelenburk (let gravity shift baby off cord)
O2
wrap cord in sterile towel
never attempt to push cord back in
emergency C-section
Risk factors for post party hemorrhage
twins or triplets
macrocosmic fetus
preeclamsia
prolonged labor
use of forecasts or vacuums during delivery
placenta previa
placenta abruptia
what is a boggy uterus
uterus that is not contracting to clamp down on the blood vessels
feels soft instead of hard
signs of shock
decreased LOC
pale
diaphoretic
hypotensive
tachycardia
assessment of PPH
boggy uterus
blood loss (saturate a pad every 15 minutes)
shock
Interventions for PPH
massage the fudus every 15 minutes at minimum
estimate blood loss
monitor hemoglobin and hematocrit
ocytocin
methylegonovine
blood products
