Maternity Flashcards
First trimester
First trimester (Week 1 through Week 13):
Presumptive 4 Signs of Pregnancy:
Presumptive Signs of Pregnancy:
1.)Amenorrhea – what is the name of the hormone that causes this?
It’s the corpus luteum
=The small structure that left over after the Follicle have ruptured. It secrete progesterone
_progesterone elevates in the blood and induces amenorrhea. it also make your temp go up after u ovulate
2.)N/V
3.)Frequency – can be one of the first signs.
Because the uterus starts to expand and puts pressure on the bladder
4.)Breast Tenderness – excess hormones
Can occur throughout the entire pregnancy
Probable Signs of Pregnancy: mnemonic=Bad People Can Hurt Good People Using Dumb And False Logic
When are Chadwick sign seen ?
When are hegar signs seen?
Goodell signs seen?
Probable Signs of Pregnancy: mnemonic=Bad People Can Hurt Good People Using Dumb And False Logic
A positive pregnancy test – since it is based on the presence of hCG levels.
There are other conditions that can ↑ hCG levels:
hydatidiform mole;
drugs.
Goodell’s sign (softening of _ cervix_; second month)
Chadwick’s sign (bluish color of vaginal mucosa and cervix; week _4__)
Hegar’s sign (softening of the lower uterine segment; 2nd/3rd month)
Uterine enlargement
Braxton Hicks contractions (throughout pregnancy; move blood through the placenta).
Pigmentation/changes of skin
Linea nigra ( stretch marks)-that dark line down the center of the abdomen
Abdominal striae
Facial chloasma (mask of pregnancy)
Darkening of the areola (around the nipple)
Positive Signs of Pregnancy:
Fetal heartbeat: Doppler→ _________ - _______ weeks
Fetal heart tones_____
• Fetoscope→ ___________ - ___________ weeks
• Fetal movement_____, ___
Fetal sex ______
• Ultrasound
Positive Signs of Pregnancy:
Fetal heartbeat: Doppler→ __10-12_____weeks
Fetal heart tones can be detected by 7 weeks gestation.
Fetoscope→ __17-_ - _20_____ weeks
Fetal movement (Quickening, the awareness of fetal movements, occurs around 18-20 weeks gestation in primigravidas and at 14-16 weeks in multigravidas.) Ultrasound
Fetal sex may be determined on ultrasound as early as the end of 12 weeks gestation.
d. Miscellaneous Information:
1) Gravidity: # of times someone has been pregnant
2) Parity: # of pregnancies in which the fetus reaches _________________.
3) Viability ___________ weeks = Infant has the ability to live outside the
uterus.
• A 20 week baby is NOT considered __________________.
4) TPAL: acronym that gives you further information on parity
T= term
P= preterm
A= abortion – this includes spontaneous and elective abortions L= living children
5) Naegele’s Rule:
• Find the first day of the LMP
• Add ______ days
• Subtract ______ months
• Add _______ year
2. Client Education/Teaching: a. Nutrition:
• 4 food groups
• Increase calories by _______ per day after the first trimester
Adolescent: ↑ calories by ______ after first trimester
• Increase protein to ________ grams per day
b. Weight Gain:
• Expect to gain _________ pounds in the first trimester
c. Prenatalvitaminsupplements:
• • • •
Why don’t women like to take iron? It causes _____________________. Take iron with vitamin _________ to enhance absorption.
Folic acid prevents? ________________ defects
Daily dose? _________mcg/day
1) Gravidity: # of times someone has been pregnant
2) Parity: # of pregnancies in which the fetus reaches _____20 weeks___.
3) Viability 24 weeks = Infant has the ability to live outside the
uterus.
A 20 week baby is NOT considered _________viable_.
4) TPAL: acronym that gives you further information on parity
T= term
P= preterm
A= abortion – this includes spontaneous and elective abortions
L= living children
5) Naegele’s Rule:
Find the first day of the LMP
Add ___7 days
Subtract __3 months
Add ____1year
Client Education/Teaching:
a. Nutrition:
4 food groups
Increase calories by __300_ per day after the first trimester
Adolescent: ↑ calories by __500 after first trimester
Increase protein to ___60__ grams per day! Normally about 40 to 45 g per day
b. Weight Gain:
Expect to gain __4_ pounds in the first trimester
c. Prenatal vitamin supplements:
Why don’t women like to take iron? It causes __ constipation & G.I. upset so take it with food
Take iron with vitamin __c_ to enhance absorption.
Folic acid prevents? __neurotube defects example –Spina bifida!
Daily dose? __400_mcg/day
d. Exercise Rules:
• No high impact_____, ______________and ________& ____ are best.
• No heavy or unaccustomed exercise program.
• No overheating (no hot tubs or electric blanket either☺)
• Why? __________________________________ = birth defects Exercise Rule: Don’t let your heart rate get above ____.
• If the heart rate goes over _____bpm = _______________________ and uterine perfusion will drop.
d. Exercise Rules:
No high impact; ____excerise !walking __and swimming are best.
No heavy or unaccustomed exercise program.
No overheating (no hot tubs or electric blanket either)
Why? ______________ increased body temperature__ = birth defects
Exercise Rule: Don’t let your heart rate get above 140. Can cause birth defect
If the heart rate goes over 140bpm = ____CO and uterine
perfusion will drop.
e. Danger Signs: 8
mnemonic =sherry blueberry pen stains and inks every notepad
e. Danger Signs: mnemonic =sherry blueberry pen stains and inks every notepad
Sudden gush of vaginal fluid Bleeding Persistent vomiting Severe headache Abdominal pain Increased temps Edema No fetal movement
Common Discomforts:ln the first trimester
(14)
Mnemonic:Nancy big breast feel very hard hot tough and fake in normal large clothes
Common Discomforts: Nancy big breast feel very hard hot tough and fake in normal loose clothes N/V Breast Tenderness Backache Frequency Varicose veins Hemorrhoids Heartburn Tender gums Fatigue Ankle edema Increased vaginal secretions Nasal stuffiness-caused by excess estrogen Leg cramps Constipation
g. Medications:
• What are you going to tell the pregnant person about taking medications? ________________________
h. Smoking:
• What are you going to tell them? _____________________
. Physician visits: How often should a pregnant client visit the physician? • First 28 weeks: \_\_\_\_\_\_\_\_\_ • 28-36 weeks: \_\_\_\_\_\_\_\_\_\_\_ • 36 weeks: \_\_\_\_\_ until delivery
j. Ultrasounds:
• Before an ultrasound what will you ask the client to do? ________
To distend the bladder → pushes ________________ to abdominal surface. What about an ultrasound prior to a procedure? __
g. Medications:
What are you going to tell the pregnant person about taking medications?
_________ don’t unless you ask the doctor
h. Smoking:
What are you going to tell them? stop
i. Physician visits:
How often should a pregnant client visit the physician?
First 28 weeks: __1 a month
28-36 weeks: ___every 2wks or twice a month
36 weeks: weekly until delivery
j. Ultrasounds:
Before an ultrasound what will you ask the client to do? drink water
To distend the bladder → pushes _______________ uterus_ to abdominal surface.
What about an ultrasound prior to a procedure? _____void
Second Trimester
Second Trimester (Week 14 through Week 26):
Second trimester
S/S:
1. Weight Gain:
• Expected weight gain per week? _____________
2. Should the client still be experiencing?
• Nausea and vomiting _______
•Frequency _______
•Breast tenderness __________
3. Quickening:
What is it? _______________ ________________
4. Fetal Heart Rate:
What should the fetal heart rate be during the second trimester? ______________
B. Second Trimester (Week 14 through Week 26):
S/S:4
1. Weight Gain:
Expected weight gain per week? __1lb about 4lbs a month
2. Should the client still be experiencing?
Nausea and vomiting ___no_
Frequency ___no_
Breast tenderness _____yes_
3. Quickening:
What is it? ______fetal movement__
4. Fetal Heart Rate:
What should the fetal heart rate be during the second trimester? ________120 -160____
Second trimester Miscellaneous Information:
Kegel Exercise:____?
Pregnancy is considered term if it advances to ________ to ________ weeks. Never to earlier to start these
Miscellaneous Information:
Kegel Exercise:
Exercise to strengthen the pubococcygeal muscles; these muscles help stop urine flow, help prevent uterine prolapse.
Pregnancy is considered term if it advances to __37______ to 40________ weeks. Never to earlier to start these
When does the third trimester start?
Third Trimester (Week 27 through Week 40): but pregnancy is considered term if it adVances 37 to 40 weeks
Third Trimester
Assessment:
a. Expected weight gain per week?
b. Monitor BP and report any ______________ from the baseline.
c. Fetal Heart Rate: _____________
d. How is fetal position/presentation determined? _____________ ____________
You palpated the mother’s abdomen looking for ? And why is this important?
• What should you have the client do first? _________________
• If the client is having contractions, should these maneuvers be done during or
between contractions? _________________
Third Trimester (Week 27 through Week 40): but pregnancy is considered term if it adVances 37 to 40 weeks
1. Assessment:
a. Expected weight gain per week? No more then a 1b a wk
b. Monitor BP and report any _____increase__ from the baseline.
c. Fetal Heart Rate: ____120-160
d. How is fetal position/presentation determined? _______ Leopold maneuvers__
Your_Palpating the mother’s abdomen looking for the fetus head, back and butt,
We care the fetus back is because this is where u need to listen for the fetal heart rate
What should you have the client do first? ___void
If the client is having contractions, should these maneuvers be done during or
between contractions? ___between_______
9 Signs of labor:
1) Lightening:
2) Engagement
3) Fetal stations:
4. ) Braxton Hicks Contractions: More frequent and stronger
5) Softening of the ___ cervix it normally feel like the tip of the nose_ but he closer I get to deliver the softer it gets
6) Bloody show- no heavy bleeding
7) Sudden burst of _____ Energy___, called _____________nesting_
8) Diarrhea
9)Rupture of the ____________membranes
What is Lightening:
• Usually occurs ______________ before term.
• When the presenting part of the fetus (usually the head) descends into the
pelvis.
• The client will feel less ___________, and breathe easier, but urinary ________________ is a problem (again).
Lightening:
Usually occurs ____2wks_ before term.
When the presenting part of the fetus (usually the head) descends into the
pelvis.
The client will feel less __ congested__, and breathe easier, but urinary frequency__ is a problem (again).
What is Engagement?
- The ___ presenting part is in the pelvic inlet.
- Hopefully, the____is presenting first.
Engagement:
The largest presenting part is in the pelvic inlet.
Hopefully, the fetal head is presenting first.
What is Fetal stations???:
measured in __, measures the relationship of the _______of the fetus to the ______of the mother.
Fetal stations:
measured in cm, measures the relationship of the presenting
part of the fetus to the ischial spines of the mother.
When should the client go to the hospital?
When the contractions are __________ minutes apart or when the membranes _________________
once the membranes rupture when want them to deliver within ______ hours because the risk for ____
• What are we worried about when membranes rupture? ___________ __________
When the contractions are _____5__ minutes apart or when the membranes__ ruptures( once the membranes rupture when want them to deliver within 24 hours because the risk for infection
What are we worried about when membranes rupture? ____ prolapse cord___
Diagnostic Tests during the third trimester?
- ) Non-stress test: (NST)
- ) Biophysical Profile Test: (BPP)
- ) Contraction Stress Test (CST): Oxytocin Challenge Test:
Non-stress test: (NST)
We want to see with the non-stress test?
Want to see two or more accelerations of _______15__ beats/minute (or more) with fetal movement.
A Acceleration is the ?
How is this acceleration Visualize?
How should much should this increase be ?
fetal heart rate has an abrupt increase from the baseline. This is visualized on the fetal heart monitor. The increase is > 15
beats/min. above the baseline and lasts at least 15 seconds but the heart rate
should come back to baseline within 2 min.
Each increase should last for _______seconds and recorded for ______.
c. Do you want this test to be reactive or non-reactive?
What does reactive mean ?
Each increase should last for _______15_seconds and recorded for ______20_min.
c. Do you want this test to be reactive or non-reactive? Reactive means a accelerations are present
Biophysical Profile Test: (BPP)
a. When is this done?.
High risk pregnancy may have a BPP ___ or ____ a week in 3rd
trimester.
b. How are Measurements are done?
each parameter counts _____ points.?
10/10 is great
once the result for the NST are known then this may be done
a. Done in the ___last_ trimester, but can be done at 32-34 weeks in high
risk pregnancy.
High risk pregnancy may have a BPP every week or twice a week in 3rd
trimester.
b. Measurements are done by ultrasound, each parameter counts ____2_ points.
10/10 is great
BPP measurement. ( looks at 5 things )
Mnemonic-Heavy Men Mash Big Ants
What 5 things make up BPP
What are you looking for with the H?
What are looking for with The M?
What are you liking for with The M?
What are you looking for with the B?
What are you looking for with the A?
d. Observation time is ___ minutes.
e. Results are evaluated:
8-10 =
6 =
<4 =
1) Heart rate – was Non-Stress Test (NST) reactive?
F2) Muscle tone
Does baby have at least 1 flexion and ; extension movement in 30 minutes? Of arm , hands or legs
3) Movement
Does the baby move at least 3 times in 30 minutes?
4) Breathing
Does the baby have breathing movements at least once in 30 minutes?
5) Amniotic fluid
Is there enough fluid around the baby?
d. Observation time is 30 minutes.
e. Results are evaluated:
8-10 good
6 worrisome
<4 ominous
Contraction Stress Test (CST): Oxytocin Challenge Test:
a. When do you do a CST?
b. Performed on high risk pregnancies: ___, ______, and any
condition in which ________[ is suspected.
c. What does this test determines?
d. what do urinary contractions decrease?
e. Define deceleration?
f. You Do not want to see _____________________ decelerations?
What so late deceleration mean?
g. Do you want a positive or negative test? __________
h. This test is rarely performed before how many weeks? ________
a. Done when the NST is __________noreactive_____.
b. Performed on high risk pregnancies: preeclampsia, maternal diabetes, and any
condition in which placental insufficiency is suspected.
c. This determines if the baby can handle the stress of a_______ Uterine contraction_________________.
d. Uterine contractions decrease blood flow to the uterus and to the placenta.
e. If blood flow decreases enough to cause hypoxia in the fetus the fetal heart rate
will decrease from the baseline HR.
This is called ____ deceleration__
f. Do not want to see _________________late____ decelerations?
This means uteroplacental insufficiency aka The placenta is wearing out.
g. Do you want a positive or negative test? _______negative___
h. This test is rarely performed before how many weeks? ________28__
