Maternity Nursing Flashcards
First Trimester:
Week 1 -13
Presumptive signs of pregnancy:
amenorrhea, N/V, frequency, and breast tenderness
what is the name of the hormone that causes amenorrhea?
Progesterone
Probable signs of pregnancy:
positive pregnancy test, goodell, chadwick, hegar, uterine enlargement, braxton hicks contractions, pigmentation/changes of skin
Goodell’s Sign
softening of the 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
Braxton Hicks contractions
throughout pregnancy; move blood through placenta
Pigmentation/Changes of Skin
Lina Nigra (dark line down abdomen), abdominal striae (stretch marks), facial chloasma (mask of pregnancy), darkening of areola
Positive Signs of Pregnancy
Fetal heartbeat (10-12 wks), Fetoscope (17-20wks), fetal movement, ultrasound
Gravidity:
number of times someone has been pregnant
Parity:
number of pregnancies in which fetus reaches 20 weeks
Viability
24 plus weeks= infant has ability to live outside uterus
Nutrition Teaching:
4 food groups, increase calories by 300 per day after 1st trimester, adolescent: increase calories by 500 after 1st trimester, increase protein 60g per day
Weight gain first trimester?
gain 4 pounds in first trimester
Why don’t women like to take iron?
Causes constipation and GI upset
You should take iron with what vitamin?
Vitamin C helps absorb
Folic acid prevents what defect?
Neural Tube Defect
Daily dose of vitamin?
400 mcg/day
Danger signs:
sudden gush of vaginal fluid, bleeding, persistent vomiting, severe headache, abd pain, increased temps, edema, no fetal movement
Common discomforts:
N/V, breast tenderness, frequency, tender gums, fatigue, heartburn, increased vaginal secretions, nasal stuffiness, varicose veins, ankle edema, hemorrhoids, constipation, backache, leg cramps
Weight gain second trimester?
4 pounds per month
What is quickening?
Fetal movement
Expected weight gain third trimester?
no more than 1 pound a week
How is fetal position/presentation determined?
Leopold’s maneuver
If pt is having contractions, should maneuvers be done during or between contractions?
Between
Signs of Labor:
Lightening, engagement, fetal stations, braxton hicks contractions, softening of cervix, bloody show, sudden burst of energy (nesting), diarrhea, rupture of membranes
What are we worried about if membranes rupture?
prolapsed cord
Non-stress test
Want to see two or more accelerations of 15 beats/min or more w/fetal movement, each increase should last for 15 secs and recorded for 20 min, and want it to be reactive
Accerlation:
FHR has an abrupt increase from baseline
Biophysical Profile Test
done in last trimester, but can be done at 32-34 weeks in high risk pregnancy (high risk pregnancy may have BPP every week or twice week in 3rd trimester); measurements done by u/s, each parameter counts 2 pmts (10/10 great); BPP measurement (HR, muscle tone, movement, breathing, amniotic fluid); observation time is 30 min, results evaluated
Contraction Stress Test (CST): Oxytocin Challenge Test
done when NST is nonreactive, performed on high risk pregnancies, determines if baby can handle stress of uterine contraction
Uterine contraction causes what?
decrease blood flow to uterus and placenta
What is deceleration?
blood flow decreases enough to cause hypoxia in fetus fetal heart rate will decrease from baseline HR
Do not want to see late decelerations?
uteroplacental insufficiency (placenta weakening)
Do you want a positive or negative CST?
negative
Early Decelerations
caused by physiological hypoxia from fetal head compression
Late Decelerations
caused by uteroplacental insufficiency
True Labor
Regular contractions, increase contraction frequency and duration, discomfort in back and radiates to abdomen, pain level increases w/activity
False Labor
irregular contractions, discomfort in just front abdomen, pain decreases w/activity
Epidural Position
Lie on left side, legs flexed, not as arched as w/lumbar puncture
When do you give an epidural?
Stage 1 at 3-4 cm dilation
Major complication w/epidural?
hypotension (monitor BP)
What should you give with epidural to help fight hypotension?
IVFS: Bolus w/1000mL of NS or LR
What position to prevent vena cava compression?
semi-folwers on side (alternate side by side hourly)
When should oxytocin be discontinued?
contractions are too often, contractions last too long, fetal distress
What position should client receiving oxytocin be placed?
any position except flat on their back, if fetal HR is unreassuring then put on left side to enhance uterine perfusion
What should be done w/infusion if late decelerations occur?
turn off
