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NCLEX-RN Comprehensive Saunders Review > Maternity Pyramid Points > Flashcards

Maternity Pyramid Points Flashcards

This is all of the saunders book pyramid points.

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1
Q

TYPES OF PELVIS
Gynecoid Pelvis? (Whats special about it?)
Anthropoid Pelvis?
Android Pelvis?

A
  • *Gynecoid:** Normal female pelvis, Transversely rounded or blunt. This is the most favorable pelvis for labor and birth.
  • *Anthropoid:** Oval shape, Adequate outlet, with a narrow pubic arch.
  • *Android:** Heart-shaped or angulated, Resembles a male pelvis, Not favorable for labor and vaginal birth, Narrow pelvic planes can cause slow descent and mid-pelvic arrest.
  • *Platypelloid:** Flat with an oval inlet, Wide transverse diameter, but short anteroposterior diameter, making labor and vaginal birth difficult.
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1
Q

Saftey Point: Cephalopelvic disproportion (CPD)

What is it?
What does it mean?

A

WHAT: a pregnancy complication in which there is a size mismatch between the mother’s pelvis and the fetus’ head. The baby’s head is proportionally too large or the mother’s pelvis is too small to easily allow the baby to fit through the pelvic opening.

What this means: the normal labor process will be delayed and most likely result in a cesarean delivery.

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2
Q

FERTILIZATION

What is it?

When does it occur?

Once fertilized what happens?

How many chromosome in each reprodcutive cell?

What is the male chromosomes?Female?

A

What: action of the womans eggs being fertlized.

When: Fertilization occurs in the ampulla of the fallopian (uterine) tube when sperm and ovum unite.

Reproductive cell chromosomes: 23 chromosomes.

Male chroms: X Y, Female: XX.

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3
Q

IMPLANTATION

What is it?

Whats going on?

A

?

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4
Q

FETAL ENVIROMENT: AMNION

What is it?

When does it form?

What does it form?

A

What is it: Is the inner membrane, Encloses the amniotic cavity.

Forms when: forms about the second week of embryonic development.

What forms: Forms a fluid-filled sac that surrounds the embryo and later the fetus.

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5
Q

FETAL ENVIROMENT: CHORION

What is it?

Main job?

A

What: Is the outer membrane enclosing the amniotic cavity.

Main job: Becomes vascularized and forms the fetal part of the placenta.

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6
Q

FETAL ENVIROMENT: AMNIOTIC FLUID

What is it?

How much is there?

What is its main role?

What does amniotic fluid tell us about the baby?

How does the fetus modify the amnitic fluid?

A

What: fluid baby floats around in the womb.

How much: 800 to 1200 mL by end of pregnancy.

Jobs: Surrounds, cushions, and protects the fetus and allows for fetal movement, Maintains the body temperature of the fetus.

Modification of the amnitic fluid: The fetus modifies the amniotic fluid through the processes of swallowing, urinating, and movement of fluid through the respiratory tract.

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7
Q

FETAL ENVIRMOMENT: PLACENTA

What is it?

What is the job of the placenta?

When does it begin to form?

What does it produce?

What happens, special, during the third trimester?

What can we do by week 10 to 12?

What can and cannot pass through the placneta?

A

What: an organ that developes in the uterus during preganancy.

Job: The placenta provides for exchange of nutrients and waste products between the fetus and mother.

When: The placenta begins to form at implantation; the structure is complete by week 12.

Produces: It produces hormones to maintain pregnancy and assumes full responsibility for the production of these hormones by the 12th week of gestation.

Third trimester: In the third trimester, transfer of maternal immunoglobulin provides the fetus with passive immunity to certain diseases for the first few months after birth.

week 10 to 12: genetic testing can be done via chorionic villus sampling (CVS).

Large particles cannot pass through the placenta, but nutrients, medications, alcohol, antibodies, and viruses can pass through the placenta.

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8
Q

FETAL CIRCULATION: UMBILICAL CORD

What does it contain?

What do the areteries of the cord carry?

What does the vein carry?

A

Contains: It contains 2 arteries and 1 vein.

Artreties: carry deoxygenated blood and waste products from the fetus.

Vein: The vein carries oxygenated blood and provides oxygen and nutrients to the fetus.

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9
Q

FETAL CIRCULATION: FETAL HEART RATE (FHR)

Depends on what?

Rule of thumb for knowing?

A

FHR depends on: gestational age; FHR is 160 to 170 beats per minute in the first trimester but slows with fetal growth to 110 to 160 beats per minute.

Rule: FHR is about twice the maternal heart rate.

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10
Q

FETAL CIRCULATION: FETAL CIRCULATION BYPASS

Why do we use it?

When must it close?

The ductus arteriosus ?

The ductus venosus?

The foramen ovale is the?

A

Why: Fetal circulation bypass is present because of nonfunctioning lungs.

when: Bypasses must close after birth to allow blood to flow through the lungs and the liver.

Dutus Arteriousus: The ductus arteriosus connects the pulmonary artery to the aorta, bypassing the lungs.

Ductus venosus: The ductus venosus connects the umbilical vein and the inferior vena cava, bypassing the liver.

Ovale: The foramen ovale is the opening between the right and left atria of the heart, bypassing the lungs.

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11
Q

FETAL DEVELOPMNET: PREEMBRYONIC PERIOD

When is it?

A

First 2 weeks after conception.

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12
Q

What must happen with fetal circulation bypass?

A

Close after birth to allow blood to flow through the lungs and liver.

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13
Q

When it come to family planning who preferences are the most important?

A

The woman’s preferences as well as her culture that may affect her decision.

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14
Q

CHAPTER 20: PRENATAL PERIOD

A

CHAPTER 20: PRENATAL PERIOD

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15
Q

What is Näegele’s Rule used for?

A

To give an estimate on the child’s birth date.

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16
Q

What is Nägeles rule simplified?

A

Add 9 months and a week.

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17
Q

Gravisity?

A

The number of pregnancies.

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18
Q

Gravida

A

Means a pregnant woman.

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19
Q

Nulligravida

A

A woman who has never been pregnant.

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20
Q

Primitagravida

A

Woman who is pregnant for the first time.

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21
Q

Parity

A

Number of births carried past 20 weeks of gestation , wether the fetus was born or not.

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22
Q

What is GTPAL used for?

A

Used to describe pregnancy outcomes.

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23
Q

What does the term GTPAL stand for?

A

G = gravidity, the number of pregnancies including the present one. T= term, number of babies born that made it past 37 Weeks gestation. P= preterm births, number of babies born before 37 weeks. A= abortions, includes in gravida of before 20 weeks. L= number of current living children. (Multiples(twins) count as one).

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24
Q

Presumptive sighns of pregnancy

A

Presumptive sighns of pregnancy

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25
Q

What are the probable sighns of pregnancy?

A

All the signs are the probable signs. Hegars, Chadwick, goodells, ballomente, braxtons hicks contractions . Positive pregame check test.

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26
Q

Hegars sighn?

A

Compressibility or softening of the lower uterine segment at about 6 weeks.

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27
Q

Goodell’s sighn?

A

Softening of the cervix at the second month.

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28
Q

Chadwicks sighns?

A

Violet discoloration of cervix, vagina, and vulva at 6 weeks.

29
Q

Ballottement?

A

Rebounding of the fetus against examiners fingertips.

30
Q

Practice GTPAL

A

Practice GTPAL

31
Q

What are the positive signs of pregnancy?

A

Fetal heart rate detected by Doppler transducer at 10 to 12 weeks. Active fetal movements felt by practitioner. Outline of fetus on sonography.

32
Q

What is the fundal height?

A

Measure to evaluate the gestational age of the fetus.

33
Q

What is special about fundal height during the second and third trimesters(weeks 18 and 30)?

A

Fundal height in cm is about equal to fetal age in weeks + or - 3 cm.

34
Q

What should be the fundal height at 16 weeks?

A

Halfway between symphysis pub is and the umbilicus.

35
Q

When is the fundal he aight at the umbillicus?

A

20 to 22 weeks.

36
Q

Where is the fundal height at 36 weeks?

A

Xiphoid process.

37
Q

When assessing fundal height what else should you monitor for?

A

Supine hypotension when placed in supine position.

38
Q

Just use cathey Parkes cards to for physiological maternal changes.

A

Just use cathey Parkes cards to for physiological maternal changes.

39
Q

When the weight of the uterus increases what should you note and encourage?

A

Weight causes a forward pull on boney pelvis, encourage correct sitting to prevent back ache.

40
Q

Ambivalence?

A

Normal even if planned , mother has a dependent vs I depend role conflict and father can have it too. Not wanting to be more responsible or helpless now that pregnant.

41
Q

What should the mothers relationship to the fetus look like?

A

Mother starts thinking about her life with baby: normal and healthy to talk to, and nick name the fetus.

42
Q

Interventions for nausea and vomiting?

A
  1. Eat dry crackers before standing up. 2.) avoid brushing teeth right away after standing. 3.) eating small, frequent, low fat meals all day.
43
Q

Interventions for syncope in the first trimester?

A

Sitting with feet elevated. Teach her to change positions slowly.

44
Q

What position should a pregnant woman avoid laying in?

A

Supine position especially in 2nd and 3rd trimester can cause supine hypotension.

45
Q

What causes supine hypotension?

A

Pressure of the uterus on the superior vena cava.

46
Q

Interventions for urinary frequency?

A

Drinking less than 2000mL Limit fluid intake in evening Voiding at regular intervals

47
Q

Breast tenderness interventions?

A

Wearing a supportive bra Avoiding use of soap on the nipples to prevent drying.

48
Q

Interventions for increased vaginal discharge?

A

Proper cleansing techniques Cotton underwear Avoid douching

49
Q

Interventions for nasal stuffiness?

A

Encourage use of a humidifier.

50
Q

Interventions for fatigue?

A

Have frequent rest period throughout day. Correct posture and body mechanics. Avoid caffeine Regular Exersize.

51
Q

Interventions for heartburn?

A

Eating small frequent meals Sitting upright 30 mins after eating a meal. Drinking milk between meals

52
Q

Ankle edema interventions?

A

Elevate legs at least twice a day and when resting. Sleep in the side lying position. Wear Ted hose Avoid sitting for standing in one position for long periods of time.

53
Q

Interventions for varicose veins?

A

Wear Ted hose Elevate feet when sitting Lying with hips and feet elevated Avoid long stands Don’t cross legs Don’t wear constricting clothing

54
Q

Interventions for headaches?

A

Change position slowly. Cool cloth on forehead Eat a small snack Acetonetaphine if prescribed.

55
Q

Interventions for hemorrhoids?

A

Soaking in a warm sitz bath Sit on soft pillow Eat high fiber get plenty of fluids Walking Ointments from doctor.

56
Q

Interventions for constipation!

A

Eating high fiber foods Drink no less than 2000ml 20 min of Exersize a day Doctor collab for stool softeners

57
Q

Interventions for backaches?

A

Rest Support active shoes Performing pelvic tilt(rock) Exersizes and conscious relation exersizes.

58
Q

Leg cramps interventions?

A

Regular Exersize , especially walking. Dorsiflexion the foot of affect leg. Increase calcium intake.

59
Q

Shortness of breath interventions?

A

Frequent rest periods, Sleep on side or head of bed elevated Avoid overexertion.

60
Q

What age group of wome are at risk for adverse perinatal outcomes?

A

You get than 20 and older than 35.

61
Q

Why is there adolescent pregnancy?

A

La k of knowledge of birth controls, early Menzies, sexual behavior at this age group.

62
Q

Issue with adolescent mother?

A

Poor nutrition Emotional difficulties Lack of support system

63
Q

Issues with fetus of an adolescent mother?

A

Increased risk of stillbirth. Low Birth weight infants Cephalicopelvic disportion

64
Q

Role of the nurse in adolescent pregnancies?

A

First always encourage early and continued parental care. Second reffer them to appropriate assisnatce like WIC

65
Q

What is the most important vitamin to take for a pregnant woman and why?

A

Folic acid to prevent neural tube defects and pro facial clefts of the fetus.

66
Q

How should you asses for abuse?

A

In a private place and help develop a Saftey plan.

67
Q

German measels?

A

Rubella maternal infection dying first 8 weeks of gestation carries the highest rate of fetal infection.

68
Q

How can a mother specifically pass hiv on to the baby?

A

Infectious secretions during birth, breast milk. Unsafe sex practices.

69
Q

What may be recommended and may decrease the risk of transmission of hiv from mother to fetus?

A

Perinatal admin of zidovudine.

70
Q

Left off on page 273

A

273

NCLEX-RN Comprehensive Saunders Review (6 decks)

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