module 4 Flashcards
presumptive signs
subjective changes felt by the woman (mood swings, missed period)
probable signs
objective signs observed by the examiner (hegar sign, pregnancy test, ballottement)
positive signs
signs attributed to the presence of a fetus (heart beat, ultrasound)
what is naegeles rule
used for the estimated date of birth, -3 months and add 7 day and 1 year from last normal menses
normal feelings of first trimester?
fear, happy, shifting realities, asking questions and concerns
normal feelings of second trimester?
usually 13 weeks announces pregnancy, accepting the fetus
normal feelings of third third trimester?
preparing for the baby, clothes, crib
up until week 28 how often do you need to visit the doctor?
monthly visits
28 weeks to 36 weeks visit the doctor?
every 2 weeks
36 weeks until birth visiting the doctor?
every week
what nutrition tips are good for during pregnancy?
prenatal vitamins, iron, calcium
drink lots of water to prevent UTIs
lower caffeine
no alcohol or smoking
what is false labour?
irregular contractions, cervix does not dilate, no increase in frequency, duration, intensity
what is true labour?
regular contractions, increase in frequency, duration, intensity
-cervix dilates
what is the onset of labour caused by?
no single cause
- linked to hormones produced by fetus
- uterine distension
- intrauterine pressure due to increased estrogen oxytocin
3 phases of first stage of labour?
latent 0-3cm
active 4-6cm
transition 7-10cm
first stage is uterine contractions until full dilation
what is the second stage of labour?
cervix dilated to the birth of the fetus
latent the baby descends, active PUSH
third stage of labour?
birth of the fetus to the delivery of the placenta, 3-4 pushes required
fourth stage of labour?
1-4 hours after birth
-homeostasis recovered
what is the apgar?
assessment at 1 and 5 minutes after birth to test newborns transition into extrauterine existence on basis of 5 signs
5 signs of the apgar
- heart rate
- resp rate
- muscle tone
- reflexes
- skin colour
what is the apgar score mean?
on 0-10 scale.. each is rated out of 2
0-3= severe distress
4-6= moderately difficult
7-10= minimal difficulty
when is apgar reassessed?
at 10 minutes if it is less than 7
gravida?
pregnant
multigravida?
2+ pregnancies
nullipara?
no pregnancy beyond 20 weeks
primigravida?
first time pregnant
nulligravida?
never pregnant
multipara?
completed 2 or more > 20 weeks pregnancys
parity?
of pregnancies to reach 20 weeks
primipara
completed one pregnancy > 20 weeks
what is a term pregnancy
37-40 6 days
what is a preterm pregnancy
20-36 weeks
what is a early term
37-38 6 days
what is a full term
39-40 6 days
what is late term
41 weeks
what is post term
42 weeks
GTPAL?
gravida term preterm abortion living
what does lightening mean
fundus height decreases, descends into pelvis during week 38-40
hegar sign?
6 weeks, softening and compressibility of lower uterine segment
ballottement?
passive movement of unengaged fetus
fundus height?
12-14 weeks over pubis symphysis
20-22 weeks at umbilicus
37 weeks at xiphoid
38-40 weeks descends!
what are the 7 cardinal movements of labour
engagement descent flexion internal and external rotation extension birth by expulsion
psychosocial assessment of the labouring woman?
- verbal interactions
- perceptual ability
- body language
- discomfort level
what is involution?
the uterus returning to nonpregnant state, begins immediately after expulsion of placenta and with contractions of smooth muscle
what are afterpains?
they are pains more commonly felt by over distended births or second time mothers
does the cervix go back to normal?
no, looks like a jagged slit, thin for several days
what is diastasis recti abdominis?
the abdominal wall separates
how long does the abdomen protrude for?
2 weeks, returns at 6 weeks to normal
what are the 4 p’s of labour?
passenger
passage
powers
psyche
passenger?
determined by fetal head size, presentation, lie, attitude, position
what is the passage?
birth canal with bony pelvis, cervix, perineum, vagina
what are the powers?
primary= involuntary uterine contractions secondary= cervix fully dilated, "bear down" by woman increases abdominal pressure
what is the psyche?
the emotional state of the woman
lochia rubra?
3-4 days, red
lochia seroa?
pink/brown, 4-10 days
lochia alba?
whitish yellow, 10-28 days
three phases into parenthood?
- taking in (relies on nurse, uncertain, needs to rest and recover)
- taking hold (more assertive, interested, seeks guidance)
- letting go (defines new role as a mother, makes adjustments)
common changes during pregnancy? LOOOOTs
linea nigra (line on belly) bleeding gums, increased nail growth pigmentation of nipples striae angiomas, itching cholasma (mask of pregnancy) quickening (first fetal movements) appetite changes (PICA) heart burn braxton hicks contractions goodel sign, hegar sign chadwick sign leukorrhea BV increases 40-50% gravity shifts forward pelvic joints relax and more motility BR increases
goodell sign vs hegar
goodel= cervix softens hegar= uterine segment softens
what is chadwicks sign
increased vascularity (violet/blue) of vaginal mucus and cervix
leukorrhea?
white vaginal discharge with musty odour
what are montgomery tuburcles?
secrete lubrication and anti-infective material in the areola
is proteinuria normal?
only during labour and birth
