NR 465- Exam 1 Flashcards
When does the fundal height decrease?
between 36-40 weeks
How long should fetal kick count be measured
for 2 hours, or until the fetus makes 10 distince movements
0 is right at the ischial spine.
- Transverse Lie shoulder presentation
This is a condition in pregnancy characterized by high blood pressure, sometimes with fluid retention and proteinuria
preeclampsia
is protein in the urine a normal finding during pregnancy?
yes
What defines the transition phase of labor?
contractions every 1-2minutes, may have an urge to push down
becomes very anxious during this time
Longitudinal Lie Vertex Presentation
How do late decelerations appear
like early decelerations but are shifted to the right
When is a neonate most alert?
the first hour
breast feeding is important!
What is the ointment used in the newborn’s eyes to prevent gonorrhea?
Erythromycin.
How long does the latent phase last?
from the beginning of labor until about 3-5cm
- woman is sociable and excited*
- 8 hours*
What is the role of corpus luteum
first 6-7 weeks produces progesterone until placenta can take over
What does an engaged fetus mean?
the largest diameter of the head entered the pelvic cavity. Zero or lower. Takes place before the onset of labor.
When the head passes through the pelvis the bones may overlap, what is this called?
molding
How do we measure the descent of the fetus
in relation to the ischial spine. +1 is crowning of the head
Why are presumptive signs not considered diagnostic?
because they are changes that could happen outside of pregnancy
Examples of Probable Signs
- Chadwicks Sign
- Goodell’s Sign
- positive pregnancy test
- skin hyperpigmentation
- striae
Duration is how long
1 contraction lasts
How many arteries/veins does a fetus have
- 2 arteries (deox to placenta)
- 1 vein (oxgenated away)
What position allows greater perfusion to the fetus?
Wedged to the left
How long does the fourth stage of labor last?
2 hours to 6 weeks
What defines the 3rd stage of labor?
Devliery of the plancenta
can last up to 30 min
What does restitution mean?
after the head is born, it turns to the same side it was in utero to realign with the shoulders and back.
What hormone does estrogen/progesterone block during pregnancy?
FSH (follicle stimulating hormone) and LH (lutenizing) from anterior Pituitary
Why doesn’t blood pressure increase during pregnancy?
due to decreased resistance in the vessels
What is a term used for false labor contractions?
braxton hicks
What could be the cause of variable deceleration?
cord compression, ask to reposition
On a newborn, what shape should the posterior fontanel be upon palpation?
triangular where the occipital and parietal bones meet. Between 0.5 and 1 cm. It closes by 2 to 4 months of age.
frequency is the time from the beginning of one contraction…
to the beginning of the next
On a newborn, what shape should the anterior fontanel be upon palpation?
a diamond, between frontal and parietal bones. Should be soft and flat
What are women at risk for during third trimester?
Anemia -should take iron supplements
What is nagels rule?
First day of LMP, minuse 3 months, plus 7 days
What is the main difference between a presumptive sign and a probable sign?
that involve physoligcal and anatomical changes (still subjective)
Pre-term is the number of pregnance delievered between…?
20 and 37 weeks
What tool can measure contractions graphically?
cardiotocography
What can be used to determine a normal developing fetus versus an ectopic pregnancy?
Serial Quantitative hCG, Progesterone levels, Ultrasounds
slower rises in hCG usually occur
Why do hematocrit and hemoglobin levels drop during 1st and 2nd trimester?
because of blood volume expansion
What do strong contractions feel like upon palpation?
a forhead
What does the LH trigger?
ovulation and development of corpus luteum
What do moderate contractions feel like upon palpation?
a chin
What does FSH hormone do?
regulates the development, growth, pubertal maturation and reproductive processes of the body
What causes hemodilution during pregnancy?
increase in plasma larger than the increase in RBC’s
Normal Weight of a newborn?
2500- 4000 grams
5-8 lbs
Toco transducer
What could be the cause of early deceleration?
fetal head compression, causing the vagus nerve to slow the heart rate.
no intervention needed
What makes a positive sign of pregnancy
objective findings, through listen, seeing, feeling
What defines an acceleration before 32 weeks gestation?
an increase in 10 bpm that lasts at least 10 seconds
What is another word for Valsavla maneuver
Closed Glottis pushing during 2nd stage of labor
What is Caput Succedaneum?
feels spongy, crosses suture lines
will go away on its own
When should prenatal visits begin?
as soon as woman supsects pregnancy
What does APGAR stand for?
- Appearance
- Pulse
- Grim (cry)
- Activity
- Respiratory
Primary Powers
What is considered a “term” pregnancy?
37 weeks or later
What defines the 2nd stage of labor?
complete (10cm) dilation and full effacement of the cervix. It ends with the birth of the baby.
lasts avg 50 min, woman is agitated and irritable
What hormone causes the vessels to be dilated during 2nd trimester?
progesterone
BP will decrease
What is the size of dilation during the active phase?
between 4cm and 6cm
What happens to vascular resistance during pregnancy?
it decreases
What do mild contractions feel like upon palpation?
the tip of a nose
What are the 7 cardinal movement of labor
- Descent
- Engagement
- Flexion
- Internal Rotation
- Extension
- Restitution
- External Rotation
- Expulsion
What are the 3 components of the first stage of labor?
- Latent
- Active
- Transient
What are the 2 most important components of a biophysical profile
-
Non-stress test
- nervous system
-
Amniotic Fluid Volume Index
- kidney perfusion
- normal means shunting has NOT occurred
What could be the cause of late deceleration?
- depressed cardiac function
- poor oxygenation
- maternal hypotension
- excessive uterine stimulation.
What is the peak of the contraction called?
acme
3 parts of the fetus skull that are not fused together?
- Frontal
- Parietal
- Occiptal
What does 100% effacement mean?
Cervix is no longer palpable, powerful contractions
What does progesterone do to myometrial activity?
decreases it to maintain during pregnancy (dec uterine contractions)
What are complications of a closed glottis
reduces blood return to the heart and maternal oxygen sat and decreases placental blood flow.
(prolonged breath holding)
It is officially considered a para if…
the child has reached 20 weeks
What is relaxin secreted from?
corpus luteum and placenta
open glottis promotes perineal stretching.
It is considered an abortion if…
termination before viability (20weeks)
Pre term
20-36.6 weeks
What does amniotic fluid tell you?
good organ development, placental function
What is an acceleration tell you
intact CNS reactive good sign
Biophysical Profile
- Accelerations- FHR (non stress test)
- Tone, (flexed)
- Movement
- Lung Expansion
- Amniotic FLuid index
Why do you give IV fluids when administering epidural?
to keep BP stabilized
