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Nursing 2910 > Nursing care of the childbearing family > Flashcards

Nursing care of the childbearing family Flashcards

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1
Q

Gravida

A

a woman who is pregnant

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2
Q

Nulligravida

A

a woman who has never been pregnant and is currently not pregnant

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3
Q

Primigravida

A

a woman who is pregnant for the first time

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4
Q

Multigravida

A

a woman who has had two or more pregnancies

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5
Q

Nullipara

A

a woman who has not completed a pregnancy with a fetus or fetuses who have reached at least 20 weeks of gestation

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6
Q

Primipara

A

a woman who has completed one pregnancy with a fetus or fetuses who have reached 20 weeks of gestation or more

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7
Q

Multipara

A

a woman who has completed two or more pregnancies to 20 weeks of gestation or more

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8
Q

Preterm

A

a pregnancy that has reached 20 weeks of gestation but ends before 37 weeks 0 days of gestation

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9
Q

Late preterm

A

a pregnancy that has reached between 34 weeks 0 days of gestation and ends before 36 weeks 6 days gestation

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10
Q

Full term

A

a pregnancy that has reached between 37 weeks 0 days and 41 weeks 6 days gestation

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11
Q

Post-term

A

a pregnancy that has reached 42 weeks and 0 days beyond gestation

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12
Q

Viability

A

the capacity to live outside the uterus; there are no clear limits of gestational age or weight

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13
Q

What age is considered to be the threshold of viability and vulnerable to brain injury

A

22 to 25 weeks of gestation

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14
Q

What skin problems do post-term babies usually have

A

dry and peeling skin

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15
Q

Amenorrhea

A

no period

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16
Q

Quickening

A

fetal movement between 10-12 weeks

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17
Q

EDC

A

estimated date of confinement, the due date

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18
Q

What is the common method for collecting EDC

A

determine the first day of the LMP, subtract 3 calendar months and add 7 days, then change the year

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19
Q

What does the EDC assume

A

that the woman has a 28-day cycle and that fertilization occurred on the 14th day

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20
Q

5 digit obstetric history

A

GTPAL

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21
Q

2 digit obstetric history

A

GP

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22
Q

What does the G stand for in obstetric history

A

gravida: number of pregnancies (current pregnancy is included)

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23
Q

What does the T stand for in obstetric history

A

term births: number of term gestations delivering between 37 and 42 weeks

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24
Q

What does the P stand for in obstetric history

A

pre-term births: number of preterm pregnancies ending greater than 20 weeks but before completion of 37 weeks

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25
Q

What does the A stand for in obstetric history

A

abortions/miscarriages: number of pregnancies ending before 20 weeks of viability

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26
Q

What does the L stand for in obstetric history

A

living children: number of children currently living

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27
Q

What is the best way to ensure a healthy outcome for both the mother and child

A

early and regular prenatal care

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28
Q

What is inadequate antepartum care closely associated with

A

low birth weight and increased premature birth, increasing neonatal mortality

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29
Q

What are the subjective/presumptive changes during pregnancy

A

amenorrhea, nausea/vomiting, excessive fatigue, urinary frequency, breast tenderness/enlargement, and quickening

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30
Q

What is the definition of subjective/presumptive changes

A

these changes are not definitive and could be caused by something other than pregnancy

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31
Q

What are the objective/probable changes during pregnancy

A

enlargement of the abdomen, cervical changes, uterine changes, pregnancy tests

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32
Q

What is the definition of objective/probable changes

A

changes that are observed by an examiner but may have other causes and do not confirm pregnancy

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33
Q

Goodell’s sign

A

softening of the cervix from the consistency of the tip of your nose to the consistency of your earlobe

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34
Q

Hegar’s sign

A

6th week of pregnancy, the lower uterine segment is so soft that it can be compressed to the thinness of paper, allowing the uterine segment to be flexed against the cervix

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35
Q

Chadwick’s sign

A

bluish, purple discoloration of the mucous membranes of the cervix/vagina; caused by increased vascularity of the pelvic organs, one of the earliest signs of pregnancy

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36
Q

Fetal outline

A

can be palpated by an experienced practitioner by the 2nd half of pregnancy

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37
Q

Ballottment

A

when a sudden tap on the cervix during vaginal examination near mid-pregnancy causes the fetus to rise in amniotic fluid and rebound to its original position

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38
Q

Braxton hicks

A

contractions that occur throughout pregnancy and are usually irregular and painless, most women do not notice until the 3rd trimester

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39
Q

Pregnancy tests

A

based on the presence of hCG in maternal urine and may be used as early as 3 days after a missed period (home kits are 97% accurate if used correctly)

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40
Q

Radioimmunoassay tests

A

use radioactive markers to detect antibodies against hCG in the blood or urine, done in a lab and are accurate as early as 1 week after ovulation

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41
Q

ELISA enzyme

A

linked immunosorbent assay uses antibodies to detect hCG in the blood and urine, positive 5 days before a missed period, certain drugs may affect accuracy

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42
Q

What is the definition of positive/diagnostic changes

A

conclusive proof of pregnancy

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43
Q

What are the positive/diagnostic changes during pregnancy

A

fetal heartbeat, fetal movement, visualization of the fetus

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44
Q

When can you hear a fetal heartbeat with an electronic doppler

A

10-12 weeks

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45
Q

When can you hear a fetal heartbeat with a fetoscope

A

18-20 weeks

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46
Q

What should the fetal heart rate be

A

160-170 bpm

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47
Q

Transvaginal ultrasound

A

visual examination of the fetus 4-6 weeks after LMP (identify the fetus and the heartbeat)

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48
Q

When are women screened for glucose levels

A

average: 24-28 weeks of gestation
high-risk: early 1st trimester

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49
Q

When is further glucose testing required

A

fasting: >126 mg/dl
challenge test: >140 mg/dl

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50
Q

What is given if the antibody tier for Rh is negative

A

RhoGAM is given

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51
Q

Group B streptococcus

A

normal for the mom, harmful for the baby, vaginal/rectal cultures are obtained at 35-37 weeks gestation, treated during active labor with antibiotics in an IV

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52
Q

Rubella

A

prevent the possibility of contracting rubella in future pregnancies through the MMR vaccine

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53
Q

Hepatitis B screen

A

important if the mother is positive because the infant must be given immune globulin after birth

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54
Q

Varicella

A

a vaccine is given postpartum and during follow up visit in women that have no immunity

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55
Q

What blood draws are done during pregnancy

A

alpha-fetoprotein (AFP), triple/quad screen, cell-free

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56
Q

Alpha-fetoprotein (AFP)

A

screens for neural tube defects and multiple pregnancies, done 15-18 weeks

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57
Q

Triple/quad screen

A

determines the risk of neural tube defects and down syndrome, done 15-18 weeks

58
Q

Cell-free (DNA) screen

A

tests for trisomies 13/18/21, fetal rH status, fetal sex, gene disorders, done at 10 weeks

59
Q

Nuchal translucency ultrasound

A

measures fluid, nasal bone, nuchal fold, trisomy 13/18/21 abnormalities, 10-14 weeks

60
Q

Ultrasounds

A

fetal heart activity, gestational age, fetal growth, fetal anatomy, placental position/appearance, fetal well-being

61
Q

Amniocentesis test (biochemical)

A

fetal sex, 40 different genetic abnormalities, inborn errors of metabolism, neural tube defects, 15-20 weeks

62
Q

Chronic villus sampling (biochemical)

A

obtains a sample of the chorionic villi for prenatal evaluation of chromosomal disorders, enzyme deficiencies, fetal sex determination, sex-linked disorders, 10-12 weeks

63
Q

What should weeks gestation equal

A

uterine centimeters measured
20 cm = 20 weeks

64
Q

When is the embryonic period

A

3rd week until 8th week

65
Q

Embryonic disc layers (3)

A

ectoderm, mesoderm, endoderm

66
Q

When are all major organ systems in place

A

the end of the 8th week

67
Q

What do teratogens do during the embryonic period

A

cause major structural and functional damage to developing organs

68
Q

When is the fetal period

A

9 weeks after conception until birth

69
Q

What happens during the fetal period

A

dramatic growth and refinement of established organ systems

70
Q

When do neural tube defects occur

A

3-16 weeks

71
Q

When do heart malformations occur

A

end of 6 weeks to end of 8 weeks

72
Q

When does the cleft lip palate occur

A

late 6 weeks to early 9 weeks

73
Q

What growth occurs at 4 weeks

A

developing structures that will form into the face and neck, home pregnancy test is positive

74
Q

What growth occurs at 5 weeks

A

neural tube, fetal spine

75
Q

What growth occurs at 9 weeks

A

umbilical vessels, ribs, ear buds, placental attachment, neural tube closes, called a fetus

76
Q

What growth occurs at 14 weeks

A

can see all 3 umbilical cord vessels

77
Q

What growth occurs at 20 weeks

A

weighs about 20 ounces, 6 inches long, the uterus is at belly button level, the fetus can yawn/suck a thumb/stretch/make faces

78
Q

What are the fetal membranes (2)

A

Amnion (inner), chorion (outer)

79
Q

Amnion

A

inner membrane, the developing embryo draws amnion around itself to form a fluid-filled sac, becomes the covering of the umbilical cord and covers the chorion on the fetal surface of the placenta

80
Q

Chorion

A

outer membrane, becomes the covering of the fetal side of the placenta, contains major umbilical blood vessels

81
Q

Amniotic fluid

A

protects the fetus and promotes development, derived from fetal urine (cause of kidney problems), fetus breaths in amniotic fluid while in utero

82
Q

Umbilical cord veins and arteries

A

2 arteries that carry non-oxygenated blood to the placenta from the fetus, 1 vein that carries oxygenated blood to the fetus

83
Q

What is involved in the 5 adaptions made during fetal circulation

A

umbilical vein, ductus venosus, foramen ovale, ducts arteriosus, umbilical arteries

84
Q

What does the umbilical vein turn into

A

the ligamentum teres after the cord is clamped because it is functionally closed

85
Q

Ductus venosus

A

Most of the blood passes through here into the inferior vena cava. There mixing with deoxygenated blood from the fetal legs and abdomen on its way to the right atrium

86
Q

What does the ductus venosus turn into

A

the ligamentum venosum after the cord is clamped because it is functionally closed

87
Q

Foramen ovale

A

most of the blood passes straight through the right atrium and through the foramen ovale, an opening into the left atrium. There mixing with the small amount of deoxygenated blood returning it from the fetal lungs through the pulmonary veins

88
Q

What happens to the foramen ovale

A

closes at birth because there is an increased pulmonary blood flow from the left side, causing increased pressure in the left atrium

89
Q

Ductus arteriosus

A

fetal lungs do not function for respiratory gas exchange, so the pathway bypasses the lungs, blood flows from the pulmonary artery to the aorta

90
Q

What does the ductus arteriosus turn into

A

the ligamentum arteriosum after the cord is clamped because it is functionally closed

91
Q

What happens to the PO2 level when the ductus arteriosus closes

A

increases

92
Q

What has an important role in closing the ductus arteriosus

A

circulating prostaglandin E

93
Q

What does the umbilical artery turn into

A

medial umbilical ligament after the cord is clamped because it is functionally closed

94
Q

What does clamping of the umbilical cord cause

A

a rise in blood pressure which increases circulation and lung perfusion

95
Q

Vena cava syndrome

A

when the gravid uterus rests on top of the vena cava, maternal blood flow is diminished or cut off, causing maternal hypotension and dizziness

96
Q

Human chorionic gonadotropnin (hCG)

A

early pregnancy hormone that stimulates the corpus lutem to produce progesterone and estrogen to maintain pregnancy, causes a positive pregnancy test

97
Q

Human placental lactogen (hPL)

A

antagonist to insulin, freeing fatty acids for energy so glucose becomes available for fetal growth

98
Q

Estrogen

A

stimulates uterine and breast (duct) development, produced by the placenta after the 7th week

99
Q

Progesterone

A

maintains uterine lining for implantation, relaxes all smooth muscles preventing contractions, develop breasts (lobules) for lactation, facilitates deposits of maternal fat stores for energy, inhibits oxytocin

100
Q

Relaxin

A

inhibits uterine activity diminishing the strength of uterine contractions, aids in softening of the cervix, relaxes muscles and joints in the body

101
Q

Prolactin

A

prepares the breasts to produce milk

102
Q

Oxytocin

A

stimulates contractions of the uterus to help birth occur, helps to keep the uterus contracted to prevent hemorrhage after birth

103
Q

First trimester discomforts of pregnancy (7)

A

nausea/vomiting, urinary frequency, fatigue, breast tenderness, increased vaginal discharge, nasal stuffiness and epistaxis

104
Q

What is the cause of nausea and vomiting in the first trimester

A

unknown but believed to be elevated hCG/estrogen levels, decreased blood sugar

105
Q

What is the cause of urinary frequency in the first trimester

A

the bladder is being squeezed by an enlarging uterus

106
Q

What is the treatment for urinary frequency

A

urinate frequently, Kegel exercises

107
Q

What is the cause of fatigue in the first trimester

A

effects of relaxin, hypoglycemia, anemia

108
Q

What is the cause of breast tenderness in the first trimester

A

effects of estrogen and progesterone

109
Q

What is the cause of increased vaginal discharge in the first trimester

A

increased production of mucus due to increased estrogen levels

110
Q

What is the cause of nasal stuffiness and epistaxis in the first trimester

A

elevated estrogen levels

111
Q

Second-trimester discomforts of pregnancy (7)

A

heartburn (pyrosis), constipation, hemorrhoids, varicose veins, leg cramps, ankle edema, backache

112
Q

What is the cause of heartburn in the second trimester

A

diminished gastric motility, displacement of the stomach by the enlarging uterus, relaxation of the cardiac sphincter

113
Q

What is the cause of hemorrhoids in the second trimester

A

vascular engorgement of the pelvis, constipation, prolonged standing, straining during stool

114
Q

What is the cause of constipation in the second trimester

A

decreased bowel motility due to increased progesterone levels, diet, decreased fluids, lack of exercise

115
Q

What is the cause of varicose veins in the second trimester

A

family history, obesity, the weight of the uterus compresses venous return causing stasis, prolonged standing

116
Q

What is the cause of leg cramps in the second trimester

A

imbalance of calcium/phosphorus ratio, low magnesium levels, increased pressure of the uterus on nerves

117
Q

What is the cause of ankle edema

A

prolonged sitting/standing, increased levels of sodium due to hormonal influences, circulatory congestion

118
Q

What is the cause of backaches in the second trimester

A

increased curvature of the lumbosacral spine as the uterus enlarges, softening of cartilage from increased hormone levels, poor body mechanics, preterm contractions

119
Q

How does a doppler transducer work

A

high frequency sound waves reflect the mechanical movement of the fetal heart, need to use gel

120
Q

Tocotransducer (toco)

A

pressure-sensitive device that detects changes in abdominal contour to measure uterine activity (non-invasive), assess the frequency and duration of contractions and relative intensity and uterine resting tone

121
Q

Baseline variability

A

evaluates the function of the fetal autonomic nervous system, especially the parasympathetic branch

122
Q

Absent variability

A

amplitude range is undetectable

123
Q

Minimal variability

A

detectable but less than 5 bpm amplitude

124
Q

Moderate variability

A

6-25 bpm
adequate oxygenation
want to be here

125
Q

Marked variability

A

greater than 25 bpm

126
Q

Decelerations

A

periodic decreases in FHR from the normal baseline (early, late, variable)

127
Q

Warning signs during all trimesters (9)

A

spotting/bleeding, painful urination (infection), severe persistent vomiting (hyperemesis gravidarum), fever higher than 100, pain in the calf (deep vein thrombosis), sudden gush or leakage of fluid from the vagina, periorbital/facial edema, severe upper abdominal pain, headache with visual changes

128
Q

Warning signs during the first trimester (3)

A

lower abdominal pain, dizziness, shoulder pain (ectopic pregnancy)

129
Q

Warning signs during the second trimester (2)

A

regular uterine contractions, absence of fetal movement for more than 12 hours

130
Q

Warnings signs during the third trimester (2)

A

sudden weight gain, decrease in fetal movement for more than 24 hours

131
Q

When does a hypercoagulative state occur

A

during pregnancy

132
Q

What is the most effective way to dilate the cervix

A

the fetal head

133
Q

Attitude

A

the relation of fetal parts to one another

134
Q

Normal attitude

A

head is flexed forward, arms and legs are flexed onto the trunk, efficient use of space

135
Q

What is the easiest way to deliver

A

complete flexion

136
Q

What position is a sunny side up baby in

A

occiput posterior position

137
Q

What are the most common and easiest positions to deliver in

A

left occipital anterior and right occipital anterior

138
Q

What does station have to do with

A

the ischial spine

139
Q

Effacement

A

thinning of the cervix

140
Q

Dilation

A

opening of the cervix

141
Q

What does maternal position do during labor

A

affects anatomic and physiologic responses

142
Q

What can position changes during labor do

A

relieve fatigue, improve circulation, enhance comfort

Nursing 2910 (15 decks)

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