OB Class 1 Flashcards
location of fundus at 8 weeks
cannot be palpated: below symphysis pubis
how to you find EDD using nagele’s rule
from LNMP
subtract 3months
add 7days
adjust year
fundus location at 12weeks
symphysis pubis
fundus location at 16weeks
midway between symphysis pubis and umbilicus
fundus location at 20weeks
umbilicus
fundus location at 36 weeks
xiphiod process
fundus location at 40weeks
uterus sinks to lower level after fetal head descends into pelvic cavity (lightening)
describe braxton hicks contractions (false labor)
irregular, painless contractions
during 3rd trimester occur more frequently
Chadwick’s sign
occurs during first half of pregnancy
hyperemia occurs leading to a bluish purple color extending to the vagina and labia
one of earliest signs of pregnancy
Goodell’s sign
cervix softens
acidic vaginal discharge leads to
persistent yeast infections
acidic environment favors growth but prevents bacterial growth
colostrum present beginning….weeks
12-16weeks
blood components that increase…
fibrinogen
leukocytes 5K- 15K
describe melisma, cholasma (mask of pregnancy)
areas of increased pigmentation (brownish patches) on forehead, cheeks, and nose that occur as early as 8weeks due to elevated estrogen, progesterone and melanocyte stimulating hormone
-women with dark hair and skin exhibit more hyperpigmentation than women with light hair and skin
human chorionic gonadotropin (hCG)
stimulates the corpus luteum to produce progesterone and estrogen
—increased with preg. and tumrs: not best preg indicator
estrogen
1) stimulates uterine growth and increase blood supply to uterine vessels
2) aids in developing the ductal system in the breasts in prep for lactation
3) associated with hyperpigmentation
Progesterone
maintains endometrial layer for implantation
stimulate lobes and lobules in breast for lactation
facilitate deposit of maternal fat stores
stimulate ventilation: increasing resp sensitivity to CO2
***human chorionic somatomammotropin (hCS)
human placental lactogen
increases availability of glucose for the fetus
promotes mobilization and use of free fatty acids to provide energy to the pregnant woman
relaxin
softens connective tissue
lengthens pubic ligaments
Para: number of pregancy
Nullipara
never completed a pregnancy past 20weeks
Primipara
delivered one pregnancy at 20weeks or more
multipara
delivered 2 or more pregnancies at 20weeks +
***Everytime pt comes in for visit take…
BP
Weight
Urine
GTPAL
G: pregnancies T: term births (38-42) P: preterm births (20-38) A: abortions (less than 20weeks) L: living children
Nausea & Vomiting interventions
dry crackers before arising small frequent meals fluids separate from meals avoid fried, greasy foods ginger, peppermint or combo tart and salty
backache
correct posture
avoid high heels
squat rather than bend to pick up things
when sitting, use foot supports, arm rest, and pillows behind back
last trimester weight gain
1-2lbs per week
normal BMI weight gain total
25-35lbs total
low BMI weight gain total
28-40lbs total
high BMI weight gain total
12-25lbs total
prenatal care starts at ….weeks
8-10weeks
foods to avoid during pregnancy
excess fat soluble vitamins (A,D,E,K)
caffiene
soft cheeses (blue, feta, brie)
sex of baby with ultrasound
20weeks
first trimester ultrasound
transvaginally
detects presence and location of pregnancy, detect multifetal gestations, and confirm fetal viability
2nd & 3rd trimester
transabdominal ultrasound
confirm fetal viability, evaluate fetal anatomy, estimate GA, assess progress of fetal growth, eval amniotic fluid, determine location and relation of placenta and umbilical cord
**alpha-fetoprotein (AFP)
can be measured in the maternal serum and in the amniotic fluid
abnormal concentrations are assoc. with fetal abnormalities
***between 16-18weeks
Amniocentesis
***15-20weeks
during 2nd trimester
examine fetal cells to identify abnormalities
eval the fetal condition when woman is sensitized to Rh- blood
nonstress test (NST)
ability of fetal heart to respond to stimuli
contraction stress test
induced to eval if baby receives enough oxygen during contractions induced by breast stimulation or oxytocin
***S/S of fetal hypoxia
erratic fetal heart rate
decreased fetal HR (decels)
lack of fetal movement
***interventions for fetal hypoxia
maternal position changes- knee to chest postions
oxygen mask
pt teaching: spotting
expect after intercourse or vag exam
o.k if not excessive
if occurs w.o intercourse see doctor
***pt teaching meds
avoid motrin and aspirin
bleeding
avoid NSAIDs
***pt teaching, signs to report
lower abdominal pain
cramping
pelvic pain
***Preterm labor indicator
baby is balling up then relaxing
***report immediately
3rd trimester if water breaks need to deliver within
24hrs to prevent infection
Amniogenesis
baby’s organs done forming first 8weeks
first trimester weight gain total
3-5lbs
normal weight BMI
18.5- 24.9
underweight BMI
less than 18.5
overweight BMI
25- 29.9
obese BMI
30+
