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OB/Peds Nursing > OB - Exam One > Flashcards

OB - Exam One Flashcards

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1
Q

How is the sex of a fetus determined?

A

X and Y chromosomes

Y = male
X = female
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2
Q

What vessels are in umbilical cord?

A

2 arteries that carry deoxygenated blood away and 1 vein that carries oxygenated blood to the baby

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3
Q

Three Fetal Circulatory Shunts

A

1) Ductus venosus- diverts some blood away from liver as it returns from the placenta.
2) Foramen Ovale- diverts most blood from the right atrium directly to left atrium, rather than circulating in the lungs.
3) Ductus arteriosus- diverts most blood from the pulmonary artery into the aorta.

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4
Q

When does the fetal heart begin to beat?

A

Week 3 - primitive heart begins; heart has all four chambers

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5
Q

Week 3 Fetus Characteristics

A

Mesoderm and neural tube form, and primitive heart begins to pump. Some woman realize they missed their periods, and suspect they are pregnant.

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6
Q

Week 4 Fetus Characteristics

A

Esophagus and trachea separate, and the stomach forms. Neural tube closes, forebrain forms, upper and lower limb buds appear, ears and eyes begin to form.

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7
Q

Week 6 Fetus Characteristics

A

Auditory canal forms, eye is obvious. Heart has all 4 chambers, nasal cavity and upper lip form.

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8
Q

Week 8 Fetus Characteristics

A

Distinct human appearance, purposeful movements occur, tail has disappeared, sex organs form, most external and internal structures are formed, embryo enters fetal period.

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9
Q

Week 17 Fetus Characteristics

A

Genitalia and leg movements are visible on ultrasound and may be felt by the mother, bones are ossified, eye movements, sucks/swallows amniotic fluid, ovaries contain ova, no subcutaneous fat, blood vessels of scalp are visible.

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10
Q

Week 25 Fetus Characteristics

A

Wrinkled skin, lean body, eyes are open, fetus is now viable, Stronger movements, schedule of sleeping and moving, vernix caseosa is present on the skin, covers body, brown fat is formed, lungs begin to secrete surfactant, fingernails are present, respiratory movements begin.

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11
Q

Week 29 Fetus Characteristics

A

Fetus assumes cephalic position in utero, CNS functioning, skin less wrinkled, spleen stops forming blood cells and bone marrow start to form blood cells, ↑ surfactant is present in the lungs.

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12
Q

Week 36 Fetus Characteristics

A

Subcutaneous fat is present, skin is pink and smooth, grasp reflex is present, circumference of head and abdomen are equal, Surge in lung surfactant production occurs.

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13
Q

What complications can develop if respiratory distress is left untreated?

A

Increased pressure in the right ventricle causing reopening of the foramen ovale.

Possible death if severe.

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14
Q

What can folic acid help prevent during pregnancy?

A

 Reduces the incidence of neural tube defects such as spina bifida and anencephaly when taken at conception, and supplementation for 3 months before pregnancy may prevent autism.

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15
Q

What is the age of viability?

A

20 weeks - the lungs have matured enough functionally to survive outside the womb

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16
Q

Fetal Circulation

A
  1. Blood enters fetal body through umbilical vein.
  2. About half goes to the liver, remainder enters inferior vena cava through the ductus venosus, then goes through foramen ovale, then ductus arteriosus
  3. Blood containing waste products is returned to placenta through umbilical arteries
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17
Q

Describe the sperm that is ejaculated into the cervix.

A

Sperm travel through the cervix and uterus into the fallopian tubes by means of flagellar activity. Can reach fallopian tubes within 5 minutes after sex. Remain capable of fertilizing the ovum for up to 5 days after being ejaculated into the area of the cervix

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18
Q

Functions of Amniotic Fluid

A

Maintains even temperature
Prevents the amniotic sac from adhering to fetal skin
Allows symmetrical growth
Allows buoyancy and fetal movement
Acts as a cushion to protect the fetus and umbilical cord from injury

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19
Q

How do you document obstetric hitory using the TPALM method?

A

TPALM is a standardized way to describe the detailed outcomes of a woman’s pregnancies on her prenatal record.

T = number of term infants after 37 weeks
P = number of preterm infacts 20 - before 37 weeks
A= number of pregnancies aborted before 20 weeks
L = number of children now living
M = multiple birth number or multiple gestations
20
Q

Gravida

A

Any pregnancy (all; even one in progress)

21
Q

Primigravida

A

Woman who is pregnant for the first time

22
Q

Para

A

A woman who has given birth to one or more children who reached the age of viability, regardless of the number of fetuses delivered and regardless of whether children are living now

23
Q

Primipara

A

A woman who has given birth to her first child (past age of viability) regardless of whether child was alive at birth or is now living. (term also used to describe a woman before the birth of her first child)

24
Q

Multipara

A

A woman that has given birth to two or more children past age of viability

25
Q

Nullipara

A

A woman who has not given birth to a child who reached the age of viability

26
Q

Abortion

A

Termination of pregnancy before viability either spontaneous or induced

27
Q

What is Chadwick’s sign and what is the cause of it?

A

Purplish or bluish discoloration of the cervix, vagina, and vulva caused by increased vascular congestion. Hormonal imbalance or infection may also cause this.

28
Q

What physiological changes occur with the woman during pregnancy?

A

Endocrine - produces estrogen and progesterone and hCG and Human placental lactogen, and increases maternal insulin resistance during pregnancy.

Uterus - grows from 10 mL to 5000 mL and reaches xiphoid process

Cervix - softens and thick mucous creates a mucous plug that is expelled after effacement and dilation

Ovaries - don’t produce ova but produce progesterone to maintain uterine lining

Respiratory - O2 consumption increases by 15% Diaphragm rises 4 cm

Cardio - Blood volume increases by 45%

29
Q

How can you determine a woman’s expected delivery date using Nagel’s rule?

A

Determine the first day of the last normal period. Count back 3 months and then add 7 days. Correct year if needed.

Example: LMP 1/27/17. Count back 3 months: 10/27. Add 7 days. EDD = 11/3/17.

30
Q

What is the normal fetal heart rate?

A

110-160 bpm

31
Q

What foods are high in calcium?

A

Enriched cereals, legumes, nuts, dried fruits, broccoli, green leafy vegs, canned salmon, and sardines that contain bones

Recommended intake = 1200 mg for pregnancy

32
Q

What are some nursing interventions for a woman who has gained too much weight too quickly in her pregnancy?

A

Weight gain-normal weight: 25-325 lbs. underweight: 28-40lbs. Overweight: 11-25 bs. Obese women: 11-15 lbs.
Normal gaining: 4.4 lbs in first trimester and 1 lb a week until end
Weight gain is good. Women should not try to diet or workout to lose weight. They need to maintain the level of fitness they are at.
Calories increase of about 300kcal/day is recommended. Lactation should be about 500 more than non-preg women.

33
Q

Presumptive Sign of Pregnancy

A

Amenorrhea, Nausea, breast tenderness, deepening pigmentation, urinary frequency, fatigue and drowsiness, quickening (fetal movement felt by mom *16-20 wks)

34
Q

Probable Sign of Pregnancy

A

Goodell’s sign (softening of cervix), Chadwick’s sign ( purplish discoloration of cervix, vagina, vulva), Hegar’s sign (softening of the lower uterine segment), McDonald’s sign ( easy to flex body of uterus against the cervix), Abdominal enlargement, Braxton Hicks contractions, Ballottement/fetal outline, Abdominal striae, positive preg test

35
Q

Positive Sign of Pregnancy

A

Audible fetal heartbeat, Fetal movement felt by examiner, US with visualization of fetus

36
Q

What labs would be ordered on a pregnant woman with sickle cell?

A

Electrophoresis study of the patient’s RBC and hemoglobin

Possible clotting tests

37
Q

What is the difference between morning sickness and hyperemesis gravidarum?

A

Morning sickness can be treated/managed. Hyper emesis gravidarum has excessive nausea and vomiting that interferes with food intake and fluid balance (major weight loss). Fetal growth may be restricted resulting in low birth weight of baby. Dehydration impairs perfusion of the placenta which decreases blood O2 and nutrients to fetus

38
Q

Spontaneous (Nonintentional) Abortion

A

 Threatened-cramping & backpain with light spotting. Closed cervix & no tissue passed
 Inevitable-increased bleeding, cramping, dilation of cervix
 Incomplete-bleeding, cramping, dilation and passage of tissue
 Complete-passage of all POC, cervix closes and bleeding stops
 Missed-fetus dies in utero but not expelled. Sepsis can occur
 Recurrent -2 or more consecutive abortions (Habitual abortions)

39
Q

Induced Abortion

A

 Therapeutic-to preserve health of mom

 Elective-for other reason than health of mom (fetal anomalies)

40
Q

Ectopic Pregnancy

A

Pregnancy that occurs outside of the uterus. 95% is in Fallopian tubes caused by obstruction or abnormality of tube.

41
Q

Three Degrees of Placenta Previa

A

Marginal - within 2-3 cm of the cervical opening

Partial - placenta partially covers the opening

Total - completely covers the opening

Pain is an important symptom that distinguishes abruptio placentae from placenta previa

42
Q

What signs in a woman with gestational hypertension report to the doctor immediately?

A

Visual disturbances-blurred vision. (Preeclampsia and convulsions can occur) headache, severe epigastric pain, hyperreflexia, and hemoconcentrations

43
Q

Purpose of Magnesium Sulfate

A

Administered to control seizures from GH also slightly reduces BP but main purpose is an anticonvulsant

44
Q

Nursing Considerations for Use of Magnesium Sulfate

A

Monitor I/O, loss of deep tendon reflexes, respiratory depression, and death can occur. Monitor Mag levels: 4-8 mg/dL is therapeutic. Also inhibits contractions and most will receive oxytocin to strengthen. Monitor fundus after birth to maintain a firm uterine fundus

45
Q

What happens when the pelvic joins relax from hormonal changes in pregnancy?

A

Preparing for childbirth

46
Q

What is the best position for a woman with placenta previa?

A

Lie on her side or have a pillow under one hip to avoid supine hypotension.

OB/Peds Nursing (6 decks)

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