OB Term Flashcards
Amenorrhea
Suppression/ absence of menstruation
Term
37-42 weeks
Normal duration
Quickening
First movements of fetus felt by the mother (16-18 weeks); may be later (20 weeks) for first time moms
Funic Soufflé
Hissing sound synchronous with fetal heart beat; produced by umbilical cord
maternal blood pulsating through the placenta; synchronous with the maternal pulse
Uterine Soufflé
Bloody Show
discharge of blood tinged mucous from the cervix as labor begins
thinning measurement of the cervix (%)
Effacement
Abnormal Labor Patterns:
Protracted
Prolonged
Arrested
Protracted Labor
slow rate of progress
Prolonged Labor
long span of time for progress to occur
Arrested Labor
progress stops
Gestation
number of weeks since first day of last menstrual period
Abortion
birth that occurs BEFORE end of 20 WEEKS gestation
Fetal Demise
death of a fetus
time between conception and the onset of labor; prenatal
Antepartum
time from onset of true labor until birth of infant and placenta
Intrapartum
time from birth until woman’s body returns to prepregnant condition
Postpartum
labor that occurs after 42 weeks gestation
Postterm labor
infant born dead after 20 weeks gestation
Stillbirth
Nulligravida
has never been pregnant
pregnant for the 1st time
Primigravida
woman who is in her second or any subsequent pregnancy
Multigravida
birth after 20 wks gestation regardless of whether infant is born alive or dead
Para
refers to pregnancy, not number of fetuses, so twins are para 1
Nulliparous
no births at > 20 wks gestation
Primiparous
one birth at > 20 wks gestation
Multiparous
2+ births at > 20 wks
Gravida
the # of times pregnant(multiples, i.e. twins, triplets, etc. count as one pregnancy)
Para
the # of births after 20 weeks’ gestation regardless of whether infant is born alive or dead (multiples i.e. twins, triplets each count as only one time giving birth)
GTPAL
G=# of times pregnant T= # of term births (ea. baby counts as one… twins=2) P= # of premature births (20-37) A= # of pregnancies ending in abortion L=number of living children
Postpartum Assessment
BUBBLE-HE
BUBBLE-HE
Breast Uterus (should be midline) Bladder-toilet q3h; ~3000mL in 24h Bowel Function Lochia Episiotomy/ Perineum
Homan’s Sign
Emotional Status
Rubra
bright red color
Disadvantages of Electronic Fetal Monitoring
impaired by:
- certain positions of the mother
- maternal obesity
Device placed over fetal back and transmits to the monitor; On going assessment of fetal monitoring
Electronic Fetal Monitoring
Advantages of Electronic Fetal Monitoring
Easy to use
Noninvasive
Records Continuously
Appearance of Lochia- day 10
Clear and colorless
Lochia appearance day 1-3
Very red; similar to menstrual flow
Progress to watery serous
Thin & colorless by day 10
Notify the physician if the lochia
looks abnormal
has an unusual odor
contains clots other than small shiny ones.
Lochia appearance (first 3 days)
Rubra
Lochia appearance (d3-d10)
Serosa (pink)
Lochia appearance (d10-14)
Alba
Emergency amt of Lochia
Saturates pad (tip to tip) in 15 mins
Scant Lochia
<1 in within 1 hr
Change pad q3-4 h
Light Lochia
<4inches in 1h
Moderate Lochia
<6 inches in 1 hour
Change pad q2-3h
Heavy Lochia
Saturates pad in 1 h (tip to tip)
Interventions for a boggy uterus (5)
- Fundal message
- Express clots: massage and give gentle downward pressure to express
- Breast-feeding
- Oxytocin
- Continuous bleeding
suspect laceration of the uterus when…
Normal tone, below umbilicus, steady trickle of blood
Early ambulation …
Decreases stasis of blood in uterus, increases uterine tone
Second priority nursing diagnosis
Risk for infection – intrauterine (endometritis)
Factors that increase the risk of infection:
Episiotomy
Premature rupture of membrane
Prolonged rupture of membranes
#Vaginal exams after ROM
Fourth degree laceration (through to rectum)
Pre-existing infection of reproductive track
Anemia
How long must you wait before taking a tub bath postpartum
2 weeks
No tampon
No douche
No sex
FOR….
6 weeks
uterine tenderness, pain, foul-smelling lochia, temperature elevation, tachycardia, nausea/vomiting, chills, subinvolution
S/s of uterine infection
Lower abdominal discomfort
Dysuria, frequency
Bladder distention
S/s UTI in postpartum patients
Maybe masked by decreased bladder tone in postpartum
POPI
Position Change: L Lateral (1st choice)
O2: 10L Non-rebreather
Pit Stop: stop oxytocin/ pitocin
IV Bolus: increase blood volume (999)
No pumping before
2 weeks
When can babies be given pumped breast milk?
4-6 weeks of age
of hora thawed milk can be refrigerated
24h do NOT refreeze
Pacifiers may NOT be given for the first ….
4-6 weeks
MgSulfate
Stops contractions