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OB/Peds Test 1 > OB Week 1 > Flashcards

OB Week 1 Flashcards

Test 1

1
Q

OB Week 1

What is EDD?

A

Estimated date of delivery

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2
Q

OB Week 1

What is EDC

A

Estimated date of confinement

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3
Q

OB Week 1

How is the estimated date of a baby’s birth is calculated from:

A

The 1st day of a baby’s birth is calculated from the the 1st day of the woman’s last normal menstual period.

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4
Q

OB Week 1

Nagel’s Rule

A
  • Subtract 3 months from first day of last LMP
  • Add 7 days
  • Correct the year if necessary
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5
Q

OB Week 1

Any pregnacy loss before the 20th week or weighing less than 500 grams. Abortion can be either spontaneous” (SAB) or “therapeutic” TAB

A

Abortion

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6
Q

OB Week 1

A birth occurring between 34 0/7 weeks and 36 6/7 weeks of gestation (71% of all preterm births & about 12% of all births)

A

Preterm Birth

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7
Q

OB Week 1

A birth occuring after the 42 nd week

A

Post term Birth

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8
Q

OB Week 1

A birth occuring between 34 0/7 weeks and 36 6/7 weeks of gestation (71% of all preterm births & about 12% of all births.

A

Late Preterm

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9
Q

OB Week 1

The # of times a women has been pregnant (including this pregnancy), regardless of duration or outcome.

A

Gravida

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10
Q

OB Week 1

The # of pregnanies a women has completed past 20 week, regardless of whether infanct is born alive or dead. (refers to number of pregnancies not fetuses).

A

Para

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11
Q

OB Week 1

More complex method of describing “PARA”

A

TPAL method

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12
Q

OB Week 1

Is often recorded in 4 numbers

A

PARA

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13
Q

OB Week 1

The number of term deliversis (after 37 weeks)

A

T= Term

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14
Q

OB Week 1

The number of premature deliveries (> 20 and < 37 wk)

A

P= premature

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15
Q

OB Week 1

A= the number of abortions (either spontaneous or therapeutic)

A

A= abortions

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16
Q

OB Week 1

L= the number of living children

A

L= Living

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17
Q

OB Week 1

A women who is pregnant for the 1st time

A

Primigravida

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18
Q

OB Week 1

A women who has been pregnant more than once.

A

Multigravida

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19
Q

OB Week 1

A women who has never completed a pregnancy past weeks 20 weeks.

A

Nullipara

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20
Q

OB Week 1

A women who has given birth 2 or more times over 20 weeks of gestation.

A

multipara

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21
Q

OB Week 1

A women giving birth for the first time of a pregnancy over 20 weeks gestatiion.

A

primapara

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22
Q

OB Week 1

PLACENTA Size

A

6-10” and 1” thick

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23
Q

OB Week 1

Placenta weight

A

1 lb to 1.5 lbs.

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24
Q

OB Week 1

Placenta structure

A

Divided into sections or segments called Cotyledons.

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25
Q

OB Week 1

Placenta has two sides

A
  • Fetal side- shiny and smooth in appearance, the amniotic sac is attached to it.
  • Maternal side- dark red and rough in appearance.
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26
Q

OB Week 1

Psysiology and functions of Placenta 1 A

A

Endocrine Gland: produces several hormones necessary for normal pregnancy

  • HCG (human chorionic gonadotropin)
  • Estrogen
  • Progesterone
  • Human Placental Lactogen
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27
Q

OB Week 1

Pacenta also functions as 2 A:

A

Site of nutrient and O2 exchange and fetal waste excretion

  • Occurs in the Intervillous space.
  • About 150ml of the mother’s blood is briefly outside of her circulatory system while it bathes the Chorionic Villi.
  • These are “treelike” structures that are derived from fetal tissure.
  • The blood is exchanged 3 to 4 times per minute in this space.
  • Maternal and Fetal blood do not mix.
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28
Q

OB Week 1

Placenta also function as 3 A.

A
  • Blocks certain harmful substance- most Bacteria and some Viruses are too large to pass through the placenta.
  • Maternal antibodies- many immunoglobulins are passesed to the fetus giving passive immunity to diseases, such as measles.
  • Metabolic functions- substances are synthesized in the placenta (glycogen, cholesterol, fatty acids)
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29
Q

OB Week 1

Umbilical Cord- 1 A

A

The lifeline between mother and fetus
-20” -22” long, 1 “ thick.
Contains 3 vessels: 2 arteries and 1 vein, which are prtected by “wartons jelly”.

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30
Q

OB Week 1

Umbilicial Cord- 2 A

A

If abnormal # of vessels present- often associated with fetal anomoloies (heart and/or kidneys).

  • The arteries carry “dirty blood” away from the fetus. The vein carries “clean” blood to the fetus.
  • Central insertion into the placenta is normal.
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31
Q

OB Week 1

Fetal Membranes

A

-Called the Bag of Waters
-Consists of two layers
+AMNION- innermembrane, next to the fetus
+Chorion- outer membrane, next to the mother

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32
Q

OB Week 1

Fetal Membranes functions to:

A

House the fetus for the duration of pregnancy, protect fromoutside world, prevent vertical transmission of infection.

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33
Q

OB Week 1

Is made up mainly from fetal unine, fluid from maternal blood, castoff cells, verniz and fetal wast products.

A

Amniotic Fluid-1 A

34
Q

OB Week 1

Its function is to cushion fetus and prtect frominjury, to keep infant at stable 98.6 tempature, to allow room for fetal movement and growth.

A

Amniotic Fluid- 2 A

35
Q

OB Week 1

Normal volume -500 to 1000 ml at term.

A

Amniotic Fluid- 3 A

36
Q

OB Week 1

Oligohydramnios

A
  • Too little amniotic fluid (<500 ml)
  • Complications: poor fetal lung development, compression syndrome
  • Associated with fetal kidney abnormalities or inadequate blood flow throgh placenta.
37
Q

OB Week 1

Polyhydramnio

A

Also called “Hydramnios”

  • Too much amniotic fluid (>2000 ml)
  • Associated with fetal CNS or GI tract abnormalities that prevent the normal fetal cycle involving ingestion of amniotic fluid.
38
Q

OB Week 1

NEWBORN ASSESSMENT

A
  • INITIAL ASSESSMENT
  • Respiratory functions-1st
  • Circulatory function-1st
  • Gestational age assessment.
  • Comprehensive physical exam.
39
Q

OB Week 1

General SURVEY of NEWBORN

A
  • Appearance
  • Symetry, any obvious deformities, size, smell, muscle tone, sex posture
  • Behavior
  • Crying, lethagic, responsive, relfexes, jittery.
40
Q

OB Week 1

Measurements of NEWBORN.

A

-Normal Length- 18-22” or 45-55 cm
-Head circumference- 13-15” or 32-38 cm
(measure right above eyebrows)
-Chest circumference- 12-14” or 30-36 cm
(measure at the nipple line)

41
Q

OB Week 1

Normal weight of a NEWBORN

A
  • 2500-4000gms

- 5 lbs, 8 oz -8 lbs, 13oz.

42
Q

OB Week 1

AGA - Weight of NEWBORN

A

appropriate for gestational age

43
Q

OB Week 1

SGA- Weight of NEWBORN

A

small for gestation age (below normal)

44
Q

OB Week 1

LGA- Weight of NEWBORN

A

Large for gestation age (above normal)

45
Q

OB Week 1

VITAL Signs- Tempature-Newborn

A

Temperature- first is usually taken axillary (36.5-37.3 C or 97.7-99.1 F) but may be taken rectally, PRN (36.5-37.5C or 97.7-99.8F)

46
Q

OB Week 1

Vital Signs- Pulse -Newborn

A

-120-160 bpm, unless sleeping (100) or crying (180)

47
Q

OB Week 1

Vital Signs-Respiration -Newborn

A

30-60 with periodic breathing (brief periods of 5-10 sec. pauses-apnea is common) AOP.

48
Q

OB Week 1

Vital Signs-B/P-Newborn

A

If suspected heart problems or premature infant; average systolic 65-95mm Hg, average diastoic 30-60 mm Hg.

49
Q

OB Week 1

SKIN of NEWBORN

A
  1. Color - Pink
  2. Pink with blue hands and feet (Acroyanosis)
  3. Mottled (lacy appearance)
  4. Pale (white)
  5. Normal Peeling
50
Q

OB Week 1

Harlequin

A

Vasomotor instability along the vertical axix, No clincial significance.

51
Q

OB Week 1

Harlequin signs

A

ichyocis refers to a relatively uncommmon group of skin disorder charcterized by the precessance of exessive amounts of dry surface scales. It is regarded as a disorder of karatinzation or confication and it is due to abnormal epidermal differation or metaboloism.

52
Q

OB Week 1

Skin appearance 2 a

A
  • Vernix - white chessy substance
  • Lanugo-fina hair (usually on shoulders, ears and back)
  • Milia (usually on chin or nose)- keratin filled epithethial cysts which occur in up to 40% of newborns.
  • Sebaceous Hyperplasia- lecsion are more yello than milia, sometiime referred to as “miniature puberty of the newborn” (hormonal exposure)
53
Q

OB Week 1

Skin appearance NEWBORN 3 a

A

-Rashes/Marks
-Erythema Toxicum-(NEWBORN RASH)
-Forceps Marks
-Mongolian Spots
-Birthmarks
-Portwine stain
Stork bit/Nevi
-Strawberry mark
-Cafe au lait
-Petechia

54
Q

OB Week 1

Head of NEWBORN- 1 A

A

Size 1” (2-3cm) larger than chest C
If larger -the normal growth curve is indicate of hydrocephalus.
< 32 cm micorcephaly
-Shape
-Round
-Molding - suture lines overlap and head elongates.

55
Q

OB Week 1

Head of Newborn - 2 A

A

Caput Succedaneum- head elongates and there is also edem of the soft tissue
-Cephalchematom- hemorrhage into the cranial bone, selling and bluish color on one side of the head- does not cross the suture line.

56
Q

OB Week 1

Head of Newborn- 3A

A

Anterior one is diamond shaped-closes at about 18 months.

  • Posterior one is trangular shaped- closes by 2-3 months.
  • Palpate for softness
  • Should be flat, not bulging.
  • Bulging may indicate; infection or increased ICP; may bulge when crying.
  • Sunken may indicate dehydration.
57
Q

OB Week 1

Head of Newborn-4a

A
  • Facial nerplasy; usually mandibular branch)

- Eyes-shape, slanted, hemorrhages, edema, strabismus, color by 6th month.

58
Q

OB Week 1

Newborn Nose-assess

A

Patency of each nares to r/o “Cjpama; Atesia” a narrowing or blockage of the nsasal airway by tissue.

59
Q

OB Week 1

Newborn Mouth-assess

A

For cleft lip and palate, for neonatal teeth Epstein’s pearls, thrush.

60
Q

OB Week 1

Newborn HAIR assess

A

Fine with consistent hair pattern (abnormal hair patterns indicated genetic abnormatlites
-Unusual Hair Whorls.

61
Q

OB Week 1

Newborn Ears

A
  • Normal Shape, Cartilage firm (term)
  • Patent
  • Even with eyes (low set ears indicate congentiatl abnormalites)
  • Pits or tages (kidney US)
  • Hearing screen done before DC home!!!
62
Q

OB Week 1

Anencephaly

A

Major birth defect of the head in which a neural tube defect where only the brain stem grows and there is no brain tissue.

63
Q

OB Week 1

Encephalocele

A

Another neural tube defect where the cranium does not close and the meniges protrude out of the head.

64
Q

OB Week 1

Neck and Clavicles assess

A

Is the neck thick or webbed?

Do the clavicles feel intact, no crepitus?

65
Q

OB Week 1

Chest assess Newborn

A
  • Size - 1” smaller than head
  • Shape-Cylinder shape is normal
  • Asymmetry can be caused by Pneumothorax or Diaphragmatic Hernia
  • Nipples, Location, distance apart, any accessory nipples
  • May secrete a whitish substance “withces milk”
66
Q

OB Week 1

Lung Sounds -assess

A

Clear or mosist, equal, bowel sounds in chest?
S/S of respiratroy distress: tachypnea, grunting, retraction, nasal flaring cyanosis
-Rate: Listen for 1 full minute
-Common to have faint crackles for the 1st few hours after birth.

67
Q

OB Week 1

Heart Sounds Assess

A
  • Assuculate for rate and rhythm
  • Presence of murmurs (murmurs are common in the newborn period-90% are transient and considered normal)
  • :ostem fpr 1 full minute
  • Report any abnormal rate, rthms or sounds to pediatrician
  • If suspected heart problems- take B/P on all four extemities & check peripheral pulses.
68
Q

OB Week 1

Abdomen ASSESS

A
  • Size: the same or smaller than chest
  • Shape:round, dome shaped, no distention
  • Bowel sounds:present,hypo, hyperactive
  • Cord
  • # of vessels
  • clamp on tight (no skin attached), no bleeding noted color white at birth, dry in 24 hus, oderless
  • Assess for any obvious deformities (Gastroschisis, Omphalocele)
69
Q

OB Week 1

Genitalia: Assess Female

A

Labia may be swollen and red from delivery, hymenal tag

  • Pseudomenses: may have a blood tinged vaginal discharge
  • Whitsh drainage
70
Q

OB Week 1

Genitalia: Assess Male

A

Rugae on scrotum, large and pendulous testes, should be descented at term.
-Hydrocele: enlarged scrotum due to excess fluid
-Examine for inguinal hernia
Check location of uniary meatus
+Hypospadias- urethral opening is on the underside
+Epispadias-urethral opening is on the upperside.

71
Q

OB Week 1

Neonate with amgious genitalia

A
  • Will require genetic testing to determine sex
  • Check for an anus patency- check for stool (taking temp rectally) PRN per order
  • Brick reddish uric crystal deposits in diaper
72
Q

OB Week 1

Extremities- Arms and Hands

A 
Symmetry
10 fingers
Hand creases: may be abnormal in FAS (Fetal alcohol syndrome), in Down syndrome Simian crease, short fingers may be present
-Polydactily-extra digits
Syndactly-webbing of digits
-brachical pulse.
73
Q

OB Week 1

S/S of Hip Dysplasia

A
  • Barlow’s manevber; dislocates the joint
  • Ortanlani’s test: Hip click reducces an out of hip joint.
  • One leg shorter
  • Gluteal creases are asymmetrical.
74
Q

OB Week 1

Treatment for Congenital Hip Dysplasia

A
  • Goal: hip reduction and stability
  • Timing is critical: before 2 months, adjusted Q2 weeks for 6-12 weeks
  • May need surgery to reconstruct hip sockets if condition is severe
75
Q

OB Week 1

Genitalia: Assess Male

A

Rugae on scrotum, large and pendulous testes, should be descented at term.
-Hydrocele: enlarged scrotum due to excess fluid
-Examine for inguinal hernia
Check location of uniary meatus
+Hypospadias- urethral opening is on the underside
+Epispadias-urethral opening is on the upperside.

76
Q

OB Week 1

Neonate with amgious genitalia

A
  • Will require genetic testing to determine sex
  • Check for an anus patency- check for stool (taking temp rectally) PRN per order
  • Brick reddish uric crystal deposits in diaper
77
Q

OB Week 1

Extremities- Arms and Hands

A 
Symmetry
10 fingers
Hand creases: may be abnormal in FAS (Fetal alcohol syndrome), in Down syndrome Simian crease, short fingers may be present
-Polydactily-extra digits
Syndactly-webbing of digits
-brachical pulse.
78
Q

OB Week 1

Treatment for Congenital Hip Dysplasia

A
  • Goal: hip reduction and stability
  • Timing is critical: before 2 months, adjusted Q2 weeks for 6-12 weeks
  • May need surgery to reconstruct hip sockets if condition is severe
79
Q

OB Week 1

Legs and Feet -Assess

A
  • Symmetry
  • 10 toes
  • Femoral pulse
  • No club feet (ponseti casting is superior to surgery; 90 % effective if started 1st month
  • Crease covering bottome of feet covering at least 2/3
  • Wide space between big toe and 2nd toe is common in Down Syndrome.
80
Q

OB Week 1

Back and Buttocks

A
  • Straight spine
  • SPina Bifida Occulta- dimple or tuft of hair
  • Menigocele (sac with fluid only)
  • Meningomyelocele (sac with fluid and spinal cord)

OB/Peds Test 1 (3 decks)

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