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
# OB Week 1 Placenta has two sides
- Fetal side- shiny and smooth in appearance, the amniotic sac is attached to it. - Maternal side- dark red and rough in appearance.
26
# OB Week 1 Psysiology and functions of Placenta 1 A
Endocrine Gland: produces several hormones necessary for normal pregnancy - HCG (human chorionic gonadotropin) - Estrogen - Progesterone - Human Placental Lactogen
27
# OB Week 1 Pacenta also functions as 2 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.
28
# OB Week 1 Placenta also function as 3 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)
29
# OB Week 1 Umbilical Cord- 1 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".
30
# OB Week 1 Umbilicial Cord- 2 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.
31
# OB Week 1 Fetal Membranes
-Called the Bag of Waters -Consists of two layers +AMNION- innermembrane, next to the fetus +Chorion- outer membrane, next to the mother
32
# OB Week 1 Fetal Membranes functions to:
House the fetus for the duration of pregnancy, protect fromoutside world, prevent vertical transmission of infection.
33
# OB Week 1 Is made up mainly from fetal unine, fluid from maternal blood, castoff cells, verniz and fetal wast products.
Amniotic Fluid-1 A
34
# 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.
Amniotic Fluid- 2 A
35
# OB Week 1 Normal volume -500 to 1000 ml at term.
Amniotic Fluid- 3 A
36
# OB Week 1 Oligohydramnios
- 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
# OB Week 1 Polyhydramnio
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
# OB Week 1 NEWBORN ASSESSMENT
- INITIAL ASSESSMENT - Respiratory functions-1st - Circulatory function-1st - Gestational age assessment. - Comprehensive physical exam.
39
# OB Week 1 General SURVEY of NEWBORN
- Appearance - Symetry, any obvious deformities, size, smell, muscle tone, sex posture - Behavior - Crying, lethagic, responsive, relfexes, jittery.
40
# OB Week 1 Measurements of NEWBORN.
-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
# OB Week 1 Normal weight of a NEWBORN
- 2500-4000gms | - 5 lbs, 8 oz -8 lbs, 13oz.
42
# OB Week 1 AGA - Weight of NEWBORN
appropriate for gestational age
43
# OB Week 1 SGA- Weight of NEWBORN
small for gestation age (below normal)
44
# OB Week 1 LGA- Weight of NEWBORN
Large for gestation age (above normal)
45
# OB Week 1 VITAL Signs- Tempature-Newborn
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
# OB Week 1 Vital Signs- Pulse -Newborn
-120-160 bpm, unless sleeping (100) or crying (180)
47
# OB Week 1 Vital Signs-Respiration -Newborn
30-60 with periodic breathing (brief periods of 5-10 sec. pauses-apnea is common) AOP.
48
# OB Week 1 Vital Signs-B/P-Newborn
If suspected heart problems or premature infant; average systolic 65-95mm Hg, average diastoic 30-60 mm Hg.
49
# OB Week 1 SKIN of NEWBORN
1. Color - Pink 2. Pink with blue hands and feet (Acroyanosis) 3. Mottled (lacy appearance) 4. Pale (white) 5. Normal Peeling
50
# OB Week 1 Harlequin
Vasomotor instability along the vertical axix, No clincial significance.
51
# OB Week 1 Harlequin signs
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
# OB Week 1 Skin appearance 2 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
# OB Week 1 Skin appearance NEWBORN 3 a
-Rashes/Marks -Erythema Toxicum-(NEWBORN RASH) -Forceps Marks -Mongolian Spots -Birthmarks -Portwine stain Stork bit/Nevi -Strawberry mark -Cafe au lait -Petechia
54
# OB Week 1 Head of NEWBORN- 1 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
# OB Week 1 Head of Newborn - 2 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
# OB Week 1 Head of Newborn- 3A
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
# OB Week 1 Head of Newborn-4a
- Facial nerplasy; usually mandibular branch) | - Eyes-shape, slanted, hemorrhages, edema, strabismus, color by 6th month.
58
# OB Week 1 Newborn Nose-assess
Patency of each nares to r/o "Cjpama; Atesia" a narrowing or blockage of the nsasal airway by tissue.
59
# OB Week 1 Newborn Mouth-assess
For cleft lip and palate, for neonatal teeth Epstein's pearls, thrush.
60
# OB Week 1 Newborn HAIR assess
Fine with consistent hair pattern (abnormal hair patterns indicated genetic abnormatlites -Unusual Hair Whorls.
61
# OB Week 1 Newborn Ears
- 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
# OB Week 1 Anencephaly
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
# OB Week 1 Encephalocele
Another neural tube defect where the cranium does not close and the meniges protrude out of the head.
64
# OB Week 1 Neck and Clavicles assess
Is the neck thick or webbed? | Do the clavicles feel intact, no crepitus?
65
# OB Week 1 Chest assess Newborn
- 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
# OB Week 1 Lung Sounds -assess
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
# OB Week 1 Heart Sounds Assess
- 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
# OB Week 1 Abdomen ASSESS
- 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
# OB Week 1 Genitalia: Assess Female
Labia may be swollen and red from delivery, hymenal tag - Pseudomenses: may have a blood tinged vaginal discharge - Whitsh drainage
70
# OB Week 1 Genitalia: Assess Male
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
# OB Week 1 Neonate with amgious genitalia
- 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
# OB Week 1 Extremities- Arms and Hands
``` 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
# OB Week 1 S/S of Hip Dysplasia
- 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
# OB Week 1 Treatment for Congenital Hip Dysplasia
- 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
# OB Week 1 Genitalia: Assess Male
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
# OB Week 1 Neonate with amgious genitalia
- 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
# OB Week 1 Extremities- Arms and Hands
``` 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
# OB Week 1 Treatment for Congenital Hip Dysplasia
- 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
# OB Week 1 Legs and Feet -Assess
- 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
# OB Week 1 Back and Buttocks
- Straight spine - SPina Bifida Occulta- dimple or tuft of hair - Menigocele (sac with fluid only) - Meningomyelocele (sac with fluid and spinal cord)