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Mat-Child Nursing > Objective 2 > Flashcards

Objective 2 Flashcards

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1
Q

none

A

null

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2
Q

primi

A

one

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3
Q

multi

A

several

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4
Q

of pregnancies regardless of duration including current one

A

gravida

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5
Q

a person who has never been pregnant

A

nulligravida

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6
Q

a person who is pregnant for the first time

A

primigravida

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7
Q

a person who has two or more pregnancies

A

multigravida

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8
Q

of births where the infant (alive or dead) was 20 weeks or more at the time of birth
does not consider # of babies (twins etc)

A

para

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9
Q

a person who has given birth to their first child after 20 weeks gestation, regardless of whether the child was alive at birth or now living

A

primipara

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10
Q

a person who has given birth to two or more children, regardless of whether the children were alive at birth or is now living

A

multipara

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11
Q

a person who has not completed a pregnancy past 20 weeks gestation

A

nullipara

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12
Q

prenantal age of the developing fetus calculated from the first day of the pregnant persons last menstrual period

A

gestational age

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13
Q

a fetus that has reached the stage (usually 22-24 wks gestation) where it is capable of living outside the uterus

A

viability

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14
Q

what does GTPAL stand for?

A

gravidity, term, preterm, abortions, living children

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15
Q

what are the 4 phases of childbearing period?

A

preconception
antepartum
intrapartum
postpartum

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16
Q

identifies risk factors that may be changed before conception

A

preconception care

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17
Q

what are the prenatal goals?

A

Promote the health of the mother, fetus, newborn, and family
Decrease risk factors
Teach healthy habits
Educate in self-care
Develop a partnership with parents and family
Provide physical care and support
Prepare parents for parenthood

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18
Q

why is prenatal care important?

A

Decrease # of low-birth-weight infants
Decrease mortality and morbidity for moms and newborns

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19
Q

frequency of deaths

A

mortality

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20
Q

incidence of illness

A

morbidity

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21
Q

who does prenatal care?

A

Obstetricians
Family practitioners
Registered midwives

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22
Q

when does prenatal care take place?

A

Conception to 28 weeks
Every 4 weeks
29-36 weeks
Every 2-3 weeks
37 weeks to delivery
Weekly

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23
Q

what does prenatal care consist of?

A

Laboratory and diagnostic tests
Urinalysis
Protein, glucose, ketones
Detects infection, renal disease, and hypertension
Detects diabetes
Complete blood count (CBC)
Detects various problems including anemia, infection, cell abnormalities
Rh factor
Determines risk for maternal-fetal blood incompatibility
Routine assessments
Prenatal education

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24
Q

what are the routine assessments at each prenatal visit?

A

risk factors
VS
urinalysis
blood glucose
fundal height
fetal movement counting
fetal heart rate
emotional health
any discomforts

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25
Q

what is full term?

A

40wks (280days)

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26
Q

what is Nagele’s rule?

A

Determine 1st day of LNMP
Add 7 days
Count forward 9 months
Correct year if necessary

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27
Q

Cessation of menses, in a healthy and sexually active person, is often the first sign of pregnancy. however, strenuous exercise, changes in metabolism and endocrine dysfunction, chronic disease, certain meds, anorexia nervosa, early menopause, or stress may also be the cause

A

amenorrhea

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28
Q

Occur in up to 80% of all pregnancies. Morning sickness describes the symptoms, but they may occur at any time of date. Distaste for certain foods or their odours may be the main symptoms. Begins between the first and second missed periods and usually improved by 12 to 16 weeks

A

nausea/ fatigue/ drowsiness

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29
Q

Tenderness and tingling as hormones from the placenta stimulate growth of the ductal system in prep for breastfeeding

A

breast changes

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30
Q

Common in early months of pregnancy. The enlarging uterus, along with the increased blood supply to the pelvic area exerts pressure on the bladder. Occurs in the first semester until the uterus expands and becomes an abdominal organ in the second trimester

A

urinary frequency

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31
Q

Fetal movement felt by the pregnant person, is first perceived at 16-20 weeks of gestation as a faint fluttering in the lower abdomen in a primigravida. Pts who have given birth previously often report quickening as early as 14 weeks

A

quickening

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32
Q

Softening of the cervix and vagina caused by increased vascular congestion

A

goodells sign

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33
Q

The purplish or bluish discoloration of the cervix and vaginal mucosa caused by increased vascular congestion

A

chadwicks sign

34
Q

Softening of the lower uterine segment. Because of the softening, it is easy to flex the body of the uterus against the cervix, which is known as McDonald sign

A

hegars sign

35
Q

Rather irregularly at the onset of pregnancy. By the end of the 12th week, the uterine fundus may be felt just above the symphysis pubis, and it extends to the umbilicus between the 20th and 22nd weeks

A

enlargement uterus/abdomen

36
Q

Irregular, painless uterine contractions that begin in the second trimester. These give the sensation of the abdomen being hard and tense and they may become progressively more noticeable as term approaches and are more pronounced in multigravidas

A

braxton hicks contractions

37
Q

A manoeuvre by which the fetal part is displaced by a light tap of the examining finger on the cervix, and then the part rebounds quickly. Uterine or cervical polyps may cause the sensation aswell

A

ballottement

38
Q

Use maternal urine or blood to determine the presence of hCG.

A

positive pregnancy test

39
Q

May be detected as early as 10 weeks of pregnancy by using a doppler device. When assessing, the pts pule rate must be assessed at the same time to be certain that the fetal heart is what is actually being heard. 110-160bpm

A

fetal heartbeat

40
Q

Can often be felt during the second trimester by an examiner and can also be seen with ultrasonography

A

fetal movements

41
Q

what are the endocrine system chages?

A

Increase in hormone production- essential to maintain pregnancy
Table 4.2, pg 72
Placenta is a temporary endocrine organ during pregnancy
Produces lrg amts of estrogen and progesterone to maintain pregnancy
Produces hCG and hPL

42
Q

what are the uterus changes?

A

Increases in size (60g to 1100g)
Capacity increases from 10mls to 5000mls

43
Q

what are the cervix changes?

A

Color, consistency, mucous plug

44
Q

what are the overies changes?

A

Production of eggs ceases

45
Q

what are the vagina changes?

A

Bluish color r/t inc blood supply (chadwicks sign)
Vaginal secretions increase, dec vaginal PH (more acidic) for protection, glycogen levels icrease which contribute to candida albicans growth

46
Q

what are the breast changes?

A

Increase levels of estrogen and progesterone to prepare for lactation
Colostrum “premilk” expressed = high protein, fat soluble vitamins and minerals

47
Q

what are the respiratory system changes?

A

Oxygen consumption increases by 20-40%
Diaphragm rises
Ribs flare
Possible dyspnea
Congestion and swelling of nose, pharynx, mouth, trachea r/t inc in estrogen
Mom may complain of nasal stuffiness, epistaxis and voice changes

48
Q

what are the cardiovascular system changes?

A

Blood volume increases by 40-50%
Heart rate increased by 10-15bpm
Hypercoagulability
Supine hypotension syndrome
Orthostatic hypotension

49
Q

what are the GI system changes?

A

Displacement of stomach and intestines
Ptyalism (inc salivary secretions)
Tender oral mucosa, easy to bleed
Increase thirst and appetite
Decreased gastric emptying and delayed intestinal movement
Constipation
Pyrosis (heartburn)
Nausea & vomiting
Gallbladder problems

50
Q

what are the urinary system changes?

A

Glomerular filtration rate increases
Glucose and protein in urine
Fluid retention
UTI’s

51
Q

what are the integumentary chages?

A

Striae (stretch marks)
Spider Nevi
Sweat and sebaceous glands become more active
Pruritus
Pigmentation changes

52
Q

what are the musculoskeletal system changes?

A

Low back aches
Relaxation of the pelvic joints
Waddling gait
Change in the center of gravity

53
Q

Uses high-frequency sound waves to visualize structures within the body
Can do either on the stomach (more full bladder), or transvaginal (empty bladder)

A

ultrasound

54
Q

what are the uses of ultrasound during pregnancy?

A

Visualize gestational sac
Identify site of implantation
Verify fetal viability or death
Identify a multifetal pregnancy
Diagnose fetal physical abnormalities
Determine gestational age
Locate placenta
Determine amount of amniotic fluid
Observe fetal movements

55
Q

Uses ultrasound to measure the amniotic fluid pockets in all four quadrants
<5cm oligohydramnios insufficient amniotic fluid
5-19cm normal levels
>25cm polyhydramnios excess amniotic fluid

A

amniotic fluid volume

56
Q

Should feel movements within 16-20 weeks
Mother records fetal kicks every day
Minimum of 6 kicks in 2 hours

A

kick count

57
Q

A procedure in which a thin needle is inserted through the abdominal and uterine walls to collect a sample of amniotic fluid
Done between 15-17 weeks
The primary risk of having a spontaneous abortion
Early pregnancy:
Identifies chromosomal abnormalities and disorders
Late pregnancy:
Identifies severity of maternal-fetal blood incompatibility, and assesses fetal lung maturity

A

amniocentesis

58
Q

Evaluation with an electronic fetal monitor of the FHR
Two accelerations of at least 15bpm lasting 15 seconds in a 20 min period and usual fetal movement patterns are considered normal in fetus >32 weeks
Identities fetal compromise in conditions related to poor placental function

A

non-stress test (NST)

59
Q

Fetal HR and reactivity (NST)
110-160bpm
Should raise with movement
Fetal breathing movements
Episodes lasting greater than 60seconds with movement
Fetal body movements
Fetal tone (closure of hands)
Extension of limbs
Flexion
1 ep of extension
Volume of amniotic fluid in 4 quadrants (AFI)

A

biophysical profile (BPP)

60
Q

what are the warning/danger signs requiring immediate attention?

A

Sudden gush of fluids from vagina
Vaginal bleeding
Abdominal pain
Epigastric pain
Decreased or absent fetal movements after 26-28 weeks
Persistent vomiting- hyperemesis
Significant edma of faces and hands
Severe persistent headache
Blurred vision or dizziness
Chills with fever over 37.8c
Painful urination or reduced urine output
Feeling something is ‘just not right’

61
Q

Excessive naueas and vomiting that interferss with the nutritional status of mom and baby
Fetal growth may be restricted due to reduced delivery of blood, oxygen, and nutrients to the fetus

A

hyperemesis gradidarum

62
Q

Abnormal implantation of placenta in lower part of the uterus
Three degrees: low lying/marginal, partial, and total
Signs & symptoms:
Painles, bright red vaginal bleeding
Fetal presentation often abnormal
Postpartum complications:
Infection
Hemorrhage
Maternal shock/fetal compromise
Fetal anemia

A

placenta previa

63
Q

Premature separation of the normally implanted placenta
Partial (marginal or central) or total detachment
S&S:
Dark vaginal bleeding, or concealed
Abdominal pain or lower back pain uterus is firm; may be tender
Often accompanied by impaired blood clotting (DIC)
PP complications:
Infection
Hemorrhage
Maternal shock/fetal compromise
Fetal anemia

A

placenta abruption

64
Q

Unintentional termination of pregnancy before the age of viability (22 wks). Often referred to as a miscarriage

A

spontaneous abortion

65
Q

Intentional termation of a pregnancy before the age of viability

A

induced abortion

66
Q

Labor that occurs after 20 weeks gestation and before 37 weeks

A

preterm labor

67
Q

Fertilized ovum implanted outside uterine cavity
Signs & symptoms:
Possible sudden severe lower abdominal pain
Vaginal bleeding
Signs of hypovolemic shock
Shoulder pain may also be felt

A

ectopic pregnancy

68
Q

Hypertension that develops after 20 wks gestation in the normotensive women

A

gestational hypertension

69
Q

Increase in BP that occurs after 20 wks, with or without proteinuria, with end organ involvement
S&S:
With or without proteinuria
Presence of one or more of:
Headache, visual disturbances
Epigastric pain & nausea
Low platelets (thromboytopenia)
HELLP H hemolysis of RBC’s, EL- elevated liver enzymes, LP- low platelets
Elevated uric avid, creatinine & liver enzymes

A

preeclampsia

70
Q

Hypertension that involves one or more tonic-clonic seizures

A

eclampsia

71
Q

Autoimmune destruction of beta cells of the pancreas = insulin deficiency

A

type 1 DM

72
Q

Typically caused by insulin resistance; genetic predisposition

A

type 2 DM

73
Q

Diabetes that existed before pregnancy

A

pregestational DM

74
Q

Glucose intolerance with onset during pregnancy. In true GDM, glucose usually returns to normal by 6 weeks PP

A

gestational DM

75
Q

what are the predisposing factors of GDM

A

BMI greater than 30 KG
Hx macrocosmic infant; greater than 4000g
Member of high risk group
Greater than age 35
Unexplained stillbirth orcongenital abnormalities
Hx previous GDM
Family Hx DM
Using corticosteroids
Glucose challenge test results: 7.8-11 mmol/L

76
Q

Parasite acquired by contact with cat feces or raw meat. Transmitted through the placenta

A

toxoplasmosis

77
Q

The organism can be found in the womens rectum, vagina, cervix, throat or skin. A culture of the rectum & vagina is rountinely taken at 35-37 weeks gestation. All positive cultures required antibiotic treatment during labour

A

group b streptococcus infection

78
Q

The newborn acquires the disease by contact with untreated mother. If the mother has active pulmonary TB, the infact must be ketp in a separate area

A

tuberculosis (TB)

79
Q

Pregnancy alters self-cleaning actions due to pressure on urinary structures and prevents the bladder from emptying completely. The retained urine becomes more alkaline

A

urinary trac infections (UTI)

80
Q

Bordella pertussis is a respiratory pathogen that can cause critical issues with infants less than 6 months old. When pregnany, the mother will receive TDAP vaccine if required at the 26-32 week mark of pregnancy with the intention of increasing antibodies in prep for birth

A

pertussis

Mat-Child Nursing (21 decks)

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