Obstetrical Assessment Flashcards
Define gestation/how many days and Nagele’s rule
Time of fertilization of ovum - estimated date of delivery
~ 280days
Nagele’s Rule = women required to have regular 28 day cycle
Take first day of last period (day, month, year)
Subtract 3 months
Add 7 days
Add 1 year
Define G.T.P.A.L
G = Gravidity = # of pregnancy including present one
T = Term Births = # born at term (>37 wks gestation)
P = Preterm Births = # born before 37 wks gestation
A = Abortions/Miscarriage = # of abortions/miscarriages (including in gravida (pregnancies) before 20 wks gestation/ in parity (births) past 20 wks gestation.
L = # of living children
Identify the Presumptive Signs of pregnancy
1) Amenorrhea
2) Nausea/Vomitting
3) Increased size/feeling of fullness in breasts
4) Pronounced Nipples
5) Urinary Frequency
6) Quickening = first perception of fetal movement by mum can happen btwn 16-20 wk gestation
7) Fatigue
8) Discolouration of vaginal mucosa
Identify probable signs of pregnancy
1) Uterine Enlargement
2) Hegar’s sign = compressibility/softening of lower uterine segment/ occurs ~ 6wks
3) Goodell’s sign = softening of cervix/ beginning of second month
4) Chadwick’s sign = violet coloration of mucous membranes of cervix, vagina and vulva/ occurs ~ week 4
5) Ballottement = rebounding of fetus against examiners fingers on palpation
6) Braxton Hicks Contractions = irregular painless contractions/ occur intermittently throughout pregnancy
7) Positive pregnancy tests = Human Chorionic gonadotropin (HCG)
Describe the positive signs of pregnancy
Think diagnostic
1) Detection of fetal heart rate via (Doppler transducer) 10-12 wks / (fetoscope) at 20 wks gestation
2) Fetal movement palpable
3) Outline of fetus vid radiography or ultrasonography
1) Why is the fundal height measured?
2) At 16 wks were would the nurse expect to the fundus to be located?
3) At 20-22 wks were would the nurse expect the fundus to be located?
4) At 36 wks were would the nurse expect the fundus to be located?
5) What should the nurse know about the 2 and 3 trimester of pregnancy in relation to fundal height and the fetus?
1) to evaluate gestational age of fetus
2) ~ halfway between the symphysis pubis and umbilicus
3) ~ at the umbilicus
4) At the xiphoid process
5) 2 and 3 trimesters are from 18-30 weeks gestation and the fundal height in CM approximately = fetal age in weeks -/+ 2 cm
1) What are some factors that result in adolescent pregnancy?
2) What are some major concerns related to adolescent pregnancy?
3) What are some of the nurses role in reducing risks and complications of adolescent pregnancy?
1) early onset of menstruation (menarche)/ changing sexual behaviours/ problems with family relationships/ poverty/ lack of knowledge of reproduction and birth control
2) Poor nutrition status/ emotional-behavioural difficulties/ lack of support systems/ increased risk of still birth/ low birth weight for baby/ fetal mortality/ cephalopevic disproportion/ increased risk of maternal complications (eg. Hypertension, anemia, prolonged labor, infections)
3) Encourage early/ continued prenatal care, referral if necessary (can help counter effects of SES environment
1) why is it important to assess a pregnant women for German Measles (rubella)?
Maternal infection during the first 8wks of gestation carries higher rate of fetal infection
Baby is at risk for infection
1) What are some ways HIV can be transmitted and what is important to teach mom about breast feeding who is positive for HIV?
2) As the nurse caring for a pregnant women about to go into labor what drug would you anticipate to administer perinatally and why?
1) Blood, blood products, bodily fluids eg. Urine, semen, vaginal secretions
Can be transmitted through vaginal birth and Breast milk
2) Zidovudine, decrease risk of HIV transmission from mum to fetus
