Part 2 OB Flashcards
Reproductive Organs
Uterus most dramatic change. Goes from 2 oz to 2.2 lbs due to hypertrophy.
Endometrium
The lining of the uterus.
Ovulations ceases when
High estrogen and progesterone levels.
Hyperplasia
as a result of estrogen
Goodells sign
Cervix softens
Chadwick sign
Estrogen stimulates glandular tissue, causing it to congest it with blood. Pink to Blue.
Mucuous Plug
Cervical canal to block bacteria.
Vaginal cells contain more glycogen causing rapid trunover and increased vaginal discharge.
Acidic and decrease bacteria but favors growth of yeast.
Milky discharge
Normal during pregnancy.
Mcdonalds method
Accurate between 22-34 weeks but it can be detected from 16-38 weeks.
McDonald Method
Measure fundal height from uterus and see where it folds.
If a women is 20 weeks pregnant
It is going to be underumblicas.
At 36 weeks it will be
some where at xyfoid process.
Breast - Colostrum develops at
12-16 weeks of pregnancy.
Breast
Women develop darken areola and veins become prominent.
Striae
Stretch mark of the breast
Majority of breast cancer
Develops in the upper right quadrant. -Should recommend the patient check for breast examination.
Heart sounds
Splitting of the first heart sound and a murmur common in 90%.
Normal blood loss
500 vaginal and 1000 c section
How do we take IRON?
Can cause constipation so you will need to drink a lot of fluids and need stool softners.
What helps with absorbtion of IRON
Vitamin C
Juice - Orange juice or tomato
Hgb<11
May need Iron therapy..
Vena Caval Sydrome
When women lays on her back Supine she may experience do to uterus compression . This reduces blood flow terturning to the heart and may cause materanl hypotension. -BABIES CONDITION WILL BE COMPROMISED AS WELL.
Pregnat resperiration
It is increased 15-20%
Progesterone
Causes relaxation of smooth muscle, whci can result in dyspnea and fainting.
Do to vascular congrestion -ESTROGEN
ESTROGEN-It is normal to have nasal stuffiness and occasional nosebleeds. (NORMAL)
GI SYSTEM
Estrogen causes gums to bleed and excessive salivation (Ptyalism)
Progesterone cause realxation of ..?
Esphagean sphinter, leading to Heartburn. Stomach takes longer to empty. So patient needs to be told not to eat too much during meals.
Constipation
More common and hemmorrhoids- because of increase in progesterone levels.
Nasia and vomiting common in early pregnacy
but Hyperemisis is not normal
Need to know how to educate women with hemororiods and what helps with it.
If they need help they should see a doctor.
PICA
Craving dirt, startch other strange items.
Urinary tract.
Bladder
doubles in size do to relaxed muscles, and it icrease risk for UTI and Pyelonephritis.
Bladder
Pressure on bladder causes stress, urge incontinence and nocturia.
Nocturia is common
In pregnancy…
During giving birth why would we pay attention to bladder if it is full or not?
Because it could displace the baby not the uterus.
If at any time a women needs surgerical intervention while pregnant what semester would they perform it in.
2ND
Integumentary System
Hyperpignmentation (Melonocyte stimulating hormone stimulated by increased Estrogen)
Chloasma
Hyper pigmentation of face- mask of pregnancy, patches darker than own skin town. - USE SUNBLOCK PROTECTION
Linea Nigra
Line on stomach.
Stretch Marks
Striae Gravidarum- DOES NOT GO AWAY…..but it can get lighter and fade after giving birth…
Decreased hair growth
FALL OUT after birth and during birth.
Hyperactive sweat and sebaceaus glands
Pregnancy.
Musculoskeletal System
Relaxin hormone causes relaxation of pelvic joints, leads to waddling gait, and change of center of gravity.
Lordosis
Curvature of lower spine occurs in later stages of pregnancy.
Calcium and phosphorus
Needs are increased
Seperation of Recus abdominis
Occurs
Attention span and memory and memory
decreases
Sleep problems are common
In pregancy.
Edocrine
Estrogen
Produced by the placenta, stiumulates uterin growth, stiumlates grwoth of breast ductal system, cause hyperpigmentation and vascular changes.
Progesterone
Most imporatnt hormone of pregnancy, prduced by the C.I. then the palcenta, maintaines endometrial layer of uterus, prevents miscarriage by relaxing smooth muscle throut the body, stimulates breast lobes and lobules, facilitates fate stores for energy.
Human Placental Lactogen
Promotes fetgal growth by increasing the avaialbity of gluclose use, therby increasing maternal blood sugar. Promotes breast development for lactation.
Ethics in pregnacy
The best course of action in certain situations.
Bioethics
The application of ethics to healthcare, utilizing four ethical principles.
Beneficiece
One is required to do or promote good for others
Nonmaleficence.
One must avoid risking or causing harm to others.
Autonmy
People have the right to self-determination. This includes the right to respect, privacy, and the information necessary to make decisions.
Justice
All people should be treated equally and fairly regardless of disease or social or economic staus. Rendering to others what is due to them.
Cultural Factors
-Cerenibuak rituals, rites around life events
California Nursing Practice Act
BRN website: Tells you about the scope of practice.
Generalization is difficult
-Cultural assessment important aspect of prenatal care
-Identify main believes
_understand different cultures.
Prenatal Care
Early 1st Trimester for health promotion and care.
-Psychosocial assessment and intervention High Risk Screening.
Signs of Pregnacy-SUBJECTIVE
Presumptive and subjective
absense of menstruation -Nausea and vomiting. Fatique Unrinary Frequency Breast changes Amenorrhea
Fetal movement
Quickening
Signs of Pregnancy-Objective
-Abdominal Enlargement
-Changes in cervix
-Chadwick sign
Goodells signs
Changes in Uterus
-Ballottement
Rebouns -24week
Hegar’s sign- softening of uteros
-Braxton Hicks-6 weeks of pregnacy
Contractions
-Unterine hear over contactionss
Funic Sourffle hear from ambilical cord.
Leopolds Manuever
Used to find the position of the baby.
Fetal heart
Can be heard as early as 10 to 12 weeks by dopler
Fetal movements
after 20 weeks
Visualization of fetus by x ray ultersournd
gestational sac 4-5 weeks.
Antepartum Care
Info. on previous pregnacies. -Ob History info about Pregnancies Menstrual History Family history domestic violence alcohal
Leopld Maneuvers
provide a systematic ethod for plapating the fetus through the abdominal wall during the later part of pregnancy. The maneuvers provide valuable information about the location and presentation of the fetus.
Nesting
behaviors include obtaining clothing and arranging a place for the infant to sleep.
Couvade
pregnancy rleated symptons and behavior in the expectant father. “ mock labor”