Pregnancy Care and Nutrition Flashcards
1
Q
how many weeks is considered full term for a pregnancy
A
40 weeks
2
Q
what does EDD stated for
A
estimated date of delivery
3
Q
how is the EDD calculated
A
it is calculated from the LMP by counting back 3 months and add 7 days
4
Q
what does gravida mean
A
number of pregnancies
5
Q
term for number of pregnancies
A
gravida
6
Q
term for no pregnancies
A
nulligravida
7
Q
what does nulligravida mean
A
no pregnancies
8
Q
term for 1 pregnancy
A
primigravida
9
Q
what does primigravida mean
A
1 pregnancy
10
Q
what does multigravida mean
A
two or more pregnancies
11
Q
term for two or more pregnancies
A
multigravida
12
Q
what is the term for number of pregnancies in which fetus has reached viability
A
parity
13
Q
what does parity mean
A
pregnancies that have reached viability (whether stillborn or alive or whether twins or not)
14
Q
what does nulliparous mean
A
no births
15
Q
what does viability mean
A
the capacity of fetus to live outside uterus
16
Q
at how many weeks is viability considered to be reached or at what weight
A
22 to 24 weeks or more than 500g
17
Q
how many weeks is considered preterm
A
20 - 36 and 6
18
Q
how many weeks is considered early term
A
37 - 38 and 6
19
Q
how many weeks is considered full term
A
39 - 40 and 6
20
Q
how many weeks is considered late term
A
41 - 41 and 6
21
Q
how many weeks is considered post term
A
42 and beyond
22
Q
T of TPAL refers to
A
term births
23
Q
P of TPAL refers to
A
preterm births
24
Q
A of TPAL refers to
A
abortions
25
L of TPAL refers to
living children
26
TPAL calculate:
1 delivery at 40 wks, living
1 delivery at 25 wks, living
currently pregnant
G3P1102
27
```
TPAL calculate
twins born at 28 wks, both living
1 miscarriage
1 abortion
1 delivery at 41 wks, living
currently pregnant
```
G5P1123
28
```
TPAL calculate
1 delivery 39 wks (yesterday), living
1 delivery 27 wks, living
1 first trimester elective abortions
1 spontaneous abortion (miscarriage) at 15 wks
```
G4P1122
29
changes that are subjective and felt by the woman are considered to be _____ indicators
presumptive
30
amenorrhea, nausea and vomiting, fatigue, breast tenderness are all considered _____ indicators
presumptive
31
if changes can be caused by something other than pregnancy they are considered to be _____ indicators
presumptive
32
changes that are physical and observed by the provider are considered to be ______ indicators of pregnancy
probable
33
positive pregnancy test, Braxton-hicks contractions, hegar sign, goddells sign are all examples of ______ indicators of pregnancy
probable
34
the softening of the lower uterine segment at 6 weeks is ____ sign?
hegar sign
35
the deep violet blue color of the cervix and vaginal mucosa at 6-8 weeks is _____ sign
chadwicks sign
36
the soften of the cervical tip at 6 weeks is ______ sign
goddells sign
37
changes that are directly attributed to the fetus are considered to be _______ indicators of pregnancy
positive indicators
38
fetal movement felt by examiner, fetal heartbeat distinct form mothers are examples of _____ indicators of pregnancy
positive
39
how reliable is an ultrasound at visualizing the fetus at 8-9 weeks
100%
40
at how many weeks can the fetus be visualized by ultrasound
8-9 weeks
41
at how many weeks can the fetus be detected by doppler
8-17 weeks
42
at how many weeks can the fetus be detected by fetal scope and stethoscope
16-20 weeks
43
sensation described by patients as fluttering is referred to as
quickening
44
what kind of indicator is quickening considered
presumptive unless it is felt by provider or verified by ultrasound
45
when are quickenings felt by a multiparous woman
16 weeks
46
when are quickenings felt by a nulliparous woman
20 weeks
47
what 4 factors determine quickening
location of placenta, the mothers BMI, fetal position, and parity
48
when the placenta is on the ____ side of the uterine wall she may not feel fetal movement or quickenings
anterior
49
what adaptations to pregnancy occur in the breasts
- fullness/heaviness
- heightened sensitivity (tingling or sharp pain)
- areolae pigmentation
- leaking colostrum
50
adaptations to pregnancy in the cardiovascular system
- increase blood volume
- increased cardiac output
- slight hypertrophy of heart (enlargement)
51
what shifts up and to the left due to the displacement of the diaphragm when a woman is pregnant
the point of maximal impulse (PMI)
52
after 20 weeks the pulse increases by ______bpm until term
10-15
53
what affect does pregnancy have a womans blood pressure throughout her pregnancy
it decreases by 5-10 both systolic and diastolic in 2nd trimester and then returns to normal after 20 weeks
54
what 2 c's of the CV system are also affected by a woman's pregnancy
circulation and coagulation times
55
WBC cell counts _____ during womans 2nd trimester until birth
increase
56
by how much does a womans blood volume increase by during pregnancy and why
by 40-50% in order to meet needs of hypertrophy of vascular system and fetal tissue
57
dependent edema, varicose veins, and hemorrhoids in pregnant woman are a result of
pressure put on the iliac veins and the inferior vena cava which reduce blood flow to the legs
58
why does a womans hematocrit and hemoglobin decrease during pregnancy
because they are more diluted due to the increased blood volume
59
physiologic anemia refers to what occurring in pregnant woman
decreased hct and hgb due to dilution of blood
60
when does physiologic anemia occur in pregnancy (what trimester(s))
2nd and 3rd trimester
61
why should a pregnant woman who is over 20 weeks be cautious to lie flat on their back
because it can cause supine hypotensive syndrome
62
what is supine hypotensive syndrome
- drop in BP as a result of compression of the vena cava
63
while palpating a pt abdomen they report they are feeling dizzy and faint, and their arms and legs are tingling, what would you expect to be occuring
supine hypotensive syndrome
64
does the height of the fundus equal the number of weeks gestation
yes
65
chloasma, linea nigra, and striae gravidarum are all examples of what
integumentary adaptations to pregnancy
66
general hyperpigmentation during pregnancy is referred to as
chloasma
67
pigmented line from pubic area to fundus is called
linea nigra
68
stretch marks are called
striae gravidarum
69
changes in posture, changes in center of gravity, relaxation and softening of pelvic joints are examples of what
musculoskeletal adaptations to pregnancy
70
what hormone causes the relaxation and softening of the pregnant woman's pelvic joints
relaxin
71
what causes the respiratory adaptations to pregnancy
the elevation of the diaphragm to make room for the growing fetus
72
a person who craves non food items is lacking what
iron
73
when you have non food cravings it is called
pica
74
decreased appetite in first trimester, nausea, vomiting, pica, spongy swollen gums, distended gall bladder and liver, constipation are all examples of
GI adaptations to pregnancy
75
excessive vomiting and dehydration in first trimester is referred to as
hyperemesis gravidarium
76
what can happen as a result of hyperemesis gravidarium
5% weight loss and electrolyte imbalance
77
what treatment options are available for hyperemesis gravidarium
NPO, phenergen, reglan, Zofran, IV fluids, doc I/O
78
what fetal structures can an ultrasound test
heart, kidneys, bladder, ventricles
79
what 5 main things does an ultrasound test
```
fetal structure
fetal size
placenta
quantity of amniotic fluid
maternal structures
```
80
what maternal structures are observed during ultrasound
uterus, cervix, adnexa, and pelvis
81
what does an ultrasound look at with regards to the placenta
its position, its density, an the presence of gestational trophoblastic disease
82
at how many weeks is an ultrasound usually done by
18 weeks
83
is a screening the same as a diagnostic test
no
84
what screening is know as the first trimester screen
fetal nuchal translucency (FNT)
85
what is involved in the fetal nuchal translucency screening
It is an intravaginal ultrasound that measures fluid in the babys subQ space on their neck
86
what measure of FNT is considered abnormal and combined with other factors can predict down syndrome
greater than 2.5 mm
87
at what point is the FNT screen performed
11 - 13.6 weeks
88
benefits of FNT screening
- essentially non-invasive
| - early diagnosis means less bonding, more privacy, termination easier and safer
89
disadvantages of FNT screening
- patient must present early
- not access neural tube defects
- not diagnostic
- difficult when more than one fetus
- can identify babies that would have been miscarriage
90
what does AFP stand for (fetal test)
alpha-fetoprotein test
91
what does the AFP test for
blood test that evaluates the plasma protein, alpha-fetoprotein, produced by the fetal liver
92
if there are increased levels of AFP what could it indicate
neural tube defects, multiple gestation
93
decreased levels of AFP could indicate
down syndrome
94
is AFP testing recommended for all pregnant woman and at what weeks is it done
yes all pregnancies at 15-18 weeks
95
advantages of AFP testing
- noninvasive as blood is taken form mother
| - relatively inexpensive
96
disadvantages of AFP testing
- late diagnoses
- no diagnostic or 100% accurate
- unnecessary amniocentesis
97
chorionic villus sampling is performed at what point
10-12 weeks
98
what does chorionic villus sampling detect
fetal karyotype, sickle-cell anemia, phenylketonuria, down syndrome, Duchenne muscular dystrophy, other genetic disorders
99
fetal test that can detect sickle cell-anemia, phenylketonuria, down syndrome, muscular dystrophy and others
chorionic villus sampling
100
advantages to chorionic villus sampling
early diagnosis and rapid results
101
disadvantages to chorionic villus sampling
- maternal hemorrhage or infection
| - fetal limb defects, pregnancy loss, leak of amniotic fluid, injury from needle
102
when is amniocentesis performed
15-20 weeks
103
which fetal test is done with full bladder
chorionic villus sampling
104
which fetal test is done with an empty bladder
amniocentesis
105
for which test would RhoGAM be admin if the mother were Rh-
chorionic villus sampling, amniocentesis
106
test that checks for genetic disorders, fetal lung maturity, fetal hemolytic disease, meconium, gender determination
amniocentesis
107
test with maternal complications such as hemorrhage, infection, labor, abruption placentae, intestinal or bladder damage, or amniotic fluid embolism
amniocentesis
108
test with fetal complications that include hemorrhage, infection, injury from needle, miscarriage or preterm labor, leakage of amniotic fluid
amniocentesis
109
difference between amniocentesis and chorionic villus sampling
amniocentesis needle inserted through abs and draws amniotic fluid
chorionic villus sampling is inserted through vagina and samples the chorionic villus surrounding the fetus
110
what does PUBS stand for
percutaneous umbilical blood sampling
111
what does PUBS test involve
inserting needle directly into fetal umbilical vessel and drawing blood
112
what is the PUBS test primarily used for
to detect inherited blood disorders such as hemophilia
113
hemophilia is associated with which fetal test
PUBS
114
main complications of PUBS test
fetal hemorrhage and infection
115
advantage to PUBS test
fetus can be treated before birth
116
disadvantages of PUBS
miscarriage rate after PUBS is 2%, risk infection, bleeding, ruptured membranes, late diagnosis
117
folic acid is also called
folate
118
what is the importance of folic acid during pregnancy
daily dose of 0.4 mg of folic acid can prevent neural tube defects
119
when does the neural tube develop
17-30 days of gestation
120
what can result if there is abnormal neural tube development
spina bifida
121
what is the ideal weight gain in the first trimester
3-4 lbs
122
obese women should gain how much weight over course of pregnancy
15 lbs
123
normal weight women should gain
25-35 lbs
124
low weight women should gain
28-40 lbs
125
underweight BMI
below 18.5
126
normal BMI
18.5 - 25
127
overweight BMI
25-30
128
obese BMI
over 30
129
how many extra calories is a woman to eat a day in order to gain the proper weight
300kcals/day
130
what is the minimum daily calorie intake in order to avoid negative nitrogen balance
1800kcals/day
131
folate recommendations
400 IU/day or 0.4 mg
132
what must be taken with iron supplement
something acidic or with orange juice, vitamin C is needed
133
what increases the absorption of iron
calcium
134
how long does first stage of labor last
6-20 hours
135
second stage of labor can last how long
5 min to 2 hours
136
third stage of labor last
5-30 minutes
137
fourth state of labor last how long
1-4 hours
138
what does the first stage of labor involve
transition from 1cm to fully dilated
139
what does the second stage of labor involve
pushing from fully dilated until delivery
140
what does the third stage of labor involve
baby's delivery until placenta delivery
141
what does the fourth stage of labor involve
period of maternal adjustment
142
what phases make up the 1st stage of labor
latent phase
active phase
transition phase
143
which phase of labor is encouraged to be done at home
latent phase
144
0-3 cm dilated is what phase
latent phase
145
latent phase characterized by
10-30 second contractions
5 minutes apart
0-3 cm dilated
146
active phase characterized by
40-50 second contractions
2-4 min apart
4-7 cm dilated
147
transition phase characterized by
90 second strong contraction
1-2 min apart
8-10 cm dilated
148
when is episiotomy performed
during crowning when the perineal musculature is distended
149
what is an episiotomy
incision into perineum to enlarge vaginal outlet
150
what may be attempted before an episiotomy
warm compresses or stretching with oil
151
what is the most common degree of an episiotomy
2nd degree
152
the risk of what increases as the length of the third stage of labor increases
hemorrhaging
153
when does third stage of labor end
when placenta is delivered
154
during third stage of labor how often are vitals taken
q 15 minutes
155
vitals done how often in fourth stage of labor
first hour: q 15 min x 4
second hour: q 30 min x 2
third to sixth: every hour
156
what assessments are necessary during 4th stage of labor
fundal firmness, fundal location, bladder fullness, lochia
157
what would you do if the fundus is boggy
first check to see if bladder is full, if not then massage until it is firm
158
nursing care during active phase
change of positions, pain meds, epidural, breathing technique, ice birthing ball, effleurage
159
96% of birth presentations are
cephalic - head first
160
cephalic presentation is what
head first
161
3% of birth presentations are
breech - buttocks first
162
what is breech presentation
butt or feet first
163
what does fetal lie tell you
the relation of the baby's spine to the spine of mom
164
longitudinal lies are what
vertical
165
longitudinal lies can be either
breech or cephalic
166
what is a transverse lie
baby is sideways
167
can mother have baby vaginally if the lie is transverse
no, vaginal birth cannot occur
168
station refers to
relation of babys largest presenting part to the ischial spines either above below or in line with
169
what are primary powers
involuntary contractions
170
what are secondary powers
bearing down efforts once cervix is dilated
171
what is effacement
measured from 0-100% and is thinning of cervix
172
what usually occurs first dilation or effacement
effacement
173
hat is dilation
widening of cervix
174
another term for effacement is
cervical ripening
175
oxytocin is always administered via
IV infusion pump
176
is informed consent necessary for oxytocin
yes
177
side effect of epidural
hypotension
