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NURS 2725 Clinical > Prenatal Labour And Delivery > Flashcards

Prenatal Labour And Delivery Flashcards

1
Q

presumptive signs

A
  • subjective changes reported by the patient
  • potential to be caused by other conditions

ex. amenorrhea, fatigue, breast changes

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2
Q

probable signs

A
  • objective changes assessed by examiner
  • strong indicator of pregnancy when combined with presumptive signs of pregnancy

ex. ballottement, pregnancy tests

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3
Q

positive signs

A
  • objective signs assessed by an examiner that can be attributed only to the presence of the fetus
  • definitive confirmation of pregnancy

ex. ultrasound of fetus

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4
Q

what adaptations to preg occur in the reproductive system and breasts

A

changes in size, shape, postition, contractility
uteral placental blood flow changes
cervical changes
changes related to fetal prescence

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5
Q

what does the height of the fundus measure

A

growth of fetus in uterus

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6
Q

why does the fundal height drop slightly at 40wks

A

baby drops into pelvic cavity

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7
Q

what adaptations during preg occur in the breasts

A

increase in size (fullness, heaviness)
heightened sensitivity from tingling or sharp pain
areolae become more pigmented
Montgomery’s tubercles more pronounced
colostrum

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8
Q

montgomerys tubercles

A

promote fluid for lubrication when feeding
protects skin from breakdwon

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9
Q

colostrum

A
  • first milk produced
  • contains nutrients and antibodies
  • won’t lactate until after delivery
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10
Q

what adaptations occur in preg with CVS

A

blood pressure decreases
increased cardiac output
increased circulation and coagulation time
increased blood volume,
changes in blood composition

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11
Q

why does bp decrease in preg

A

fetal pressure on IVC and veins

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12
Q

what is a hyperdynamic circulation

A

increased cardiac output
heart rate
and blood volume

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13
Q

how does blood composition change in pregnancy

A

increased plasma and RBC
decreased hemoglobin and hematocrit

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14
Q

hemodilution physiological anemia

A

Decreased hemoglobin and hematocrit

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15
Q

gestational thrombocytopenia

A
  • mild and asymptomatic
  • platelet > 70 000
  • resolves in 2-12 weeks post-partum
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16
Q

hypercoaguable state

A

causes increase risk of PE, DVT and decreased bleeding at deliv

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17
Q

what respiratory adaptations occur during pregnancy

A

increased nasal congestion
increased need for O2
changes in ventilation
alkalosis

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18
Q

why does respiratory alkalosis occur in pregnancy

A

helps co2 cross the placenta

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19
Q

what GI adaptations occur in pregnancy

A

decreased motility (constipation)
suppressed/increased appetite
bleeding in oral mucosa
gastroesophageal reflux
increased gallstones

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20
Q

what renal system adaptations occur in pregnancy

A

increased renal tubule reabsorption (swelling)
increased excretion of proteins/albumin
decreased bladder capacity
increased urinary frequency
increased kidney stones, UTI

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21
Q

what integumentary adaptations occur in pregnancy

A

chloasma
linea nigra
striae gravidarum
angiomas
palmar erythema
polymorphic eruption of pregnancy (PEP)

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22
Q

what Musculoskeletal adaptations occur in preg

A

increase in relaxin causes relaxation of pelvic ligaments and joints
growing uterus stretches abdominal muscles (diastasis recti abdominis)

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23
Q

what are the functions of the placenta

A

(endocrine gland) produces hormone necessary to maintain pregnancy and support embryo/fetus

metabolic function (respiration, nutrition, excretion, and storage)

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24
Q

hCG human chorionic gonadotropin

A

excreted by: fertilized ovum and chorionic villi

effects: maintains corpus luteum and prod. of est. and prog. until placenta takes over

levels: highest at 60-90 days –> progressive fall during pregnancy

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25
Progesterone
excreted by: placenta (corpus luteum until wk. 14) effects: - suppresses secretion of FSH and LH - relaxes smooth muscle - decreases uterine contractility - decreases maternal ability to utilize insulin - causes fat deposition in SC tissue levels: - decreased with expulsion of placenta
26
Estrogen
excreted by: placenta (corpus luteum until wk. 14) effects: - suppresses secretion of FSH and LH - decreases maternal ability to absorb insulin - promotes Na and H2O retention - increased vascularity levels: - decreased with expulsion of placenta
27
hCS human chorionic somatomammotropin
excreted by: placenta effects: - acts as growth hormone --> contributes to breast development - increases fatty acids for metabolic needs - decreases maternal metabolism of glucose levels: - decreased with expulsion of placenta
28
serum prolactin
excreted by: anterior pituitary gland effects: prepares breasts for lactation levels: decreases with placenta, increases with breastfeeding
29
Oxytocin
excreted by: posterior pituitary gland effects: stimulates uterine contraction and breastmilk ejection
30
first trimester
weeks 1-13
31
2nd trimester
wks 14-26
32
3rd trimester
wks 27-term
33
whats the earliest biochemical marker of pregn
hCG (beta subunit)
34
whas the most accurate method to determine EDB
first trimester ultrasound
35
Nageles rule
determine first day of last missed period (LMP) subtract 3 months add 7 days plus a year
36
what is GTPAL
5 digit system Gravidity- total number of preg at any gestation T- # term infants delivered (more than 37wks gestation) P- number of preterm infants (delivered at 20-37wks) A- number of abortions or losses (intrauterine with fetus less than 20 wks or 500g of weight induced or spontaneous) L- number of living children
37
what is gravidity/parity
2 digit system less accurate G- number of preg P- number of preg reaching 20+ wks gestation
38
heartburn
- relaxation of lower esophageal sphincter increases risk of reflux from stomach - trimester 1,2,3
39
constipation
decreased peristalsis trimester 1,2,3
40
round ligament pain
- pain in right/left lower quadrant that's worse with walking and improves with rest - caused by increased stress on round ligament - trimester 2
41
urinary freq
- decreased plasma osmolarity, -increased vascularity -pressure of enlarged uterus -pressure of fetal head on bladder - trimester 1,2,3
42
leukorrhea
- hormonal effects of pregnancy lead to increased blood flow to vagina resulting in increased white/yellow mucous discharge from the vagina - trimester 1,2,3
43
what are key nutritional recommendations in preg
Fish (not too much bcz of mercury) omega 3 fatty acids folate iron
44
what increases as obesity increases in relation to preg
gestational diabetes issues maintaining baby's blood sugar increased risk for c-section
45
what are excercise recommendations in preg
at least 150 min of moderate intensity physical activity per week, over minimum 3 days a week aerobic and resistance training, pelvic floor muscle training
46
whats the main goal of nursing in prenatal care
promote health and well being of the pregnant patient, fetus, newborn and family
47
whats a main emphasis during a nursing and prenatal care
preventative care and optimal self care
48
whats the main goal of perinatal and childbirth education
assist women and family to make informed safe decisions about - pregnancy -birth -early parenthood
49
what occurs during the initial nursing management
interview physical exam lab tests
50
what nursing management occurs during subsequent visits?
fetal assessment (gestational age) health status laboratory tests collaborative care
51
the frequency of visits is based on gestational age
up to 32 weeks: every 4 weeks 32-36 weeks: every 2 weeks 36 week to delivery: every week
52
topics of childbirth education programs
- physical and emotional changes - chest feeding - nutrition - working - labour and birth pain management - becoming a parent; transition - newborn care
53
components of education program
- births - pain management - relaxation, imagery and visualization, conscious breathing, biofeedback, and massage
54
how to assess and identify part of the fetus in the upper uterus
use hands to feel top of the fundus
55
how to assess location of the fetal back
use hands to palpate sides of the fundus (vertical)
56
how to asess for presenting part of the fetus
one hand at the bottom of the baby bump to papate for the head
57
how to determine the descent of the presenting part
palpate with both hands to determine which is the back and where the arms are (vertical) look for either side of the babys spine
58
whats the rule for fundal height measurements
matches number of weeks of pregnancy +/- two cm
59
steps to measuring the fundal height
- mother semi recumbent with bladder empty - palpate to determine fundus with two hands - secure tape with hand at top of fundus - measure to top of symphysis pubis - measure along longitudinal axis of uterus, note metric measurement
60
whats the benefit of focused breathing in labour
interrups the pain signals to the brain and stimulates endorphines reframes thoughts about labour too
61
how to perform abdominal belly diaphragmatic breathing
- breath in, abdomen moves out - breath out, abdomen moves in
62
support with breathing
- support person breathes in sync with birth partner - eye contact, hands on shoulder, leaning on them
63
pant blow breathing
- encourage change of position - 4 pants, blow, 4 pant, blow, and so on - encourages breathing between contractions
64
breathing when pushing
encourage pushing as many times per contraction as they feel the urge
65
cervical cap
fits snugly over the cervix, preventing sperm from entering the uterus *barrier method*

NURS 2725 Clinical (4 decks)

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