Spec Maternity Flashcards
Hormone that induces amenorrhea
Progesterone. It also makes the temperature go UP
Signs and symptoms of pregnancy are classified to
Presumptive signs which could be something else and client will be the one to recognize
Probable signs which the HCP will recognize
Positive signs which is sure evidence
Presumptive signs
A BUN
Amenorrhea is the absence of menstruation
Breast tenderness can occur throughout the pregnancy due to excess hormones
Urinary frequency, wherein after implantation uterus starts to stretch and applies pressure on bladder
Nausea and vomiting
Probable signs
Positive PT
("HCG 242")
Hegar's sign
Chadwicks sign
Goodell's sign
Braxton-hicks
Uterine enlargment
Pigmentation changes
Pregnancy test is positive.it is based on hcg levels. Other conditions that increases hcg are hydatidiform pregnancy (molar pregnancy) which is benign neoplasm of grape like vesicles that can become malignant or some meds
Hegar’s is the softening of the lower uterine segment; 2nd or 3rd month
Chadwicks is the bluish color of the vagina and cervix due to vasocongestion on the 4th week.
Goodells is the softening of the cervix which is usually in second month
Uterine enlargement which is assessed by the HCP
Braxton-hicks is the contraction that occurs throughout pregnancy. False contractions that progresses in pregnancy
Pigmentation changes like:
Linea nigra, the dark line down the center of the abdomen
Facial chloasma mask of pregnancy
Stretch marks
Dsrkening of areola
Positive signs of pregnancy
Heartbeat
Movement
UTZ
Fetal heartbeat:
Doppler: 10 to 12 weeks
Fetoscope: 17 to 20 weeks
Fetal movement Which means you feeling the baby move.
Ultrasound
Gravidity is
Parity is
Viability is
TPAL
The number of times someone has been pregnant
The number of pregnancies that fetus reaching 20 weeks
The ability of infant to live outside uteruswhich is at 24 weeks
Term
Preterm
Abortion which include miscarriage and elective abortions
Living children
Spontaneous abortion
Think miscarriage if these s/s appear
Hcg
Occurs
Also called miscarriage
Bleeding,cramping,backache
Hcg will drop with an imminent miscarriage
Mostly occurs before 20 weeks
First trimester
Nutrition Weight gain Prenatal vitamins(i C FA) Exercise Temp Danger signs and potential complications PAIN BLEED
Week 1 through week 13
Have a well balanced diet
Increase protein to 60 grams/day. Also consider culture nutritional influences like kosher and fasting
Expect weight gain of 1 to 4 pounds. It will also be dependent on pts. BMI. Some lose weight because they are very sick
Iron that can cause constipation and GI upset. That is why always take iron with vit. C(which promotes absorption of iron). Folic acid which prevents neural tube defects with a daiky dose of 400 mcg/day
Walking and swimming are best exercises. NO heavy exercise program and DONT LET HR GO >140!!! this could lead to decreased CO and decreased uterine perfusion thus the baby will not have enough blood
Dont get overheated.No hot tubs or heating blankets because these will increase body temperature and can cause birth defects.
Persistent vomiting
Abdominal pain
Increased temperature
No fetal movement
Bleeding
vaginaL fluid(sudden)
sEvere headache
Edema
Common discomforts of pregnancy
CAN BUT F
HI NaVaL BaHe
Constipation
Ankle edema
Nausea and vomiting
Breast tenderness
Urinary frequency
Tender Gums
Fatigue
Heartburn
Increased vaginal secretions
Nasal congestion
Varicose veins
Leg cramps
Backache
Hemorrhoids
Medications during pregnancy?
Smoking in pregnancy?
How many visits in pregnancy?
Ultrasounds
Before
What about ultrasound before a procedure like an amniocentesis?
No medications without prescription
Stop smoking. It is associated with low birth weight babies, cleft lip or palate, and risk for abruptio placenta doubles
First 28 weeks: once a month
28 weeks to 36 weeks: 2/week or 2x per month
After 36 weeks: weekly until delivery
But high risk clients have to visit more
Before an ultrasound ask client to drink water to distend the bladder which pushes uterus up closer to abdominal surface. It is easier to get a good pictude
We want them to void to decrease puncture of bladder
Second Trimester
Calorie diet
Weight Gain
Should the client still be experiencing
Nausea and vomiting?
Breast tenderness?
Urinary frequency?
Week 14 through week 26
Increase intake of calorie to 300 per day. If they are an adolescent, they can increase their calories by 500 a day
Expected weight gain is 1lb per week. Depends also on the bmi of client
NO
Yes
NO
In the first trimester the uterus is a pelvic organ while in second trimester uterus rises and relieves pressure on the bladder.
Second trimester
Quickening is
FHR
Kegels
A fetal movement that occurs 16 to 20 weeks
110 to 160 is the normal range. But if less than 110, you should PANIC.
Kegels exercise must be done frequently to strengthen the pubococcygeal muscles. Because the pubococcugeal muscles help stop the urine flow, they keep the uterus from falling out
Third trimester
Assessment
Weight gain
Monitor BP
Pre-eclampsia
DOC
-vasodilates
What is the difference of pre-eclampsia and eclampsia?
Weeks 37 through 49. It is considered term if it advances to this stage.
No more than 1lb a week. If greater than 11 lbs then assume the worst. ☆WEIGHT GAIN of 2 or more lbs a week should be watched closely and worry about possible pre-eclampsia
Pre-eclampsia develops after 20 weeks gestation and the client will have, increased blood pressure, proteinuria and edema
Pre eclampsia is defined as BP of 160/110 or greater that is 6 hours apart. Pre-eclampsia clients can have seizure.
DOC is magnesium sulfate which is given IV and watched closely. Acts like a anticonvulsant and sedates. With vasodilation,this will decrease blood pressure and increase placental perfusion
SEIZURE. It is called eclampsia when they have a seizure.
Fetal position is determined by
What should the client do first?
If contractions is present?
Where to listen FHR?
Leopold’s Maneuver
Void first to relieve the pressure.
Do leopolds maneuver between contractions. Because during contractions, you cant feel the baby because the uterine is hard
Fetal back
Signs of Labor
Lightening -occurs -presenting part -breathe more -urinary frequency Engagement Fetal Stations
Usually occurs 2 weeks before term
Presenting part which is usually the head descends into the pelvis
The client will notice that she is able to breathe more easily because the pressure on diaphragm decreases
Urinary frequency is a problem again because of increased pressure on the bladder
The largest presenting part is in the pelvic inlet,hopefully fetal part is presenting first
Measured in cm, which neasures the relationship of presenting part of fetus to the ischial spines of mother
Other signs of labor Braxton Softening of cervix Bloody show Sudden Watery stool ROM
When should the client go to the hospital?
What are we worried about when membranes rupture?
Braxton hicks-contractions more frequent and stronger than before Not heavy bleeding Sudden burst of energy called NESTING Diarrhea Rupture of membranes
When the contractions are 5 mins apart and membranes rupture
Prolapsed Cord which is acute
