Terminology Flashcards
ECD
Endocardial cushion defect
Fails to form properly
Holes in atrial and ventricular wall and tricuspid and mitral valves form together as a large valve
Often seen in Down’s syndrome
Repaired surgically
ECD s/s
Shortness of breath Respiratory distress Periorbital edema Failure to thrive Resp infections Distended liver
ECD diagnosis
Heart murmur
Chest X-ray
ECG
Confirmation:
Echocardiogram
Cardiac catheterization
MRI
Gravid
Pregnant
Gravida
Pregnant woman
Gravidity
Number of times woman has been pregnant
Parity
Number of pregnancies carried to 24 weeks
Ex para 1
Striae
Stretch marks
Braxton Hicks
Contractions are irregular and painless
16th week gestation
Chadwick’s sign
Bluish discoloration of cervix, vagina, labia
Increased blood flow
Present as early sign of pregnancy
Amenorrhea
Abnormal absence of period
Hyperemesis gravidarum
Severe nausea and vomiting
Leopolds maneuver
Determine position of fetus inside women’s uterus
Estimate term fetal weight
Colostrum
Breast fluid that precedes breast milk
Quickening
Fetal movement
2nd trimester
Lightening
38 weeks
Fetal head settles into pelvic cavity moving uterus downward
Beginning of engagement
Doppler
Ultrasounds stethoscope
Locate fetal heart sounds
Fetoscope
Usually used if avoiding Doppler
Still need to palpate women abdomen accurately to determine fetal position and locate fetal shoulder
Amniocentesis
Invasive procedure
Removal of amniotic fluid
Needle inserted into maternal abdomen and into amniotic sac
Maternal Serum Alpha Fetal Protein (MSFAP)
Plasma protein produced by fetus in mothers blood
Human chorionic Gonadotropin (hCG)
Diagnose pregnancy
Produced by trophoblast (outer layer of blastocyst)
Maintains corpus luteum (ovarian follicular left after ovulation)
Keep levels of estrogen and progesterone until placenta has developed
Van limit maternal immune response
LMP
Last normal menstrual period
Menarche
First period
12.5 average age
Nagle’s rule
Calculating due date of pregnancy when assuming 280 days gestational
Expected date of delivery (EDD)
Add a year, subtract 3 mo, add 7 days to gestational age
Fundal height
Uterine size
Correlates with fetal growth
22-34 weeks gestation
Tape measure and finger breadths above umbilicus (only works with same examiner)
Bishops score
Cervix score
Pre labor scoring system
Prediction if induction is needed
Also assessed likelihood of preterm delivery
Friedman’s curve
Average time it takes to dilate each centimeter
Cervical dilation
Opening of cervix
Entrance of uterus
Natural or induced
Occurs during childbirth, miscarriage, abortion, gynecological surgery
Effacement
Cervical ripening
Thinning of cervix
Component of Bishop score
Percentage
*thick of elastic stretching and thinning out
Station
Extent of fetal descent through maternal pelvis
Pap smear
Cervical cancer
Collection of cells
Progesterone
Produced by corpus luteum
Supply oxygen and nutritents to endometrium
Amniotic fluid use
Inside the amnion
Barrier from infection
Growth and development, protection from mechanical injury, body temp regulation, symmetrical fetal growth, prevent adherence of amnion to fetus, musculoskeletal development
Amniotic fluid appearance
3 weeks
30 mL- 10 weeks
800 mL- 24 weeks
700-800 mL- full term
Amniotic fluid clearance
Fetal swallowing
Absorption through placenta
Amniotic fluid components
Slightly alkaline
Antibacterial and protective substances found in breast milk
Albumin, uric acid, creatinine, lecithin, sphingomyelin, bilirubin, vernix, leukocytes, epithelial cells, lanugo
Leukorrhea
Increase white vag discharge
Hyperplasia of vaginal mucosa and increased mucus production from endocervical glands
Leukorrhea teaching
Call provider if discharge is yellow/green, thicker, bloody, foul odor
Itching, irritation, pain
Embryo
Flattened sick between amnion and yolk sac
Embryo connected to yolk sac by body stalk
Embryo until 8 weeks
Abortion
Loss of fetus 20-22 weeks gestation
Less than 500 grams
Too immature to survive outside the uterus (extrauterine)
Preterm or premature
Fetus born before 37 weeks
Non stress test (NST)
Antenatal screening
Electronic fetal monitoring (EFM) 20 minutes
Moves at intervals so CNS and myocardium respond to movement
Response by acceleration of FHR
Contraction stress test
FHR response to uterine contraction
Fetal oxygenation
EFM obtains FHR 20 min
Biophysical profile
Noninvasive
Fetal physical examination
FHR combined with ultrasonography
Fetus responds to central hypoxia by movement, muscle tone, breathing, HR patterns
5 components of byophysical profile (BPP)
Non stress test (NST) Fetal breathing (30 sec) Fetal movement (3+ body/limb mvmt) Fetal tone (flexion/extension) Determination of amniotic fluid volume
Amniotic fluid index
Long term placenta function
Greater than 5 cm is adequate
Vertex
Area between anterior and posterior fontanelles
Breech
Fetal buttox enter maternal pelvis first
Occur in 3%. Births
Attitude of fetal hips and knees
Preterm births or hydrocephaly (large head)
Breach disadvantages
Umbilical cord prolapse
Fetal buttocks or feet not as smooth and hard as fetal head (less effective to dilate cervix)
Umbilical cord compression
Corpus luteum
Second half, literal phase of ovarian cycle
14 day lifespan
Secretes estrogen and progesterone to produce negative feedback signals to anterior pituitary gland to decrease production of FSH and LH
Ptyalism
Excessive salivation
Increased hormone levels
Can be symptom of hyperemesis gravidarum, extreme: dehydration
Pytalism teaching
Small frequent meals
Avoid starchy foods
Drink plenty of water in small sips
Suck on hard candies
Brush teeth frequently
Pica
Consumption of nonnutritive substances
Ex. Eating clay, dirt, cornstarch, Ice
Disabled, African Americans, middle eastern
Fetal fibronectin
Cervicovaginal fluid 16-20 weeks gestation
“Glue” attaches to fetal membranes and uterine decidua
Released when contractions occur
Amnisure test
Detects (PAMG-1) amniotic protein in vaginal discharge following rupture of membrane
Amniotic fluid test
Apgar
1 minute after birth and 5 min after birth
5 signs evaluated
Heart rate Respiratory effort Muscle tone Reflex irritability Color
Moro reflex
Infants head lift
Extension of both arms and flexion of both legs
Ballard scale
Neuromuscular maturity and physical maturity
Identify decreased level of muscle and joint flexibility and ability to return to original position after movement
Within first 12 hours life
10-36 hours best
Caput
Vacuum extractor marking on infant head
Disappear after hours or up to 7 days
Not harmful
Complications: hematoma, hemorrhage,
Laceration
Observe: trauma and infection, jaundice
*think cone head
Erythema toxicum
Face and chest, over body
Most common in neonates
“Erythema neonatorum” or “newborn rash” or “flea bite”
Small, irregular, flat red patches on cheeks
Small yellow pimples on chest, abdomen, extremities
Can persist up to 1 mo
Lanugo
Fine, Downy hair
Present at 20 weeks
Covers body except palms, soles, areas hair isn’t found
Acrocyanosis
Cyanosis at 1 min apgar check
Normal
Meconium
20% births
Rupture of membrane
Careful surveillance of EFM and possible fetal scalp blood sampling
Meconium passed during labor
Hypoxia
Sphincter relaxation
Breech presentation
Umbilical cord compression
Gastroschisis
Congenital
Diagnosed during prenatal ultrasound
Stomach and intestine herniate through abdomen wall
Anencephaly
Incomplete closure of anterior portion of neural tube
Portions of brain, forehead, skull , occiput missing
Respirators and monitored to asses viability
Omphalocele
Congenital
Intestines protrude into umbilical cord region of abdominal wall
Trisomy 13 and 18
Greater than 4cm (less than=hernia)
Meaningocele
Protruding sac on cervical, thoracic or lumbar vertebrae
Thin layer of muscle and skin covers lesion
Myelomeningocele
Most severe form spina bifida
Evident on delivery
Meninges protrude though the defect and meninges contain spinal cord elements
Spina bifida s/s
Visualization of meningocele or Myelomeningocele
Weakness
Paralysis
Sensory loss
Severe spina bifida s/s
Visualization of Myelomeningocele
Neurological defects
Hip and joint disformigies
Impaired bowel and bladder function
Spina bifida prevention
Exposure to hyperthermia (hot tub, sauna)
Avoid anti seizure meds
400 mcg folic acid
Green leafy veg, liver, legumes, Oj, fortified breakfast cereals, multivitamins
Spina bifida nursing intervention
Prevent injury and infection at site
Redness, purulent drainage, bleeding, necrosis assessment
Is sac ruptured and leaks CSF risk for meningitis
Bulb syringe
Suction nose and mouth
Erythromycin ophthalmic
Prevent ophthalmia neonatorum, eye inflamm from gonorrheal or chlamydial infection from birth canal
Necrotizing enterocolitis (NEC)
Preterm newborns
Ischemic episode in bowel
Lack of oxygen
Blood shunted from nonessential organ (bowel) to kings and brain
Food and gas build up
Necrotizing enterocolitis (NEC) worst complication
Septicemia
Necrotizing enterocolitis (NEC)s/s
Lack of bowel movement
Emesis
Prefeeding aspirates
Abdominal distention
Increase 1-2cm abd circ from last feed
Irritability
Lethargy
Necrotizing enterocolitis (NEC)diagnosis
X-ray
Sausage shaped dilation of intestine present
Free air is dangerous
Necrotizing enterocolitis (NEC) lab findings
Leukopenia Metabolic acidosis Anemia Electrolytes imbalance Leukocytosis
Necrotizing enterocolitis (NEC) prevention
Keep O2 within range
Decrease environmental stress
Necrotizing enterocolitis (NEC)nursing interventions
Measure and record abd circumference
Auscultate bowel sounds before every feeding
Observe for abd distention
Frontal occipital circumference (FOC)
Paper tape tenths of cm
Place above eyebrow and pinna of ears
Wrapped around occipital prominence in back of head
3x largest recording
Norm: 13-15 in (33-38 cm)
Repeated until 36 mo
Torticollis
Deviation of neck to one side caused by spasmodic contraction of neck muscles
Head positioned on one side and neck opposite side
Subinvolution
failure of uterusnto return to non pregnant state
Multiple births, hydramnios, prolonged labor, difficult birth, infection, Grand multiparity, excessive maternal analgesia
Full bladder or retained placental tissue
Involution
Reduction of uterus size after birth
