Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medical Conditions 3 > The Obstetric Patient > Flashcards

The Obstetric Patient Flashcards

You may prefer our related Brainscape-certified flashcards:
USMLE® Step 1 flashcards
1
Q

Define the trimesters of pregnancy

A

1st trimester

  • month 0 = weeks 0-4
  • Month 1 = weeks 5-8
  • Month 2 = 9-12
  • Month 3 = weeks 13

2nd trimester

  • month 3 = weeks 14-17
  • Month 4 = 18-21weeks
  • Month 5 = weeks 22-25
  • Month 6 = 26-27 weeks

*3rd trimester

  • month 6 = 28-30 weeks
  • month 7 = 31-34 weeks
  • month 8 = weeks 35-38
  • month 9 = 39-42 weeks
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what systems

experience changes during pregnancy

A
  • GI
  • Urogenital
  • Cardiovascular
  • endocrine
  • respiratory
  • metabolic
  • musculoskeletal
  • neurologic
  • integumentary
  • psychiatric
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Changes during pregnancy

A
  • respiration rate unchanged – deeper breaths
  • hyperventilation –to meet oxygen demands
  • dyspnes –20% increase by 12 weeks
  • heart rate increases 10-16 beats per minute
  • CO increase 30-60%
  • blood volume increases 40-45%
  • weight gain average of 25-35 lbs
  • uterus: non pregnant 2”x4 pregnant 10”x14
  • chest circumference increases 5-7 cm
  • diaphragm elevates 4 cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Postural changes during pregnancy

A
  • center of gravity shifts forward 4 cm and upward 4 cm
  • exaggeration of A-P spinal curves
  • shoulders internally rotate and protract
  • knees hyperextended
  • feet pronated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Examination: history

A
  • previous pregnancies
  • complications
  • general health
  • environment: physical, psychological, emotional
  • medications
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Examination considerations

A
  • physical positioning
  • avoid prolonged periods in supine
  • prone position uncomfortable early not recommended in later stages
  • left side-lying with pillows supporting from behind
  • support belly
  • avoid activites that strain pelvic floor and abdominal muscles
  • avoid positions that cause rapid orr uncontrolled bouncing o swinging - balance
  • avoid vigorous stretching of adductors - pubic symphysis
  • avoid overheating or increasing core temp
  • deep heat or electical stim over turnk is containidcated
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Imaging considerations

A
  • MRI or US preferred
  • CT, x-ray not recommended due to radiation exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Lab tests for the pregnancy patient

A

chorionic Villus sampling (CVS)

  • 10-13 weeks - genetic disorders
  • US guided
  • 1-2% chance of miscarriage

Amniocentesis

  • high rrisk or over 35 recommended
  • 15 weeks
  • US guided
  • 1 in 270 change of miscarriage

Glucose testing;

  • 3 hr testing
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Common medical conditions with obstetric patients

A
  • backache
  • HA
  • heartburn
  • nausea/vomiting
  • CTS
  • edema
  • fainting
  • Fatigue
  • urinary frequency increase
  • hemorhoids
  • varicosities
  • breast tenderness
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Special concerns for Obstetric patient

Gallbladder disorders

A
  • increase bile production decreased emptying time
  • R upper quadrant pain referred pain to scapula
  • food intolerance

will be related to eating - they feel better after eating

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Special concerns for Obstetric patient

urinary tract

A
  • acute cystitis 1% - referral over sacral spine
  • acute pyelonephritis - flank pain, fever, nausea/vomiting
  • incontinence 21-46%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Special concerns for Obstetric patient

Fecal incontinence

A
  • postpartum
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Special concerns for Obstetric patient

Organs

A
  • organ prolapse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Special concerns for Obstetric patient

endocrine

A
  • gestational diabetes
  • relaxin production (especially post partum)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Special concerns for Obstetric patient

cardiovascular

A
  • progressive dyspnea or orthopnea
  • nocturnal cough
  • hemoptysis
  • syncope
  • chest pain
  • COVID-19
  • supine hypotension due to compression of inferior vena cave
  • hypertension
  • venous thromboembolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Special concerns for Obstetric patient

hypertension

A
  • 5-10% pregnancies
  • preeclampsia BP >/= 140/90 can cause death to fetus
  • risk of intacranial hemorhage, renal failure, retinal detachment, pulmonary edema, liver rupture, abruptio placenta, death
17
Q

Special concerns for Obstetric patient

venous thromboembolism

A
  • 5x higher risk than non-pregnant
  • DVT - 24% chance of PE => 15% mortality
18
Q

Special concerns for Obstetric patient

MSK considerations

A
  • LBP: increase laxity/changes in posture
  • SI dysfunction: posterior pain aroudn pubic symphysis
  • pubic symphysis dysfunction: 1/36, groin or pubic pain,painful gait/mobility
  • Thoracic and rib dysfunction
  • HA and cervical spine dysfunction
  • extremity dysfunction
  • osteoporosis
  • diastasis recti >2 fingertops seperation
  • coccydynia
19
Q

What conditions get worse with pregnancy

A
  • MS increases during 6 months postpartum
  • epilepsy
  • guillain-barre syndrome - postpartum first 30 days
  • psoriasis flare after pregnancy
20
Q

What conditions get better with pregnancy

A
  • MS lowers during pregnancy
  • RA
21
Q

Spina bifida

with pregnancy

A
  • folic acid lessens chance of development in fetus
22
Q

Lupus with pregnancy

A

-risk increases last trimester: heart, kidneys, miscarriage

23
Q

teen

pregnancy

A
  • increase risk pertem
  • nutrition
24
Q

benefits of exercise

A
  • promote relaxation
  • improve circulation in lower extremities and pelvis
  • muscle re-ed
  • estabilish a balance of length and strength to accommodate the changes of prergnancy
  • prevent MSK problems from developing
  • promote elasticity and strength of perineal muscles – support pelvic contents, assist in labor
  • adapt to structural and hormonal changes that affect the stability of joints
  • promote elasticity and strength of the abdominals
  • improved stability to the pelvis
  • support gravid stuctures
  • be effective for delivery
  • facilitate postpartum rehab
25
Q

exercise with pregnancy contraindications

A
  • incompetent cervix
  • vaginal bleeding of any amount
  • placenta previa
  • premature labor (prior to 37th week)
26
Q

exercise precautions

with pregnancy

A
  • multiples
  • anemia
  • diastasis recti
  • uterine contactions > 2 hours after exercise
27
Q

Guidelines for exercise and nutrition

A
  • additional intake of 500 cal/day if exercise 300/day ifno exercise
  • keep temperaturre below 102º
  • frequentcy of exercise = 3-5 times per week ?150 min/week moderate intensity
  • duration of exercise to patient tolerance up to 40 minutes
  • cool down
28
Q

exercise programs

A
  • warm up - total body stetching
  • pelvic floor muscle training
  • aerobic 15-20 minutes – focus on retraction of UE and small foot movements
  • cool down
  • relaxation
29
Q

exercise options

A
  • stretching
  • aerobic – walking, swimming
  • strengthening – t-band, free weights, phsyioball
  • back school - body mechanics
  • positioning: avoid supine and prone especially in later stages

Medical Conditions 3 (14 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions