Third Trimester of Pregnancy Flashcards
A pregnancy is considered term, when ?
If it advances to 37 to 40 weeks
What is the expected weight gain per week in the Third trimester ?
No more than 1 lb per week
if more assume the worst
What should be monitored in the Third trimester ?
BP
Why should you monitor BP in the 3rd trimester and report any increases from baseline ?
Because Pre-eclampsia develops after 20 weeks gestation and client will have…
- Increased BP
- Proteinuria
- Edema
(All indicate trouble)
In the 3rd trimester you should watch closely and worry about pre-eclampsia if what occurs ?
Two or more pounds of weight gain in a week
The client with Pre-eclampsia can have what ?
A seizure
What is the Drug of choice for severe pre-eclampsia ?
Magnesium Sulfate
How is Magnesium Sulfate given ?
Given…
- IV
- In Hospital setting
- Under close supervision
What is Pre-eclampsia defined as ?
BP of 160/110 or greater that is documented 6 hours apart
What does Magnesium Sulfate act like ?
An Anticonvulsant
Magnesium Sulfate also does ___________ & ____________ ?
Sedates & Vasodilates
What is the difference between Pre-eclampsia and eclampsia ?
The seizure
Its called Eclampsia when ?
They have a seizure
What should the fetal HR be in the Third Trimester ?
110 to 160
How is the fetal position/presentation determined in the 3rd trimester ?
Leopold maneuvers
–> palpating the abdomen to find the head, back (listen to fetal HR) and butt
Before performing Leopold maneuvers, what should you have the client do first ?
Void
If a client I shaving contractions, when should Leopold’s be done ?
Between contractions
What are signs of labor in the Third Trimester ?
- Lightening
- Engagement
- Fetal stations
- Other signs
When does Lightening usually occur ?
2 weeks before term
What is Lightening defined as ?
When the presenting part of the fetus (usually the head) descends into the pelvis
What sign in the Third trimester will tell the mother that Lightening has occurred ?
Client will be able to breathe more easily
-B/c the pressure on the diaphragm decreases
When does Urinary frequency become a problem again ?
In the 3rd trimester
Why does Urinary frequency become a problem again in the 3rd trimester ?
Because of lightening occurring and the baby descending into the pelvis
(takes pressure off the diaphragm, BUT puts it back on the bladder)
What is Engagement defined as in the 3rd trimester ?
The largest presenting part is in the pelvic inlet
hopefully the fetal head is presenting first
what is Fetal station measured in ?
cm
What does fetal station measure ? (won’t ask on NCLEX)
Measures the relationship of the presenting part of the fetus to the ischial spines of the mother
What other signs of Labor in the 3rd trimester ?
- Braxton Hicks contractions (more frequent and stronger than before)
- Softening of the cervix (ripening before it will dilate)?
- Bloody show (Dont want to see heavy bleeding)
(blue post-it ash book on pg 221) - Sudden burst of energy called Nesting
- Diarrhea
- Rupture of the membranes
When should a pregnant client go the Hospital ?
When the contractions are 5 minutes apart OR when the Membranes Rupture
What are we worried about when the membranes rupture ?
Prolapsed cord (could kill baby fast)
infection also, but always pick the worst possible answer
