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Nur 231 > Unit 1 > Flashcards

Unit 1 Flashcards

1
Q

By 18-20 weeks

First fetal movements felt by mother

A

Quickening

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2
Q

amniotic fluid volume below 400 ml’s. This condition makes it very difficult for the baby to move and poses a great risk for cord compression. If the cord gets compressed in utero, the baby will die. The baby could develop kidney problems in which the kidneys aren’t excreting fluids as they should be.

A

Olgohydramnios

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3
Q

– procedure that might be done in a case of olgohydramnios; warm normal saline or ringers lactate is instilled into the uterus. If this procedure is done, the pregnancy is considered high risk.

A

Amnioinfusion

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4
Q

– the same as polyhydranmios, it means too much amniotic fluids, with an index over 2000 ml’s. It causes the chest muscles to go up and the diaphragm to rise, causing difficulty breathing. Some amniotic fluid might be extracted so the woman can breathe easier – known as a needle amniotomy. The baby can develop some esophageal problems.

A

Hydramnios

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5
Q
  • connects the umbilical vein to the inferior vena cava
A

Ductus venosus

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6
Q

– opening between the right and the left atrium.

A

Foramen ovale

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7
Q
  • connects the pulmonary artery to the aorta.
A

Ductus arteriosus

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8
Q 
o Raw green leafy vegetable
o Oranges
o Whole grain
o Whole cereal
o Liver
o Dried peas & beans
o Yeast
A

Folic Acid food source

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9
Q

fish, clown fish and tuna. Canned tuna should be limited to 1-2 cans per week.

A

Food containing Mercury

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10
Q

o Assist with different breathing techniques
o Make sure the patient isn’t hyperventilating
▪ The first s/s for hyperventilation is numbness and tingling of the fingers
▪ In case of hyperventilation, instruct the patient to cup their mouth with their hands and breath in to elevate the carbon dioxide levels
o The nurse is responsible for all comfort measures, such as a wet cloth, counter pressure on the back, and lip balm
▪ Baby born with the back of its head pressing on the mother spine AKA posterior position baby causes the mother to have back labor which can be relieved with counter pressure on back
▪ Lips get very dry due to mouth breathing during labor
o Remember to relieve the partner

A

NI for labor

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11
Q
  • the softening of the lower segment of the uterus. An examiner can feel if the lower uterine segment is soft. This is considered a probable sign of pregnancy
A

Hegar’s sign

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12
Q

– white odorless discharge as a result of overproduction of mucus from the endocervical gland. Advise the patient to wear panty liners.

A

Leukorrhea

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13
Q

softening of the cervix due to increased vascularization

A

Goodell’s sign

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14
Q
  • bluish purplish discoloration of the vagina and cervix
A

Chadwick’s sign

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15
Q 
Chadwick’s sign
Goodell’s sign 
Hegar’s sign
Positive pregnancy test
Ballottement
Pigmentation changes
A

Probable signs of pregnancy

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16
Q

– mask of pregnancy. It spread over the cheek bones and across the nose, resembling the Zorro mask.

A

Chloasma

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17
Q

This causes intense itching. If a woman develops PUPP during pregnancy, it will go away after the pregnancy. Some women develop PUPP after delivery, and that takes a week or two to go away. Teach woman to take oatmeal baths.

A

PUPP – pruritic urticarial papules and plaques

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18
Q

separation of abdominal muscle due to enlarged uterus
• have to woman lie down and raise her head and shoulders off the bed, her stomach will separate and uterus will move forward
o Usually seen in post partum period
o Exercise such as leg raises will help muscles mesh back together

A

diastasis recti

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19
Q 
lack of  period (amenorrhea)
▪ nausea & vomiting 
▪ fatigue 
▪ urinary frequency 
▪ enlarged and tender breast 
▪ fetal movements
A

Presumptive signs

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20
Q

o Fetal heartbeat (by 4 weeks of pregnancy)
o Fetal movement felt by the examiner not the patient
o Visualization of fetus by sonogram or X-ray

A

Positive signs of pregnancy

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21
Q

o First day of last menstrual period minus 3 mos +7 days

A

Nagle’s Rule

22
Q

uterus is anchored in place by the cervix, but should be able to move around without causing pain. If it does cause pain, it is a sign of a pelvic inflammatory disease

A

chandelier sign

23
Q

promotes normal nutrition & growth for the fetus as well as breast development for lactation
• DECREASE maternal insulin insensitivity & glucose (makes more glucose available for the fetus to grow-considered an insulin ANTAGONIST)
• Most women can make more insulin to counteract HPL BUT there are some women who develop gestational diabetes b/c of this

A

HPL(human placental lactogen)

24
Q

poor placental blood flow, preterm rupture of membranes, kidney
disease in the baby, blocked urinary excretion, & compression of fetal parts

A

Oligohydramnios

25
Q

multifetal pregnancy(2 babies urinating), chromosomal abnormalities, malformation of CNS or GI, uncontrollable diabetes in mother

A

Polyhydramnios

26
Q
  • done 16-18 weeks of pregnancy
    • Test to rule out trisomy disorder & neural tube defects
A

Alpha fetal protein test

27
Q
  • d/t the big, over distended uterus during pregnancy & postpartumly
    the uterus WONT contract the way it should which puts her at risk for bleeding/hemorrhaging
A

Uterine atony postpartum

28
Q
  • when the baby dies in utero BUT it’s NOT expelled
    • The woman doesn’t know the baby died
A

Missed abortion

29
Q
  • sew up LOWER part of cervix so it WONT dilate • Done about 14-18 wks.
    • Most common & considered temporary
    • The HCP will tell you to come into the hospital at 38 wks. & they will snip the sutures & you‘ll go into labor within 1-2 hrs
A

McDonald cerclage

30
Q
  • sew up HIGHER part of cervix
    • Considered permanent
    • When delivering your baby you NEED to have C-section
    • Post cerclage- LIGHT activity about 2 days after
    • May expect light spotting/bleeding NOT heavy
A

Shirodkar cerclage

31
Q

• Damaged fallopian tubes-PID, STD, clogging of tubes
• Congenital anomalies of fallopian tube
• Tubal surgery-adhesions could form in tubes
• Ovarian hyper stimulation syndrome
• Hormonal problems-we know as a woman ages she LOSES estrogen which is why they go
into menopause & if she gets pregnant at an older age that estrogen wont help the baby move
through the fallopian tube & it may get stuck growing in tube

A

Ectopic food

32
Q

HYPOvolemic shock- main concern
Vaginal bleeding, hemorrhage, abd. pain, pelvic pain, tenderness on palpation, cervical motion tenderness
shoulder pain(when tube ruptures blood that comes out can lift
the diaphragm

A

Ectopic pregnancy

33
Q

spontaneous abortion in 1st trimester, gestational diabetes, C-section, preeclampsia, preterm birth, multiple gestation, placenta problems)

A

Delayed pregnancy risk factors

34
Q

• Occurs when a woman has PAINLESS, dilation of the cervix usually early in 2nd trimester • Causes spontaneous abortion in 2nd trimester

A

Cervical insufficiency

35
Q

• Cervical trauma
• Previous GYN procedure- biopsy or laser tx of cervix
• Short cervix-

A

Cervical Insufficiency

36
Q

• ABNORMAL growth of trophoblastic cells
• You have a GROSS proliferation of chorionic villi
• Fluid-filled villi that resemble grapes

A

Hydatidiform Mole-Gestational Trophoblastic Disease

37
Q

40 years old; Asian decent; hx of previous molar pregnancy(once you’ve had 1 chances of it happening again are GREATER)
• Complete- NO fetus present
• Partial- fetal tissue present BUT it’s grossly abnormal, & incompatible w/ life

A

Hydatidiform Mole-Gestational Trophoblastic Disease

38
Q

HIGHER hCG levels expected for gestation
• Larger appearance of uterus of gestation
• Dark-brown prune juice-like bleeding
• Hyperemesis gravidarum- associated w/ exposure to hCG
• Preeclampsia- BEFORE 20 wks. gestation
• Diagnosed by sonogram & the sonogram will show a grape-like appearance inside uterus w/
NO FHR present

A

Clinical manifestations Hydatidiform Mole-Gestational Trophoblastic Disease

39
Q
  • Beta hCG- levels monthly for next 6 months & then at 9 months & then at 1 year
    • oxytocin after evacuation to contract the uterus
  • no pregnancies for one year
A

Hydatidiform Mole-Gestational Trophoblastic Disease

40
Q
  • ABNORMAL implantation of the placenta in the LOWER uterine segment
  • MORE common in women with advanced age, hx of C-section, D&C, tobacco & cocaine users
A

Placenta previa

41
Q

PAINLESS, vaginal bleeding in LAST half of pregnancy

A

Placenta previa

42
Q

• Placenta detachment from uterus
• RF- cocaine use, HTN, INCREASED maternal age, INCREASED parity, tobacco use, birth
after first twin, short umbilical cord, & abdominal trauma
• 2 types:
• Concealed hemorrhage
• Apparent hemorrhage

A

Placenta abruptio

43
Q

– a pulse heard from the uterus that matches the mother’s pulse. This pulse is blood going through the uterine arteries.

A

Uterine soufflé

44
Q
  • a rapid pulse heard from the uterus that does not match the mother’s pulse. This pulse is blood going through the umbilical vein.
A

Funic soufflé

45
Q

– to test for syphilis (to rule out STDs)

A

VDRL

46
Q

– increased secretion of saliva. Saliva can’t be controlled. Women can’t swallow all the saliva produced. Teach patient to use mouth wash and limit starch intake (high starch intake increases

A

Ptyalism

47
Q

fundal height measurement. The top of fundus to symphysis pubis distance in centimeters is equal to gestational age, done between the 20th- 31st week of pregnancy
o Can not be used in late pregnancy, obese patient, multiple fetus pregnancy or patient with polyhydramnios
o Woman’s bladder should be empty
o Knees should be flexed
o Should be done by the same examiner throughout pregnancy
▪ Lay patient down, measure from top of symphysis pubis to the top of fundus. The number in centimeters equals the weeks of gestation 20cm =20 weeks
▪ Give or take two weeks

A

McDonald’s rule

48
Q
  • N/V
  • Urinary frequency
  • Fatigue
  • Breast tenderness and tingling
  • Nasal stuffiness & epistaxis
  • Ptyalism
A

First trimester common problems

49
Q 
• Pyrosis – heart burn
• Ankle edema
• Varicose veins
• Flatulence
• Hemorrhoids
o Always check with pen light
• Constipation
• Backache
• Leg cramps
• Faintness
o Due to vena cava syndrome/ supine hypotension syndrome
• Shortness of breath
o Due to rising diaphragm  (growing uterus is pushing everything up)
• Difficulty sleeping
• Ligament pain
o Due to stretching of broad and round ligament
• Carpal tunnel syndrome
o Due to edema of the median nerve
A

Second & third trimester

50
Q

o Screening test to evaluate plasma protein given off by the fetal liver
o The protein crosses amniotic fluid into maternal blood
o The protein is measured
▪ if level is high it could mean the baby has neural tube defect
▪ If level is low it could mean the baby has down syndrome

A

alpha fetal protein test

Nur 231 (2 decks)

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