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NUR 126 > Wk 13 Obstetrics: antepartum > Flashcards

Wk 13 Obstetrics: antepartum Flashcards

1
Q

Define: Braxton Hicks contractons

A

irregular, usually mild uterin contractions that occur through out preg and become stronger in the last trimester. May be confused with true or false labor

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2
Q

Define: Chadwick’s sign

A

bluish purple color of the the cervix, vagina and labia during pregnancy, increased vascular congestion

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3
Q

Define: Chloasma

A

A condition in which brown patches appear on the face due to hormonal changes during pregnancy

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4
Q

Define: Goodell’s signs

A

softening of cervix during pregnancy

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5
Q

Define: quickening

A

first movements of fetus mother feels

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6
Q

Define: striae gravidarum

A

irregular pink to purple streaks on the abdomen, breasts or buttocks resulting from tears in the connective tissue (stretch marks)

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7
Q

Define: trimester

A

division of pregnancy one of three equal parts of 13 weeks each

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8
Q

process of fertilization

A

spermatozoon enters the ovum and the two nuclei containing the parents chromosomes merge. 23 from the sperm and 23 from chromosomes from the ovum. Ovum now called zygote is ready for the first mitotic cell divison

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9
Q

process of implantation

A 
upper uterus (fundus)
rich supply of blood and optimal gas exchange and nutrition
uterine lining is thick in fundus preventing placenta from attaching so deeply that it does not easily detach
upper uterus limits blood loss after birth due to strong interlacing muscle fibers
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10
Q

role of the following in pregnancy and labor:

Human chorionic somatomammotropin (hCS)

A

Promotes normal nutrition and growth for the fetus, maternal breast development, decrease insulin sensitivity making more glucose available for the fetus

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11
Q

role of the following in pregnancy and labor:

Progesterone

A

causes the endrometrium to change into the decidua (the thick layer of modified mucous membrane which lines the uterus during pregnancy and is shed with the afterbirth), reduces uterine contractions, suppresses maternal reactions to fetal antigens, with other hormones causes growth of the breast

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12
Q

role of the following in pregnancy and labor:

Estrogen

A

causes infringement of the uterus and breasts, enhances uterine activity as term approaches

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13
Q

role of the following in pregnancy and labor: pelvic shape and size

A

??

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14
Q

Differentiate between the hormonal levels of a pregnant and nonpregnant woman

A

Pregnant:
Nonpregnant:

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15
Q

Identify the functions of the amniotic fluid

A

protects growing fetus and promotes normal prenatal development by:
cushioning
stable temp
symmetric development of fetus as body surfaces fold toward midline
keeping membranes from adhering to fetal parts
providing room and buoyancy for movement

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16
Q

Explain the functions of the placenta

A

metabolic
transfer of substances between mother and fetus
endocrine

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17
Q

Describe the physical development of the fetus given a specific time during normal pregnancy
Embryonic period

A

Embryonic period: beginning of 3rd week through 8th week after conception ?????

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18
Q

Describe the physical development of the fetus given a specific time during normal pregnancy
Fetal period

A

Fetal period: begins 9 weeks after conception. 9th-38th weeks

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19
Q

Fetal period: 9-12 weeks

A

begins to produce urine
fetal sex is apparent
intestines enter abdomen

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20
Q

Fetal period: 13-16 weeks

A

Fetus grows rapidly in length, head becomes smaller, “quickening” movements felt
face looks human

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21
Q

Fetal period: 17-20 weeks

A

vernix and lanugo cover skin

eyebrows and head appear

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22
Q

Fetal period: 21-24 weeks

A

lungs produce surfactant

may survive if born now

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23
Q

Fetal period: 25-28 weeks

A

subcutaneous fat is deposited under skin.

Usually head down.

24
Q

Fetal period: 29-32 weeks

A

Toenails are present, finger nails extend to tips. more subcutaneous fat. survival rate good with neonatal care

25
Q

Fetal period: 33-38 week

A

growth of all body systems. full term is 38-42 weeks gestational age

26
Q

Identify the physiological changes that occur in the various body systems during pregnancy
Uterus

A 
Weight and size increase
Fibrous connective tissue
Cervical softening
Mucus plug
Under goes Braxton Hicks
Blood flow rises
27
Q

Identify the physiological changes that occur in the various body systems during pregnancy
Cerix

A

Color and consistency
Estrogen causes hyperema
Collagen fibers decrease causing softening (Goodell’s)
mucus plugs cervical canal and blocks the ascent of bacteria
Bloody show- disruption of cervical capillaries

28
Q

Identify the physiological changes that occur in the various body systems during pregnancy
Vagina and Vulva

A

Estrogen influence
Hypertrophy
Hyperplasia of lining
Thick white secretions

29
Q

Identify the physiological changes that occur in the various body systems during pregnancy
Cardiovascular

A 
Increase heart rate
Blood volume increases
Cardiac output increases up to 50%
Palpitations
Murmurs
lower serum plasma protein
Diastolic BP decrease by 24 weeks but returns by term
Supine hypotension
30
Q

Distinguish between positive, probable, and presumptive signs of pregnancy
PRESUMPTIVE

A 
Amenorrhea
N/V
Fatigue
Urinary frequency
Breast/skin changes
Vaginal/cervical color changes
Fetal movement
31
Q

Distinguish between positive, probable, and presumptive signs of pregnancy
PROBABLE

A 
Abdominal enlargement
Cervical softening (Goodell's)
Bluish vagina (Chadwick's)
Softening of uterus (Hegar's)
Fetus rebound (Ballottement)
Braxton Hicks contractions
Pregnancy test
32
Q

Distinguish between positive, probable, and presumptive signs of pregnancy
POSITIVE

A

Auscultation of fetal heart sounds
Fetal movement felt by examiner
Visualization of the fetus, ultrasound

33
Q

Compute the expected date of delivery using Naegel’s Law

A

First day of last period, subtract 3 months, add one year, add 7 days

34
Q

Define: Gravida

A

refers to a woman who is or has been pregnant regardless of the duration of pregnancy

35
Q

Define: Primigravida

A

woman who is pregnant for the first time

36
Q

Define: Multigravida

A

woman who has been pregnant more than once

37
Q

Define: Para

A

Number of pregnancies that have ended at 20 or more weeks regardless of whether the infant was born alive or was stillborn

38
Q

Define: Nullipara

A

woman who has never completed a pregnancy beyond 20 weeks of gestation because she has never been pregnant or has had a spontaneous or elective abortion

39
Q

Define: Primipara

A

woman who has delivered one pregnancy at 20 or more weeks of gestation

40
Q

Define: Multipara

A

woman who had delivered two or more pregnancies at 20 or more weeks of gestation

41
Q

Assess the prenatal patient for appropriate weight gain

A

general recommendation of increments of 1.1-4.4 lbs during the first trimester.
2nd and 3rd trimester 0.8-1 lb weekly

42
Q

Three germ layers: developing structures

ECTODERM

A 
brain/spinal cord
peripheral nervous system
pituitary gland
sensory epithelium of eye/ear/nose
epidermis
hair
nails
subcutaneous glands
mammary gland
tooth enamal
43
Q

Three germ layers: developing structures

MESODERM

A 
cartilage
bone
connective tissue
muscle tissue
heart
blood vessels
blood cells
lymphatic system
spleen
kidneys
adrenal cortex
ovaries
testes
reproductive system
lining membranes (pericardial, pleural, peritoneal)
44
Q

Three germ layers: developing structures

ENDODERM

A 
gastrointestinal/respiratory tracts lining
tonsils
thyroid
parathyroid
thymus
liver
pancreas
urinary bladder/urethra lining
ear canal lining
45
Q

two fetal membranes of the amniotic sac

A

Amnion is the inner membranes

Chorion is the outer membrane

46
Q

Nutrition during pregnancy

A

Energy: carbs, fats, nutrient density calories
Protein
Vitamins
Folic Acid: neural tube deficit preventative
Minerals: iron, sodium, calcium (lactose intolerance)
Nutritional supplements (disadvantages/dangers)
Water

47
Q

Foods to avoid

A 
Raw fish
Under cooked eggs
Under cooked meat
Excessive amounts of caffeine
Alcohol
Certain types of fish
48
Q

Foods to eat

A 
Oatmeal
Approved tatty fish
Leafy greens
Nuts
Beans/Lentils
Yogurt
Avocados
Lean meats
49
Q

Adaptations to pregnancy

FIRST TRIMESTER

A

Uncertainty
Ambivalence
Self as primary focus
Focus on mom

50
Q

Adaptations to pregnancy

SECOND TRIMESTER

A 
Physical evidence of pregnancy
Fetus as primary focus
Narcissism and introversion
Body image
Changes in sexuality
51
Q

Adaptations to pregnancy

THIRD TRIMESTER

A

Vulnerability
Increasing dependence
Preparation for birth

52
Q

Family adaptation

FATHER

A

Struggling for recognition as a parent

Creating role of involved father

53
Q

Family adaptation

SIBLINGS

A

Toddlers unaware of changes
Older children realize a baby is being born benefit from being included in preparation
Adolescents some are embarrassed, others may be indifferent unless it affects them

54
Q

Family adaptation

GRANDPARENTS

A

Age: older grand parents react with joy

Relationships with grand parents second in importance only to their parent child relationship

55
Q

Erickson’s stage

INFANCY

A

Trust VS Mistrust
Development of a sense that the self is good and the world is good when consistent, predictable, reliable car is received; characterized by hope

56
Q

Erikson’s stage

ADOLESCENCE

A

Identity VS Role confusion
Begins to develop a sense of “I”; this process is lifelong; peers become of paramount importance; child gains independence from parents; characterized by faith in self

57
Q

Erkson’s stage

ADULTHOOD

A

Intimacy VS isolation

development of the ability to lose the self in genuine mutuality with another; characterized by love

NUR 126 (23 decks)

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