Exam 1

Nursing 3024 with O'neal at Oklahoma Christian University of Science & Arts

About this deck

By: Melissa Etheridge
Textbook:

Maternal Child Nursing Care (Wong, Maternal Child Nursing Care)

Maternity & Women's Healthcare: Irm

Study Guide for Maternity Nursing
Created: 2012-01-19
Size: 81 flashcards
Views: 43

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3 stages of intrauterine development

Pre-embryonic (<14 days) - cellular multiplication and formation of germ layers

Embryonic (15 - 8wks) - all organ systems present at 8 weeks, teratogens

Fetal (8 weeks - end of pregnancy) - human being, refinement and perfection

purpose of amniotic fluid

maintains body temp, source of oral fluid/waste/ cushions fetus, barrier to infection, freedom of movement, prevents tangling

oligohydramnios and hydramnios

oligo = (<300ml) = renal abnormalities

hydra = (>2L) = GI or other malformations

umbilical cord

provides fetus with blood and nourishment, 2 arteries 1 vein

fxn of placenta

site of metabolic exchange, acts as fetal "lungs", storage, nutrients, barrier

When is the GI system mature?

@ 36 weeks

Heart is beating, blood cell and vessel formation

3rd week

4 chambers

5th week

heart is complete

9th week

respiratory movements

11th week

lungs are mature

35 weeks

taste, reacts to temp

5th month

can hear, can see, REM observed

24 weeks

clomiphene citrate

induces ovulation and luteal phase, PO, blocks estrogen,

AE: flushes, abdominal pain, NV, breast tenderness

Danazol

androgens, treats endometriosis, suppresses ovarian activity

AE: hair incre, acne, weight gain

amniotic fluid

inside sac, contains fat, proteins, albumin, uric acid, fructose, enyzmes, urine

ductus arteriosus

respiratory exchange, bypasses the lungs

ductus venosus

goes into inferior vena cava with deoxygenated blood

hematopoiesis

formation of blood, in yolk sac starting 3rd week, then in liver after 6th week

hCG

secreted after implantation and makes positive preg test and maintains estrogen and progesterone levels to maintain pregnancy

L/S ratio

lecithin to sphingomyeline, determines lung maturity, 35 weeks

teratogens

harmful first 8 weeks, embryonic period

wharton jelly

lubrication inside umbilical cord

"fertile" period of ova and sperm

sperm = 2-3 days

ova = 24 hrs after ovulation

approx. 72 hr window of fertility

ballottement

examiner place finger in vagina and taps gently upward causing fetus to rise, fetus then sinks, and a gentle tap felt on finger, 16-28 weeks, could be mistaken for tumor

chadwick sign

bluish mucus membranes of the cervix, vagina, and vulva

colostrum

creamy white to yellowish to orange premilk fluid, may be expressed from nipples as early as 16 weeks

funic souffle

sound made by blood rushing through the umbilical vessels and synchronous with fetal heart rate

goodell sign

softening of cervix, probable sign of pregnancy, could be mistake for pelvic congestion, 6th week in normal unscarred cervix

gravida

woman who is pregnant

gravidity

pregnancy

hCG

earliest chemical marker for pregnancy, detected early as 7-10 days after conception, 60-70 weeks peak then decline

hegar's sign

probable sign of pregnancy, softening of the lower uterine segment

leucorrhea

white or slightly gray mucoid discharge with a faint musty odor

multigravida

woman who has had two or more pregnancies

multipara

woman who has completed two or more pregnancies to 20 wks or more

nulligravida

woman who has never been pregnant

nullipara

woman who has not completed a pregnancy with fetus 20 weeks or more

operculum

mucus plug

parity

number of pregnancies in which fetus reached 20 weeks (still born or live)

postdate/postterm

pregnancy that goes beyond 42 weeks

preterm

reached 20 wks but ends before completing 37 weeks

primigravida

woman who is pregnant for the first time

primipara

woman who has completed one pregnancy with a fetus who has reached 20 wks gestation

ptyalism

excessive salivation

quickening

initial motion of the fetus

term

37-42 weeks

uterine souffle

sound made by blood in the uterine arteries that is synchronous with maternal pulse

viability

capacity to live outside uterus, 22-25 weeks considered on threshold

GTPAL

GRAVIDITY

TERM

PRETERM

ABORTION

LIVE CHILDREN

presumptive signs of pregnancy

those changes felt by the woman (breast changes, amenorrhea, n/v, urinary frequency, fatigue, quickening)

probable signs of pregnancy

those changes observed by healthcare provider (Goodell sign, Chadwick, Hegar, positive urine or serum test, Braxton hicks, ballottement)

positive signs of prenancy

those signs that are only attributed to presence of fetus (visualization of fetus, FHT, fetal movements felt and seen)

height of fundus compared to weeks of gestation

7 wks - large hen egg

10 wks - orange

12 wks - grapefruit

12-14 wks - palpated above symphysis pubis

22-24 wks - at level of umbilicus

38-40 wks - drops as fetus descends into pelvis (lightening)

cardio changes in body

HR increases 10-15 bpm, BP shouldn't change too much, blood volume increases, RBC increase, H&H decrease, WBC increases, cardiac output increases

respiratory changes in body

RR is unchanged, oxygen capacity is increased

fluid and electrolyte body

sodium is retained, mom is thirsty, edema decreases renal blood flow, proteinuria is abnormal

skin changes

hyperpigmentation of nipples, areolae, axillae

chloasma (mask of pregnancy) blotchy, brownish spots over cheeks, nose, forehead

linea nigra - pigmented line from symphysis pubis to top of fundus

stretch marks in over half preg. women, palmar erythema, nail growth, oily skin or radiant, sweating

musculoskeletal

increasing weight leads to curvature of spine and waddling gait, slight relaxation/increased mobility of pelvic joints, diastasis recti lose tone

appetite changes, mouth bleed easily, hernias, estrogen decreased acid in stomach which helps with peptic ulcer formation, heartburn, more iron is needed, constipation, gas, cramping, uterine contractions, round ligament tension

endocrine

estrogen and progesterone suppress FSH and LH leading to amenorrhea

prolactin is responsible for initial lactation

oxytocin stimulate uterine contractions

fetus requires glucose to grow

Lab values: H&H

pregnant hemoglobin is >11

hematocrit is >33

IUGR

baby has trouble growing in uterus, may be due to malnutrition

LBW

2500 g (5.5lbs) or less, caused by preterm deliver, smoking, adolescence, malnutrition

neural tube defects

failures with closing of neural tube RT folic acid intake

physiologic anemia

h&h decrease bc of excess of plasma, this is normal, supplements are common

most important nutrient needs before conception

folate pill and or fortified foods like cereal or natural foods like leafy greens anf ruits, need 0.4mg /day

dietary intake/important nutrients/ supplements needed during pregnancy

protein-meat, dairy, nuts, water, iron-meats, zinc for CNS- wheat germ, cocoa, lamb, peanuts. potassium, magnesium, sodium, vitamins, esp the B vitamins. don't take lots of A

diet and supplement during lactation

about the same as pregnancy, lots of fluid, no smoking, alcohol, or excessive caffeine, no more than 200 mg /day for lactating or pregnant women

problems with inadequate weight gain

preterm labor, LBW, IUGR, etc

problems with excessive weight gain

macrosomia, fetopelvic disproportion, c/s, postpartum hemorrhage, birth trauma, preeclampsia, GD, infection

pattern of weight gain

1st trimester: 2-5 lbs

2nd and 3rd trimester: about 1lb per week

pre-pregnancy bmi and recommendations for pregnancy weight gain

normal: (19.8-26) 25-35 lbs

underweight (<19.8) 28-40 lbs

overweight (26-29) 15-25 lbs

obese (>29) 11-20

recommended caloric intake for pregnant and lactating

pregnant: 300kcal

lactating: 330 kcal

interventions for n/v

eat dry bland foods before you get up in the morning and when your nauseous, do not drink large amounts of fluid, small frequent meals, move slowly, decrease fatty foods, increase carbs, fresh air, cool foods, don't brush teeth right after eating, herbal teas with raspberry or peppermint

interventions for heartburn

small frequent bland meals, low fluids with meals, loose clothing, don't lay down after eating

iron supplementation

take with vit C, don't take with tea, bran, milk, or oxalates, take between meals, at bedtime if GI discomfort occurs, childproof, constipation, and dark tarry stools are common

EDB

use naegels rule

nagele's rule

determine first day of lmp subtract 3 calender months, add 7 days plus one year

trimesters

1st - 1-13 weeks

2nd - 14-26 weeks

3rd - 27-40 weeks