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40 Cards in this Set
- Front
- Back
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Placenta- what can and cannot pass to fetus? |
CANNOT: Bacteria
CAN: Oxygen&Carbon Dioxide, Nutrients, Meds, Alcohol, Antibodies, Viruses, Waste Products |
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Umbilical cord? |
2 arteries, 1 vein Artery: Deoxygenated blood(carbon dioxide) and waste FROM fetus Vein: Oxygenated blood and provide oxygen & nutrients TO fetus FHR 110-160/170 (depending on gestational age), slows down as fetal grows. FHR 174= distress |
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What part of circulatory system allows blood to bypass the fetal lungs? |
ductus arteriosus |
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Sex of baby by which week? |
Week 12 gestation |
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What is ductus arterios vs ductus venosus responsible for? |
Ductus arteriosus: allows blood to bypass fetal lungs Ductus venosus: connects umbilical vein to the Inferior Vena Cava |
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Why does implantation stay in Ampulla in follapian tube for 3 days? |
Promotes fertilized ovum normal implantation in top part of uterus |
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Amniotic Fluid vs Placenta? |
Amniotic Fluid: Allow fetal movement; Surrounds&protect fetus, maintain body temp, can measure fetal kidney function Placenta: Prevent large particles from passing to fetus, exchange of nutrients & removal of waste |
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Naegelse Rule? |
+7 days, - 3 months, + Year as apply |
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GTPAL? |
Gravidity: # of pregnancy,including current Term: Born after 37+ Preterm: Born before -37 weeks Abortion/Miscarriage: Living: currently living |
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Presumptive Pregnancy Signs? |
Amenorrhea-No period N/V Bigger Breasts Pronounced Nipples Urine Frequency Quickening: Felt by Mother(16-20w) Fatigue Discoloration of vaginal mucousa (Chadwicks sign) |
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Probable Signs of Pregnancy? |
Uterine Enlargement Hegars Sign: soft uterine segment Goodells: soft cervix Ballotement: Rebounding of fetus against examiner hand Positive Preg test Braxton Hicks
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POSITIVE signs of Pregnancy? |
1.FHR by Doppler or other electronic device 2. Active fetal movements by examiner 3. Ultrasound/Xray |
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Oxytocin(Pitocin) purpose? |
Stimulate uterine contractions |
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Why is folic acid important during pregnancy? |
Prevent neural tube defects |
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Antepartum health visits? |
Up to 32 weeks: Q 4weeks 32-36 weeks: Q 2 weeks 36-40 weeks: Every week 40+: twice a week |
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If mother is RH Negative- what needs to happen? |
Repeat antibody screening and get RhoGam at 28 weeks gestation |
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If woman has Negative Rubella tither-what needs to happen? |
Need to be given postpartum & effective BirthControl for 1-3 months (NOT given in pregnancy, crosses placenta and is a live virus) |
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What vaccination is NOT contraindicated in Pregnancy? |
Hept B Tetanus Flu vaccine (inactivated) |
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Biophysical Profile? |
Noninvasive Assessment of fetus -fetal breathing movements -fetal movemements -fetal tone -amniotic fluid index -FHR patterns via nonstress test |
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Fetoprotein screening? |
Determine: Down Syndrome, Spina Bifida ** maternal blood draw between 16-18weeks gestation |
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Test to determine if there is amniotic fluid leakage? |
Fern test: specimen obtain from cervix and put on slide, looked at under microscope Nitrazine test: test strip used to detect amniotic fluid in vaginal secretions |
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What is fibronectin testing for? |
Test by sampling vaginal&cervical secretions to detect onset of labor *used in patients at risk for preterm labor |
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Dietary requirements? p.297 in book |
Average weight gain: 25-35lbs (normal prepregancy weight) **Increase of 340 calories/ day (2nd trimester) ***452 Cal/day (3rd Trimester) 2200-2900 Cal/day *500 calories/day lactation Folic Acid: prevent neural tube defects, orofacial cleft Protein: 71g/day Iron: 1000mg/day -Increased fluid **Watch excess of fat soluable vit (Vit K,A,D,E) not excreted but stored so can result in toxic effect |
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Nonstress Test? |
Nonstress Test: ultrasound transducer & toco applied, 20 min duration of FHR with activity **Reactive= Healthy fetus (2+ FHR accelerations of 15 beats/min, lasting 15 sec during 20 min period **Nonreactive= Abnormal No accelerations or less than 15 beats/min or less than 15 seconds in 40 min **If abnormal, contraction stress test is performed!! |
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Contraction Stress Test? |
Diluted oxytocin or nipple stimulation performed with 20-30min baseline strip **Negative= No late decelerations of FHR (Normal) **Positive= Late decelerations of FHR with 50% of contractions |
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Kick Count? |
If fewer than 10 kicks in 2 hour ((x2)) should notify MD
*If less than 20 in 2hrs, do it again over another 2 hours if still less than 10 kicks call MD **Patient should NOT lie flat b/c hypotension |
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Fundal Height? |
Weeks gestation +-2 Ex: 28 weeks at 30 cm (normal) |
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(DIC)Disseminated Intravascular Coagulation and HELLP syndrome? |
*HELLP Syndrome may lead to DIC **HELLP Syndrome: Hemolysis, Elevated liver enzymes, low platelet **DIC: micro clots and uncontrollable bleeding
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Treatment for DIC? |
Oxygen Fluid Replacement Blood Component Therapy Heparin possibly |
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Methotrexate given for what OB medical condition? why? |
*Ectopic Pregnancy
Methotrexate is an folic acid antagonists- inhibits cell division in developing embryo |
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Immunizations contraindicated in Pregnancy? |
Live virus vaccines MMR Measles Mumps Rubella Varicella Smallpox |
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Weight Gain in Pregnancy? |
Normal weight: 25-35lbs Underweight: 28-40 lbs Overweight: 15-25 lbs Obese 11-20lbs **1-4lbs in 1st Trimester **1 lbs a week after 1st Trimester (for Normal prepreg weight) |
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Hydatidiform Mole (gestational trophoblastic diease) |
-Occurs when trophoblasts develop abnormally-as result, placenta grows but not fetus -May be Complete (no fetus)/Partial (fetus remains present) S/S: Vaginal bleeding (Brown or Red) Elevated HCG levels, Increased fundal height, N/V, Preeclampsia s/s (elevated BP & proteinuria) Nurse Care: Monitor HCG levels, prepare for uterine evacuation, Monitor bleeding, |
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Hyperemesis Gravidarum? |
Persistent, uncontrollable Vomitting during 1st Trimester & may continue throughout Nurse Care: Reduce N/V, Maintain nutrition and fluid imbalance, Emotional support |
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Placenta Previa? |
Improperly implanted placenta in lower part of cervix os (should be attached at top/side of uterus)
S/S: Sudden PAINLESS bright red vaginal bleeding, uterus soft&nontender, fundal height increase
Care: No vaginal exams to prevent further bleeding, Monitor fetus, maintain side lying position bed rest, IV fluids, tocolytics(anticontraction), possible RhoGam |
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Abruptio Placentae? |
Premature separation of placenta from uterine wall after 20 weeks gestation & before fetus is delivered
S/S: Dark Red/Brown blood, Severe abdominal PAIN, uterine pain or tenderness,Uterine rigidity, Clotting,
Care: Bed rest in lateral or trendelenburg position, prepare for fetus delivery, monitor for DIC, Assess Pain |
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True Labor vs False Labor? |
True: Regular contractions, stronger, longer, closer together *Cervical dilation and effacement is progressive *Fetus engaged in pelvis and descend
False: Does not produce dilation, effacement or descent, Irregular w/out progression, walking or activity relieves labor
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Know VEAL-CHOP! |
V-arriable deceler. C-cord compress E-arly deceler. H-ead compression A-acceleration. O- okay! L-ate deceleration. P- lacental insuff |
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When should oxytocin be discontinued? |
When contraction pattern is obtained (2-3 min, lasting 60 sec) *d/c when frequency is <2 min or longer than 90 seconds or fetal distress |
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What is Terbutaline administered for? |
To stop contractions b/c lung maturity is reached at (L/S ratio 1.4:1) |
