chapter 26 & 27, pregnancy
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chapter 26 & 27, pregnancy - Leaderboard
chapter 26 & 27, pregnancy - Details
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| 🇬🇧 | 🇬🇧 |
| A gelatinous tissue that remains when the embryonic body stalk blends with the yolk sac within the umbilical cord | Wharton’s jelly |
| The normal umbilical cord has how many arteries and veins? | Two arteries and one vein |
| 5 important functions amniotic fluid has for the fetus | 1. it acts as cushion against mechanical injury 2. helps regulate fetal temperature 3. allows the developing embryo or fetus room for growth 4. ^ which promotes musculoskeletal development 5. and provides for fetal development of lungs |
| The amniotic fluid appears | Clear yellow with a slightly alkaline pH |
| Baseline fetal heart rate | 120-160 |
| HCG hormone: initially secreted by the throphoplast in the developing pregnancy. it is responsible for stimulation to the | Corpus leteum to promote production of estrogen and progesterone until placenta is functioning |
| Estrogen: secreted by corpus luteum and later the placenta. it is responsible for the increased | Vascularity needed in the developing pregnancy |
| Progesterone: secreted by the corpus leteum and later the placenta. it is often referred to as the | Maintenance hormone of pregnancy |
| Relaxin: linked to the softening of | The cervix and pubic symphysis |
| Presumptive signs of pregnancy | Amenorrhea nausea and vomiting frequent urination breast changes change in shape of abdomen quickening skin changes chadwick’s sign |
| Probable signs of pregnancy | Changes in the reproductive organs positive pregnancy test result |
| Hegar’s sign | Softening of the segment between the fundus and the cervix |
| Goodell’s sign | Change and softening or increased pliability of the cervix |
| Ballottment | Technique used 16 to 18 wks of gestation is a technique that involves palpating the uterus in such a way that the examiner feels the rebound of the floating fetus |
| Positive signs of pregnancy | Palpation of the fetal outline visualization of the pregnancy with ultrasound scan presence of fetal heartbeat |
| Defining parity: five digit system: GTPAL | Gravidity Term births Preterm births Abortions Living children |
| Guidelines for counting fetal movements (kick counts) the mother should pick a time when she can | Sit or lie quietly |
| Guidelines for counting fetal movements (kick counts) each fetal movement should be counted, the goal is | 10-12 movements/kicks in a 1-2 hour period |
| Danger signs during pregnancy | Visual disturbances headaches edema rapid weight gain pain signs of infection vaginal bleeding vaginal drainage persistent vomiting muscular irritability absence or decrease in fetal movements |
| Linea nigra and chloasma are more obvious in women with darker hair and skin and may be worsened with | Sun exposure |
| Excessive stress on the abdominal wall muscles may cause a | Separation (diastasis recti abdominis) |
| Cardiovascular changes in pregnancy: heart rate - blood pressure - | Increases 10-15 bpm slight decrease in second trimester |
| Exercises used to help tone the muscles of the perineum and prevent stress incotinence | Kegel exercises |
| This can help reduce leg cramps | Dorsiflexion of the foot |
| Factors that negate the woman’s use of a birthing center | Complications of pregnancy or necessary cesarean section |
| Signs of impending labor: a series of signs may occur as labor is about to begin approximately | 2 weeks before the onset of labor |
| Occasionally, a woman may have seepage or sudden outflow of fluid from the vagina. an evaluation performed to determine what the fluid is. a simple test with | Nitrazine paper can determine the fluid |
| Process of labor and delivery: the five Ps | Passageway Passenger Powers Position of the mother Psyche |
| Process of labor and delivery: the five Ps Passageway stands for | The pelvis and soft tissues |
| Process of labor and delivery: the five Ps Position of the mother stands for | Standing, walking, side lying, squatting, on hands and knees |
| Process of labor and delivery: the five Ps Psyche stands for | Psychological response |
| The most common position for delivery is | Left occiput anterior (LOA) |
| LOA is in which the occiput (back of head or skull) of the fetus points toward the left anterior segment of the | Maternal pelvis |
| Second most common position for delivery is | Right occiput anterior (ROA) |
| Placental separation is indicated by signs such as | A firmly contracting fundus a change in the uterus shape a sudden gush of dark red blood apparent lengthening of umbilical cord a vaginal fullness |
| Primary powers are | Involuntary contractions |
| Primary powers are responsible for | The effacement and dilation of he cervix |
| Secondary powers are | The woman experiences an involuntary urge to push (no effect on dilation) |
| Cardinal movements of labor: 1 engagement | Fetal head crosses the pelvic inlet |
| Cardinal movements of labor: 2 descent: (this is referred to) | Downward progress of the presenting part, this is referred to station |
| Cardinal movements of labor: 3 internal rotation: | The largest diameter of the fetal head aligns with the largest diameter of the pelvis |
| Cardinal movements of labor: 4 extension: | When the occiput passes under the symphysis pubis |
| Cardinal movements of labor: 5 restitution: | As soon as the head is delivered, it moves to realign with the body and shoulders |
| Cardinal movements of labor: 6 external rotation: | Occurs as the shoulders and body move through the birth canal |
| Cardinal movements of labor: 7 expulsion: | When the body of the infant leaves the pelvis |
| Stages of labor and delivery: first stage: dilation (3 parts) | Begins with contractions and ends with complete dilation (10-12 hours) 1. latent phase: 0-3 cm 2. active phase: 4-7cm 3. transitional: 8-10 cm |
| Stages of labor and delivery: second stage: delivery of the fetus | Begins with complete dilation at 10cm and ends with the birth of the baby (30mins-2hours) |
| Stages of labor and delivery: third stage: delivery of the placenta | Begins with the delivery of the infant and ends with the delivery of the placenta (5-20mins) |
| Stages of labor and delivery: fourth stage: stabilization | When the mothers body attempts to recover from the efforts of labor, monitored closely for 2-4 hours |
| Station measured how | Even with ischial spines: 0 2cm above spines: -2 2cm below spines: +2 |
| Magnesium sulfate: need to monitor | Check deep tendon reflexes |
| Magnesium sulfate: action | Seizure prevention in preeclampsia and eclampsia |
| Narcan: action | Suspected narcotic induced respiratory depression in neonates (given IM vastis lateralis) |
| Oxytocin: action | Producing uterine contractions; stimulates milk ejection by breasts |
| Normal fetal baseline | 120-160 |
| Fetal tachycardia | (for 10minutes) moderate increase: 160-180 marked increase: greater than 180 |
| Early decelerations | Caused by pressure on fetal skull, correspond to contractions |
| Late decelerations | Caused by decreased oxygen blood flow too fetus, absence of variability |
| Variable decelerations | Caused by compression on umbilical cord |
| APGAR: | Appearance Pulse Grimace Activity Respiration |
| Hypoxia | Insufficient availability of oxygen to meet metabolic needs |
| Meconium | The infants first stool, viscid, sticky, dark greenish brown, almost black; sterile odorless stool |
| Meconium staining | Meconium released from the fetal rectum in response to hypoxia |
| Surfactant | Decreased the surface tension within the alveoli and permits inflation |
| Regional anesthetics include | Paracervical, epidural, spinal, and pudendal blocks |
| To displace the uterus from the vena cava, and promote placenta blood flow | A wedge is placed under right side, or table turned to left side |
| Adverse effects of anesthesia | Regurgitation with aspiration of acidic gastric contents is fatal complication aspiration infection |
| Measures to reduce adverse effects of anesthesia | Restrict intake to clear fluids administer drugs to raise gastric pH administer drugs to reduce secretions |
| Avert neonatal respiratory depression by | Reducing time from induction of anesthesia until umbilical cord is clamped keeping use of sedating drugs to minimum until cord is clamped |
| Precipitous labor | Labor that lasts less than 3 hours demo onset of contractions to time of birth |
| Maternal complications | Uterine rupture lacerations of birth canal amniotic fluid embolism postpartum hemorrhage |
| Fetal complications | Hypoxia intracranial hemorrhage lasted to rapid birth as a result to rapid descent and related to fetal distress, meconium standing and aspiration may result (lower apgar scores) |
| Amniotomy | Artificial rupture of fetal membrane |
| Oxytocin stimulation | Induce labor that is not making adequate progress |
| Uterine inertia | Absence of weakness of uterine contractions |
| Newborn with forceps-assisted delivery may have & maternal complications include | Ecchymosis or edema lacerations, episiotomy extension, hematomas, and increased bleeding |
| Indications for cesarean birth (maternal) | - cephalopelvic disproportion (the head of the fetus if larger than the pelvic outlet) - previous c section - breech presentation - medical conditions that endanger mother (cardiac conditions) - abnormal conditions of placenta )placenta previa) - infections of vaginal canal - pelvic abnormalities |
| Indications for cesarean birth (fetal) | - hypoxia - prolapse of umbilical cord - breech - malpresentations - congenital abnormalities |
| Placenta previa | When placenta covers opening of mothers cervix |