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64 Cards in this Set
- Front
- Back
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External genitalia |
Labia - soft tissue that protect the entrance to the birth canal
Perineum - soft tissue and muscle found between the vaginal opening in the anus.
Mons pubis - soft tissue anterior to the vaginal opening where hair grows. |
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Internal genitalia |
Vagina - smooth muscle connects the uterus to the outside world. Birth canal.
Fallopian tubes or oviducts - Ducts where eggs travel to the uterus. Common site for ectopic pregnancies.
Uterus - where egg implants and fetus is developed.
Cervix - Separates the uterus from birth canal.
Ovary - Produces ova or eggs. |
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Uterus wall structure. |
Inner wall - Endometrium
Middle wall - Myometrium
Outer wall - Perimetrium |
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Female reproductive cycle. |
Production of estrogen and progesterone stimulate cycle events. Ovaries release ovum through ovulation. Walls of uterus thicken in preparation for implantation of the egg. Hey moves through peristalsis. Is usually fertilized in the Fallopian tube. When it is not fertilized the walls of the uterus slough off and are expelled through the vaginal channel. |
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Fertilization |
Embryo - Point of fertilization through eight weeks.
Fetus - Eight weeks of development through delivery. |
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Nine months of pregnancy |
Broken down into three trimesters.
First trimester - Fetus is formed little uterine growth.
Second trimester - Fetus growth Reaches umbilicus by fifth month.
Third trimester - Reaches epigastrium by seventh month. |
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Placenta |
Catch to the wall of the uterus and serves as an exchange area between mother and fetus.
Fetus has own blood supply and oxygen and nutrients are transferred through diffusion by the umbilical cord. |
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Amniotic sac |
Contains amniotic fluid which cushions and protects the fetus.
Can contain up 2 quarts of fluid commonly referred to as the bag of waters. |
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Physiologic changes |
Increase in blood volume, but no increase in red blood cells.
Commonly referred to as anemia
Massive increase in vascularity(Presence of blood and blood vessels).
Increased oxygen demand and consumption.
Compression of the stomach sex digestion. Nausea and vomiting.
Hormones released with pregnancy makes ligaments of pregnant women's Musculoskeletal System more elastic and more prone to injury. |
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Supine hypotensive syndrome |
During third trimester the weight of the fetus will tend to compress the inferior vena cava a reducing return of blood to the heart.
Causes dizziness and drop blood pressure. Commonly referred to as supine hypotensive syndrome.
Causes vena cava compression syndrome where body compensates by redirecting blood the major organs. Can severely affect fetus. |
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Stages of labor |
First stage - regular contractions and thinning of the cervix ends when cervix is fully dilated. Braxton hicks contractions. Lightening is the term used to describe the movement of the fetus high in the abdomen down toward the birth canal.
Second stage - baby enters birth canal until birth.
Third stage - afterbirth, umbilical cord and placenta delivered. |
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Meconium staining |
Indicates baby is being born under stress. Presence of fecal matter. Danger of Aspiration. |
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Assessing a women in labor |
1. Name, age, and expected due date.
2. Is this her first pregnancy.
3.Has she seen a doctor regularly.
4. When did labor start and how often is she having pains. As for water broken.
5. Does she feel the urge to push or move her bowels.
6. Examine for crowning.
7. Feel for uterine contractions.
8. Vital signs. |
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Decision Points |
Is delivery of the baby eminent.
Should I deliver or moved to the Ambulance. |
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Findings that might indicate need for neonatal resuscitation. |
No prior prenatal care.
Premature delivery.
Labor induced trauma or medical conditions affecting the mother.
Multiple births
History of problems with pregnancy.
Labor induced by drug use.
Meconium staining with the rupture of membranes. |
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Preparing the mother for delivery. |
1. Control the scene for mothers privacy.
2. In addition to gloves should have eye protection mask and get gown.
3. Play song back. Raise buttocks. Need to feet of work space below buttocks.
4. Remove any clothing that obstruct view of the vaginal opening.
5. Position birth partner at mothers head. Watch for vomiting and provide encouragement.
6. I have obstetrics kit in easy reach.
7. If possible make environment as warm as possible. |
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Preparing the mother for delivery. |
1. Control the scene for mothers privacy.
2. In addition to gloves should have eye protection mask and get gown.
3. Play song back. Raise buttocks. Need to feet of work space below buttocks.
4. Remove any clothing that obstruct view of the vaginal opening.
5. Position birth partner at mothers head. Watch for vomiting and provide encouragement.
6. I have obstetrics kit in easy reach.
7. If possible make environment as warm as possible. |
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Steps of normal delivery. |
1. Continue to have someone support mother positioned at her head.
2. Position gloved hands at vaginal opening when babies head appears.
3. One hand below babies head. Be careful of babies soft spots or fontanelles.
4. If bag of water has not broken by the time babies fed appears manually break it. If fluid is not clear and meconium present prepared to suction.
5. Once they hit appears check to see that the umbilical cord is not wrapped around the baby's neck.
6. Help deliver the shoulders
7. Support the baby throughout the entire birth process. Be prepared to suction and watch for pulsating in the umbilical cord.
8. Assess the airway. Such in the mouth first then the nostrils.
9. Nope it's that time of birth and provide last name and time of delivery on tape on the babies wrist. |
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Neonate |
Newly born baby and infants less than one month old. |
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Infant |
Baby in first year of life. |
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Infant |
Baby in first year of life. |
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Fetus |
Baby as it developed in womb. |
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Assessing the Neonate |
Note breathing, heart rate, crying, movement, and skin color.
Pulse should be greater than 100/min. Should be breathing easily and crying.
Apgar Score Appearance: blue, blue extreme ties, pink all over. Pulse: 0, 100 Grimace: none, face, cry Activity: none, slight, vigorous. Respiratory: none, slow, normal.
Determine 1 minute after birth and again at 5 minutes.
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Caring for neonate |
Keep baby warm. Loss of body heat affects glucose levels and oxygen exchange.
As soon as possible move baby to mothers chest and encourage breast-feeding. |
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Cutting the umbilical cord. |
What necessitates cutting the cord:
If the court is around the baby neck and cannot be removed.
If the cord impedes resuscitation.
This attachment interferes with need to transport.
Some protocols require cord to be cut.
There is no hurry to cut the cord. Check for pulsating in the cord before you cut it. |
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Procedure for umbilical cord care. |
1. Keep input warm and dry.
2. You sterile clamps and ties in kit.
3. Apply first clamp 10 inches from the baby.
4. Play second clap 7 inches from the baby.
5. Cut the cord between the clamps with sterile scissors.
6. Be careful during transport but the cord is not become open and bleeding starts. |
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Meconium staining |
1. To reduce aspiration, do not stimulate infant until suctioning mouth and nose.
2. Suction mouth than nose.
3. Maintain airway.
4. Provide ventilation or compressions if needed.
5. Transport |
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Other complications |
Vaginal bleeding
Syncope
Lack of movement after twenty weeks.
Placenta Previa - Placenta formed over cervix.
Abruptio Placenta - Separates from uterine wall.
Ectopic pregnancy - egg implants outside uterus. (Fallopian tube, in cervix or pelvic cavity).
Seizures - eclampsia
Preeclampsia - pregnancy induced hyper-tension. (Altered mental status, swollen hands, feet, and face, high blood pressure) |
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Seizure treatment |
1. Ensure airway 2. High con O2 no rebreather 3. Transport left side. 4. Handle gently 5. Keep warm 6. Suction ready 7. Have delivery kit ready 8. Contact ALS |
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Miscarriage and Abortion |
Spontaneous Abortion - Happens on its own. Also called miscarriage
Induced Abortion - One that is deliberately induced. |
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Miscarriage. Cramping Bleeding Vaginal discharge |
1. Obtain vitals 2. Signs shock and give O2 3. Sanitary napkin for bleeding 4. Transport 5. Save all blood soaked pads 6. Save all expelled tissue 7. Provide emotional support |
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Trauma in pregancy |
Hemorrhage
Falls
Auto collisions-uterine rupture or premature separation.
Blunt trauma - bleeding and shock |
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Assessment steps in trauma during pregnancy |
1. Pregnant patient has pulse rate 10 to 15 beats faster than normal.
2. Because of high volume of blood, may have 30 to 35 per cent blood loss before symptoms of shock.
Shock is most likely cause of death due to uterine injury.
Question patient to determine if she has received any blows to abdomen pelvis or back.
Ask patient if she has had bleeding or rupture of the bag of waters.
Examine the unconscious patient for abdominal injuries. |
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Neonatal resuscitation |
This baby does not begin breathing after 30 seconds of warming and drying resuscitate.
By warmth and assess the babies airway.
Stab wish that the baby is breathing if not vigorously row babies back snap index fingers across soul of babies feet.
Assess babies heart rate. If heart rate less than 100 provide them ventilation at the rate of 40 to 60 per minute.
CPR 120/minute ( 90 compressions 30 ventilations)
If adequate pulse rate and ventilations reassess airway. |
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Care after delivery |
A woman who is delivered a baby is at risk for serious bleeding infection and emboli. |
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Delivering the placenta |
Transportation to the hospital can be delayed up to 20 minutes for delivery of the placenta.
Save all afterbirth tissues. |
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Controlling vaginal bleeding after birth |
1. Place sanitary napkin over vaginal opening.
2. Mother lower legs and keep them together.
3. Massage the uterus to help it contract. Painful for the mother. |
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Child birth complications |
Breech: 1. Rapid transport. 2. Do not pull on legs. 3. High concentration O2 4. Head down with pelvis elevated. 5. If body delivers form V to keep obstructions from breathing. 6. Care for baby, mother, cord and placenta as in cephalic birth. |
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Limb presentation |
1. If prolapsed cord provide removal of pressure on cord.
2. Transport
3. Head down pelvis raised
4. High- Con O2 |
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Prolapsed Umbilical Cord |
Cord squeezed between uterine wall and babies head or other body part.
1. Head down pelvis raised. Elevate hips, O2, keep warm Keep baby head away from cord Do not push cord back. Wrap cord sterile moist towel Transport with pressure on babies head.
2. High-Con O2, non rebreather
3. Check cord pulse
4. Insert fingers to remove pressure on cord.
5. Stay in position until hospital is reached.
6. Rapid transport required. |
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Multi births |
1. Assure appropriate resources
2. Clamp or tie first baby before second is born.
3. Second born either before or after placenta expelled.
4. Provide care for babies.
5. Take special care to keep babies warm. Usually smaller. |
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Premature Birth |
Born before 37th week.
1. Keep warm
2. Keep patent airway. Suction.
3. Provide ventilation and compressions if needed.
4. Watch umbilical cord for bleeding.
5. Avoid contamination
6. Transport infant in warm ambulance.
7. Call ahead to hospital. |
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Procedure for umbilical cord care. |
1. Keep input warm and dry.
2. You sterile clamps and ties in kit.
3. Apply first clamp 10 inches from the baby.
4. Play second clap 7 inches from the baby.
5. Cut the cord between the clamps with sterile scissors.
6. Be careful during transport but the cord is not become open and bleeding starts. |
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Meconium staining |
1. To reduce aspiration, do not stimulate infant until suctioning mouth and nose.
2. Suction mouth than nose.
3. Maintain airway.
4. Provide ventilation or compressions if needed.
5. Transport |
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Other complications |
Vaginal bleeding
Syncope
Lack of movement after twenty weeks.
Placenta Previa - Placenta formed over cervix.
Abruptio Placenta - Separates from uterine wall.
Ectopic pregnancy - egg implants outside uterus. (Fallopian tube, in cervix or pelvic cavity).
Seizures - eclampsia
Preeclampsia - pregnancy induced hyper-tension. (Altered mental status, swollen hands, feet, and face, high blood pressure) |
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Seizure treatment |
1. Ensure airway 2. High con O2 no rebreather 3. Transport left side. 4. Handle gently 5. Keep warm 6. Suction ready 7. Have delivery kit ready 8. Contact ALS |
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Miscarriage and Abortion |
Spontaneous Abortion - Happens on its own. Also called miscarriage
Induced Abortion - One that is deliberately induced. |
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Miscarriage. Cramping Bleeding Vaginal discharge |
1. Obtain vitals 2. Signs shock and give O2 3. Sanitary napkin for bleeding 4. Transport 5. Save all blood soaked pads 6. Save all expelled tissue 7. Provide emotional support |
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Trauma in pregancy |
Hemorrhage
Falls
Auto collisions-uterine rupture or premature separation.
Blunt trauma - bleeding and shock |
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Assessment steps in trauma during pregnancy |
1. Pregnant patient has pulse rate 10 to 15 beats faster than normal.
2. Because of high volume of blood, may have 30 to 35 per cent blood loss before symptoms of shock.
Shock is most likely cause of death due to uterine injury.
Question patient to determine if she has received any blows to abdomen pelvis or back.
Ask patient if she has had bleeding or rupture of the bag of waters.
Examine the unconscious patient for abdominal injuries. |
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Trauma in pregnancy |
1. Provide resuscitation if necessary.
2. Provide high concentration of oxygen non-rebreather mask.
3. Greater risk for vomit be ready with suction.
4. Control external hemorrhage
5. Transport as soon as possible.
6. Provide emotional support. |
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Neonatal resuscitation |
This baby does not begin breathing after 30 seconds of warming and drying resuscitate.
By warmth and assess the babies airway.
Stab wish that the baby is breathing if not vigorously row babies back snap index fingers across soul of babies feet.
Assess babies heart rate. If heart rate less than 100 provide them ventilation at the rate of 40 to 60 per minute.
CPR 120/minute ( 90 compressions 30 ventilations)
If adequate pulse rate and ventilations reassess airway. |
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Care after delivery |
A woman who is delivered a baby is at risk for serious bleeding infection and emboli. |
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Delivering the placenta |
Transportation to the hospital can be delayed up to 20 minutes for delivery of the placenta.
Save all afterbirth tissues. |
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Controlling vaginal bleeding after birth |
1. Place sanitary napkin over vaginal opening.
2. Mother lower legs and keep them together.
3. Massage the uterus to help it contract. Painful for the mother. |
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Child birth complications |
Breech: 1. Rapid transport. 2. Do not pull on legs. 3. High concentration O2 4. Head down with pelvis elevated. 5. If body delivers form V to keep obstructions from breathing. 6. Care for baby, mother, cord and placenta as in cephalic birth. |
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Limb presentation |
1. If prolapsed cord provide removal of pressure on cord.
2. Transport
3. Head down pelvis raised
4. High- Con O2 |
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Prolapsed Umbilical Cord |
Cord squeezed between uterine wall and babies head or other body part.
1. Head down pelvis raised. Elevate hips, O2, keep warm Keep baby head away from cord Do not push cord back. Wrap cord sterile moist towel Transport with pressure on babies head.
2. High-Con O2, non rebreather
3. Check cord pulse
4. Insert fingers to remove pressure on cord.
5. Stay in position until hospital is reached.
6. Rapid transport required. |
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Multi births |
1. Assure appropriate resources
2. Clamp or tie first baby before second is born.
3. Second born either before or after placenta expelled.
4. Provide care for babies.
5. Take special care to keep babies warm. Usually smaller. |
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Premature Birth |
Born before 37th week.
1. Keep warm
2. Keep patent airway. Suction.
3. Provide ventilation and compressions if needed.
4. Watch umbilical cord for bleeding.
5. Avoid contamination
6. Transport infant in warm ambulance.
7. Call ahead to hospital. |
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Stillbirths |
Born dead or dies shortly after birth.
Keep accurate records of the time of stillbirth in care rendered for completion of fetal death certificate. |
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Cardiac arrest in the pregnant patient |
Worst case scenario.
Form CPR with uterus displaced if more than 20 weeks pregnant. 1 to 2 inches higher on the sternum to compensate for shifting heart and large uterus.
Can and should be defibed. |
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Vaginal bleeding - Hypovolemic Shock |
1. Take standard precautions
2. Ensure Airway
3. Assess for shock
4. Give O2
5. Transport |
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Sexual assault |
Both medical and psychological care.
Generally prefer same sex care giver.
1. Immediate life-threats
2. Do not disturbed evidence.
3. Exam genitals only if severe bleeding
4. Crime scene preservation.
5. Discourage bathing, voiding or cleansing of wounds.
6. Document situation.
7. Learn what social resources are available. |
