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37 Cards in this Set
- Front
- Back
Intrapartum |
time women is in labor |
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postpartum |
after baby and placenta has been delivered
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Naegele's rule |
day of last menstraual period, add one year, subtracts three months and adds seven days estimated date of confinement |
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number of days in gestational period |
280 days |
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how many trimesters |
three thirteen week trimesters |
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gravida |
pregnancy terms - number of times she has ever been pregnant |
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para |
number of births after 20 weeks- includes still borns |
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GTPAL |
G is number of pregnancies including current pregnancy T- Term-number of pregnancies delivered at 37 weeks or later P-Preterm-number of pregnancies delivered between 20 and 37 weeks A-Abortion-number of pregnancies ending in spontaneous or therapeutic abortion L- living-number of currently living children |
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changes that occur in pregnancy that are subjective- can be caused by other conditions beside pregnancy |
amenorrhea, nausea and vomiting, excessive fatigue, urinary frequency, breast changes, quickening- from 16-20 weeks after last menstrual period- baby movement |
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objective changes during pregnancy |
changes in pelvic organs (chadwicks sign making it bluish/ purpleish)(hagers sign-softening of cervix), enlargement of abdomen, braxton hicks, abdominal striae, uterine souffle (auscultation of maternal pulse through uterine arteries), changes in skin pigmentation (darkening of melanin in face) (darkening of line from abdomen to pubis), ballottement, positive pregnancy test (just confirms HCG produced from placenta) (can be false positive) |
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hemagglutination-inhibition test |
pregnancy test- use urine which is added to HCG sensitivezed RBC and if HCG is in urine, then clumping of cells is inhibited can be done 4-10 days after missed period |
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latex agglutination test |
pregnancy test- same thing as hemagglutination -inhibition test, but done with latex instead of HCG |
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radioimmunoassay |
pregnancy test- have increased accuracy of pregnancy tests- detect pregnancy 8 days after ovulation expensive radioactive medical waste |
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home pregnancy tests use... |
enzyme-linked immunosorbent assay (ELISA) false negative results are more common than false positive marijuana, methodone, aspirin can all cause false positive hormonal changes in menopause and tumors can cause false positive false negative are due to low levels of HCG - should repeat it one week after first test |
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how do pregnancy tests work |
antigen-antibody response hcg is antigen in urine- hcg binds to the implanted antibodies test region contains anti hcg antibodies- bind on stick and changes color of stick control area changes stick color to show antibodies are doing what they should and test is behaving appropriately |
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positive signs of pregnancy |
auscultation of fetal heart beat (10-12 weeks), fetal movement (20 weeks), visualization of fetus (ultrasound, 4-5 weeks, vaginal is 10 days after implantation) |
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uterus changes |
pre pregnancy is 2 ounces, at the end is 2 pounds. enlargement from hypertrophy braxton hicks is irregular or intermittent tightening to fill blood in spaces |
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cervical changes |
mucous plug develops, hegar's sign- softening of isthmus goodell's- softening of cervix chadwick's sign- bluish/ purple discoloration |
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vaginal changes |
estrogen induced changes, hypertrophy, hyperplasia, acidic pH helps with bacterial infections, loosening of supportive tissue. |
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basal metabolism in pregnancy |
oxygen increases and therefore respiratory alkalosis occurs to compensate for this |
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cardiovascular changes |
blood volume increases 40-50%, decrease of impact of blood loss after delivery, blood composition changes to more red blood cells (vitamin supplements helps this), plasma volume increases more than red blood cells though (technically this is physiologic anemia) hemoglobin is 12 37-44for hematocrit (amount of space red blood cells take up) blood pressure adapts so there is not an increase in blood pressure even though there is a larger volume of blood |
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postural hypotension |
more prone during pregnancy. can also lead to lower extremity edema |
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kidney changes |
glomerulo filtration rate increases a lot increased flow and volume, decreased buin and creatine levels, increased volume of blood some drugs might be at a subtherapeutic level sugar in urine is common increased susceptibility to urinary infection |
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skin changes |
hyperpigmentation lineanegra- darkening of line from umbilicus to pubis chloasma- darkening patches on face and extremities vascular spider nevi- from increased blood flow stretch marks hair changes- hair feels thicker- rate of hair growth decreases and resting phase prolongs excellerated sweat and sebaceous glands- more acne |
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relaxin |
causes ligaments and joints to relax in order to facilitate delivery of baby |
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center of gravity changes |
lumbar spine changes causing sway back and shoulder, neck, and upper extremity discomfort |
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rubin's tasks of pregnancy |
ensuring safe passage through pregnancy, labor, and birth seeking of acceptance of this child by others seeking of commitment and acceptance of self as mother to the infant learning to give of oneself on behalf of one's child |
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couvade |
physical changes of father during pregnancy |
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ultrasound |
establish gestational age, fetal life, fetal number, fetal presentation and anatomy, amniotic fluid index, placental position, evaluate cervix and uterus can see cervix and uterus to see if there are any problems. can determine crown rump measurement fetal activity (fetal cardiac movement) |
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Maternal Serum Alpha Fetoprotein |
secreted by fetal liver and secreted into mother's blood elevated in neural tube defects |
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nuchal translucency on transvaginal ultrasonography |
can show down's syndrome if abnormalities in neck region (fluid filled sack) 15-20 weeks of pregnancy |
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amniocentesis |
metabolic disorders, genetic testing, embryonic cells, chromosomes, blood typing invasive- risk for infection- slight risk of spontaneous abortion |
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chorionic villus sampling |
piece of chorionic villus 10-12 weeks. if done earlier, short limb syndrome can happen genetic abnormality testing alpha fetal protein is not obtainable so can't test neural tube defects |
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nonstress test |
accelerations of heart beat imply intact CNS without stress being placed- if there are two or more fetal heart rate accelerations is normal |
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contraction stress test |
evaluates uteral placental function placenta is lungs of baby in utero identifies hypoxia of baby if fetus is compromised, FHR decreases with contraction |
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negative contraction stress test |
good. late or variable decelerations |
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biophysical profile |
nonstress test and an ultra sound nonstress is looking at CNS fetal heart rate accelerations ultrasound has four sections- fetal breathing, movements, tone, amniotic fluid volume (tells us if kidneys are working) |