Nurs-215 COTC exam 1

Nurs-215 COTC exam 1 antepartum time between conception and onset of labor intrapartum time from the onset of true labor until the birth of the infant postpartum Time from birth until the woman's body returns to prepregnant condition. Typically 6 weeks gestation Number of weeks from the first day of the last menstrual period abortion Birth that occurred 20 weeks gestation, or birth of a fetus under 500g. An abortion can occur spontaneously or may be induced term previously used to indicate normal duration of a pregnancy early term pregnancy 37 weeks 0 days to 38 weeks 6 days full term pregnancy 39 weeks to 40 weeks and 6 days late term pregnancy 41 weeks to 41 weeks and 6 days post term pregnancy >42 weeks Pre-term labor 20-37 weeks -gravida any pregnancy, regardless of gestation or outcome, including present pregnancy nulligravida no pregnancies primigravida first pregnancy multigravida a woman who has had two or more pregnancies -para birth 20 weeks gestation regardless of outcome nullipara a woman who has never gave birth after 20 weeks gestation stillbirth Loss of fetus after 20 weeks of pregnancy How long does it take in fertilization for the blastocyst to implant on the uterine lining? 7-10 days Subjective (presumptive) signs of pregnancy Amenorrhea; nausea and vomiting of pregnancy; excessive fatigue; urinary frequency; changes in the breast; quickening (women feel movement in the belly) REPORTED BY WOMEN Objective (probable) signs of pregnancy Changes in pelvic organs; enlargement of abdomen, Braxton hicks (contractions), changes in skin pigmentation, fetal outline, positive pregnancy test, Chadwick's sign (mucus membranes turn blue). NOTICED BY A HEALTHCARE PROVIDER Dx of pregnancy (positive) Fetal heartbeat, fetal movement felt by a PCP MUST HAVE BEEN SEEN, HEARD, OR MOVEMENT BY A PCP Pregnancy test detects? HCG, can be detected 7-9 days after contraception or 5 days after a missed period (Not a positive sign of pregnancy) Frequency of prenatal visits: 1. 0-28 weeks gestation? 2. 29-36 weeks gestation? 3. 37 weeks through delivery? 1. Q4 weeks 2. Q2 weeks 3. every week Time frame? first trimester Second trimester third trimester every 13 weeks is new trimester What to check during routine visits? -BP - Weight gain: 3.5 Lbs. per first trimester, 12-15 lbs. for both 2nd and 3rd trimester -Urine: for protein (preeclampsia) and glucose -Fundal height (22-36 weeks): weeks = Cm High -fetal HR w/ Doppler: 10-12 weeks -Ask about quickening: 16-22 weeks -pelvic/cervical exams: 37-38 weeks Ultrasound: early vs late Early gestation: -Abdominally @ 10 weeks -transvaginally < 10 weeks Can assess the fetus as early as 4 weeks (heartbeat can be seen at 6 weeks) -Conformation of pregnancy -Cervical assessment -Date pregnancy Mid Gestation: -Screen for anomalies Late Gestation: -Used to see if the infant's head is down or if a c-section is needed How many extra calories a day should a mother intake? pregnancy = 300 lactation = 500 Pregnancy screening test: Urine culture: Why? Rubella titer: want negative or positive result? ABO and Rh typing? when? and why? What is pseudoanemia? Group B strep: STI? what do we give for it? urine culture- For infection and infection can cause pre-term labor Rubella titer- want positive result because it means the mom has antibodies blood typing: mom is Rh - and baby is Rh +. must give RHoGAM pseudoanemia: increased plasma (50% increase) but not as many red cells (30%) Group B strep: Not an STI and give ATX to protect the child Danger signs of pregnancy: name at least 5 1. vaginal bleeding 2. fluid coming out vagina 3. swelling of fingers, face, or around eyes 4. continuous pounding headache 5. visual disturbances 6. epigastric pain (liver) 7. muscular irritability or seizures 8. fever over 101 9. painful urination 10. persistent vomiting 11. absent fetal movement 12. signs of preterm labor: rigid abdomen, backache, abdominal pressure, vaginal spotting changes in uterus during pregnancy 1. Braxton Hicks- Irregular, painless contractions that usually start around month 4; the difference from regular contractions is contractions open cervix 2. Hegar sign- softening of the isthmus (between cervix and uterus 3. Mcdonalds sign- Ease of flexing uterus Goodell's sign softening of the full cervix Normal findings of the cardiovascular system? 1. swollen lower extremities 2. fainting- because of change in blood volume 3. postural/orthostatic hypotension- because of pooling of blood in dependent veins 4. Supine hypotensive syndrome- sweaty, dizzy (put patient on side preferably left side) Exercises? Kegels- makes them push better and have better muscle tone Maternal Assessment: advised for 28 weeks gestation Cardiff method- Daily fetal movement record (DFMR) method-