Maternal Midterm Exam Study Guide

Preembryonic stage - Fertilized ovum becomes morula, then blastocyst, amnion, and germ layers form (conception - 2 weeks) Embryonic stage - Implantation, neural tube fuses, heartbeat week 3, limb buds form, respiratory and digestive tracts begin to form (2-8 weeks) Fetal stage - Weeks 9-38, movements begin, kidneys function, genitalia forms Placenta gas exchange - Responsible for gas exchange for fetus Dirty Duncan - The side of the placenta that is the mother's Placenta functions - Circulation, protection, and hormone production hCG - Human chorionic gonadotropin, hormone that makes the positive sign on a pregnancy test Umbilical cord function - Serves as a conduit for blood traveling to and from the embryo/fetus Umbilical cord size - At birth 55 cm long and 2 cm in diameter on average Umbilical cord contents - Contains one large vein carrying oxygenated blood and two smaller arteries carrying deoxygenated blood to the placenta Wharton jelly - Substance the umbilical cord is covered in Gestational parent thyroid hormones - Supplies to the fetus until the 12th week of pregnancy Insulin needs in pregnancy - Steadily increase in the second half of pregnancy Cortisol increase - Occurs in the second trimester of pregnancy and may promote lung and neurological development Oxytocin - Hormone producing contractions, postpartum uterine contractions, and milk ejection Oxygen consumption increase - 15% to 20% in pregnancy Estrogen effects - Causes congestion of mucous membranes, swelling, and frequent nose bleeds Cardiac output increase - By 50% in pregnancy Blood volume increase - By 40% to 45% in pregnancy White blood cell increase - Occurs during pregnancy but doesn't always mean infection Colostrum - A yellowish form of early milk, produced and may leak from the nipple Uterus size - Between the 16th and 36th week of pregnancy, equals the number of weeks' gestation Mucus plug - Forms inside the cervical canal to create a barrier against pathogens Vaginal pH - Slightly more acidic, preventing against bacterial pathogens Relaxin and progesterone effects - Increase the mobility of pelvis for birth but make joints less stable Round ligament - Position and stabilize the uterus, can stretch and cause pain Supine hypotension - Caused by the pressure of the pregnant uterus on the inferior vena cava when the patient lies on the back Headaches in pregnancy - Common but should be monitored carefully as they can be a sign of preeclampsia Prenatal care appointments - Every 4 weeks until week 28, every 2 weeks between 28 and 36 weeks, and weekly after 36 weeks Prenatal appointments - Include physical assessment, history, vital signs, fetal heart rate assessment, fundal height measurement, fetal activity, and pertinent education Five Ps - Power, passageway, passenger, psyche, position Signs of impending labor - Contractions become regular, presence of bloody show, descent of the fetus, nesting impulse, GI distress, and weight loss First stage of labor - Dilation and effacement of the cervix, including latent and active phases Cardinal Movements - Engagement, descent, flexion, internal rotation, extension, external rotation, and expulsion Third stage of labor - Begins with the birth of the baby and ends with delivery of the placenta Fourth stage of labor - Begins with the delivery of the placenta and ends after 4 hours or when the patient becomes clinically stable Newborn bpm - 110 and 160 bpm Moderate vulnerability - 6-25 Variable decelerations - Caused by cord compression Late decelerations - Caused by poor placental perfusion Category I FHR Monitoring - Baseline FHR 110-160, moderate variability, with or without accelerations, and with or without early decelerations