UNRS 402 - OB Final Exam Study Guide. Complete Guide.

UNRS 402 - OB Final Exam Study Guide. Complete Guide. UNRS 402 OBFinal Exam Study Guide ANTEPARTUM 1. What is antepartum? a. Pertaining to the time during pregnancy before the onset of labor 2. Probable, presumptive, positive signs of pregnancy. Presumptive indications: indications that are subjective changes that are experienced and reported by the women. Least reliable when confirming pregnancy; can be caused by conditions other than pregnancy a. Amenorrhea: absence of menstruation b. Nausea and vomiting:60-80% of women experience N/V. Beginning at 4-8 weeks and usually ending at 10-12 weeks c. Fatigue: fatigue and drowsiness during the first trimester; cause unknown (hormone changes possible) d. Urinary frequency: results from hormonal and fluid volume changes e. Breast and skin changes: breast changes begin by 6th week-breast tenderness, tingling, fullness, increased size and pigmentation of areolae. Increased pigmentation of skin resulting from estrogen and progesterone on melanocytes f. Vaginal and cervical color change: Chadwick sign is one of the earlies signs of pregnancy- Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion g. Fetal movement: not until second trimester. 16-20weeks. Probable indications: objective findings documented by examiner h. Abdominal enlargement i. Cervical softening: noted during pelvic exam j. Changes in uterine consistency k. Ballottement: tap on cervix during vaginal exam may cause the fetus to rise in the amniotic fluid and then rebound to its original position l. Braxton Hicks contraction m. Palpation of the fetal outline n. Pregnancy tests: detect hCG which is secreted by placenta and present in maternal blood and urine Positive indications o. Auscultation of fetal heart sounds: heart sounds can be heard with a fetoscope by 18 – 20 weeks. Doppler is used to detect heart motion and makes audible sound by 9 – 12 weeks p. Fetal movements felt by examiner: considered a positive sign; not to be deceived by peristalsis in large intestine q. Visualization of the fetus: ultrasonography-view the embryo or fetus and observe the fetal heartbeat 3. Normal pregnancy labs a. UNRS 402 OBFinal Exam Study Guide b. 4. Missed, threatened, incomplete, inevitable abortion. a. Abortion: loss of pregnancy before the fetus is viable, or capable of living outside the uterus b. Symptoms: i. Bleeding ii. Cramping iii. Loss of pregnancy symptoms (Matching question) c. POC-products of conception d. D&C-dilation and curettage (surgery that dilates the cervix and cleans out the uterus) Spontaneous Abortion (SAB): termination of pregnancy without action taken by the woman or another person e. Common cause is severe congenital abnormalities that are often incompatible with life i. Threatened abortion: the cervix is not dilated, and the placenta is still attached to the uterine wall, but some bleeding occurs. 1. The baby is still alive. The bleeding might resolve with bedrest, and she might be able to continue the pregnancy, but a miscarriage is a possibility. ii. Imminent/Inevitable abortion: the placenta has separated from the uterine wall, the cervix has dilated, and the amount of bleeding has increased. 1. There is so much bleeding that a miscarriage is inevitable, it can’t be stopped. The baby still has a heartbeat a. Vacuum curettage: removal of uterine contents with a vacuum curet- to clear uterus if natural process is ineffective or incomplete b. Dilation and curettage (D&C): stretching the cervical os to permit suctioning or scraping the uterine walls- if pregnancy is more advanced or if bleeding is excessive iii. Incomplete abortion: the embryo/fetus has passed out of the uterus; however, the placenta remains 1. Priority intervention-start an IV for fluid replacement and drug administration