Antepartum Care

Card Set Information

Author:
cblake
ID:
15619
Filename:
Antepartum Care
Updated:
2010-04-21 22:35:32
Tags:
Pregnancy
Folders:

Description:
Maternal-Newborn Concepts
Show Answers:

Home > Flashcards > Print Preview

The flashcards below were created by user cblake on FreezingBlue Flashcards. What would you like to do?


  1. Luteinizing Hormone
    • -Stimulates the follicle to produce estrogen
    • -LH surge results in the establishment of the corpus luteum, which produces estrogen and progesterone.
    • -Menstrual cycle hormone
  2. Preembryonic Stage (time frame)
    fertilization through 2 weeks
  3. Embryonic Stage (time frame)
    end of 2nd week through 8th week
  4. Fetal Stage (time frame)
    end of 8th week through birth
  5. Preembyronic Development
    • -Fertilization in ampulla of fallopian tube
    • -union of sperm & ovum forms a zygote (46 chromosomes)
    • -cleavage cell division continues to form a morula (mass of 16 cells)
    • -Inner cell mass is called blastocyst, which forms embryo & amnion
    • -Outer cell mass is called trophoblast, which forms placenta & chorion
    • -Implantation occurs 7-10 days post conception into endometrium
  6. Blastocysts
    Form embryo and amnion
  7. Trophoblasts
    Form placenta and chorion
  8. Ectoderm
    Forms the central nervous system, special senses, skin & glands
  9. Mesoderm
    Forms skeletal, urinary, circulatory & reproductive organs
  10. Endoderm
    Forms respiratory system, liver, pancreas & digestive system
  11. Functions of Placenta and Umbilical Vessels
    • -Hormone production to maintain pregnancy
    • -Vehicle for fetal gas exchange
    • -Source of fetal nutrition
    • -Essential to a healthy pregnancy
  12. Placenta
    • -Means of metabolic and nutrient exchange b/w embryonic/fetal circulation & maternal circulation
    • -Begins to function around 3rd week, fully functional at about 11-14 weeks
    • -Suppresses maternal immunologic response so antibodies don't attack fetus as foreign body
    • -Maternal portion: decidua basalis
    • -Fetal portion: chorionic villi
    • -Functions: fetal respiration, nutrition and excretion - produces glycogen, cholesterol & fatty acids - hormone production
  13. Placental Hormones
    • -hCG (human chorionic gonadotropin)
    • -hPL (human placental lactogen)
    • -2 steroid hormones (estrogen and progesterone)
    • -Progesterone is main hormone of pregnancy
  14. Umbilical vessels
    • -Umbilical vein (1) carries O2 from mother to fetus
    • -Umbilical arteries (2) carry depxygenated blood from the fetus to the mother
  15. Amniotic Fluid
    • -Embryonic membranes from amniotic sac - amniotic membrane = amnion & chorion
    • -Production of amniotic fluid - fetus develops & urinary system activates - amniotic fluid from mom is swallowed and excreted as urine = amniotic fluid
    • - Functions: protection & cushion for fetus & umbilical cord - temp control - allows fro development of musculoskeletal system - allows for fetal movement - contains fetal cells (useful in testing) - can tell about the fetus' lungs
  16. Nageles' Rule for EDD/EDB/EDC
    • -1st day of LMP 11/21/07
    • -Subtract 3 months 8/21/07
    • -Add 7 days 8/28/07
    • -Adjust the year 8/28/08
  17. Gravida
    Gravida I (primagravida)
    Gravida II (secundgravida)
    Nulligravida
    Multigravida
    Grandmultigravida
    • pregnant woman
    • 1st pregnancy
    • 2nd pregnancy
    • Has never been pregnant
    • 3+ pregnancies
    • 5+ pregnancies
  18. Parity
    Primapara
    Multipara
    • a woman who has produced one or more offspring carrying a pregnancy 20 weeks or more
    • one birth after a pregnancy of at least 20 weeks
    • 2+ pregnancies resulting in viable offspring
  19. G
    T
    P
    A
    L
    • Gravida: all pregnancies including the present one
    • Term births: # of pregnancies ending @ 38-42 weeks gestation
    • Preterm births: # of preterm pregnancies ending > 20 weeks but < 38 weeks
    • Abortions: # of pregnancies ending before 20 weeks
    • Living children: # of children currently living
    • *multiple births (twins, etc.) = 1 pregnancy
  20. 1st trimester (timing)
    • conception - end of 13 weeks
    • **All organs developed
    • **Placenta developed
    • **Baby developed
  21. 2nd trimester (timing)
    week 14 - end of 26th week
  22. 3rd trimester
    • week 27 - birth
    • **transfer of maternal antibodies to baby (34-36 weeks)
  23. Presumptive Signs of Pregnancy
    • -Fatigue (12 weeks)
    • -Brest Tenderness (3-4 weeks)
    • -N & V (4-14 weeks)
    • -Amenorrhea (4 weeks) - major signs
    • -Urinary frequency (6-12 weeks)
    • -Fetal Movements/Quickening (16-20 weeks)
    • -Hyperpigmentation of skin (16 weeks)
    • -Uterine Enlargement (7-12 weeks)
    • -Breast Engorgement (6 weeks)
  24. Probable Signs of Pregnancy
    • -Braxton-Hicks contractions (16-28 weeks)
    • -Positive pregnancy test (4-12 weeks)
    • -Abdominal Enlagement (14 weeks)
    • -Ballottement (16-28 weeks) - uterus pushes back
    • -Goodell's Sign (5 weeks) - softening of cervix
    • -Chadwick's Sign (6-8 weeks) - cervix becomes blue
    • -Hegar's Sign (6-12 weeks) - softness in the middle of the uterus
    • -Uterine Souffle - sound of blood going through the uterus
  25. Positive Signs of Pregnancy
    • -Ultrasound verification of embryo or fetus (4-6 weeks)
    • -Fetal movement felt by experienced clinician (20 weeks)
    • -Auscultation of fetal heart tones via doppler (10-12 weeks)
    • -Fetal heart beat - 2-3 weeks; can auscultate at 10-12 weeks; can ultrasound at 5-6 weeks
  26. 1st Prenatal Visit
    • -Comprehensive Health Hx
    • -Physical Exam - head to toe assessment
    • -Psychosocial Hx - alcohol, smoking
    • -Pelvic Exam
    • -Labs - CBC, hormones, blood type & Rh, HIV, rubella, group B strept (GBS), STDs, TORCH
    • -Doppler HR
    • -Baseline VS
  27. T
    O
    R
    C
    H
    • Toxoplasmosis
    • Other (HIV)
    • Rubella
    • Cytomegalovirus
    • Herpes
  28. Prenatal Visit Schedule
    • -Every 4 weeks up to 28 weeks
    • -Every 2 weeks from 28-36 weeks
    • -Every week from 36 weeks to birth
    • -Pt. will be seen with greater frequency to monitor & manage high risk conditions
    • -Poor compliance with visit schedule has been associated with poor outcomes
  29. Assessments at subsequent prenatal visits
    • -weight and BP
    • -UA for protein, glucose, ketones & nitrates - gestational diabetes
    • -fundal height - assesses fetal growth
    • -Assess for quickening
    • -Assess FHR (120-160 bpm = normal)
    • -Preeclampsia: toxemia of pregnancy, characterized by HTN, albuminuria & edema
    • -Give rogam if mom is Rh - : just in case she's carrying an Rh + baby to stop her from creating antibodies against the body
  30. Pregnancy & Nutrition
    • -Caloric intake increased 300 kcal/day
    • -"eating for 2" leads to excessive weight gain
    • -RDA for most nutrients increase
    • -Folic Acid & Iron supplements usually the only recommended - possibly calcium also
    • -Limit fish intake
    • -Avoid weight loss diets
    • -Limit Soda, Caffeine
  31. Weight Gain During Pregnancy
    • -Recommended total wt. gain for women beginning singleton pregnancy at normal wt. = 25-30 lbs
    • -1st trimester = 3-5 lb wt. gain
    • -2nd & 3rd trimesters = 1 lb/week
    • -Pattern of wt. gain is as significant as total wt. gain!
  32. Weight Gain Distribution:
    -Breasts
    -Blood
    -Extra H2O
    -Uterus
    -Placenta, Fetus, Amniotic Fluid
    -Maternal Stores
    -Total
    • Weight Gain Distribution:
    • -Breasts = 3 lbs
    • -Blood = 4 lbs
    • -Extra H2O = 2-3 lbs
    • -Uterus = 2 lbs
    • -Placenta, Fetus, Amniotic Fluid = 11 lbs
    • -Maternal Stores = 5-10 lbs
    • -Total = 25-35 lbs
  33. Danger Signs of Pregnancy
    • -Bleeding or spotting
    • -Persistent vomiting
    • -Dysuria
    • -Fever > 100.0 F
    • -Sudden gush or leakage of fluid from vagina
    • -Severe upper abdominal/epigastric pain
    • -Severe HA
    • -Visual disturbances
    • -Pain in calf
    • -Decreased fetal movement
    • -Preterm Labor
  34. Progesterone
    Greatest role is maintaining pregnancy. Relaxes smooth muscle and inhibits uterine contractions
  35. Human Chorionic Gonadotropin (hCG)
    Secreted by fertilized egg to stimulate corpus luteum to secrete setrogen and progesterone
  36. Human Plactenal Lactogen
    Decreases insulin sinsitiviey, insulin antagonist, increases insulin resistance so glucose can go to the fetus
  37. Estrogen
    Uterine & breast development. Produced in corpus luteus then placenta
  38. Prostaglandins
    Decreased placental vascular resistance

What would you like to do?

Home > Flashcards > Print Preview