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back 3 months and add seven days from first day of last period
total number of pregnancies regardless of duration
number of pregnancies that have gone beyond point of viability (regarldess if baby born alive or not)
presumptive signs of pregnancy
changes felt by woman
ex-- amenorrhea, NV, fatigue, quickening
probable signs of pregnancy and examples (6)
changes observed by examiner
- uterine enlargement
- Hegar's sign (thinning/softening of lower uterus)
- Goodell's sign
- Chadiwck's sign
- positive pregnancy test
- Braxton Hicks
alpha-fetal protein (AFP) test purpose
predicts neural tube defects, fetal distress
decreased levels suggest DS
nursing care for amniocentesis (4)
patient should empty bladder before procedure
can cause preterm labor, infection, amnitoic embolism
monitor fetus after and monitor for contractions
pt should report dec. fetal movements, contractions, abdominal discomfort, or fever
positive NST means what?
two or more FHR accelerations of 15 bpm lasting 15 seconds over 20 minute interval and returns to normal baseline
what does an early deceleration of FHR indicate?
what does a late decel indicate? is it good or bad?
indicates fetal hypoxia
onset is after contraction and slow to return to baseline
variable decels def and indicate what?
def-- decreases more than 15 bpm, lasts 15 seconds, returns to baseline within 2 min
indicates cord compression
ominous if repetitive, prolonged, severe or slow to return to baseline
what is a possible method to relieve variable decels?
change mothers position
nursing interventions for late decels (4)
position mom on left side
admin oxygen by mask
prep for C section
nursing intervetion for cord prolapse (4)
elevate presenting part off of cord
call for help
place client in trendelenburgs or knee chest position
lochia appearance changes over 10 days after delivery
days 1-3: rubra (bloody, fleshy odor, may be clots)
days 4-9: serosa (pink/brown, fleshy odor)
days 10+: alba (yellow/white, no odor)
s/s of severe preeclampsia (4)
blood pressure 150-160/100-110
what does HELLP stand for?
Elevated Liver enzymes
Low Platelet count
s/s of eclampsia (3)
tonic clonic seizures, coma
nursing care for preeclampsia (4)
left lateral position
meds -- mag sulfate
def of placenta previa
placenta implanted over lower segment of uterus, usually over cervical opening
nursing care for placenta previa (4)
bedrest side lying
no vaginal exams unless delivering
monitor amount of blood loss (at risk for fluid volume deficit)
Hgb and Hct
s/s of placenta previa (1 major one)
bright red painless bleeding
s/s of abruptia placenta (4)
painful dark bleeding
increased incidence WITH COCAINE USE
nursing care for abruptio placentae (2)
monitor for maternal shock and fetal distress
nursing care for hydatiform mole (3)
pregnancy discouraged for one year
hCG levels monitored for one year (do not want them to remain elevated as when mole is present)
contraception discussed -- NO IUD
nursing interventions for postpartum hemorrhage (3)
massage uterus if not firm
admin Pit, Methergine and Hemabate as ordered
monitor for shock
what are risk factors when carrying twins 3
twin to twin transfusion (draining of blood from one twin to the other)
purpose of an ultrasound (3)
identify major anatomical features of baby/abnormalities
determine gestational age
what is the purpose of the development of highly acidic, clear vaginal secretions during pregnancy?
aids in controlling the growth of pathological bacteria
What is the average amount of weight gain suggested for pregnancy?
More for underweight and less for overweight
what are foods high in folic acid? (1 main group)
green leafy veggies -- asparagus, spinach, brussel sprouts, broccoli, etc.
what 3 drinks inhibit the absorption of iron and what helps the absorption of iron?
inhibits -- coffee, tea and caffeinated soft drink
helps -- vitamin C
how is a chorionic villi sampling done?
a thin catheter is inserted into the vagina and uterus to obtain a sample of the chorionic cells to test for fetal anomalies
when is quickening usually experienced and what can cause it to be felt earlier than normal?
usually fet between 16-20 weeks
multiparous may be able to feel 14-20 weeks
what is the purpose of the AFP test?
rule out Down syndrome (low level) and neural tube defects (high level)
when are AFPs usually done?
what is the purpose of a Leopold maneuver?
abdominal palpation of fetus presenting part, lie, attitude, descent
patient prep for leopolds maneuver (3)
empty bladder before starting
wedge under right hip to prevent vena cava syndrome
what is the purpose of assessing fundal height? What level at 20 weeks until 36 weeks?
gross estimate of gestational age
20 weeks -- at umbilicus
increases 1 cm for each week utnil 36 weeks
what are possible complications of amniocentesis? (6)
amniotic fluid emboli
maternal or fetal hemorrhage
fetal damage or anomalies
miscarriage or preterm labor
what is a serious effect of polyhydraminos on the fetus?
what is normal fetal heart rate in the first trimest?
what is an expected fetal heart rate near or at term?
what should the fundus height measure in the third and trimester in relation to the gestational age?
the same as the gestational age +/- 2 cm
def of Goodell's sign
softening of the cervix
positive signs of pregnancy examples (3)
- fetal heart rate heard on monitor
- active fetal movements felt by examiner
- outline of fetus on sonogram/ultrasound
Sx of mother in Stage 1 latent phase of labor (3)
cervix 1-4 cm
uterine contractions spread apart and mild
mom is talkative and eager
sx of mother is stage 1 active phase of labor (3)
cervix is 4-7 cm
contractions every 3-5 min and moderate
may start to feel hopeless and restless
sx of mother in Stage 1 transition phase of labor (3)
cervix 8-10 cm
contractions every 2-3 min and strong
tired, feels out of control, restless