Child Bearing

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Child Bearing
2013-01-23 10:11:26

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  1. Naegele's rule
    back 3 months and add seven days from first day of last period
  2. gravida
    total number of pregnancies regardless of duration
  3. para
    number of pregnancies that have gone beyond point of viability (regarldess if baby born alive or not)
  4. presumptive signs of pregnancy
    changes felt by woman

    ex-- amenorrhea, NV, fatigue, quickening
  5. 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
  6. alpha-fetal protein (AFP) test purpose
    predicts neural tube defects, fetal distress

    decreased levels suggest DS
  7. 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
  8. positive NST means what?
    two or more FHR accelerations of 15 bpm lasting 15 seconds over 20 minute interval and returns to normal baseline

  9. what does an early deceleration of FHR indicate?
    head compression

    benign patter
  10. what does a late decel indicate? is it good or bad?
    indicates fetal hypoxia


    onset is after contraction and slow to return to baseline
  11. 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
  12. what is a possible method to relieve variable decels?
    change mothers position
  13. nursing interventions for late decels (4)
    position mom on left side

    admin oxygen by mask

    stop oxytocin

    prep for C section
  14. nursing intervetion for cord prolapse (4)
    elevate presenting part off of cord

    call for help

    place client in trendelenburgs or knee chest position

    give oxygen
  15. 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)
  16. s/s of severe preeclampsia (4)
    blood pressure 150-160/100-110

    3-4+ proteinuria


  17. what does HELLP stand for?

    Elevated Liver enzymes

    Low Platelet count
  18. s/s of eclampsia (3)


    tonic clonic seizures, coma
  19. nursing care for preeclampsia (4)
    complete bedrest

    left lateral position

    monitor I/O

    meds -- mag sulfate
  20. def of placenta previa
    placenta implanted over lower segment of uterus, usually over cervical opening
  21. 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
  22. s/s of placenta previa (1 major one)
    bright red painless bleeding
  23. s/s of abruptia placenta (4)
    painful dark bleeding

    abdomen tender


    increased incidence WITH COCAINE USE
  24. nursing care for abruptio placentae (2)
    monitor for maternal shock and fetal distress

    IMMEDIATE delivery
  25. 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
  26. nursing interventions for postpartum hemorrhage (3)
    massage uterus if not firm

    admin Pit, Methergine and Hemabate as ordered

    monitor for shock
  27. what are risk factors when carrying twins  3

    perterm labor

    twin to twin transfusion (draining of blood from one twin to the other)
  28. purpose of an ultrasound (3)
    confirm pregnancy

    identify major anatomical features of baby/abnormalities

    determine gestational age
  29. what is the purpose of the development of highly acidic, clear vaginal secretions during pregnancy?
    aids in controlling the growth of pathological bacteria
  30. What is the average amount of weight gain suggested for pregnancy?
    25-35 lbs.

    More for underweight and less for overweight
  31. what are foods high in folic acid? (1 main group)
    green leafy veggies -- asparagus, spinach, brussel sprouts, broccoli, etc.
  32. 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
  33. 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
  34. 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
  35. what is the purpose of the AFP test?
    rule out Down syndrome (low level) and neural tube defects (high level)
  36. when are AFPs usually done?
    15-22 weeks
  37. what is the purpose of a Leopold maneuver?
    abdominal palpation of fetus presenting part, lie, attitude, descent
  38. patient prep for leopolds maneuver (3)
    empty bladder before starting

    lie supine

    wedge under right hip to prevent vena cava syndrome
  39. 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
  40. what are possible complications of amniocentesis? (6)
    amniotic fluid emboli

    maternal or fetal hemorrhage


    fetal damage or anomalies


    miscarriage or preterm labor
  41. what is a serious effect of polyhydraminos on the fetus?
    congenital anomalies
  42. what is normal fetal heart rate in the first trimest?
  43. what is an expected fetal heart rate near or at term?
  44. 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
  45. def of Goodell's sign
    softening of the cervix
  46. positive signs of pregnancy examples (3)
    • fetal heart rate heard on monitor
    • active fetal movements felt by examiner
    • outline of fetus on sonogram/ultrasound
  47. 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
  48. 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
  49. 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