Term
|
Definition
1. Kick count: Assessment by mother, <3/hr requires further testing
2. Ultrasonography
3. Nonstress Test (NST) via EFM for reactivity
4. Contraction test: fetal monitoring during contractions, nipple stim, or pitocin
5. Biophysical profile (BPP) |
|
|
Term
|
Definition
| Fetal HR activity, gestational age, fetal growth, anatomy, genetic disorders, Amniotic Fluid volume, placental function and position |
|
|
Term
|
Definition
fetal well being by point system
-reactivity of fetal HR: reactive=2
-Fetal breathing movements: at least 1 episode of 30 sec. in 30 min.
-Gross body movement: at least 3 body or limb extensions with return to flexion
-Fetal Tone: extension to flexion
Amniotic fluid volume: at least 1 pocket of fluid cm in 2 planes |
|
|
Term
|
Definition
Normal AFI is 10-25 cm
-Oligohydraminos
-Polyhyamions
abnormalities in AFV are frequently associated with fetal disorders |
|
|
Term
| Indications for use of BPP |
|
Definition
| Nonreactive stress test, suspected oligohydraminos or polyhydramion, suspected fetal hypoxemia/hypoxia, premature rupture of membranes, maternal infections |
|
|
Term
|
Definition
HIGH RISK: can cause hemorrhage, infection, preterm labor
aspiration of fluid for analysis |
|
|
Term
| Indications for use of Amnio |
|
Definition
| genetic disorders, fetal lung maturity, fetal hemolytic disease |
|
|
Term
| Chorionic Villus Sampling (CVS) |
|
Definition
1rst trimester alternative to amnio
-early diagnosis and rapid results (performed at 10-12 weeks)
-Tissue specime from fetal portion of placenta |
|
|
Term
|
Definition
AFP (alpha-fetoprotein) for neuro defects
-from amnio between 16-18 weeks
-serum screening for neural tube defects, anencephaly, abd. wall defects, trisomy 21 |
|
|
Term
|
Definition
Type1,2 and drug/infection induced
-require preconception counseling
Maternal Risks: hydramnios, ketoacidosis hypo/hyperglycemia, miscarriage, infection, should dystocia
Fetal Risk: sudden/unexplained stillbirth, congentical anomolies (CNS, cardiac, skeletal) |
|
|
Term
|
Definition
Any degree of glucose intolerance with onset or recognition during pregnancy
-Careful management through diet, exercise and sometimes medication |
|
|
Term
| Changes in cardiac function during pregnancy |
|
Definition
Increased Intravascular Volume
Decreased systemic vascular resistance
cardiac output changes during labor and birth
Intravascular volume changes occur after birth |
|
|
Term
|
Definition
increased incidence for miscarriage and stillbirth
preterm labor/birth are more common
IUGR
Mothers w/ congenital heart abnormalities increase likelihood in children |
|
|
Term
Pruritic Urticarial Papules and Plaques of Pregnancy
(PUPP) |
|
Definition
Extremely itchy rash, primarily on the abdomen but can spread.
therapy: relieve discomfort |
|
|
Term
| Intrahepatic Cholestasis of Pregnancy |
|
Definition
| Extreme itchiness, typically affects palms of hands and soles of feet |
|
|
Term
|
Definition
| Onset of HTN without proteinuria after the 20th week of pregnancy. BP 140/90 or greater. |
|
|
Term
|
Definition
| develops only during pregnancy, HTN develops after the 20th week of pregnancy. decreased organ perfusion causes HTN and protenuria. focus is on poor perfusion. |
|
|
Term
|
Definition
| HA, BP>140/90, hyperreflexia, blurred vision, epigastic/RUQ pain, edema, proteinura. sometimes tachycardia, AMS, anxiety, dyspnea, weakness, N/V |
|
|
Term
| Diagnosis of Preeclampsia |
|
Definition
| Diastolic BP is > 90 in same arm at least 2x and one of the following: proteinuria, maternal symptoms, maternal signs of organ dysfunction, abnormal maternal test, fetal morbidity |
|
|
Term
|
Definition
| Fluid Restrition, magnesium sulfate(anticonvulsant)(antidote: calcium gluconate), control blood pressure(antiHTN meds), minimize risk, delivery |
|
|
Term
|
Definition
hepatic dysfunction involved in severe preeclampsia includes symptoms:
H-Hemolysis: destruction of RBCs
EL- Elevated Liver enzymes (AST, ALT)
LP- Low Platelets (normal is above 100)
--may require transfusion |
|
|
Term
|
Definition
seizure activity or coma following DX of preeclampsia
-no HX of seizures
-presentation varies: in labor, during delivery, within 72hrs of delivery |
|
|
Term
|
Definition
premonitory S/S: HA, blurred vision, severe epigastric pain, altered mental status
immediate care required: ensure patent airway, prevent self-injury, decision regarding timing and method of birth required |
|
|
Term
|
Definition
presentation before pregnancy or before 20 weeks.
R/t: increased risk of placenea abruptio, perinatal mortality, fetal growth restriction and SGA
*can still get preeclampsia/ecplampsia |
|
|
Term
|
Definition
Management before conception, lifestyle modifications, medications continued
Consistent BP measurements, check for edema, DTRs, clonus, headache, blurred vision, epigastric pain |
|
|
Term
|
Definition
| Excessive vomiting accompanied by weight loss, electrolyte imbalance, and ketonuria-prolonged past 12 weeks |
|
|
Term
| Management of Hyperemesis Gravidarum |
|
Definition
| IV fluids, NPO, Vit. B supplements, antiemetics, severe cases TPN |
|
|
Term
| Risk factors for Hyperemesis gravidarum |
|
Definition
| <20 yrs., obesity, first pregnancy, multifetal pregnancy, trophoblastic disease, hx of psych. disorder, Vit. B deficiency, high stress levels |
|
|
Term
| Vaginal Bleeding (First trimester) |
|
Definition
ALWAYS abnormal during pregnancy
Spontaneous abortion (miscarriage)
Ectopic Pregnancy |
|
|
Term
| Vaginal Bleeding (Second Trimester) |
|
Definition
ALWAYS abnormal during pregnancy
Gestational trophoblastic disease
Incompetent cervix |
|
|
Term
| Vaginal Bleeding (Third Trimester) |
|
Definition
| placenta previa, abruptio placenta, preterm labor |
|
|
Term
| Miscarriage (spontaneous abortion) |
|
Definition
| pregnancy that ends as a result of natural causes before 20 weeks |
|
|
Term
|
Definition
Threatened (influencing factors)
Inevitable
Incomplete (tissue is retained)
Complete (everything has passed, no intervention needed)
Missed (death inside but nothing has happened)
Recurrent |
|
|
Term
| Signs and Symptoms of Miscarriage |
|
Definition
| vaginal spotting or moderate to heavy bleeding with or without pain, cramping, backache, passage of tissue, rupture of membranes, fever (possible infection) |
|
|
Term
|
Definition
| Fertilized ovum implanted outside the uterine cavity - maternal death by hemorrhage |
|
|
Term
|
Definition
| abdominal pain (usually unilaterally), delayed menses, abnormal vaginal bleeding |
|
|
Term
| Management of Ectopic Pregnancy |
|
Definition
surgical removal, methotrexate (to induce passing), high rate of reccurence depending on cause
Risk Factors: PID, IUD |
|
|
Term
| Signs and Symptoms of Hydatidiform Mole |
|
Definition
Early stages: normal pregnancy
Later stages: bright red or brown vaginal bleeding, excessively enlarged uterus, abnormal fundal height, dense growth of vesicles but no fetus |
|
|
Term
| management of hydatidiform |
|
Definition
-most pass spontaneously, suction
-curettage is safe to aspirate and evacuate mole
*follow up is very important: hCG every 1-2 weeks, then continue every 2-4 weeks for 6 months then every 2 months for 1 yr for malignant transformation |
|
|
Term
|
Definition
Placenta is implanted near or over the internal cervical os.
classified based on location: complete, partial, marginal
-major complication: maternal hemorrhage, fetal prematurity, death
Risk Factors: previous previa, uterine scarring, >35 yo. multifetal pregnanacy, multiple gestations, or closely spaced pregnancies |
|
|
Term
| Diagnosis of Placenta Previa |
|
Definition
| Ultrasound: any painless bleeding after 20 weeks |
|
|
Term
|
Definition
Minimize contractions: pelvic rest (no vaginal exam), observation, bed rest
Fetal Monitoring
Cesarean birth |
|
|
Term
|
Definition
premature separation of placenta
Risk factors: maternal HTN, abd. trauma, cocaine abuse, previous abruption, cigarette smoking, premature ROM, short umbilical cord, multifetal pregnancy
- IUGR and premature birth |
|
|
Term
|
Definition
depends on blood loss and fetal status.
-NO vaginal exams
-May need a transfusion
-Usually Delivery is emergency C-section due to fetal distress |
|
|
Term
| Velamentous Insertion of Cord |
|
Definition
| cord vessels branch at membranes and course onto placenta |
|
|
Term
|
Definition
| Vessels run through membranes |
|
|
Term
| Disseminated Intravascular Coagulation |
|
Definition
Diffuse clotting causing widespread external and internal bleeding, often triggered by the release of large amounts of thromboplastins
could be triggered by HELLP or preeclampsia |
|
|
Term
|
Definition
T: toxoplasmosis (cat poop)
O: other infections (Hep A and B)
R: Rubella
C: Cytomegalovirus
H: Herpes Simplex |
|
|
Term
|
Definition
| Cervical change and uterine contractions occurring between 20-37 weeks |
|
|
Term
|
Definition
any birth that occurs before 37 weeks of pregnancy
-decreased length of time in utero correlates with immaturity of body systems in the infant
can be spontaneous or indicated |
|
|
Term
| Categories of Spontaneous Preterm Birth |
|
Definition
| preterm labor, premature rupture of membrane (PROM), cervical insufficiency, Amnionitis |
|
|
Term
|
Definition
| A means of resolve maternal or fetal risk related to continuing pregnancy by infant delivery |
|
|
Term
| Treatment of Preterm Labor |
|
Definition
Activity Restriction (bedrest, limited work, restriction of sexual activity)
Suppression of Uterine Activity (tocolytics)magnesium sulfate, terbutaline, nifedipine, indomethacin |
|
|
Term
|
Definition
| goal is to delay birth long enough to institute interventions that delay neonatal morbidity and mortality |
|
|
Term
| Antenatal Glucocorticoids |
|
Definition
recommended for all women at risk for preterm labor
reduces incidence of: respiratory distress syndrome, necrotizing enterocolitis, intravascular hemorrhage , death
-helps to develop lungs at faster rate |
|
|
Term
| Premature Rupture of Membranes |
|
Definition
| rupture of amniotic sac and leakage of fluid beginning at least 1 hr. before onset of labor at any gestational age. |
|
|
Term
|
Definition
| labor that lasts 3 hours or less from the onset of contractions to time of birth |
|
|
Term
| Complications R/t precipitous labor |
|
Definition
| maternal cervical, vaginal or perineal damage, uterine rupture, amniotic fluid embolism, postpartum hemorrhage, fetal hypoxia, fetal cephalic trauma |
|
|
Term
|
Definition
long, difficult or abnormal labor
-dysfunctional labor from abnormal contractions preventing: dilation, effacement, descent |
|
|
Term
| Preterm Premature Rupture of Membranes (PPROM) |
|
Definition
| pathological weakness of fetal membrane, caused by infection, stress of contractions, inflammation, etc. |
|
|
Term
| Risk Factors for Dysfunctional Labor |
|
Definition
| short stature, overweight, advanced maternal age, infertility, uterine abnormalities, malpresentation or position of fetus, CPD, overstimulation with oxytocin, maternal fatigue, dehydration for electrolyte imbalance, in appropriate timing of analgesia or anesthetics |
|
|
Term
| Types of Dysfunctional labor |
|
Definition
hypertonic (primary dysfunctional labor)
Hypotonic (secondary uterine inertia)
secondary powers
abnormal labor patterns
percipitous labor |
|
|
Term
|
Definition
Version: external cephalic version or internal
Induction of Labor: elective vs. indicative |
|
|
Term
| External Cephalic Version |
|
Definition
manipulation through the abd. wall after 37 weeks to direct a malpositioned fetus into normal vertex cephalic position. for breech or transverse
risks: umbilical prolapse, bleeding |
|
|
Term
|
Definition
Determines maternal readiness for labor based on cervix. dilation, effacement, consistency, position, presenting station.
9+ for nulliparous, 5+ for multiparous |
|
|
Term
|
Definition
| deliberate initiation of uterine contractions to stimulate labor before spontaneous onset. |
|
|
Term
|
Definition
| postterm pregnancy, dystocia, prolonged rupture of membranes, maternal medical complication, fetal demise, chorioamnionitis |
|
|
Term
|
Definition
Artificial rupture of amniotic membranes (AROM)
-labor usually begins within 12 hrs.
-increased risk for cord prolapse or infection
-indicated for slow progression of labor, indicating induction or augmentation |
|
|
Term
|
Definition
Chemical agents: prostaglandins (Cytotec, Cervidil)
Mechanical Agents: Balloon catheter, hydroscopic dilators, laminaria tents |
|
|
Term
|
Definition
Hormone naturally produced by posterior pituitary gland
-stimulate uterine contractions |
|
|
Term
|
Definition
Contractions have started but labor has not progress satisfactorily
-through oxytocin, amniotomy, nipple stimulation |
|
|
Term
|
Definition
| Incision made into the perineum to enlarge the vaginal opening to facilitate delivery and minimize soft tissue damage. |
|
|
Term
| Indications for Episiotomy |
|
Definition
| Shorten the second stage of labor, assist with forceps or vacuum, prevent cerebral hemorrhage in preterm delivery, facilitate birth of large infant. |
|
|
Term
| Assisted vaginal birth types |
|
Definition
|
|
Term
|
Definition
Transabdominal incision of the uterus:
low transverse (horizontal)
Vertical (classical)
-used to preserve life or health of mother and fetus |
|
|
Term
| Indications for C-Section |
|
Definition
| CPD, malpresentation, placental abnormality, fetal distress, high risk pregnancy, active herpes, previous c-section, dystocia, multigestational, umbilical cord prolapse |
|
|
Term
|
Definition
associated with increased maternal(dysfunctional labor, birth canal trauma) and fetal (shoulder dystocia, asphyxia, compromised placenta) risks
-more interventions and fatigue are likely. |
|
|
Term
| Meconium Stained Amniotic Fluid |
|
Definition
green in color, consistency varies
-fetus has passed first meconium before birth
-increased risk for meconium aspiration: a form of aspiration pneumonia, requires neonatal resuscitation team |
|
|
Term
|
Definition
head is born, shoulders don't fit
-more likely to experience birth injury
mother at greater risk for blood loss, lacerations, extension of episiotomy or endometritis |
|
|
Term
| Managing Shoulder Dystocia |
|
Definition
Roberts maneuver: heals to mom's ears, laying flat
Suprapubic pressure: placing pressure on baby's scapula to force it through
Extension of episiotomy
Delivery of posterior arm/corkscrew maneuver (turning baby) |
|
|
Term
|
Definition
| Cord lies below the presenting part of the fetus (common with long cord, malpresentation, unengaged presenting part) |
|
|
Term
| Managing Umbilical Prolapse |
|
Definition
Prompt recognition
relieve pressure on cord
immediate delivery (ALWAYS C-section) |
|
|
Term
| Uterine Rupture Risk factors |
|
Definition
| trial of labor for VBAC, inductions, congenital uterine anomaly, prior uterine surgery, multiparity, trauma |
|
|
Term
| Signs and Symptoms of Uterine Rupture |
|
Definition
(vary with extent of rupture)
-nonreassuring fetal heart tones
-loss of fetal station
-signs of hypovolemic shock (increased HR, decreased BP) |
|
|
Term
| Management of Uterine Rupture |
|
Definition
FIRST prevention
-surgical intervention
(hysterectomy) |
|
|
Term
|
Definition
| amniotic fluid debris enters maternal blood stream tiggering a rapid series of events similar to anaphylactic shock, can cause MI, CVA, PE |
|
|
Term
|
Definition
loss of 500+ mls after vag. or 1000+ mls after c-section
-10% drop in hematocrit |
|
|
Term
| Signs and Symptoms of Postpartum hemorrhage |
|
Definition
| boggy soft fundus, large blood clots, pad saturation in <15 mins. rubra lochia after progression, constant oozing of blood, rising pulse, decreasing BP, cool clammy skin, oliguira, weakness |
|
|
Term
| Managing Postpartum Hemorrhage |
|
Definition
Monitor H/H
Admin. IV fluids, massage fundus, medications (pitocin, methergine, hemabate) |
|
|
Term
|
Definition
Neocrotizing enterocolitis, growth failure, aspiration, bronchopulmonary dysplasia, hemorrhage, patent ductus arteriosus, RDS, retinopathy
-classification based on weight and gestational age |
|
|
Term
|
Definition
| born between 34 and 36 6/7 weeks |
|
|
Term
| Risks for late preterm infants |
|
Definition
| thermoregulation, hypoglycemia, hyperbilirubinemia, sepsis, respiratory function problems |
|
|
Term
| Signs and Symptoms of respiratory distress syndrome (RDS) |
|
Definition
| Increased RR >60/min. retractions, labored breathing, fine rales, nasal flaring, grunting, central cyanosis |
|
|
Term
| Neonatal Signs and Symptoms of Hypoglycemia |
|
Definition
| poor feeding, tremors, hypothermia, diaphoresis, weak shrill cry, lethary, flaccid muscle tone, seizures, coma |
|
|
Term
| Signs and Symptoms of Hyperbilirubinemia |
|
Definition
| jaundice, lethargy, poor sucking, high pitched cry |
|
|
Term
|
Definition
| phototherapy, feeding early and often, monitoring stools. |
|
|
Term
|
Definition
| risks of complications r/t placenta and meconium, and persistant pulmonary HTN, and heart valves not fully closing |
|
|
Term
|
Definition
only Rh+ babies of Rh- mothers are at risk
-if mom is - and baby is + then mom forms antibodies |
|
|
Term
|
Definition
coombs
if baby is A,B or AB and mom is O |
|
|
Term
| Cyclic Perimenstrual Pain and Discomfort (CPPD) |
|
Definition
dysmenorrhea, PMS, PMDD
-health problems that can have significant impact on the quality of life |
|
|
Term
|
Definition
pain during or shortly before menstruation
primary (physiological alteration, <25, nsaids, decrease caffeine, exercise) or secondary (associated with pelvic pathology, >25, removal of underlying cause) |
|
|
Term
| Premenstrual Syndrome (PMS) |
|
Definition
cyclical symptoms, during the luteal phase of menstrual cycle.
-physical, psychological and behavioral symptoms
-diet, exercise, smoking cessation, herbal therapy |
|
|
Term
| Premenstrual dysphoric disorder |
|
Definition
cyclical symptoms occurring in the last 7-10 days of the menstrual cycle (severe form of PMS, focus on mood)
s/s irritability, dysphoria, anxiety, fatigue, appetite change, feeling of being overwhelmed |
|
|
Term
|
Definition
presence of growth of endometrial tissue outside the uterus
s/s: dysmenorrhea-PAIN, painful intercourse
-major cause of infertility
-BC or surgical intervention for TX |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
most common and fastest spreading STI
-often asymptomatic and highly destructive
antibiotic drug therapy |
|
|
Term
|
Definition
transmitted genital-genital, oral-genital, anal-genital, mother-newborns
s/s: women: asymptomatic, or irregular menses, pelvic/abd. pain, rectal complications
tx: antibiotic therapy |
|
|
Term
|
Definition
transmission through microscopic abrasions that occur during intercourse, kissing, biting, or oral-genital sex, transplacental transmission
-can lead to serious systemic disease and death
-penicillin and abstinence during tx |
|
|
Term
| Pelvic Inflammatory Disease (PID) |
|
Definition
single most serious frequent infection for women
-ascending spread of microorganisms from vagina to endocervix to upper genital tract
increased risk for ectopic pregnancy, infertility, chronic pelvic pain |
|
|
Term
| Human papillomavirus (HPV) |
|
Definition
condylomata acuminata (formerly genital warts)
no therapy will cure, PREVENTION and management.
high correlation with cervical cancer |
|
|
Term
|
Definition
| cooper IUD, no hormones, lasts 10 years. |
|
|
Term
|
Definition
| IUD, HORMONES, lasts 5 yrs. |
|
|
Term
|
Definition
| lack of conception despite unprotected sex for >12 months |
|
|
Term
| Assisted Reproductive Therapies |
|
Definition
| Invitro, gamete intrafallopian transfer, zygote transfer,ovum transfer, embryo adoption or hosting, therapeutic donor insemination, intracytoplasmic donor insemination, assisted hatching |
|
|
Term
| External Female Reproductive Structures |
|
Definition
| External pubis, Labia major/minor, Prepuce, Clitoris, Vestibule, Perineum |
|
|
Term
| Internal Female Reproductive Structures |
|
Definition
| Vagina, Cervix, Uterus, Uterine tubes, Ovaries |
|
|
Term
|
Definition
| Protection, Accommodation of growing fetus, anchorage of pelvic support structures |
|
|
Term
| Breast Structure and Function |
|
Definition
Mammary Glands: Lobes - Lobules - Acini
-Secrete Colostrum and milk
Change r/t ovarian cycle
-minimal level = 5-7 days after menstrual cycle |
|
|
Term
|
Definition
1. Menstrual Cycle: shedding of the uterine lining through vasoconstriction
2. Proliferation: rapid growth ~4 days to return to normal
3. Secretory: Ovulation- up to 3 days before next period
4. Ischemic- Swelling (7-10 days post ovulation) - pregnancy vs. not pregnant |
|
|
Term
|
Definition
Hormone: Oxygenated fatty acids
Effects: Ovulation, fertility, changes in cervix, tubal and uterine motility, menstruation, onset of abortion, onset of labor |
|
|
Term
| Hypothalamus & Pituitary Glands |
|
Definition
Regulate production of FSH and LH
Target tissues in ovary that produce the ova (egg)
-secret estrogen and progesterone
Feedback mechanism
-production of sex hormone secretion |
|
|
Term
|
Definition
Formation of sex cells
-spermatogenesis
-oogenesis |
|
|
Term
|
Definition
Ovum Formation: at conception, during fetal development
Ova remain suspended until ovulation
1rst meiosis occurs as an infant then not again until fertilization |
|
|
Term
|
Definition
22 autosomes
1 sex chromosome (X) |
|
|
Term
|
Definition
Meiosis occurs at puberty
22 autosomes
1 sex chromosome
2 gametes are X 2 gametes are Y
--all are viable sperm
--sperm remain viable for 2-3 days after ejaculation |
|
|
Term
|
Definition
Union of a single egg and sperm
-4 step process
1. Gamete Formation: egg/sperm
2. Ovulation: release of egg
-1 ovum matures/month and is released from ovarian follicle
-High estrogen levels increases motility propelling the egg toward the uterus
-fertilization occurs in the uterine tube w/in 24hrs. of ovulation
3. Union of gametes: embryo created
-in the ampulla (outer 1/3)
-sperm successfully penetrates the ovum
-nuclei fuse--zygote is formed
4. Implantation into Uterine wall
-6-10 days after conception |
|
|
Term
|
Definition
~40 weeks (280 days)
-calculated for LMP |
|
|
Term
| 3 Stages of Intrauterine Development |
|
Definition
1. Ovum: conception until 14 days
2. Embyo: day 15-8 weeks after conception
3. Fetus: 9 weeks-end of pregnancy |
|
|
Term
|
Definition
| Epidermis, glands, nails, hair, central and peripheral nervous system, lens of eye, tooth enamel, floor of amniotic cavity |
|
|
Term
|
Definition
| Bones, teeth, muscles, dermis, connective tissue, cardio system, splee, urogenital |
|
|
Term
|
Definition
| epithelium lining the resp and digestive tracts, oropharynx, liver, pancreas, urethra, bladder, vagina |
|
|
Term
|
Definition
MOST CRITICAL-development of organ systems and main external functions
-rapid cell division, most vulnerable to malformation from external teratogens |
|
|
Term
|
Definition
All organ systems are present
External structures are present
Embryo is unmistakably human |
|
|
Term
|
Definition
| Primitive digestive system |
|
|
Term
|
Definition
Chorion: closest to uterine wall
Amnion: closest to fetus |
|
|
Term
|
Definition
3 Vessels:
2 Arteries-smaller
1 Vein- larger |
|
|
Term
|
Definition
| Maintains body temp, po fluid for baby, repository for baby's waste, cushions baby, allows for movement |
|
|
Term
|
Definition
begins to form at implantation finished by 12th week
-Maternal-placental-embryonic circulation is formed by day 17--heart starts to beat! |
|
|
Term
|
Definition
-Hormones to maintain pregnancy and support the Fetus
-Metabolic Function |
|
|
Term
|
Definition
-hCG: supplies E and P, causes corpus luteim to function
-hCS (hPL): stimulates metabolism to supply nutrients to support fetal growth
-Progesterone: maintains endometrium, decreases contractility of uterus
-Estrogen: stimulates uterine growth, uterine to placental blood flow and myometrial contractility |
|
|
Term
|
Definition
3rd stage of development
-changes are not as dramatic
-Viability: capability of fetus to survive outside the uterus, limitation based on CNS function and lung capability, 500 g or 23 weeks
-Lungs and CNS are last to mature |
|
|
Term
|
Definition
| tubelike GI system, tubular heart, neural tube formed |
|
|
Term
|
Definition
| brain is formed from neural tube, limb buds seen, heart begins to beat |
|
|
Term
|
Definition
| Primitive Skeletal shape, chambers in the heart, respiratory system begins, ear formation begins, nares are present, webbed digits on arms, legs and tail recedes |
|
|
Term
|
Definition
| Eyelids formed, head is more erect, rectal and urogenital tubes are seperate |
|
|
Term
|
Definition
| External genitalia appear, anus is created, long bones begin to form, large muscles can contract |
|
|
Term
|
Definition
| head is 1/2 entire fetus, ossification of skeletal begins, liver produces red cells, palate is complete in the mouth, skin is pink, thyroid hormone is present, insulin is present in pancreas, curl fingers, urogenital tract is complete and form urine |
|
|
Term
|
Definition
| rapid growth, teeth begin to form, meconium begins and collects in intestines, kidneys assume shape, hair present on scalp, active movement and more muscles. Primitive lungs, Sex seen by US |
|
|
Term
|
Definition
| Mylenation of spinal cord begins, suck/swallow begins, lanugo covers the body, vernix forms |
|
|
Term
|
Definition
| respiratory movement and surfactant production begins with alveoli just beginning to form, brain appears mature, eyes are fully complete |
|
|
Term
|
Definition
| nervous system begins to regulate some functions, adipose tissue accumulates rapidly, nails, eyebrows, eyelids are present. Eyes open and close, baby is 2/3rds final size |
|
|
Term
|
Definition
pupillary light reflex is present, CNS matures enough to direct breathing movement and partial control of body temp. bones are mature but soft, lungs are still immature
Male: testes are not fully descended |
|
|
Term
|
Definition
| earlobes are soft with little cartilage, very few sole creases, lanugo disappearing |
|
|
Term
|
Definition
| adequate surfactant, vernix in skin folds and lanugo on shoulders, earlobes are firm |
|
|
Term
|
Definition
| fetal heart begins to beat |
|
|
Term
|
Definition
| All body organs are formed |
|
|
Term
|
Definition
| fetal heart rate can be heard by doppler |
|
|
Term
|
Definition
| looks like a baby, sex can be determined |
|
|
Term
|
Definition
| heartbeat w/ fetoscope, quickening, baby has sleeping schedule, sucking, kicking, hands can grasp. has a fav. position |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| fingernails, toenails, subQ fat laid down |
|
|
Term
|
Definition
| baby fills whole uterus, gets antibodies (IgG and IgM) from mother |
|
|
Term
|
Definition
fraternal twins
-2 mature ova are released in 1 ovarian cycle (2 eggs)
-2 of everything (placenta, amnion, chorion) |
|
|
Term
|
Definition
Identical Twins
-1 mature ova is fertilized by sperm
-If soon after division: 2 embryo, 2 amnion, 2 chorion, 2 placenta
-If 4-8 days after fertilization: 2 embryos, 2 amnions, 1 chorion, 1 placenta
If after 8 days: 2 embryos, 1 amnion, 1 chorion, 1 placenta (can create ciculatory problems, tangled cords, conjoined twins) |
|
|
Term
|
Definition
First: weeks 1-13
Second: weeks 14-26
Third: weeks 27-40 |
|
|
Term
| Estimated Date of Confinement |
|
Definition
estimated date of delivery or delivery
-add seven days to LMP and count forward 9 months |
|
|
Term
|
Definition
G: gravida-how many pregnancies
T: term- how many pregnancies carried to term(37 weeks)
P: preterm-how many pregnancies have reached 20 weeks but not 37 weeks
A: abortions- both spontaneous and induced, anything before 20 weeks
L: living children |
|
|
Term
| Presumptive Signs of Pregnancy |
|
Definition
| Amenorrhea, nausea, vomiting, breast tenderness, urinary frequency, fatigue |
|
|
Term
| Probable Signs of Pregnancy |
|
Definition
| positive pregnancy test, Goodell sign (softening of cervix), Chadwick sign (purpilish vaginal membranes), Hegar's sign (softening of lower uterine), ballottement |
|
|
Term
| Positive Signs of Pregnancy |
|
Definition
| presences of fetal heart beat, visualization of fetus on ultrasound |
|
|
Term
|
Definition
human chorionic gonadotropin: earliest
biochemical marker of pregnancy
-production begins at implantation |
|
|
Term
| Vulva and Vaginal Changes with Pregnancy |
|
Definition
pH of secretions becomes more acidic
more vulnerable to some vaginal infections (esp. yeast)
Chadwick's sign (purplish color) increased vascularity and sensitivity
leokorrhea (discharge)
Mucous plug is formed: acts as a barrier against bacterial invasion |
|
|
Term
| Uterine Changes with Pregnancy |
|
Definition
Change in size, shape and position
palpable at 12-14 weeks
Hegar sign: softening of the lower uterine segment |
|
|
Term
| Braxton Hicks Contractions |
|
Definition
| painless, irregular, no dilation |
|
|
Term
| Breast Changes in Pregnancy |
|
Definition
fullness, heaviness
heightened sensitivity
Areolae become more pigmented, visible blood vessels and striae
colostrum
Montgomery's tubercles |
|
|
Term
| Cardiovascular Changes with Pregnancy |
|
Definition
hypertrophy and placement (reversible postpartum)
BP decreases, Pulse increases
volume increases, output increases
increased clotting factor, decreased fribrinolytics |
|
|
Term
| Respiratory Changes with Pregnancy |
|
Definition
| increased O2 needs, ribs expand and diaphragm is displaced |
|
|
Term
| Renal System Changes with Pregnancy |
|
Definition
increased risk for UTI, irritability and sensitivity
increased GFR to maintain homeostasis
increased edema |
|
|
Term
|
Definition
| mask of pregnancy, darkening of the skin on the face during pregnancy |
|
|
Term
|
Definition
| dark line of pigment on the stomach |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
| gums hypertrophy, bleeding, red nodules |
|
|
Term
|
Definition
|
|
Term
| Musculoskeletal system changes with Pregnancy |
|
Definition
Realignment of the spine-lordosis
change in the elasticity of joints
diastasis of rectal abd. muscles(seperation of muscles) |
|
|
Term
| Neurological Changes with Pregnancy |
|
Definition
nerve compression-r/t swelling
carpal tunnel, acroesthesia(sensitivity of extremities)
tension HA r/t swelling |
|
|
Term
| GI system changes with Pregnancy |
|
Definition
appetite fluctuations (pica)
increased salivation
pyrosis (heart burn as stomach is pushed up and compressed)
constipation(decreased GI secretions and movement, more H20 is reabsorbed r/t progesterone)
increased risk of gallstones |
|
|
Term
| Endocrine Changes with Pregnancy |
|
Definition
Pituitary and Placental Hormones
Thyroid gland: increased activity
Parathyroid Hormone: slightly hyper is normal
Pancreas: fetus needs glucose, uses maternal glucose leading to decreased ability to produce=decreased insulin
the hormones and placenta cause insulin intolerance and increased insulin need with increasing need until term |
|
|
Term
| Electronic Fetal Monitoring |
|
Definition
EFM-visualization of fetal heart patterns on monitor/printed screen
-monitor infant and predict fetal compromise |
|
|
Term
| Factors leading to decreased O2 supply to the Fetus |
|
Definition
Reduction of blood through maternal vessels: maternal HTN, maternal hypotension (blood loss, dehydration), hypovolemia, reduction of 02 in blood (anemia)
Others: compression of umbilical cord, placental seperation, head compression, reduced blood flow to intervillous space in placenta (contractions or deterioration of placental vasculature with post term baby) |
|
|
Term
| Intermittent Auscultation |
|
Definition
-listening to FH sounds are periodic intervals to assess FHR
done by pinard fetoscope, Doppler, ultrasound stethoscope |
|
|
Term
| External Electronic Fetal Monitoring |
|
Definition
FHR: ultrasound transducer "cardio"
Uterine Contractions: tocotransducer |
|
|
Term
| Internal Electronic Fetal Monitoring |
|
Definition
Invasive-must have rupture of membranes
-Spiral Electrode
IUPC/Koala-pressure catheter that measures contractions |
|
|
Term
|
Definition
baseline is the average during a 10 minute segment
-normal range: 120-160
-tachycardia: >160 bpm for 10mins. or more
-bradycardia: <110-120 bpm for 10 mins. or more |
|
|
Term
|
Definition
Amount of change from the baseline in a one minute period
Average: 6-25 bpm
Minimal: 2-5 bpm
-causes: decreased O2, resting, medicine, fever, toxins
Absent: <2 bpm, completely flat line
-causes: poor blood supply
Marked: >25 bpm
-causes: fetal distress |
|
|
Term
| Periodic Changes VS. Episodic Changes (in FHR) |
|
Definition
| Periodic changes occur with contractions, episodic changes are not associated with contractions |
|
|
Term
|
Definition
Should be 15x15 in full term baby
-at least 15 seconds, at least 15 bpms. about 2x every 20 minutes
-considered highly indicative of fetal well-being
-predictive of normal fetal acid-base balance |
|
|
Term
|
Definition
response to fetal head compression
-gradual onset, mirrors contractions, decreased HR |
|
|
Term
|
Definition
response to compression of umbilical cord
-abrupt onset, not necessarily associated with contractions
-decrease at least 15 bpm below baseline for at least 15 seconds and return in <2 minutes
--lookd like a "V" |
|
|
Term
|
Definition
Uteroplacental Insufficiency
-late onset, begins after contraction has started and lowest point occurs after the peak of the contraction
-loss of placental function or abruption |
|
|
Term
|
Definition
decrease of at least 15 bpm below baseline lasting more than 2 minutes but less than 10 minutes
-caused by disruption of fetal oxygen supply |
|
|
Term
|
Definition
fetal well being during labor is measured in response of FHR to contractions.
baseline: 110-160 beats/minutes
no periodic changes
moderate variability (6-25 beats/min. of change)
Presences of ACCELERATIONS (15x15, in 2 times per 20 minutes.)
Absences of DECELERATIONS |
|
|
Term
| Nonreassuring FHR pattern Associated with: |
|
Definition
fetal hypoxemia (can deteriorate to severe fetal hypoxia-O2 deficiency at cellular level)
deficiency in arterial blood |
|
|
Term
| Nonreassuring FHR pattern includes |
|
Definition
baseline tachycardia: above 160
baseline bradycardia: below 110
Absent of minimal variability: ~2-5 (minimal) or none (absent)
Variable or Late decelerations
Prolonged decelerations
sinusoidal pattern (wavy line) |
|
|
Term
| Monitoring Uterine Activity |
|
Definition
Frequency: start of one to start of next
Duration: Length of contraction in seconds
Intensity: mild, moderate, strong (unless using internal monitor then in Montevideo units)
Resting tone: should be "relaxed" between contractions |
|
|
Term
| Nursing Care for Non-reassuring FHR |
|
Definition
Reposition pt., Increase IV fluids, O2 supplementation
Determine cause
Notify MD
possibly fetal scalp stimulation, amnioinfusion, tocolytic therapy, prepare for c-section |
|
|
Term
| What are the 5 P's of Labor and Birth |
|
Definition
Passenger
Passageway (birth canal)
Powers
Position of Laboring Woman
Physiologic response (psychological too) |
|
|
Term
|
Definition
Size of fetal head
-sutures, fontanels
-molding
Fetal Presentation
-cephalic (not breech or shoulder)
Fetal Lie (how spine of mom and baby relate)
-Longitudinal
-vertical: transverse, horizontal or oblique
Fetal Attitude (way baby faces)
-general flexion (chin-in)
Fetal Position
-presenting part in relation to maternal pelvis
-station/engagement
Placenta |
|
|
Term
|
Definition
Birth Canal
-Boney Pelivs- shape, size
-Lower uterine segment
-Cervix: effaces, dilates r/t contractions and fetal descent
-Pelvic floor muscles: separates pelvic flood from perineum, helps rotate fetus
-Vagina
-Introitus: external opening to the vagina |
|
|
Term
|
Definition
Primary Powers:INVOLUNTARY uterine contractions
-effacement, dilation, ferguson reflex (urge to bear down)
Secondary powers--VOLUNTARY
-bearing down efforts |
|
|
Term
| Position of Laboring Woman |
|
Definition
Affects
-Anatomy
-Physical adaptions to labor
Frequent Changes
-relieves fatigue, increases comfort, improves circulation |
|
|
Term
|
Definition
(Psychological too)
Sensations
Internal Force
Relates to nursing care |
|
|
Term
|
Definition
moving fetus, placenta and membranes out of uterus and through birth canal
signs preceding labor: lightening (baby drops down), bloody show |
|
|
Term
|
Definition
First Stage: onset to full dilation
Second Stage: full dilation to birth
Third Stage: Birth until placenta is delivered
Fourth Stage: 2 hrs. after delivery of placenta |
|
|
Term
|
Definition
Latent Phase: up to 3cm of dilation
Active Phase: 4-7cm of dilation
Transition Phase: 8-10cm of dilation |
|
|
Term
|
Definition
| vaginal birth after cesarean |
|
|
Term
|
Definition
Contractions: regular, increase with walking, continue despite comfort measures
Cervix: change in dilation and effacement
Fetus: presenting part is engaged |
|
|
Term
|
Definition
Contractions: irregular, intermittent, decrease with walking or position change, stop with tocolytics such as hydration
Cervix: posterior, no change
Fetus: presenting part not engaged |
|
|
Term
| Assessment of Amniotic Fluid |
|
Definition
Assessment with pH paper, ferning test, speculum
Note: color, odor, amount, time
Treatment of GBBS if positive or unknown
--increased risk for infection with prolonged rupture |
|
|
Term
|
Definition
FHR: early decels, temp. accels
Fetal Circulation: maternal position, uterine contractions, blood pressure, umbilical cord blood flow
Respiratory Movement: fetal lungfluid cleared from air passage during labor |
|
|
Term
| Maternal Adaption to Labor |
|
Definition
Cardio: CO increases, HR increases, BP increases
Resp: RR increases
Renal: possible proteinuria
Integumentary, Musculoskeletal
GI: decreased motility, N/V
Endocrine: blood glucose levels decrease |
|
|
Term
| Nursing Care During Labor |
|
Definition
General Hygiene, nutrient/fluid intake (IV), Elimination (voiding may help fetal descent), Ambulation/postion, pain management, coaching, preparing room, monitoring FHR
Emergency Interventions: FHR/UC's, vaginal bleeding, infection, cord prolapse |
|
|
Term
|
Definition
| fluid infused into uterus to supplement amniotic fluid |
|
|
Term
|
Definition
| artificial rupture of membranes to augment labor |
|
|
Term
| External Cephalic Version (ECV) |
|
Definition
| External manipulation of fetus after 37 weeks |
|
|
Term
|
Definition
~50 mins in nulliparous women
~30 mins. in multiparous women
3 phases: latent, descent, transition |
|
|
Term
| 7 Cardinal Movements of Labor |
|
Definition
Engagement: asynclitism (baby doesn't line up stops descent)
Descent: 4 forces-Amniotic fluid, contractions, abd muscles/diaphragm, baby straightens out
Flexion: chin to chest
Internal rotation: face rotates to posterior
Extension: head extends as it comes out
Restitution and external rotation: guides shoulders out
Expulsion: time of birth |
|
|
Term
|
Definition
pressure to rectum drawing downward, to upward pressure from coccygeal region to extend head and protect perineum
--prevent too rapid a birth |
|
|
Term
|
Definition
umbilical cord around the neck
-if loose can be removed
-if tight or multiple may require clamping and cutting |
|
|
Term
|
Definition
1rst degree: extends through skin to muscle
2nd degree: extends through muscles of the perineal body
3rd degree: continues through the anal sphincter
4th degree: involves anterior rectal wall |
|
|
Term
|
Definition
Lacerations- vaginal, urethral, perineal
Cervical injuries-could leave scarring
Episiotomy |
|
|
Term
|
Definition
Placental separation and expulsion
-examines placenta and membranes for intactness |
|
|
Term
|
Definition
2 origins: Visceral and Somatic
Visceral: cervical changes, distention of lower uterine segment, uterine ischemia, referred pain(originates in uterus and radiates)
Somatic: sharp, intense, burning, localized r/t: stretching/distention of pelvic floor and perineum, contractions, laceration of soft tissues |
|
|
Term
| Nonpharmacological Pain Management |
|
Definition
Provides a sense of control in childbearing process
-distraction, reposition, hypnosis, acupuncture, etc. |
|
|
Term
| Relaxation/breathing techniques |
|
Definition
Nonpharmacological-gives a sense of control
focusing, relaxation, breathing, imagery, visualization, effleurage(massage), counter pressure, music, water therapy, transcutaenous electrive nerve stimulation (TENS), acupressure, biofeedback, aromatherapy, intradermal water block, Provides a sense of control in childbearing process, distraction, reposition, hypnosis, acupuncture |
|
|
Term
|
Definition
Phenergan, Vistaril
-relieve anxiety and induce sleep (sedation)
--can only be used during early or latent phase |
|
|
Term
|
Definition
Opiod Agonist Analgesics: Dilaudid, Dermol
Opiod Agonist-Antagonist Analgesics: Stadol, Nubain
Opiod Antagonist:Narcan |
|
|
Term
| Nerve Block analgesia/anesthesia |
|
Definition
Temporary interruption of conduction of nerve impulses
-"caines": Bupivicaine, Nesacaine, Ropivacaine, Lidocaine
-Local: used for episiotomy, lacerations, assisted birth (vacuum)
--NO effects to the fetus |
|
|
Term
|
Definition
3rd, 4th, 5th, lumbar space into subarachnoid space
-c-sections
Positioned sitting or side lying
Disadvantages: marked hypotension, impaired placental perfusion, ineffective breathing pattern, possible HA |
|
|
Term
|
Definition
4th-5th lumbar vertebrae
-considered the most effective pain relief method currently available
~2/3rds of births in US
Contraindicatons: anticipated maternal hemorrhage, coagulopathy, increased intracranial pressure, maternal cardiac conditions
--MUST know platelet count |
|
|
Term
|
Definition
Not commonly used
-may be indicated for women requiring a rapid birth if a spinal/epidural is not possible |
|
|
Term
| Nursing care during 4th stage of labor |
|
Definition
Fundal massage
Administer oxytocin as ordered
Assess for Hemorrhage
Prevention of Bladder distention
Acute pain management |
|
|
Term
|
Definition
Must FULLY recover from anesthesia before leaving recovery
-Sensation: legs
-Vitals
-Alertness
-Voiding |
|
|
Term
|
Definition
Puerperium/fourth trimester
-lasts about 6 weeks
-repaid decrease in estrogen and progesterone levels after expulsion of placenta
-triggers anatomic and physiological changes |
|
|
Term
|
Definition
Return to nonpregnant state
-progresses rapidly
-Fundus descends 1 to 2 cms (fingerwidths) every 24 hrs.
-2 weeks after childbirth, uterus lies in true pelvis |
|
|
Term
|
Definition
Failure of uterus to return to nonpregnant state
-common causes: retained placental fragments and infection
--can be early or late |
|
|
Term
|
Definition
Uterine muscle contracting to decrease blood flow
-oxytocin: released from pituitary gland, strengthens and coordinates uterine contractions
-progressively become worse with each child |
|
|
Term
|
Definition
Postbirth uterine discharge
1. Lochia Rubra: dark red, brown
-blood, decidual, and trophoblastic debris
-duration: 3-4 days
2. Lochia serosa: pink or brown
-old blood, serum, leukocytes and debris
-22-27 days
3. Lochia alba: yellow to white
-10 to 6 weeks |
|
|
Term
|
Definition
Soft immediately after birth
-over the next 12-18 hrs shortens, firms, regains form
-Ectocervix appears bruised and has small lacerations (watch for infection)
-closes gradually |
|
|
Term
|
Definition
| NEVER RETURNS TO PREPREGNANCY SIZE :(( |
|
|
Term
| Concerns with Vagina/Perineum Post Partum |
|
Definition
Dyspareunia: dryness, discomfort during sex (estrogen deprivation)
Introitus: erythematous and edematous (signs of infection)
Epistotomies
Hemorrhoids and anal varicosities
Pelvic muscle support: may have been stretched or torn during delivery
-require up to 6 months to regain tone
-kegel exercises
-may experience pelvic relaxation (incontinence, uterine prolapse) |
|
|
Term
| Pituitary hormone and Ovarian function Post Partum |
|
Definition
Lactating and nonlactating women differ in timing of 1rst ovulation/menstruation
Breastfeeding: may have delayed period, depends on breastfeeding pattern and supplementation
--May ovulate before first menstrual cycle(CAN GET PREGNANT) |
|
|
Term
|
Definition
First 2 weeks: abd walls. relaxed, may use abdominal binder
-woman still appears pregnant
-about 6 weeks to return to prepregnancy state depending on previous tone, exercise and amount of fat |
|
|
Term
| Urinary System Post Partum |
|
Definition
Postpartal diuresis: pee a lot especially at night!
-within 12 hrs women being to urinate
-excessive bleeding can occur because of displacement of the uterus if bladder is full (fundus may be deviated or elevated) |
|
|
Term
|
Definition
Breastfeeding Mothers: colostrum, then milk
-tenderness may persist for 48 hrs after beginning of lactation
NonBreastfeeding Mothers: engorgement that resolves spontaneously
-discomfort decreases within 24-36 hrs.
-breast binder/sports bra, ice packs, mild analgesics, cabbage
-prevent stimulation |
|
|
Term
| Process of Parental Bonding |
|
Definition
Attachment: process by which parent and infant come to love and accept each other, strengthened through sensual responses by both parents
Bonding
Proximity
Interaction
Mutuality
Acquaintances: eye contact, touching, talking, exploring
Claiming Process: likeness to family members, difference from members |
|
|
Term
|
Definition
Taking-in: 1-2 days
-focus on self and meeting basic needs
Taking-hold: 2nd/3rd day-10 days
-focus on caring for baby and competent mothering
Letting-go: focus on forward movement of family unit
-reassertion of relationships with partner, intimacy and resolution of new individual |
|
|
Term
|
Definition
Determinant of maternal-infant relationship
-based on her awareness, perception, and responsiveness to infant cues and behaviors
-significantly impacts infants development
Effected by: engagement, commitment to being a bother, experiencing self as mother, process of growth and transformation |
|
|
Term
|
Definition
| emotionally labile and crying for no apparent reason, period of emotional and physical vulnerability, post partum fatigue |
|
|
Term
| Stages of Father's Adaption to Birth/Child |
|
Definition
1. Intention of being emotionally involved-possibly engrossment
2. Confronting reality-1rst few weeks
-intense emotions, acknowledging their expectations may have been of limited value, may feel neglected, frustrated, helpless, inadequate
3. Creating the role of the involved Father
-new priorities and understanding of role
-increased interaction with infant
4. Final: Reaping rewards
-reciprocity from infant, usually 6 weeks to 2 months |
|
|
Term
|
Definition
1. Stablization
2. Assessment Completion
3. Nursing interventions and family teaching |
|
|
Term
| First Period of Reactivity |
|
Definition
up to 30 mins. after birth
HR can be 160-180bpm, decreases after 30 mins.
Resp. can be irregular can be 6-80 breaths/min.
Alert, awake, decrease in motor activity after period followed by 60-100 mins of sleep
--best time to begin breastfeeding! |
|
|
Term
| Second Period of Reactivity |
|
Definition
Occurs 4-8hrs after birth
Tachycardia/tachypnea may occur
Passing of Meconium
Increased muscle tone, changes in skin color, mucous production |
|
|
Term
|
Definition
Done 1 and 5 minutes after birth
0-3 severe distress
4-6 moderate distress
7-10 no distress |
|
|
Term
| Initial Newborn Assessment |
|
Definition
External Structures: skin color, peeling, birthmarks, nail length, foot creases, breast tissue, nasal patency, meconium stain--ques for gest. age
Chest: Point of maximal impulse (PMI) location, ease of breathing, auscultation of heart and lung sounds
Abdomen: rounded, umbilical cord and vessels
Neurologic: Muscle tone, reflex reaction, fontanels, sutures
Genitourinary
--note malformations |
|
|
Term
| Initial Newborn Nursing Interventions |
|
Definition
Airway maintenance and adequate O2 supply
Body temp regulation
Eye prophylaxis
Vitamin K prophylaxis
Umbilical cord care
promoting parent-infant interactions |
|
|
Term
| Gestational Age Assessment Normal Values |
|
Definition
Weight: 2,500-4,000 grams
Length: 45-55 cm (18-22 inches)
Head Circumference: 32-36.8 (12.6-14.5 inches)
Chest Circumference: 30-33cm (12-13 inches)
-should be 2-3 cm less that head
Neuromuscular activity: posture, square window formation (wrist), arm recoil, popliteal angle, scarf sign, hear to ear
Physical Maturity: skin texture, lanugo, plantar surface creases, breast tissue, eye opening, ear cartilage, genitalia development |
|
|
Term
|
Definition
| Appropriate for gestational age |
|
|
Term
|
Definition
| Large for gestational age, above 90th percentile |
|
|
Term
|
Definition
| small for gestational age, below 10th percentile |
|
|
Term
|
Definition
born before 36 weeks gestation
-late preterm: 34-36 6/7 weeks |
|
|
Term
|
Definition
| Born between 38 and 42 weeks gestation |
|
|
Term
|
Definition
after 42 weeks
-postmature: after 42 weeks with effects of placental insufficiency |
|
|
Term
|
Definition
34-36 6/7 weeks
-often the size and weight of term infant
-Risks include: resp. distress, temp. instability, feeding difficulty, hyperbulirubinemia |
|
|
Term
|
Definition
RR: 30-60 breaths/min. w/ occasional short periods of apnea no longer than 15 seconds
HR: 120-160 bpm, apical for full minute
Temp: 97.7-98.9 axillary (first is rectal for accuracy)
BP: 60-80/40-50, not regularly taken |
|
|
Term
|
Definition
Sucking
Moro
Rooting
Tonic Neck
Babinski
Plantar Grasp
Stepping
Startle |
|
|
Term
| Neonatal Respiratory System |
|
Definition
Initiation of breathing starts with cutting of cord and air inflates lungs with first breath
-fluid is squeezed out from lungs in vaginal birth, may not happen in c-secton
-must maintain adequate O2 supply |
|
|
Term
| Neonatal Respiratory Distress |
|
Definition
| Nasal Flaring, intercostal or subcostal retractions, grunting with respiration, abnormal rates |
|
|
Term
| Neonatal Cardiovascular System |
|
Definition
| Significant change after birth: foramen ovale closes, ductus arteriosus closes, clamping of cord causes umbilical arteries and veins to convert into ligaments |
|
|
Term
| Neonatal Hematopoietic System |
|
Definition
red blood cells and hemoglobin are increased
leukocytes: 18,000 is normal |
|
|
Term
|
Definition
Stools:
meconium-black, tarry, sticky
transitional-3rd day, greenish brown to yellowish brown
Milk-4th day
-breastfeed: yellow to golden
-formula: pale yellow to light borwn, firmer, more offensive odor |
|
|
Term
|
Definition
Void 2-6 times for first 2 days, then 5-25 times a day after that
Uric Acid crystals: normal in first week, then indicate insufficient intake
Fluid/electrolyte imbalance: different than adults |
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Term
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Definition
| Iron storage: at birth has 4-6 months stored Carbs: feedings need to stablize blood glucose levels of 60-70 Jaundice Coagulation: infant doesn't synthesize vitamin K so coagulation factors are not made by the liver |
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