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OB
Contraception, Infertility, Antepartum, Intrapartum, Postpartum
20
Nursing
Undergraduate 4
10/27/2011

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Cards

Term
Presumptive Signs of Pregnancy
Definition
Changes experienced in woman that make her think she may be pregnant. Subjective symptoms or objective signs. May be result of other physiological factors.

amenorrhea, fatigue, nausea, vomiting, urinary changes, breast changes, quickening (fluttering), uterine enlargement, linea nigra, chloasma, stretch marks
Term
Probable Signs of Pregnancy
Definition
Changes that make examiner suspect woman is pregnant. Also can be caused by other physiological factors.

abdominal enlargement (change in size, shape, position of uterus), cervical changes, Hegars sign (softening and compressibility of lower uterus), Chadwicks sign (bluish color of vaginal mucosa due to inc. vascularity), Goodells sign (softening of cervical tip), ballottement (rebound of engaged uterus), Braxton Hicks contractions (false contractions, painless, irregular, relieved by walking), positive pregnancy test, fetal outline felt by examiner
Term
Positive Signs of Pregnancy
Definition
Signs that could only be explained by pregnancy
Fetal heart tones, visualization of fetus by ultrasound, fetal movement palpated by examiner
Term
Verifying Pregnancy (Serum and Urine Testing)
Definition
hCG can be detected within 6-11 days in serum and 26 days in urine after conception following implantation; hCG levels peak at 60-70 days, declines until 80 days, and increases from then on until term; Higher levels may indicate multifetal, ectopic, or molar pregnancy or genetic abnormality such as Down Syndrome
Term
Nageles Rule
Definition
First day of last menstrual period, subtract 3 months, add 7 days and 1 year
Term
McDonalds Method
Definition
Uterine fundal height in cm. from symphysis pubis to top of fundus measured, estimated gestational age should be equal to height of fundus
Term
GTPAL Acronym
Definition
G- gravidity (number of pregnancies)
T- term births (38 weeks +)
P- preterm births (from viability (20 wks) up to 37 weeks)
A- abortions/miscarriages (prior to viability)
L- living children
Term
Gravidity and Parity
Definition
Gravidity- number of pregnancies
Parity- number of pregnancies in which fetus or fetuses reach viability (20 to 24 weeks or fetal weight >2lb) regardless of if born alive or not
Term
Physiological Changes
Reproductive, Cardiovascular, Respiratory, Muskuloskeletal
Definition
Reproductive- uterus increases in size, change shape and position; ovulation and menses cease during pregnancy
Cardiovascular- CO, blood volume, HR increase
Respiratory- increased maternal O2 needs, decreased lung capacity, increased respiratory rate
Muskuloskeletal- pelvic joints relax, weight increases
GI- nausea and vomiting due to hormonal changes and increased abdominal pressure, constipation, increased water absorption
Term
Physiological Changes
Renal, Endocrine
Definition
Renal- filtration rate increases with increase of hormones, metabolic demands, and blood volume. Urine production remains same, but frequency is common
Endocrine- placenta is endocrine organ, produces large amounts of hCG, progesterone, estrogen, HPL, and prostaglandins. Hormones maintain pregnancy and prepare body for delivery
Term
Body Image Changes
Definition
Woman requires support from primary care provider and family; first trimester changes are not obvious, second semester there are rapid changes which may lead to negative body image, resentment, and anxiety including enlargement of abdomen, breasts, loss of mobility and balance, discomfort, fatigue etc.
Term
Expected Vital Signs
Definition
Blood pressure- within prepregnancy range in first trimester, decreases 5-10 mmHg in second, and returns to prepregnancy baseline after 20 weeks gestation. Pt may experience supine hypotensive syndrome as a result of positioning
Respirations- increase 1-2 per min, SOB may be noted
Pulse- increases 10-15 at 20 weeks gestation, remains elevated
Term
Skin Changes in Pregnancy
Definition
Cloasma- mask of pregnancy (pigmentation increases)
Linea nigra- dark line of pigmentation from umbilicus to pubic bone
Striae gravidarum- stretch marks on abdomen and thighs
Term
Physical Assessment Findings
Definition
FHR noted at 110-160 bpm
Cardiac hypertrophy may result in murmur or splitting with S3 following 20 weeks gestation
Uterine size changes, by 36 weeks fundus palpated at xiphoid process
Cervical changes- Chadwicks sign (bluish color of cervix), Goodells sign (softened consistency)
Breast changes- increase in size, areolas darkened
Term
Prenatal Care Initial Assessment
Definition
Reproductive and obstetrical hx, medical hx, family hx, recent or current illnesses or infections, current medications, substance use/abuse, psychosocial hx, hazardous enviornmental exposures, current exercise and diet habits
Term
Prenatal Visit Schedule
Definition
Uncomplicated pregnancy; 1 time a month for 7 months, every 2 weeks in 8th month, every week in 9th
Term
Initial Prenatal Visit
Definition
EDD determined by date of LMP, (vaginal US may be done) Obtain medical hx (past med. hx, social support systems, family hx, review of systems and past obstetrical hx)
Perform physical exam including baseline VS, weight, and pelvic exam
Obtain lab work including blood type, Rh factor, HIV status, rubella status, urinanalysis
Term
Ongoing Prenatal Assessment
Definition
Weight, BP, urine for glucose/proteins/leukocytes
Monitor for presence of edema
Monitor fetal development (FHR at 10-12 weeks, US at 16-20 weeks, Fundal height beginning at 12 weeks
Education for self care and how to manage discomforts of pregnancy (N/V, fatigue, backache, varicosities, activity, sexuality, heartburn)
Term
RhoGAM
Definition
Given to Rh negative moms around 28 weeks to prevent maternal fetal blood incompatibility or neonatal hyperbilirubinemia
Term
Health Promotion- Behaviors to avoid and encourage
Definition
Avoid OTC meds unless OB has approved usage, avoid alcohol consumption, avoid tobacco use and substance abuse of any kind, encourage client to receive flu shot in fall, treat current infections, avoid use of hot tubs or saunas, consumer 2-3L of water each day, get 30 min of moderate exercise daily (walking or swimming) if not medically contraindicated
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