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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
prevents person from experiencing the consequences of his/her behavior.
What does enabling do?
[]
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What are some factors affecting pain?
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
martyrdom fusion intrusion perfection addiction
Codependent behaviors:
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
mons pubis labia majora labia minora clitoris urethral meatus paraurethral glands vaginal vestibule perineal body
What are female external reproductive organs?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
vagina cervix uterus fallopian tubes ovaries bony pelvis
What are femalie internal reproductive organs?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
responsible for the production of the ovum released from anterior pituitary -->production of egg
Follicle Stimulating Hormone
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
released from ovary --> stimulates release of egg
Estrogen
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
released from anterior pituitary --> responsible for release of egg
Lutenizing Hormone
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
responsible for maintaining pregnant state
Progesterone
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
9-10 days
If an ovum is fertilized during its trip through the fallopain tube, how long until implantation?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
zygote --> morula (looks like a mulberry)
ova + sperm =
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
12-24 hrs
lifespan of ova
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
72 hrs
lifespan of sperm
[]
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During ovulation, high estrogen levels increases the contractility of fallopian tubes and make cervican mucus more readily penetrated by spermatozoa.
How does estrogen effect conception?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
60 hr after fertilization --> now a blastocyst
When does the morula enter uterus?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
embryo with a trophoblast layer (the chorion)
Blastocyst
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
ova + sperm = zygote --> morula -->blastocyst --> trophoblast
fertilization
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
implantation occurs 7-10 days after fertilization; the blastocyst attaches and buries into upper portion of uterine wall cells of the trophoblast form CHORIONIC VILLI
nidation
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
the decidua
After implantation the endometrium is called
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
decidua vera
what is the rest of the uterus called
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
decidua capsularis
what is the uterus that encapsulates the embryo called
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
decidua basalis - becomes maternal portion of placenta
what is the part of the uterus under th embryo called
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
1st membrane to form, encloses the amnion
what is the chorion?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
contains fluid and amnio; it grows until it contacts the chorion
what is the amnion?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
amniotic sac
together the chorion and amnion form the
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
they protrude from the chorion and form the placenta
the chorionic villi form the ...
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
-maintain temp -prevent adherence -allows for movement -symmetric baby growth -sound amplifier -contains particles from meconium -looks like coconut milk w/white flecks (vernix)
the amniotic fluid functions to...
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
produce RBCs until hematopoiesis begins, then becomes part of the umbilical cord
the yolk sac functions to...
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
fetal blood
the chorionic villi contains
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
maternal blood
the intervillous spaces contain
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
groups of villi (12-15)
What are cotyledons?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
HCG - human chorionic gonadotropin HPL - human placental lactogen estrogen progesterone
What hormones does the placenta produce?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
maintains corpus luteum during pregnancy (test for it)
What does HCG do?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
like growth hormone, aids in glucose transport + regulates maternal metabolism
What does HPL do?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
increases uterine blood flow via vasodilation
What does estrogen do?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
maintains endometrium, increases uterine growth, decreases uterine contractility - maintains myometrial relaxation, increases breast development
What does progesterone do?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
red, fleshy, has cotyledons "dirty duncan"
The maternal portion of the placenta is...
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
covered by amnion, shiny & gray "shiny shultz"
The fetal portion of the placenta is...
[]
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-55 cm long -has 2 arteris (deoxygenated blood) -has 1 vein (oxygenated blood) -is surrounded by wharton's jelly which protects vessels from constriction -attaches fetus to placenta
The umbilical cord...
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
when amniotic fluid is yellow or green - baby has been in stress, anal sphincter has relaxed - bm
What is meconium stain?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
process to float baby off cord
What is amniotic infusion?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
placenta --> fetal umbilical vein --> ductus venosus --> vena cava --> right atrium --> foramen ovale --> left atrium --> left ventricle --> ductus arteriosus --> aorta --> umbilical arteries --> placenta
fetal circulation
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
ductus venosus foramen ovale ductus arteriosus
What are 3 fetal structures that change at birth?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
ectoderm mesoderm endoderm * all tissues, organs, and organ systems arise from these three layers
What are the 3 cell layers?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
pre-embryonic embryonic fetal
What are the 3 stages of development?
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
-stage of the ovum: 1st 14 days; rapid growth & cell differentiation
The pre-embryonic stage consists of...
[]
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- stage of the embryo: wks 3-8; by end of this stage all major systems started, remainder of prenatal period is for refinement of structures & practice of function
The embryonic stage consists of...
[]
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wk 9 to birth; viability: fetus can do functions of like but may not sustain life
The fetal stage consists of...
[]
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20 weeks * used for determining live births
What is point of viability of fetus in Ohio?
[]
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BhCG -serum test is more sensitive *if mother at risk for miscarriage, test q 1-2 hrs.
pregnancy test
[]
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10 lunar months 9 calendar months 280 days preterm - before complete of week 37 term 38-42 weeks postterm after 42 weeks
What is the length of pregnancy?
[]
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gravida = "pregnancy" para - if woman carries past 20 weeks (viability) then, -preterm -term -abortions -living ex: gravida 1, para2, living 2 = twins
GPTAL
[]
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Estimated Date of Delivery Nagele's Rule use last day of menstrual period day-3 month+7 year+1
EDD
[]
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5-27 weeks - q mo. 28-36 weeks - q 2 wks. 37-40 weeks - q wk *vary according to risk *measure fundal height listen to FHT special tests/labs teaching done PRN
Timing of prenatal visits:
[]
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low (BMI<19.8) 28-40 lbs Normal (BMI 19.8 - 26) 25-35 lbs High (BMI> 26-29) 15-25 lbs
Total weight gain:
[]
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
amenorrhea breat tenderness & enlargement Chadwick's sign (vagina --> violet) fatigue hyperpigmentation cholasma linea nigra quickening urinary frequency N/V
Presumptive signs of pregnancy
[]
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What are some factors affecting pain?
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abdominal enlargement Ballottement Braxton-Hicks Goodell's sign (soft cervix) Hegar's sign - (soft lower uterine segment) palpate fetus +preg. test uterine enlargement
Probable signs of pregnancy
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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auscultate FHR palpate fetal movements USN verification
Positive signs of pregnancy
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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1. BhCG urine test (if neg do RIA BhCG) 2. Hx - LMP, cycle, contraceptives, gynecologic (diseases), sexual, reproductive, med-surg, psycho-social, family 3.Pelvic Exam - VS, head to toe, pelvic (pelvimetry), cervical status 4. Labs 5. prenatal ed
What happens at the 1st prenatal visit?
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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inlet - diagonal conjugate > 12.5 cm midpelvis - ischial spines - 10.5 cm outlet - ischial tuberosities 11.0 cm sacrum public arch
What is pelvimetry?
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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3-4 cm long, closed, firm, mid-posterio position *in lithotomy position, most cervices point to floor.
What is cervical status?
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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781acd65_nal_Exam_Flashcards___Cram_com__e_some_factors_affecting_pain_
blood type Rh antibody screen CBC (looking for anemia) rubella, varicella titer (give AFTER birth if not immune) syphyllis screen HIV, cyctic fibrosis, HEP PPD UA chlamydia, gonorrhea GBS - Tx during labor w/AB pap
Labs at 1st prenatal visit.
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Classification (A through X) Duration of exposure to drug Amount of drug crossing placenta Rate of drug transfer to fetus Properties and effects of drug Stage of fetal development: day 1-15 most susceptible period days 18-60 period of organogenesis first 3 months most critical for malformations 2-9 months drug effects ...
Considerations of drug use during pregnancy...
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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test to predict preterm delivery; vaginal swab for presence A biological glue attaching fetal sac to uterine lining Up to 22 weeks, FFn is normally present in cervical/vaginal secretions After 22 weeks, is not normally secreted, so it should be gone If it is still there, correlates to preterm delivery Negative test res...
What is fetal fibronectin?
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Major: multiple gestation DES exposure hydramnios uterine anomaly cervix dilated >1cm or < 1cm long @ 32 wks 2-2nd trimester AB’s previous preterm birth previous preterm labor abd surgery during preg hx of cone biopsy uterine irritability cocaine abuse Minor: febrile illness bleeding p 12 wks hx of pylonephritis smokin...
What are preterm risk factors?
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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1. Have you ever been emotionally or physically abused by your partner or someone important to you? 2. Within the last year, have you been hit, slapped, kicked, or otherwise physically hurt by someone? 3. Since you’ve been pregnant, were you hit, slapped, kicked, or otherwise physically hurt by someone? 4. Within the l...
Pregnancy is a risk factor for abuse - what are some assessment questions?
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Severe headache that does not go away with Tylenol or associated with swelling or blurred vision Fever of l0l degrees or more Inability to take fluids by mouth for more than 12 hours or solid food for more than 24 hours Decreased fetal movement after 26 weeks Contractions of the uterus that occur more than 3-4 times an...
What are some warning signs during pregnancy of serious problems?
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Group of infections that can affect a pregnant woman and her fetus These have organisms that can cross the placenta and adversely affect the development of the fetus -Toxoplasmosis - miscarriage -Rubella - defects, death -Cytomegalovirus - microcephaly -Herpes - retardation - no Tx, C/S for active lesions
What are TORCH infections?
[]
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What are some factors affecting pain?
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early access to prenatal care nutrition social support therapy for prevention of transmission
Special consideration for mothers with HIV?
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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*Fecal-oral route by ingestion of contaminated food. Possible fetal effects of first trimester exposure: fetal anomalies preterm birth fetal or neonatal hepatitis intrauterine fetal death Gamma globulin given to infected mothers and exposed neonates.
Hepatitis A
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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major concern in pregnancy, most transmitted during birth. Sexually transmitted Virus most threatening to fetus and neonate At risk women – history of multiple sex partners, STD’s, IV drug use, blood contact 50 to 100 times more contagious than HIV Disease of the liver with outcome fatal *First prenatal visit for all w...
Hepatitis B
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Gonorrhea Chlamydia Human Papilloma Virus Syphilis Hepatitis Herpes
What are some sexually transmitted diseases
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Recommended treatment is penicillin G 5 million units IV loading dose and then 2.5 million units IV q 4 hours during labor. Ampicillin is an alternative therapy.
Group B Strep
[]
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yes
Is there a Vaccine Available for Hepatitis A and hepatitis B?
[]
514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
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Presence of bacteria in urine is significant if a clean-catch specimen contains > 50,000 bacteria of the same species Contamination of a specimen is indicated and woman should not be treated, when culture results are Up to 100,000 nonpathogenic organisms/ml >100,000 if mixed species bacteria/ml
considerations of UTI?
[]
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What are some factors affecting pain?
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Wt BP urine (blood, protein, ketones, nitrites, glucose) evaluate complaints of HA, visual disturbances, dizziness, fever/chills, n&v, abd pain, back pain, dysuria, CVA tenderness, vag discharge/bleeding, constipation/hemorrhoids, varicosities, leg cramps, edema, exposure to any infectious diseases, use of any meds rev...
What happens at subsequent prenatal visits?
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What are some factors affecting pain?
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Leopold’s (after 35 wks) assess for quickening/fetal movement (16 weeks is detectable) fundal height FHR include partner/siblings assess relationship changes (increase/initiation of abuse) teaching re any concerns, complaints, questions, problems
Things to do at prenatal visits afet 35 weeks...
[]
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What are some factors affecting pain?
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review labs follow up screening
Prenatal visits - weeks 12-15:
[]
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Maternal serum Alpha-fetoprotein screen (MSAFP) or quad screen. Screening versus diagnostic testing. Quad screen (MSAFP, hCG, estradiol, possible NTD), improved identification of chromosomal anomalies over MSAFP alone. Normal values based on gestational age, maternal age, weight, race, diabetes (if present), multiple g...
Prenatal visits, weeks 15-18:
[]
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What are some factors affecting pain?
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assess for quickening USN for confirmation of gestational age AFP quad screen: BhCG, MSAFP, unconjugated estriol
Prenatal visits, weeks 16-20:
[]
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What are some factors affecting pain?
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Diabetes screen (week 28) - 1 hr GTT Coombs’ test/antibody titer (for Rh neg women) administer Rhogam if indicated retest H & H evaluate risk of PTL
Prenatal visits, weeks 24-28:
[]
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counsel re health care provider for infant counsel re infant feeding method discuss importance of fetal movement, give FMC card
Prenatal visits, weeks 29-32:
[]
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reassess for PTL and assess cervix as indicated only check cervix for S&S of labor
Prenatal visits, weeks 33-34:
[]
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Discuss S&S of labor GC culture (if necessary) Chlamydia culture GBS culture
Prenatal visits, weeks 35-36:
[]
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Assess fetal position/presentation review birth plan/expectations copy and forward records to place of birth initiate fetal surveillance as indicated examine cervix as indicated review alternative methods for cervical ripening/induction of labor discuss plans for contraception review prep for breastfeeding
Prenatal visits, weeks 37-40:
[]
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What are some factors affecting pain?
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prepare client for postdate pregnancy protocol assess cervical readiness institute fetal surveillance: USN, NST, AFI, BPP biweekly office visits
Prenatal visits, weeks 40+:
[]
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What are some factors affecting pain?
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Modified throughout pregnancy 15-20% ^ on O2 consumption between 16-40 weeks to meet ^ needs of woman, placenta, fetus Diaphragm is elevated from enlarging uterus Breathing changes from abdominal to thoracic Nasal stuffiness due to estrogen-induced edema & vascular congestion Heart is laterally displaced Blood volume ^...
USCR: AIR
[]
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What are some factors affecting pain?
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Many discomforts of pregnancy from changes in GI system N&V from HCG secreted by ovum and CHO metabolism changes Peculiar tastes & smells PICA - argo starch, nonfood substances, clay Bleeding gums Ptyalism ^ gastrin levels cause more acidic gastric contents GI symptoms from growing uterus increase during 2nd trimester ...
USCR:FOOD
[]
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^ water retention is basic alteration, caused from ^ hormones affecting Na & fluid retention, lower serum protein, & ^ intracapillary pressure & permeability 3.5L from fetus, placenta, amniotic fluid 3.5L from mother’s organs, blood volume, & interstitial fluids ^ in water intake creates flushing effect which aids in r...
USCR: WATER
[]
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Uterus Phenomenal changes: 8x5x2.5 nonpregnant to 28x24x21 at full term, weighs 1000 gms Hypertrophy under influence of estrogen, then distension from growing fetus Thickened musculature to thinning at term (5mm) Vascularity ^ to 1/6 of total blood volume Fundal height from symphysis to fundus, cms correlate with gesta...
USCR:ELIMINATION
[]
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Breasts Estrogen & progesterone changes mammary glands ^ in size and nodules from hypertorphy & hyperplasia for lactation Veins prominent, nipples erect, pigmantation enhanced, on areola-Montgomery’s follicles ^, striae Colostrum-thick, yellow secretion high in antibodies expressed by 12th week
USCR:ELIMINATION
[]
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Skin ^ estrogen & progesterone cause ^ in melanocyte-stimulating hormone causing changes in pigmentation of areola, nipples, vulva, perianal area, linea nigra, chloasma Hyperactivity of sweat & sebaceous glands ^ adrenal steroid levels cause reduced connective tissue leading to striae Vascular spider nevi Hair growth d...
USCR:ELIMINATION
[]
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Urinary tract Bladder becomes irritated from pressure or uterus early in pregnancy, then at term making it more susceptible to infection Dilation of ureters & kidneys GFR & RPF ^ Glycosuria common but R/O DM Renal fx ^ & urea & creatinine ^ (creatinine clearance test)
USCR:ELIMINATION
[]
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Bowel Hemorrhoids common especially if constipation a problem GI motility delayed, therefore constipation Smooth muscle is relaxed, electrolyte & water reabsorption ^, plus weight of growing fetus & uterus all can cause problems
USCR:ELIMINATION
[]
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Sacroiliac, sacrococcygeal, & pubic joints relax in latter part of pregnancy from hormones Center of gravity changes, lumbodorsal curve is accentuated, compensates for growing uterus ‡ frequent backaches Diastasis recti-separation of rectus abdominis Exercise-moderate routine involving large muscle groups (swimming, cy...
USCR: Activity & Rest
[]
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Life-style changes Relationship with partner may take on new meaning, roles are changed Woman is no longer a separate individual, she must now consider needs of another being who is totally dependent on her Woman often reestablishes stronger ties with own mother/grandmother Attachment to fetus is evident in fantasy, US...
USCR: Solitude & Social Interaction
[]
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Warning signs Gush of fluid from vagina Vaginal bleeding Abdominal pain Temp > 38.3 C Dizziness Blurred vision Persistent vomiting Severe HA Edema of face & hands Epigastric pain Oliguria/dysuria Decreased fetal movement Teratogens-substances that adversely affect growth & development of fetus, ie, medications, smoking...
USCR: Hazards
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Several hormones required to maintain pregnancy, produced by corpus luteum initially then by the placenta HCG-secreted by trophoblast, stimulates estrogen & progesterone production HPL-produced by syncytiotrophoblast, increases free fatty acids and decreases maternal metabolism of glucose, is an insulin antagonist Estr...
USCR: Normalcy
[]
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NST - Reactive: 2 accelerations in 20 minutes, (increase by 15 beats) Begin use at 30-32 weeks Adequate oxygenation and intact CNS
Nonstress Test
[]
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same time each day note the time it takes for 10 fetal movements if takes longer than usual or decreased movements, contact care provider
Fetal Movement Counts
[]
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Fetal gestational age, well-being, weight, multiple gestation, confirm pregnancy, placenta location, fetal position, amniotic fluid levels, fetal death
Ultrasound can measure
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514 Final Exam Flashcards - Cram.com
What are some factors affecting pain?
http://www.cram.com/flashcards/514-final-exam-282701
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