Pregnancy, Labor & Delivery, Postpartum & Newborn Care

Flashcards covering key concepts from pregnancy periods, associated risks, signs of pregnancy, prenatal care, labor and delivery, postpartum assessments, and newborn care based on lecture notes.

What are the three periods of pregnancy?

First trimester (Weeks 1-12), Second trimester (Weeks 13-27), Third trimester (Weeks 28-40 to delivery).

Name some common OBGYN risks associated with pregnancy.

Gestational diabetes, Hypertension/preeclampsia, Infection (e.g., TORCH, GBS), Preterm labor, Hemorrhage (antepartum/postpartum), Fetal growth restriction or anomalies, Multiple gestation risks, Venous thromboembolism.

What are presumptive signs of pregnancy?

Amenorrhea, nausea/vomiting, breast tenderness, urinary frequency, fatigue, quickening (fetal movement felt by mom).

What are probable signs of pregnancy?

Enlarged uterus, Hegar’s sign (softening of uterus), Goodell’s sign (soft cervix), Chadwick’s sign (blue cervix/vagina), positive pregnancy test, uterine enlargement.

What are positive signs of pregnancy?

Fetal heart tones via Doppler, ultrasound visualization, fetal movement palpated by provider.

What expected findings, assessments, and labs are common during the first trimester (Weeks 1-12)?

Baseline labs (CBC, type & screen, HIV, hepatitis, rubella, syphilis), urine tests (protein, glucose), dating ultrasound. Nausea/vomiting is common.

What expected findings, assessments, and labs are common during the second trimester (Weeks 13-27)?

Fundal height corresponds to weeks (after ~20 weeks), anatomy scan (18–22 weeks), fetal heart tones each visit, glucose tolerance testing (24–28 weeks).

What expected findings, assessments, and labs are common during the third trimester (Weeks 28-40)?

More frequent visits, Group B Strep screening (35–36 weeks), Rhogam at 28 weeks if indicated, fetal movement monitoring, labor education.

How does fundal height typically correlate with gestational age after about 20 weeks?

Fundal height in cm is approximately equal to gestational age in weeks (±2 cm).

What is important patient teaching regarding hot tubs/saunas during pregnancy?

Avoid prolonged use; it raises maternal core temp leading to an increased risk of neural tube defects and hypotension.

What is important patient teaching regarding douching during pregnancy?

Avoid douching; it disrupts vaginal flora and increases the risk of infection and preterm labor.

What is the recommended exercise guideline for pregnant women?

Continue if active before; avoid supine positions after 20 weeks, high-risk activities, dehydration; walking, swimming, yoga are encouraged.

What immunizations are recommended during pregnancy, and which ones should be avoided?

Avoid live vaccines (MMR, varicella); flu shot (inactivated) and Tdap (27–36 weeks) are recommended.

What is the preferred OTC pain medication during pregnancy, and which should generally be avoided?

Acetaminophen is preferred; avoid NSAIDs unless ordered by a provider.

Why is folic acid important during pregnancy?

It prevents neural tube defects, and 400–800 mcg daily is recommended before conception and in early pregnancy.

What are some strategies to manage nausea and vomiting during pregnancy?

Small, frequent meals; dry crackers before rising; avoid greasy/spicy foods; hydration; ginger, peppermint, lemon; nighttime prenatal vitamin if iron causes nausea.

Name the three fetal circulatory shunts and what they bypass.

Foramen ovale (R atrium → L atrium, bypasses lungs), Ductus arteriosus (pulmonary artery → aorta, bypasses lungs), Ductus venosus (umbilical vein → IVC, bypasses liver).

Where does oxygenation occur for the fetus?

In the placenta (not the lungs).

What are the key pharmacological actions and nursing considerations for Oxytocin (Pitocin) during labor?

Stimulates contractions, controls postpartum hemorrhage. Adverse effects include tachysystole and fetal distress. Nursing requires continuous FHR and uterine monitoring.

What are the common uses and nursing considerations for Magnesium sulfate in pregnancy/labor?

Prevents seizures in preeclampsia and provides neuroprotection for the fetus. Adverse effects include respiratory depression and decreased reflexes. Nursing involves monitoring RR, reflexes, urine output, and having calcium gluconate available as an antidote.

Define Dilation, Effacement, and Station in the context of labor.

Dilation is the opening of the cervix (0–10 cm). Effacement is the thinning of the cervix (0–100%). Station is the fetal head's position relative to the ischial spines (–3 to +3).

What is the most favorable fetal presentation and position for a vaginal delivery?

Cephalic, vertex, occiput anterior (OA).

Describe the four stages of labor.

Stage I (Dilation): Onset of contractions to full dilation. Stage II (Expulsion): Full dilation to delivery of baby. Stage III (Placental): Delivery of baby to delivery of placenta. Stage IV (Recovery): First 1–4 hours after placental delivery.

What is the normal fetal heart rate (FHR) range?

110–160 bpm.

Name five factors that can affect fetal oxygenation.

Maternal hypotension (especially after epidural), Uteroplacental insufficiency, Cord compression/prolapse, Maternal hypoxemia (anemia, asthma), Excess uterine activity (tachysystole from oxytocin).

What is the nursing action for a prolapsed umbilical cord?

This is an emergency. Place the patient in knee-chest or Trendelenburg position, manually hold the presenting part off the cord, and call for immediate C-section.

What are the expected characteristics of lochia postpartum?

Lochia rubra (red, days 1–3), Lochia serosa (pink/brown, days 4–10), Lochia alba (yellow/white, days 10–28).

What does a boggy uterus indicate postpartum, and what is the primary nursing intervention?

A boggy uterus indicates increased risk of hemorrhage; the primary nursing intervention is fundal massage.

What is RhoGAM, and when is it administered?

RhoGAM is Rh immune globulin given to an Rh-negative mother with an Rh-positive baby to prevent isoimmunization. It's administered IM at 28 weeks gestation and within 72 hours postpartum if the infant is Rh+.

What are the roles of oxytocin and prolactin in lactation?

Oxytocin stimulates the let-down reflex and uterine contractions (involution). Prolactin stimulates milk production.

Name some advantages of breastfeeding.

Provides antibodies & immunity, promotes bonding, reduces risk of childhood obesity/illness, aids maternal uterine involution, inexpensive, convenient, lowers maternal risk of breast/ovarian cancer.

What are some warning signs a postpartum mother should report?

Heavy bleeding, foul-smelling lochia, fever >100.4°F, severe pain/swelling/redness in legs, breast pain with redness/fever, signs of postpartum depression.

What medications are typically administered to a newborn shortly after birth?

AquaMEPHYTON (Vitamin K) to prevent hemorrhagic disease, Erythromycin ointment to prevent ophthalmia neonatorum, and Hepatitis B vaccine to prevent Hep B infection.

How do the fetal circulatory shunts (foramen ovale, ductus arteriosus, ductus venosus) close after birth?

Foramen ovale closes due to increased left atrial pressure with the baby's first breath. Ductus arteriosus closes due to increased oxygen and decreased prostaglandins. Ductus venosus closes when the umbilical cord is clamped.

What are the normal heart rate, respiratory rate, and temperature ranges for a newborn?

HR: 110–160 bpm, RR: 30–60 breaths/min (irregular, periodic pauses okay), Temp: 97.7–99.5°F (36.5–37.5°C).

Describe the Moro reflex in a newborn.

A sudden movement or loud noise causes the newborn's arms to extend then flex, often with C-shaped fingers.

What is the expected daily urine output and frequency of stools for a newborn by day 5?

6–10 wet diapers/day and 3–4 stools/day.

What are the three periods of newborn reactivity?

First period (birth to 30 min: alert, active, good bonding time), Sleep phase (2–4 hrs: deep sleep, decreased responsiveness), Second period (4–8 hrs after birth: alert again, increased HR/RR, good time for feeding/teaching).

What might a 'two-vessel cord' indicate in a newborn?

Possible renal or cardiac anomalies.

What are signs of respiratory distress in a newborn?

Tachypnea (>60 breaths/min), grunting, nasal flaring, retractions, cyanosis.

What is the difference between Caput succedaneum and Cephalohematoma?

Caput succedaneum is diffuse scalp swelling that crosses suture lines. Cephalohematoma is localized blood under the periosteum that does not cross suture lines.