Maternity and Obstetrical Nursing Lecture Review

Flashcards created from lecture notes covering maternal-newborn nursing, fetal monitoring, stages of labor, pharmacological interventions, and postpartum newborn care.

What is Supine Hypotensive Syndrome and when does it typically occur?

It is a drop in blood pressure that occurs when a pregnant woman lies flat on her back, usually occurring after $20\text{ weeks}$ of gestation.

How is Naegele's rule used to calculate the Estimated Date of Birth (EDB)?

From the first day of the last menstrual period, subtract $3\text{ months}$, add $7\text{ days}$, and add $1\text{ year}$. (Days are added or subtracted if the menstrual cycle is longer or shorter).

How is gestation defined in maternal health?

Carrying young inside the uterus from conception to delivery.

What is Ballottement in an obstetrical physical examination?

A physical exam method used by a doctor to feel a solid object float in a pool of body fluid.

What is quickening and at what gestational age is it typically felt?

It is the first time a pregnant person feels their baby move inside the uterus, starting as slight movement around $16\text{--}22\text{ weeks}$.

What is leukorrhea?

Normal or excessive whitish, yellowish, or clear vaginal discharge composed of fluid and cells from the vagina to the cervix.

What cervical changes occur during pregnancy regarding Goodell's sign and friability?

The cervix becomes thinner and shorter with softening of the cervical tip (Goodell's sign). Cervical friability means the tissue is easily damaged.

What is Chadwick's sign?

A bluish discoloration of the cervix and vaginal mucosa caused by increased blood flow.

How can the gallbladder change during pregnancy?

The gallbladder can become distended, holding up to $1\,000\,\text{mL} - 1\,\text{L}$.

How are Braxton Hicks contractions characterized?

Painless, slight uncomfortability.

Why is supplementation with folic acid critical during pregnancy?

Folic acid helps protect the fetus from developing neural tube defects.

What is amniocentesis?

A procedure to obtain amniotic fluid using a needle.

Which vaccines are contraindicated during pregnancy?

Live flu virus, measles, and chickenpox vaccines.

What do the components of the GTPAL obstetric history system represent?

G = Gravida (# of pregnancies), T = Term (# of babies carried to term), P = Preterm (# of premature babies), A = Abortion (# of spontaneous miscarriages/abortions), L = Living (# of living children).

What is the primary power versus the secondary power of labor?

Primary power consists of involuntary uterine contractions causing effacement (thinning and shortening) and dilation of the cervix. Secondary powers involve voluntary pushing and bearing-down efforts by the mother during the second stage of labor.

How does dehydration affect uterine activity during pregnancy?

Dehydration can cause contraction pains even when the woman is not in labor.

How does the Gate Control Theory of Pain function?

A neurological gate in the spinal cord can open or close to either allow pain signals to reach the brain or block them.

At how many weeks gestation can a fetal heartbeat first be detected?

At $5\text{--}6\text{ weeks}$.

What is pica?

The consumption of non-food substances, which is common in some cultures during pregnancy.

What is chloasma?

Darkening of the skin on the face in the shape of a mask.

What are the recommended maternal weight gain guidelines based on pre-pregnancy weight?

Normal weight: $25\text{--}35\,\text{lb}$; Underweight: $28\text{--}40\,\text{lb}$; Overweight: $15\text{--}25\,\text{lb}$; Obese: $15\,\text{lb}$.

Where is Human Chorionic Gonadotropin (hCG) produced and when can it first be detected?

It is produced by trophoblast cells of the placenta soon after implantation of a fertilized ovum and can be detected as early as $6\text{ days}$ post-conception.

How does estrogen production transition during pregnancy?

Estrogen is initially produced by the ovaries and corpus luteum, and then produced by the placenta after the $17\text{th week}$.

How long does the corpus luteum produce progesterone during pregnancy?

From ovulation up to the $10\text{th week}$ of pregnancy.

What is hyperemesis gravidarum and what complication can it cause?

A disorder characterized by excessive vomiting during pregnancy that can cause severe dehydration.

What non-pharmacological interventions help relieve pregnancy-related nausea?

Eating small frequent meals; eating dry toast or crackers before getting out of bed; taking Vitamin B6 or ginger capsules; and using acupuncture or acupressure.

What clinical manifestations should be monitored in the third trimester to screen for preeclampsia?

Protein in urine, elevated blood pressure, weight gain, visual disturbances, headaches, facial and hand swelling, muscular irritability, and epigastric pain.

How is Group B Streptococcus (GBS) screened and treated in pregnancy?

Cultures are taken from urine, vaginal, and anorectal areas. If transmitted to the newborn, it can cause life-threatening conditions. It is treated with IV antibiotics such as Penicillin G or ampicillin.

What do different colors of amniotic fluid indicate?

Normal: Pale, straw-colored with whitish flecks. Greenish-brown (meconium-stained): Fetal distress or breech presentation. Yellow-stained: Fetal infection or fetal hemolytic disease. Port-wine fluid: Abruptio placentae. Thick foul-smelling fluid: Infection.

What is the purpose of Leopold's maneuvers?

To determine fetal positioning by abdominal palpation.

What is the difference between an ultrasound transducer and a tocotransducer?

An ultrasound transducer monitors fetal heart rate, whereas a tocotransducer monitors uterine contractions.

What is the normal baseline fetal heart rate (FHR) and what are common causes of fetal tachycardia?

Normal baseline FHR is $110\text{--}160\,\text{bpm}$. Fetal tachycardia can be caused by maternal fever/infection or fetal anemia.

What are Terbutaline (Brethine) and Ritodrine (Yutopar) used for in obstetrics?

They are tocolytic medications given to stop contractions and prevent preterm labor.

What is Abruptio Placentae?

A pregnancy complication in which the placenta peels away from the inner wall of the uterus prior to delivery.

What is Hemolytic Disease of the Fetus and Newborn (HDFN)?

A blood disorder where maternal antibodies cross the placenta and destroy the red blood cells of the fetus or newborn.

What are the characteristics of breech, shoulder, and occiput fetal presentations?

Breech: Fetus positioned feet first. Shoulder malpresentation: Fetus lies sideways (transverse) with shoulder, arm, or trunk entering birth canal first. Occiput presentation: Fetus is head-first with the occiput leading into the birth canal.

How do Thyroxine (T4) and Triiodothyronine (T3) differ in action?

Thyroxine (T4) is released into blood, acts slowly, and converts to T3 in tissues. Triiodothyronine (T3) is the active, more potent form that directly instructs cells to consume energy.

How are fetal stations defined from $-5$ to $+5$?

Station $-5$: Presenting part is below the level of the iliac crest at the pelvic inlet. Station $0$: Presenting part is at the mother's ischial spines. Station $+4$ to $+5$: Presenting part is at the level of the ischial tuberosities and birth is imminent.

What are the parameters for the latent, active, and transition phases of Stage 1 labor?

Latent phase: Cervix $0\text{--}3\,\text{cm}$. Active phase: Cervix $4\text{--}7\,\text{cm}$. Transition phase: Cervix $8\text{--}10\,\text{cm}$ (associated with diaphoresis, amnesia, physical shaking).

What are the causes of early, variable, and late fetal heart rate decelerations?

Early decelerations: Fetal head compression causing vagal nerve/parasympathetic stimulation. Variable decelerations: Umbilical cord compression. Late decelerations: Uteroplacental insufficiency causing fetal hypoxia.

What immediate nursing intervention is indicated for late fetal heart rate decelerations?

Turn the pregnant mother onto her left side.

Why does epidural anesthesia cause maternal hypotension and how is it managed?

Sympathetic vasoconstrictor impulses are blocked, causing arteriole dilation, venous pooling, and decreased venous return to the heart. It requires frequent BP monitoring and treatment with an IV bolus of isotonic solution.

Why is oxytocin administered post-delivery?

To stimulate intermittent uterine contractions with retraction of myometrial strands, preventing uterine atony and postpartum hemorrhage.

What five clinical parameters are assessed in the Apgar Score chart shown?

Appearance (skin color), Pulse (heart rate), Grimace (reflex irritability), Activity (muscle tone), and Respiration (respiratory effort). Each parameter is scored from $0$ to $2$.

Why is Vitamin K administered to neonates at birth?

Newborns cannot synthesize Vitamin K due to the absence of intestinal flora at birth; it is needed to prevent early neonatal bleeding problems.

Why is erythromycin ophthalmic ointment applied to a newborn's eyes?

To protect the infant from gonorrheal or chlamydial eye infections.

What is uterine involution?

The gradual reduction in the size of the uterus after delivery as it contracts back to its normal pre-pregnancy size.

What is lochia and what are its three sequential types?

Vaginal discharge occurring during the postpartum period (puerperium) consisting of blood, tissue, and mucus. The three types are lochia rubra, lochia serosa, and lochia alba.

What is Phenylketonuria (PKU)?

A metabolic disorder involving a failure to convert the amino acid phenylalanine. If undetected and untreated early, accumulated phenylalanine can lead to intellectual disability and failure to thrive.