maternal unit 2

thyroid tissues appears, blood circulation begins

2-3 wks

tubular heart beat, mouth, limb buds

4 wks

embryonic sex glands appear

6 wks

digits formed, ear development, slight movement

8 wks

sex determination possible

16 wks

quickening

20 wks

alveoli in lungs

24 wks

eyelids opens; eyelash present

28 wks

fingernail, L/S ratio 2:1, completed sexual devlopment

38 wks

2:1 ratio

means respiratory system is fully developed

antepartum vitals

low bp

high pulse

high respiratory

increase bp intervention

lay on left side

sit up for reassessment

preeclampsia

can increase bp or protein in urine

elevated albumin =

preeclampsia

elevated glucose =

diabetes

elevated protein/wbc/rbc

infection

why are pregnant women have a high risk for uti

hormonal changes

uterus compressing ureters

averaging weight gain during pregnancy

25-35 pounds

1st trimester weight gain

less than 5 lb

2nd & 3rd trimester weight gain

11 lb per wk

nagele

first day of lmp - 3 months + 7 days

fundal measurement =

gestational age

ultrasound doppler device is used as early as

10-12 wks gestational

assessment of amniotic fluid

nitrazine test

nitrazine test

checks for alkaline fluid = paper turns blue

microscope slide shows ferning

normal amniotic fluid

clear and no odor

green amniotic fluid

infection

bloody amniotic fluid

issue w/ placenta

foul smelling amniotic

infection

sudden fluid gush =

d/t amniotic fluid

vaginal bleeding =

always bad

white cloudy discharge

yeast infection

greenish yellowish discharge

sti

bleeding discharge

cervix changing + placenta issue

premature hip growth

can cause issues for vaginal delivery

clonus test

pulling foot back and count how many times they hit the hand

clonus test meaning

heightened reflexes + cns irritability

where to assess dtr

patella

hyperactive reflexes =

preeclampsia w/ ns issues

hypoactive reflexes =

get mg sulfate as tx

vs in delivery

increase in hr and respirations

low risk assessment + documentation

q30 min

high risk assessment + documentation

q15 min

1st phase of first stage

latent phase

2nd phase of first stage

active phase

3rd phase of first stage

transition phase

latent phase

3 cm dilation w/ onset of regular, mild contractions

active phase

4-7 cm dilation w/ intense contraction

transition phase

8-10 cm dilation, contractions q1.5-2 min lasting 1-1.5 min

second stage of labor

begins with cervix @ 10 cm and ends w/birth of infant

third stage of labor

begins w/birth of infant and ends with delivering of placenta

lasts about 5 min on average

fourth stage of labor

1-4 hrs after delivery

blood pressure drop and increase pulse is from

blood loss

shaking and chills are from

exhausted muscles and hormone levels dropping

4+ dtrs =

2+ clonus

frequency of contraction

beginning of 1st contraction to the next

duration of contraction

how long a contraction is

intensity of contraction

assess abdomen

true labor

consistent + increases over time

impacts cervis

false labor

inconsistent/comes and go

cervix does not change

resting helps

how do true labor contractions feel

intervals get quicker + shorter

where does true labor pains occur

lower back then radiates to abdomen

how do false labor contractions feel

intervals do not change

where does false labor pains occur

abdominal discomfort

1st fetal position

upper abdomen

2nd fetal position

fetal back

3rd fetal position

presenting part above inlet

4th fetal position

head flexion/extension

name of palpating for fetal positions

leopold’s maneuvers

zero station

baby’s head is at level with ischial spines

internal electronic fetal monitoring

fetal scalp electrode (most precise d/t being on head)

external electronic fetal monitoring

ultrasound transducer

accelerations in FHR

means baby is moving = good

decelerations in FHR

low perfusion/umbilical cord compression

early decel

with peak of contraction

late decel

occurs after peak of contraction

what to do if late decel happens

lay on left side

stop oxytocin

apply o2

increase fluids

myometrial contraction

aka after birth delivers

when does myometrial contractions occur

after placenta delivers

decidual autolysis

d/t immediate drop in hormone levels = autolysis of tissue

endometrial regeneration

following stabilization of hormones @ placental site

uterus size after birth

size of grapefruit but decreases 1 finger breath each day until not palpable

what delays involution

infection

high amniotic fluid

large baby

fluids

boggy

uterus not contracted

displaced

something else is there (most likely bladder)

restoration of endometrium

all but placental site restored by 14-16 days postpartum

total healing of endometrium takes

10-12 wks

rubra

1-3 days

serosa

3-7 days

alba

1-3 wks

rubra characteristics

bright/dark red

small clots

smells like period

serosa characteristics

red/pinkish/brownish

not as heavy but increases with activity/breastfeeding

more discharge

less clots

alba characteristics

white yellow discharge

little to no blood

no clots

concerning lochia charges

large clots

lots of bleeding

more than 2 pads/hr

normal functional anatomy of cervix is restored in

6-12 wks

vaginal episiotomies/lacerations take about

3 wks

vaginal hemorrhoids take about

6 wks to decrease in size

vaginal dryness is

normal d/t estrogen decline

when can sexual activity start

2-4 wks after bleeding has stopped

placental removal =

decline in progesterone + estrogen