Pregnancy, Labor, and Maternal Care Review

Flashcards covering the signs of pregnancy, systemic changes, labor procedures, and maternal-fetal nursing care based on the lecture transcript.

L sign (bluish color)

A sign of pregnancy characterized by the bluish color of the cervix.

L sign (softening)

A sign of pregnancy involving the softening of the cervix.

HR sign

A sign of pregnancy characterized by the softening of the lower uterine segment.

Presumptive signs

Subjective signs of pregnancy felt by the woman, such as fatigue and nausea.

Probable signs

Objective signs of pregnancy that can be confirmed by a nurse or provider, such as Braxton Hicks contractions.

Subjective signs

Symptoms reported by the patient that are not externally verifiable, like tiredness or low iron feelings.

Objective signs

Clinical findings that the provider can observe or measure to confirm pregnancy.

Hyperpigmentation of the skin

A presumptive sign of pregnancy that usually appears around $16\,weeks$.

Crooked

A term used in the transcript to describe feeling the penis (fetus) moving, categorized as a presumptive sign.

Braxton Hicks contractions

Probable objective signs described as the body's way of preparing for labor, occurring between $16$ and $28\,weeks$.

True Labor Identification

Confirmed when the cervix is changing (dilation) rather than just having contractions.

Cervical Dilation

The widening of the cervix; a width of $2-3\,cm$ can be subjective and confusing for the provider to measure.

Vaginal Exam Risks

If a mother's water breaks during labor, these should be minimized to prevent infection.

Abdominal enlargement timing

A sign of pregnancy that typically occurs at about $14\,weeks$.

Positive signs of pregnancy

Diagnostic findings that confirm pregnancy, with ultrasound being the number one method.

Ultrasound verification

Confirmation of the embryo or fetus usually possible at $4-6\,weeks$.

Fetal movement (clinician)

Movement experienced by the clinician, typically at $20\,weeks$, which is a positive sign.

Auscultation of fetal heart sounds

A positive sign of pregnancy heard with a Doppler, typically around $12\,weeks$.

Doppler timing

The tool used to hear fetal heart sounds, which may be heard as early as $10\,weeks$ but is more reliable at $12\,weeks$.

Transvaginal probe

An ultrasound tool used early in pregnancy to see the embryo and heart when it cannot yet be heard by Doppler.

False Positive Pregnancy Test

A test results showing pregnancy when it is not present, sometimes caused by a molar pregnancy.

Uterus shape change

The transformation of the uterus from a pear shape to an oval shape as the baby grows.

Fundal height at $20\,weeks$

The measurement of the uterus typically reaches the umbilicus at this many weeks of gestation.

Fundal height measurement rule

A standard where the measurement in centimeters should match the number of weeks pregnant (e.g., $28\,weeks$ equals $28\,cm$).

Gudle/Gaudle sign

Another term for the softening of the cervix.

Dial sign

A term used to describe the softening of the cervix during the clinical assessment.

Mucus plug

A precursor to labor; losing this indicates the body is preparing for the actual birth process.

Chadwick's sign

A sign involving increased vascularity and darkening color of the vagina and cervix.

Bloody show

A term for the cervical mucus mixed with blood, indicating the cervix is getting ready for labor.

Ovary enlargement timing

The enlargement of the ovaries usually occurs between $12$ and $14\,weeks$ of gestation.

Ovulation during pregnancy

A biological process that stops once a woman becomes pregnant.

Breast changes

Increase in size and nodularity to prepare for lactation.

Colostrum

The initial milk produced after birth, described as the best nutrition for babies, especially premature ones.

Breastfeeding Education

The nurse's responsibility to inform the mother of benefits while respecting her choice and cultural beliefs.

Lactation Consultants

Specialists who assist mothers with positioning and latching while breastfeeding.

Latched rate

The quality of how a baby attaches to the breast, which is crucial for reducing pain during feeding.

Breech delivery

A delivery where the baby is not head-down, which can be dangerous as the head may get stuck after the body is out.

GI system motility

The gastrointestinal process where movement of contents becomes nice and slow during pregnancy.

Heartburn

A very common GI complaint in pregnancy caused by slowed motility and pressure.

Dietary recommendations for GI issues

Drinking lots of fluids and consuming high amounts of fiber.

Hemorrhoids

Common issues in pregnancy resulting from increased pressure; they usually resolve after birth.

Pushing technique

Instruction to bear down using the same muscles as a bowel movement to move the baby through the birth canal.

Epidural effects on pushing

The numbing may prevent the mom from feeling the urge to push, requiring the nurse to coach her on pressure.

Pushing with contractions

The practice of bearing down only when the uterus is tightening to utilize the body's natural force.

Lubrication (Lube/Oil)

Used during the pushing phase to make the baby slippery and try to avoid vaginal tears.

Episiotomy

A surgical cut made to the perineum that is uniform and easier to stitch than a natural tear.

Natural tear

A non-uniform injury that occurs during birth, which can be much harder and longer to repair than an episiotomy.

Cardiovascular blood volume

This increases during pregnancy to support the fetus, placenta, and uterus.

Red blood cells

The number of these cells must increase to meet the higher oxygen and volume demands of pregnancy.

Baseline vitals

The first set of vitals taken at a prenatal visit used as a comparison for all future assessments.

Hypercoagulable state

An increase in clotting factors, such as fibrinogen, to protect the mother against postpartum hemorrhage.

Fibrinogen

A clotting factor that becomes higher in pregnant women to prevent excessive bleeding after delivery.

Supine hypotension

A drop in blood pressure caused by the heavy uterus compressing the vena cava when the mother lies on her back.

Anti-hypotension positioning

Tilting with a pillow or lying on the side to ensure better perfusion to the baby.

Left side positioning

The preferred side for a laboring mother to lie on to maximize blood flow and fetal heart rate stability.

Fetal heart rate interventions

Includes changing maternal position, giving oxygen, and administering fluids when heart rates drop.

B cells (Decelerations)

Fetal heart rate drops that are concerning if they are concurrent and don't allow for re-perfusion.

Diaphragmatic breathing

The primary mode of breathing for pregnant women as the diaphragm is pushed out of the way by the uterus.

Oxygen consumption increase

A physiological change where consumption increases by $20\%$ to meet fetal demands.

Nasal congestion

A common vascular-related symptom in pregnancy; saline sprays are recommended as a safe treatment.

Renal pelvis dilation

A change in the urinary system where the structures become longer and wider.

GFR (Glomerular Filtration Rate)

This renal measurement increases by $50\%$ during pregnancy.

Urinary frequency cause

Increased kidney activity and the physical pressure of the uterus sitting on the bladder.

Ligament changes

The softening and stretching of connective tissues to allow for bodily changes and delivery.

Lordosis

The exaggerated lower back curve that shifts the center of gravity in pregnant women.

Fall risk in pregnancy

Increased risk due to the forward shift of gravity, especially later in pregnancy at $37\,weeks$.

Round ligament pain

Sharp pains that are common and normal as the body gets larger during pregnancy.

Melasma/Chloasma

Known as the mask of pregnancy, it is facial hyperpigmentation that worsens with sun exposure.

Striae gravidarum

The clinical term for stretch marks caused by skin stretching and cortisol effects.

Genetics and stretch marks

The primary factor determining whether a woman will develop striae gravidarum.

Thyroid gland enlargement

A normal endocrine change during pregnancy, though it is usually tested for stability.

TSH (Thyroid Stimulating Hormone)

This hormone level typically decreases during pregnancy.

Insulin resistance

A common metabolic change that occurs in the second half of pregnancy.

Oxytocin production

Naturally produced by the posterior pituitary and used medically to induce or augment labor.

Folic acid benefit

A nutritional requirement that helps prevent spinalysis (spina bifida).

Spinalysis (Spina Bifida)

A spinal birth defect directly correlated with insufficient folic acid intake.

Folic acid timing

The ideal time to take this supplement is before a woman becomes pregnant.

Magnesium sulfate

A medication used during fetal surgeries that makes the mother very sick and at risk for pulmonary edema.

Creative cravings (Pica)

The urge to eat non-food items like dirt or clay during pregnancy, necessitating education.

BMI $18.5$ weight gain

The ideal total weight gain for someone with this BMI is between $28$ and $40\,lbs$.

High BMI weight gain

For women with a higher BMI, the suggested weight gain range decreases to about $25\,lbs$.

Introversion

A common emotional response where the patient becomes more focused on her own bodily changes.

Binding-In

The process of an emotional attachment developing between the mother and the pregnancy/infant.

Body image changes

Challenging psychological shifts, especially for patients with history of eating disorders or body dysphoria.

Sexual desire (1st Trimester)

Typically decreases due to fatigue and nausea.

Sexual desire (2nd Trimester)

Typically increases as pregnancy discomforts often ease during this phase.

Placenta previa restrictions

A specific complicated pregnancy condition where sexual intercourse is prohibited.

Family-centered care

A nursing emphasis that recognizes diverse family structures beyond the nuclear family.

Sibling rivalry

A common occurrence when a new baby is brought home, where the older child may regress or act out.

Umbilicus

The anatomical landmark where the fundal height is measured at $20\,weeks$ gestation.

Molar pregnancy

A condition that can cause a false positive result on a pregnancy test.

Lactation

The production of milk, for which the breasts increase in nodularity and size.

Perineum

The area between the vagina and anus where pressure is felt during pushing or where an episiotomy is performed.

Hyperemesis

A severe form of nausea and vomiting in pregnancy that can require hospitalization for IV fluids.

Maternal role attainment

The process by which a mother seeks acceptance of herself and the infant in her new life role.

Posterior Pituitary

The specific gland that produces the hormone oxytocin.

Oxygen consumption (Fetal demand)

Increases significantly by $20\%$ during the course of pregnancy.

Vascularity in Vagina

The cause of thickening and lightening (Chadwick's) within the vaginal walls during pregnancy.

Pica Education

Nursing intervention required when patients report sniffing detergent or eating clay/dirt.

Fetal position for labor

The goal is for the fetus to be head down to ensure a safe vaginal delivery.