OB

GTPAL system

G - gravida T - term (38-40 weeks) P - preterm (20-37 weeks) A - abortion (up to or less than 20 weeks) L - living (how many are currently alive)

Week 9 🎓🚹🚺

Embryonic and fetal development: Genitalia are now well defined; Eyelids finish forming and seal shut. The embryo becomes a fetus. Maternal events: blood volume has increased 30%-40%

The pneumonic used to remember the Various kinds of decelerations is?

"VEAL CHOP"

A client who is pregnant for the first time and is carrying twins is scheduled for a cesarean birth. What should the nurse tell the client to expect? "We'll give you an enema before the surgery." "We'll be encouraging you to walk early after surgery." "You'll be discharged from the hospital in a week." "You should take sponge baths until the incision is healed."

"We'll be encouraging you to walk early after surgery." Early postoperative ambulation helps prevent such postpartum complications as thrombophlebitis and constipation. An enema is not necessary. Clients who have had uncomplicated cesarean births are generally discharged by the third postpartum day. Clients are permitted to shower after 48 hours or even sooner.

Normal FHR is?

120bpm-160bpm

Week 27 🌬🍇

Embryonic and fetal development: A substance called surfactant forms in the lungs, preparing them to function independently after birth. Coats the alveoli so they don't collapse. Maternal events: Respiratory movements can be detected with ultrasound scan. Mother sometimes feels baby's breathing as "hiccups."

What happens to the fetal heart rate in response to contractions, what is it called?

A decrease in FHR occurs in response to the contractions and is called a deceleration. Decelerations can be early, late, or variable.

Starting at 9 weeks the embryo is referred to as__________.

A fetus

The nurse finds the amniotic fluid in a patient to be dark greenish brown in color. What does this finding indicate? A) Hypoxia in the fetus B) Jaundice in the fetus C) Arrhythmia in the fetus D) Intracranial hemorrhage in the fetus

A) Hypoxia in the fetus Amniotic fluid turns dark greenish brown color due to the release of meconium (first stool of the fetus) from fetal rectum in response to hypoxia. Fetal jaundice is not related to dark greenish brown coloration of amniotic fluid. Fetal jaundice, intracranial hemorrhage and arrhythmias in the fetus may be caused by medications such as oxytocics.

After admitting a new patient to the maternity unit, the nurse writes a care plan. The process of determining outcomes and interventions is which stage of the nursing process? A) assessment B) planning C) implementation D) evaluation

A) assessment

Puerperium is defined as

Also called the postpartum period lasts about 6 weeks

The sex of the zygote is determined when?

At the moment of fertilization, and all other genetic characteristics are determined and do not change.

The nurse is caring for a pregnant patient who is in the first stage of labor. Which findings in the patient would confirm the second stage of labor? A) Onset of contractions B) Dilation of cervix at 10 cm C) Little change in effacement D) Thinner muscle walls of uterus

B) Dilation of cervix at 10 cm The second stage of the labor begins with the complete cervical dilation at 10 cm and ends with the birth of the baby. Onset of contractions indicates the first stage of labor. Little change in effacement is the indication of false labor. During the labor process, the walls of the upper section of the uterus have a thickened musculature that provides the force during the contractions. The muscle walls of the lower section become thinner and act as a passive tube.

A pregnant woman comes to the clinic for a scheduled examination. The McDonald method is used to measure the height of the uterus. What action if taken by the nurse would result in the most accurate measurement of the fundal height? A) Using different tools to confirm findings B) Establishing a protocol for measurement C) Use several methods of measurement to identify errors D) Taking measurements with the patient in different positions

B) Establishing a protocol for measurement The McDonald method is used when a reliable date of the last menstrual period is not known. For increased reliability of the measurement of fundal height, the same person should measure each time. If this is not possible, then a protocol should be established that specifies the measurement technique, including the woman's position on the table, the measuring device, and the method of measurement used.

Week 17 👶🍐

Baby is the size of a pear

Nipple stimulated contraction test (NST)

Be careful to avoid hyperstimulation. Contractions longer than 80 seconds or more frequent than four in a 10 minute period are considered hypertonic.

By what mechanism is a blastocyst able to enter the endometrium and implant?

By secreting enzymes that are able to break down protein and penetrate cell membranes. These enzymes allow the blastocyst to enter the endometrium and implant. The action of the enzymes normally stops short of the myometrium but may cause slight bleeding in some individuals. This is called implantation bleeding.

A newly delivered patient is lying in bed bonding with her infant. When the nurse assesses the patient, the uterine fundus lacks muscle tone and firmness. What immediate action should the nurse take? A) Place the patient on the left side B) Administer medication as prescribed C) Gently massage the fundus until firm D) Notify the primary health care provider immediately

C) Gently massage the fundus until firm If the fundus is not firm after the placenta has been delivered, the uterine muscle can be stimulated to regain tone through gentle massage until firm. Although methylergonovine (Methergine) may be given, the immediate approach to promote firmness is massaging or palpating the fundus until firm. There is no indication to call the primary health care provider, and placing the patient on the left side will not promote firmness.

A nurse is teaching a class of expectant parents about changes that are to be expected during pregnancy. What changes does the nurse explain result from the melanocyte-stimulating hormone? Multiple selection question Chloasma Linea nigra Effacement Morning sickness Cervical softening Urinary frequency

Chloasma Linea nigra Melanocyte-stimulating hormone during pregnancy causes pigmentation over the bridge of the nose and cheeks (chloasma, mask of pregnancy). The concentration of melanocyte-stimulating hormone increases from the end of the second month of pregnancy until term, causing in some women a line of pigmentation on the abdomen from the umbilicus to the symphysis pubis (linea nigra). Effacement of the cervix is a result of increased mucoidal secretion and the effects of labor. A high level of chorionic gonadotropin, secreted by the placental chorion, is associated with the nausea and vomiting that may occur early in pregnancy. Cervical softening of the cervix occurs as a result of increased mucoidal secretions and the effects of labor. Urinary frequency is related to advancing growth and pressure of the uterus on the bladder.

What is the danger of a prolapsed cord?

Cord prolapse is dangerous because pressure on the vessels in the cord can restrict blood flow to the fetus. Prompt recognition of a prolapsed umbilical cord is important because fetal hypoxia from prolonged cord compression (occlusion of blood flow to and from the fetus for more than 5 minutes) usually results in central nervous system damage or death of the fetus.

A 24-year-old client complains to the nurse in the women's health clinic that her breasts become tender before her menstrual period. What should the nurse recommend that the client do 1 week before an expected menses? Multiple choice question Take salt tablets daily Increase protein intake Eliminate daily exercise Decrease caffeine intake

Decrease caffeine intake The client is exhibiting one symptom of premenstrual syndrome (PMS); eliminating food and beverages containing caffeine can limit breast swelling. Salt intake should be reduced premenstrually to limit the development of edema. Increased protein intake is unnecessary if the client is eating a nutritious diet. Exercise should be increased before the menstrual period to help ease the symptoms of PMS.

Maternal serum alphafetoprotein (AFP) screening

Down syndrome (low levels) Neural tube defect (high levels)

When can internal monitoring of the fetus be used?

Internal monitoring can be used only during the intrapartal period because membranes must be ruptured and the cervix dilated 2 to 3 cm.

Primary powers of labor

Involuntary uterine contractions, called primary powers, signal the beginning of labor. From the pacemaker points, contractions move downward over the uterus in waves, separated by short rest periods. The primary powers are responsible for the effacement and dilation of the cervix and the descent of the fetus.

Colostrum

The first secretion produced by the breast is colostrum. This precursor to milk is thin, watery, and slightly yellow. It is rich in protein, calories, antibodies, and lymphocytes.

HCG (Human Chorionic Gonatropin) levels

HCG Is the hormone assessed in pregnancy test. This hormone can be detected in both urine and blood.

Delivery of the placenta

The last stage of birth in which the placenta detaches from the uterine wall and is expelled.

Where can you locate FHR and uterine activity in a strip chart when monitoring the fetus prior to delivery?

FHR (upper part of the strip) and uterine activity (lower part of the strip)

Common maternal discomforts weeks 17-24 👃💧💫

Faintness or dizziness occurs when standing suddenly, caused by reduced blood flow to the brain as the body adjusts to new circulatory patterns. Shortness of breath may occur. Varicose veins are often the result of rising blood pressure in the lower extremities. This is caused by the enlarged uterus cutting off blood flow back from the legs to the heart. Allergies, such as hay fever, are a common problem. Skin changes such as darkened nipples, stretch marks, splotches on cheeks and forehead, acne, and redness on palms and soles are the result of increased hormone levels in the blood. Epistaxis sometimes occurs because of increased blood volume and nasal congestion.

Naegele's Rule

First day of LMP - 3 months + 7 days

Post delivery where is the uterine fundus located?

Immediately after delivery, the uterine fundus is about midway between the umbilicus and the symphysis pubis or slightly higher.

Implantation occurs where?

Implantation usually occurs in the fundus of the uterus on either the anterior or the posterior surfaces

Crown rump length

In the first trimester, the fetal crown rump lengths used. It is the measurement from the top of the fetal head to the buttocks.

Common maternal discomforts weeks 25-32

Leg and muscle cramps may be caused by fatigue, pressure exerted on the nerves by the uterus, or too little calcium or too much phosphorus in the diet. Exercise regularly, especially walking. Elevate legs and flex toes when resting. Increase milk consumption. Pyrosis (heartburn) often occurs because the stomach emptying time is delayed, causing a burning sensation in the throat. Drink milk between small, frequent meals. This problem disappears soon after the baby's birth. Edema of ankles occurs. The pressure of the uterus on the large veins returning blood to the heart may induce water retention. Elevate legs, once or twice a day for an hour or so, level with the hips. Sleep on the left side. Constipation is another result of the decelerated digestive process. As food moves slowly through the intestines, more water is extracted, leaving the stool drier and harder. Eat foods that contain roughage, such as raw fruits, vegetables, and cereals with bran. Drink liquids and exercise frequently. Mother may have trouble sleeping because of baby's activity. Soak in a warm bath or sit on soft pillows to soothe the symptoms. Hemorrhoids may develop.

Week 19 🍈💧🍼

Maternal event: Breasts begin secreting colostrum in preparation for nursing.

Tocotransducer (TOCO)

Measures and Records the frequency and duration of contractions

Chorionic villus sampling

Monitor bleeding Monitor infection Miscarriage (potentially) Premature utarine contractions

Common maternal discomforts week 1-8 😴🚽

Morning sickness occurs because increased hormonal activity slows down the digestive system, apparently to enhance the absorption of nutrients for the baby. Eat a few dry crackers before rising. Eat frequent, small, low-fat meals during the day. Drink liquids (Remedies:) Fatigue is thought to be caused by a change in ovarian hormone production (progesterone and relaxin), the purpose of which is to relax pelvic ligaments, stimulate breast growth, and soften the cervix. Exercise regularly and get plenty of sleep with frequent naps during the day. Urinary frequency is caused by the uterus compressing the bladder against the pelvic bones, thus reducing its capacity, and also by hormonal changes that affect the water balance in the body.

Fetal attitude

Relationship of fetal body parts to one another. At term, the ideal attitude for the fetal body is flexion.

A nurse discusses herpes genitalis as part of a high school sex education program. The nurse explains to the students that herpes genitalis is: Painless in women Curable with antibiotics Transmitted by way of fomites such as toilet seats Responsible for local as well as systemic reactions

Responsible for local as well as systemic reactions Fever, malaise, and headache may accompany local reactions. Vesicles on genitalia rupture, causing painful ulcerations. Herpes is of viral origin; there is no cure, and antibiotics are ineffective. Most transmission occurs through intimate sexual contact with active or healing lesions.

Amniocentesis

Reveal sex, performed at 16 weeks.

Oral glucose tolerance test (OGTT)

Routinely done at 28 weeks, done to diagnose gestational diabetes.

An example of a teratogenic agent is__________.

Rubella or geman measles, although rubella is usually a mild childhood disease, at this stage of pregnancy , the virus can affect all of the germ layers and cause serious anomalies, such as cardiac defects, deafness, and cognitive impaired.

Villi

Short vascular processes or protrusions clustered over the entire mucous surface of the small intestine.

Common maternal discomforts weeks 9-16 ‍♀️😞

Sleeplessness may result from the discomfort or anxieties of pregnancy. Vaginal secretions are the result of an increased supply of blood and glucose to the vaginal mucosa. Severe pruritus, irritation, and malodor suggest infection. If infection is suspected, consult a professional. Headaches may occur while her body adjusts to changes in blood volume and vascular tone. Emotional tension may also be a factor.

Hegars sign

Softening of the lower uterine segment

Fontanels

The anterior fontanel (bregma) is formed by four bones and thus tends to be larger and diamond shaped. The posterior fontanel is formed by three bones and is smaller and triangular.

Molding

The bones of the fetal skull are not rigidly fused (joined), which allows the bony plates to move and overlap as they progress through the maternal pelvis. This reshaping of the skull bones in response to pressure against the maternal pelvis is called molding.

Care of the mother and newborn: the cervix, vagina, perineum

The cervix appears edematous, with bruising. Bruising and edema of the perineum is common. The episiotomy (if present) should be free of erythema, with the edges well approximated and without discharge.

A student nurse is being mentored in the delivery room by an experienced nurse. Which action if performed by the student requires immediate correction? The student provides for infant warmth. The student immediately dries the infant. The student secures identification bracelets. The student suctions the back of the baby's throat.

The student suctions the back of the baby's throat. The bulb should be compressed and placed on the side of the infant's mouth not the back of the throat. The center of the throat should be avoided because this can stimulate the gag reflex. Providing for warmth, drying the infant immediately, and securing identification bracelets are correct interventions that the nurse should implement immediately after delivery.

How does the zygote make its way the process of implantation?

The zygote moves through the uterine tube via ciliary action and some irregular peristaltic activity. It takes 3 or 4 days to enter the uterine cavity.

Transverse fetal lie is most common in women who__________.

This lie is most common in women who have had many pregnancies (resulting in weakened abdominal walls), maternal pelvic contracture, or placenta previa

What are the three types of breech presentations and what are the complications?

Three types of breech presentation are possible: complete breech, in which the buttocks present and the thighs are well flexed on the abdomen; frank breech, in which the buttocks present and the thighs are extended across the abdomen and chest; and footling breech, in which there is no flexion and one foot or two feet present. Breech presentations are more difficult to deliver vaginally. Attempts to deliver a breech presentation vaginally may result in fetal head entrapment. The fetal head is larger than the torso and may be unable to pass through the birth canal without difficulty. To decrease risks to the fetus, most breech births are delivered surgically.

Chorionic villi

Tiny vascular protrusions of the chorionic surface that project into the maternal blood sinuses of the uterus and help form the placenta. This occurs when conception has occurred.

Lochia

Vaginal discharge after childbirth, the uterine lining is shed. As the uterine lining is shed, the necrotic tissue, blood, and mucus leave the body through the vagina. Lochia has a fleshy odor similar to that of menstrual discharge. For the first day or two after delivery, the lochia is made up mostly of blood, which results in a bright red drainage called lochia rubra. Some small clots may be passed during this phase. As the placental site heals, the discharge thins and becomes pink to brown; this is called lochia serosa. After the seventh day, the drainage is slightly yellow to white and is called lochia alba. This drainage continues for another 10 days to 2 weeks. If fragments of the placenta are retained in the uterus, the uterus is not able to contract and seal blood vessels adequately, which can result in excessive blood loss and may necessitate surgical intervention.

Flagellation

Whiplike movement.

Prolactin

a hormone secreted by the anterior pituitary gland, is responsible for stimulating milk production in the mammary alveolar cells.

Ectopic pregnancy

a serious condition that refers to the implantation of the fertilized egg outside of the uterine cavity.

Chadwick's sign

bluish discoloration of the vagina and cervix

What intervention should be performed every pregnant woman is fetus is showing variable decelerations? A) Discontinue Oxytocin B) Blood transfusion C) supine position D) drug therapy

A) Discontinue Oxytocin Whenever there is a nonreassuring fetal heart rate and pattern, it is important to discontinue oxytocin (Pitocin), Because it will stop stimulation of the uterus and slow down contractions.

When planning a diet with a pregnant woman. What should the nurses initial action be? A) review in a woman's dietary intake. B) teach the woman about the choose my plate guide. C) caution the woman to avoid large doses of vitamins, especially those that are fat soluble. D) Instruct the woman to limit the intake of fatty foods.

A) review in a woman's dietary intake.

You walk into your patients room and notice a decrease in FHR from 120bpm to 90bpm what is this indicative of?

An increase or decrease of 30 bpm may indicate fetal distress and should be reported immediately

A new mother is concerned about her newborn infant contracting measles and other childhood diseases from visitors. What would be the most accurate information the nurse can share with the mother about the illnesses? If the visitors do not come, the infant will not be exposed. Unless the visitor shows signs of being ill, the infant is safe. The infant is vaccinated at birth for these and other illnesses. Antibodies from the mother will protect the infant for months.

Antibodies from the mother will protect the infant for months. Maternal antibodies against measles, mumps, rubella, whooping cough, and scarlet fever are transferred to the baby and provide protection for about 6 months until the infant's immunity takes over. Therefore the visitors will not expose the infant to these diseases. Telling the parent that the infant is safe is false reassurance. The infant is not vaccinated at birth for these illnesses.

Week 7 👁👃👄👅

Embryonic development: Development proceeds rapidly. The face is now complete, with eyes, nose, lips, and tongue—even primitive milk teeth. Tiny bones and muscles appear beneath the thin skin. Maternal events: no noticeable weight gain occurs.

Week 6 👁👂

Embryonic development: Eyes begin to take shape; external ears develop from skin folds. Maternal events: Exchange of fetal and maternal metabolites across the placenta begins, yet the two circulations are completely separate.

Week 4 💓🌾

Embryonic development: Heart, blood circulation, and digestive tract take shape. The heart also begins to beat. The embryo is now the size of a grain of rice and the head is a third of its total length.

A primary health care provider is performing the Leopold maneuver on a laboring patient to check for fetal position. What is the most common position for delivery? A) LOP B) ROP C) LOA D) ROA

C) LOA LOA stands for left occipitoanterior, the most common position for delivery. ROP stands for right occipitoposterior; this is not the most common position for delivery. ROA stands for right occipitoanterior; this is the second most common position for delivery. LOP stands for left occipitoposterior; this is not the most common position for delivery.

A nurse is caring for a patient in labor. While assessing the patient's vital signs, the nurse notes a drop in the patient's blood pressure. To prevent supine hypotension, the nurse should encourage the patient to be in what position? A) Supine B) trendelenburg C) Left lateral side-lying D) Right lateral side-lying

C) Left lateral side-lying A left lateral side-lying position helps reduce pressure on the maternal vessels and prevents their compression. The Trendelenburg position or supine position will not relieve the pressure the uterus puts on the aorta and vena cava. The right lateral side-lying position will not relieve the pressure the uterus puts on the aorta and vena cava.

A test that may be done in late pregnancy to determine fetal well-being is the nonstress test. This test is based on which phenomenon? A) fetal heart rate increases in connection with fetal movement. B) Braxton Hicks contractions cause an increase in fetal heart rate. C) fetal heart rate slows in response to contractions. D) fetal movement causes an increase in maternal heart rate.

C) fetal heart rate slows in response to contractions.

A patient is scheduled for an ultrasound scan. She is at 22 weeks gestation. The patient asked how they will be able to tell the gestational age of her fetus. When planning the response, the nurse correctly recognizes that which measurements will be used in this determination? (Select all that apply). A) abdominal circumference B) biparietal diameter C) quantity of amniotic fluid D) femur length E) crown rump length

C) quantity of amniotic fluid D) femur length

A pregnant patient at her third office visit asks the nurse, "what can I do when my leg goes into a cramp?" The Patient demonstrates understanding of the nurses instruction regarding relief of leg cramps if she: A) wiggles and points her toes during the cramp. B) applies cold compresses to the affected leg. C) extends her leg and dorsiflexes her foot during the cramp. D) avoids weight bearing on the affected leg during the cramp.

C) extends her leg and dorsiflexes her foot during the cramp.

Week 8

Embryonic development: The embryo is now a little more than 1 inch long (the size of an acorn or walnut). Maternal events: the placenta now covers 1/3 of the uterine lining.

Week 2 😳😱🚫🔴🙇‍♀️

Embryonic development: The embryonic disk (ectoderm, endoderm, mesoderm) is formed. These three primitive germ layers generate every organ and tissue in the infant's body. Maternal events: The first period is missed.

A patient has been admitted to a labor delivery and recovery (LDR) unit. The nurse is assessing the patient to determine if the membrane has ruptured. What intervention would the nurse carry out to determine the status of the membrane? A) Assess the fluid for color B) Monitor uterine contractions C) Perform a vaginal examination D) Test the fluid with nitrazine paper

D) Test the fluid with nitrazine paper Nitrazine paper is used to test the pH of amniotic fluid, which is slightly alkaline from urine and pus, which are acidic. Performing a vaginal examination is not a nursing function. Assessing color is not a definitive method of determining the status of the membrane. Monitoring uterine contractions will not indicate if the membranes are intact.

When obtaining a reproductive health history from a female patient. What should the nurse do? A) Limit the time spent on exploration of intimate topics. B) explain the purpose of questions asked and how they will be used. C) avoid asking questions that you may embarrass the patient. D) use only acceptable medical terminology when referring to body parts and functions.

D) use only acceptable medical terminology when referring to body parts and functions.

An older pregnant woman comes to the clinic for a prenatal appointment. Per the primary health care provider's orders, the nurse arranges for the patient to have an amniocentesis at 16 weeks. Based on the gestational age, the nurse understands that this test is performed for what reason? Monitoring fetal distress Assessing fetal lung maturity Detecting intrauterine infection Determining chromosomal abnormality

Determining chromosomal abnormality Early amniocentesis is performed to detect biochemical and chromosomal abnormalities. This allows the mother to decide on termination before the legal point of viability is reached. Later in pregnancy, amniocentesis is performed to determine lung maturity, to detect intrauterine infection and fetal distress, and to obtain fetal laboratory values.

Week 3 🍈😬

Embryonic development: The first body segments appear; they eventually form the primitive spine, brain, and spinal cord. Maternal event: Placenta grows to cover 1/15 of the uterine interior. Breasts may begin to feel tender. There is no weight gain.

Week 5

Embryonic development: The heart starts to pump blood; limb buds appear. Major divisions of the brain can now be discerned.

Week 1 👨‍🌾💏👩‍🌾

Embryonic development: The ovum becomes fertilized, divides, and burrows into the uterus. Maternal events: Ovaries increase production of the pregnancy-maintaining hormone, progesterone.

Week 16 👶🌱📈

Embryonic and fetal development: All organs and structures have been formed, and a period of growth begins Maternal event: placenta begins producing estrogen hormone.

Week 18 💁‍♂️💁‍♀️💓👂

Embryonic and fetal development: An oily coating protects the fetus. Fine hair covers the body and keeps the oil on the skin. Maternal event: There is a 3- to 4-lb weight gain. The fetal heartbeat can now be heard with an amplified stethoscope.

Week 29

Embryonic and fetal development: Fat deposits "brown fat" are building up beneath the skin to insulate the fetus against the abrupt change in temperature at birth.

Week 33-Term

Embryonic and fetal development: Maternal antibodies against measles, mumps, rubella, whooping cough, and scarlet fever are transferred to the baby, providing protection for about 6 mo until the infant's own immune system can take over. Maternal events: Preparing for birth, the fetus descends deeper into the mother's pelvis. In 9 mo, the miracle is complete; a single, microscopic fertilized cell has transformed into a 6 trillion-celled human.

Week 11 🐳

Embryonic and fetal development: Organs begin to function. The pancreas produces insulin; the kidneys produce urine. Maternal events: 2-3lbs weight gain and a possible increase on perspiration.

Week 30-32

Embryonic and fetal development: The digestive tract and the lungs are now nearly fully matured, and the skin becomes less red and wrinkled. The fetus has grown to about 14 inches. Maternal events: there is a 3-5lbs weight gain

Week 10 🍹

Embryonic and fetal development: The fetus assumes a more human shape as the lower body rapidly develops. Blood and bone cells form. The first movements begin (quickening) mom may/may not be able to discern. Maternal event: Some women describe the sensation of these first movements as if something were blowing bubbles through a straw in their stomachs.

Week 20-21 ⏲🗒

Embryonic and fetal development: The fetus is now following a regular schedule of sleeping, turning, sucking, and kicking and has settled on a favorite position in the uterus. Maternal events: Placenta reaches its largest size relative to fetus, covering half the uterine lining. The amniotic sac contains 400 mL of fluid.

Week 12-13 🌬

Embryonic and fetal development: The lungs have taken shape; primitive breathing motions begin. The swallowing reflex has been mastered as the fetus sucks its thumb while floating weightlessly in the amniotic fluid. Maternal event: The placenta has reached complete functional maturity, acting as the baby's lungs, kidneys, liver, and digestive and immune systems.

Week 22-24 💀📈😌🙂

Embryonic and fetal development: The skeleton is developing rapidly as the bone-forming cells increase their activity. Eyelids begin to open and close. Maternal events: the placenta becomes thicker rather than wider. Mother can now sense when baby is awake.

Week 15 👶

Embryonic and fetal development: With hands ready to grasp, the fetus, now weighing about 7 oz, kicks against the amniotic sac.

Week 26 👶🔦

Embryonic and fetal development: fetus begins to respond to voices and lights. Maternal events: there is a 3-4lbs weight gain.

Week 25 🐿

Embryonic and fetal development: the baby is the size of a squirrel

Week 14 💀👍

Embryonic and fetal development: the musculoskeletal system has matured. The nervous system begins to exercise some control over the body; blood vessels rapidly develop. Maternal events: There is a 3- to 4-lb weight gain, and her belly begins to show.

Mechanisms of labor

Engagement - occurs when the biparietal diameter of the fetal head crosses the pelvic inlet. Descend - is the downward progress of the presenting part. Extension - occurs when the occiput passes under the symphysis pubis. Internal rotation - enables the fetal head to progress through the maternal pelvis. Restitution - As soon as the head is delivered, it moves to realign with the body and shoulders, referred to as restitution. External rotation - occurs as the shoulders and body move through the birth canal, with the same maneuvers as the head. Expulsion - After the shoulders are delivered, the delivery ends with expulsion, in which the body of the infant leaves the pelvis.

A client is taking a progesterone oral contraceptive (minipill). The nurse instructs the client to take one pill daily during the: Multiple choice question Five days of the ovulatory cycle Latter part of the ovulatory cycle First week of the menstrual cycle Entire menstrual cycle

Entire menstrual cycle Maintenance of serum progesterone levels keeps cervical mucus thick and hostile to sperm at all times. Telling the client to take the pills for five days of the ovulatory cycle is inaccurate information; the pill must be taken throughout the menstrual cycle. Whereas progesterone oral contraceptives (minipills) must be taken throughout the cycle, combined estrogen and progesterone oral contraceptives are taken during the second, third, and fourth weeks of the cycle. Fertility drugs are often taken during the first part of the cycle to encourage ovulation, not for contraception.

When does fertilization occur?

Fertilization (also called conception) takes place when the sperm joins or fuses with the ovum.

Fetal lie

Fetal lie is the relationship of the cephalocaudal (head-to-buttocks) axis of the fetus to the cephalocaudal axis of the mother. If the spine of the fetus is parallel to the spine of the mother, the lie is called longitudinal (good sign). If the spine of the fetus is perpendicular to that of the mother, it is called transverse lie (not so good, may result in complications).

Fetal presentation

Fetal presentation (that part of the fetus [head, face, breech, or shoulders] that first enters the pelvis and lies over the inlet) describes the part that will be in contact with the cervix and is determined by both attitude and lie.

Stages of labor and delivery

First stage: dilatation (begins with the onset of regular contractions and ends with complete dilation of the cervix). 1. Latent phase (0 to 3 cm dilation): Contractions occur 5 to 8 minutes apart and last 20 to 35 seconds. 2. Active phase (4 to 7 cm dilation): Contractions occur at 3- to 5-minute intervals and last 40 to 60 seconds. 3. Transitional phase (8 to 10 cm dilation): Contractions occur at 2- to 3-minute intervals and last up to 90 seconds. Second stage: delivery of the fetus Third stage: delivery of the placenta (approximately 5-20 minutes afterwards). The cord protruding from the vagina lengthens, and the uterus becomes more rounded and firm. Fourth stage: Stabilization (the mother is monitored closely for 2 to 4 hours after delivery in the birthing room or in a recovery room).

How long does the embryonic stage last?

The embryonic stage begins with implantation and encompasses approximately the first 8 weeks of pregnancy. During the embryonic stage, the three primary cells (ectoderm, endoderm, mesoderm) differentiate into tissue and layers, which form the placenta, embryonic membranes, and the embryo itself. By the end of this stage the embryo had acquired a human appearance.

Cervical effacement

The stretching and thinning of the cervix in preparation for birth.

What is important to know about the size and shape of the true pelvis?

The size and shape of the true pelvis are more important than those of the false pelvis because the fetal head must be able to pass through this section of the pelvis for vaginal delivery to occur.

teratogenic agents

any drug, virus, or substance that can cause malformation of the fetus.

Zygote

cell formed by the union of two reproductive cells or a fertilized ovum.

Morula

developmental stage of the fertilized ovum in which a solid mass of cells resembles a mulberry

Implantation

embedding of the fertilized ovum (or zygote) in the uterine mucosa

Spontaneous abortion occurs when___________.

intrauterine vascular or hormonal conditions cannot sustain the implanted embryo

Abortion

is the medical term used to refer to the loss of a pregnancy before 20 weeks gestation. Most spontaneous abortions occur during the first 8 weeks of pregnancy for these reasons.

Goodell's sign

softening of the cervix

How does sperm makes its way in order for fertilization to occur?

sperm travel through the mucus of the cervical canal (if the mucus is receptive), enter the uterine chamber, and move into the ampulla, the outer third of the fallopian tube.

Perineal lacerations

•First-degree: Laceration extends through the skin and structures superficial to muscles. •Second-degree: Laceration extends through muscles of perineal body. •Third-degree: Laceration continues through the sphincter muscle. •Fourth-degree: Laceration also involves the anterior rectal wall (When caring for the woman with a third-degree or fourth-degree laceration, the nurse must assess the bowel habits). Rectal treatments such as enemas or suppositories are contraindicated for women who have third-degree or fourth-degree lacerations.

Blastocyst

the embryonic form; a spherical mass of cells with a central fluid-filled cavity surrounded by two layers of cells

endoderm

the innermost of the cell layers, which develop into the lining of cavities and passages of the body and the covering of most internal organs.

ectoderm

the outer layer of the embryonic tissue that gives rise to skin, nails, and hair. It is filled with amniotic fluid.

mesoderm

the third layer of primary cells, embryonic middle layer of germ cells that gives rise to all types of muscles, connective tissue, bone marrow, blood, lymphoid tissue, and all epithelial tissue.

Secondary powers

voluntary bearing-down efforts by the woman that augment the force of the involuntary contractions.