Maternal/Newborn Nursing content from Textbook of Basic Nursing, 11th Edition

Pregnancy precautions for pregnant woman or woman to become pregnant

Do not take any medications or drug unless prescribed by a practitioner who knows that the client is pregnant or trying to conceive. Avoid x-rays whenever possible. The client should inform the x-ray tech and her healthcare provider of the pregnancy. Avoid substance use, including limiting caffeine intake, avoid tobacco, passive smoke, recreational drugs, and any form of alcohol. Avoid or limit exposure to known environmental toxins. Avoid hyperthermia-producing situations such as hot tubs or prolonged sitting in hot water >100, and also excessive exercise.

TPAL

Term births (37 weeks' gestation), premature births, abortions, living children

Goal of Risk Assessment

To identify women and fetuses who have a chance of having a complication develop during pregnancy, labor, birth, or the neonatal period. After a risk is identified, the healthcare team can provide the appropriate type and level of care, which results in better outcomes.

BBT

basal body temperature or body temp at rest; rises when pregnant, usually less than 1 degree and is one of the earliest signs of pregnancy

3 components of prenatal care

-Early and regular prenatal care -Maintenance of maternal health; promotion of good health habits -Recognition and treatment of physical, mental, and social/economic problems

Goals of prenatal care

-Promote physical and mental wellness of the mother during the pregnancy and afterward -Help the woman give birth and without complications -Ensure a healthy baby

7 areas that need to be addressed in preconceptional care?

1. Healthy diet w/400mg of folic acid a day 2. Stopping harmful or addictive behaviors such as smoking, drinking alcohol, or using drugs. 3. Stopping use of prescription drugs that are known to be harmful to a developing infant. 4. For diabetic woman, change to insulin instead of oral diabetic agent and controlling blood sugar. 5. Referring a couple at risk of having a baby with a genetic defect to genetic testing and counseling before the pregnancy. 6. Testing the mother for infectious diseases, and either providing immunizations(such as rubella), or treating any infection found, including HIV and other STD's. 7. Reducing psychosocial risk factors. For instance helping a battered woman find services and community resources.

How long does it take the process of the morula to be swept down the fallopian tube and into the uterus?

7-9 days

fetoscope

A device used for listening to fetal heart tones (FHTs). Performed 18th-20th week

obstetrics

branch of medicine concerned with pregnancy and birth

implant

burrowing of the future embryo into the endometrium

prenatal

care before the birth that refers to the period between conception and the onset of labor.

Preconceptional care

care of the woman before she is pregnant; influences the physical changes during pregnancy and overall general health of the woman and the fetus after the start of a pregnancy.

Chadwick sign

cervix looks blue or purple when examined and may occur as early as the 6th week of pregnancy. Also occurs on the vulva and vagina.

Goodell sign

cervix softening at about the 8th week

colostrum

clear or slighly milky fluid that produces in very small amounts throughout pregnancy and is greater quantity during the first day or two after birth

hypermesis gravidarum

complication of pregnancy

preterm labor, PPROM or PROM

condition identified by either a gush of fluid or a continuous steady trickle of fluid. The gush is usually easily recognized, but the woman may not realize that a slow steady leak is a problem; second and third trimester danger sign

ductus arteriosus

connection between the pulmonary artery and the aorta that allows shunting of blood around the fetal lungs

umbilical cord

connects the fetal blood vessels contained in the villi of the placenta with those found within the fetal body, consists of two arteries and one large vein twisted around each other. Approx. 20 in (51 cm) long.

Abortion

delivery of an infant by spontaneous or therapeutic means

Zygote

ferilized ovum; beginning of potential individual human development

Viable fetus

fetus less than 24 weeks that will need significant healthcare resources for maintanance of life.

quickening

first fetal movements or flutters, usually between 18 and 20 weeks of gestation but may occur a week or two earlier in a multigavida.

GTPAL

gestations, term pregnancies, preterm pregnancies, abortions, live births

cephalocaudal

head to toe

HPL human placental lactogen

hormone that is not produced until close to the beginning of the second trimester. Primary hormone of early pregnancy that drops levels during the second trimester.

Periods of the fetus

lasts from the beginning of the 9th week after fertilization through birth, which is usually about the end of the 40th week; increasing growth, differentiation, and funtional development of the tissues that appeared during the embyonic period.

linea nigra

line of darker pigmentation that often appears on the lower abdomen and extends from the umbulicus to the pubic bone. Hormone levels cause this change.

endometrium

lining of the uterus; becomes rich in nutrients when preparing for pregnancy

Hegar sign

lower uterine segment (portion between the body of the uterus and the cervix) softens

obstetrician

medical doctor or healthcare providet that has had specialized training to the areas of obstetrics and gynecology.

spontaneuos abortion

miscarriage; primary danger in first trimester and includes vaginal bleeding or spotting, pelvic/abdominal cramping, and no longer feeling pregnant

ultrasound

most common method used to evaluate fetal size, development, and due date.

umbilicus

navel, belly button

Living children

number of children living as of today(does not include live births who died previously)

Para (P)

number of deliveries

foramen ovale

opening between the right and left atria that permits most of the blood to bypass the right ventricle.

placenta

organ with rich blood supply that supplies developing organism with food and oxygen, carries waste away for excretion by the mother, slows the maternal immune response so that the mother's body does not reject the fetal tissue, and produces hormones that help maintain pregnancy.

chorion

outermost cell layer that surrounds the embryo and fluid cavity

Female sex cell

ovum (egg)

Gestation (gestational age)

period of time that occurs from the moment a man's sperm fertilizes a woman's egg until the birth of the newborn. Normal ranges 38-42 weeks

uterine fundus

place where the embryo has implanted; usually by the 7th week

congenital anomalies (birth defects)

potentially harmful influences that are responsible for certain defects.

positive signs (proof exists)

pregnancy actually provides proof that there is a developing fetus (fetal heartbeat, fetal movement, ultrasound of fetus)

HCG, HCg, hCG human chorionic gonadotropin

pregnancy hormone that is produced by the cells that will become the placenta and found in small amounts in a woman's urine or blood by about the 7th to 10th day of pregnancy and shows in a pregnancy test or blood test.

Preterm

pregnancy of about 20-37 weeks of gestational age; more than 500g or less than 2,500g

lactation

production of milk

ballottement

rebound tap; around 16-18 weeks of pregnancy, gentle tapping the side of the pregnant womans abdomen will cause the fetus to bounce in the amniotic fluid.

PMP previous menstrual period

recalling first day of last period

ductus venosus

short duct found only in the fetus and atrophies after birth.

Wharton jelly

soft, jellylike substance that protects the cord which enters the fetus' body approx. in the middle of the abdomen at the umbillicus (navel).

Male sex cell

sperm (X or Y sex chromosome)

melasma (choasma gravidarum) or "mask of pregnancy"

suntanned, bronzed masking that may appear across the face of dark-haired women. Hormone levels cause this change.

PIH Pregnancy Induced Hypertension

suspected when there is severe headache which does not respond to over the counter remedies, visual changes (such as double vision sudden blurred vision, spots and flashing lights), sudden edema or swelling (in face, eyes, and hands), and epigastric pain or pain in the upper abdomen.

funic souffle

swishing sound produced by the pulsation of blood as it is propelled through the umbilical cord and has same rate as fetal heart rate.

uterine or placental souffle

swishing sound sound produced by the maternal blood as it flows through the large vessels of the uterus. Its rate is the same as the woman's heart rate.

Most critical time during pregnancy

the first 8 weeks when all major systems of the embyro develop

Blood exchanged by placenta

the placenta returns deoxygenated (low in oxygen) blood from the fetus to the mother through the two umbilical arteries. The placenta returns oxygenate (oxygen rich) blood to the fetus via a single vessel, the umbilical vein.

conception/fertilization

the union of the ovum and sperm

Blastocyst

thin-walled hollow structure of early embryonic growth and development

Trimesters

three-month periods; first trimester:begins on the first day of the woman's last period and ends on the last day of week 13, Second trimester includes weeks 14-27, and the third trimester begins at week 28-40.

period of the embryo

time of implantation into uterus until the 8th week after conception; all organs and structures of the human are formed and are most susceptible to damage. (called critical phase of human development)

Pueperium

time period between birth and 42 days after delivery

Live births

total number of children who survived birth but may have died any time later.

2nd and 3rd trimester danger signs

vaginal bleeding w/or w/out cramping, pressure or pain, bleeding with severe abdominal pressure, preterm labor and premature rupture of the membranes, decreased fetal movement, & PIH (hypertension)

probable signs (likely signs)

appear early in pregnancy but they are objective. Both client and healthcare personnel can observe probable signs. (positive urine pregnancy test, cervical changes)

Size of placenta

approx. 15-20 cm in diameter, 2-3 cm thick, and weighs between 500 and 600g. Weight is about one sixth the weight of the infant, if both are healthy.

congenital

"born with"

Normal fetal heart rate

120-160 BPM

When does fertilization occur?

2 weeks after a woman's last normal menstrual period (LMP or LNMP); considered gestational period.

Morula

After zygote divides, it forms this ball of about 16 indentical cells and the first differences among cells develop

certified nurse midwife (CNM)

Nurse that has received special specialized training in the management of pregnancy, labor, and birth;only works with healthy women during their pregnancies.

amniotic fluid

Made up of primarily fetal urine and fetal lung fluid and located inside the amnion and performs these functions: cushions the fetus, regulates temperature, and allows the fetus to move freely inside it, which allows normal musculoskeletal development of the fetus

decidua

Name of endometrium during pregnancy

Boy sex determination

Sperm cell carrying a Y chromosome fertilizes the ovum, a boy (XY) will result.

Girl sex determination

Sperm cell carrying an X chromosome fertilizes the ovum, a girl (XX) will result.

2 types of preconceptional visits

Visits by a women or couple planning a pregnancy and visits by a woman who is not planning to become pregnant soon but who may become pregnant

Pregnancy or antepartnum period is

a normal physiologic process, not a disease; lasts 40 weeks, 10 lunar months, and 9 calendar months

Term (T)

a pregnancy greater than 37 weeks or less than 42 weeks or greater than 2,500g

Gravida (G)

a pregnant woman; gravida followed by a number indicates the number of pregnancies

annorrhea

absence of menstruation and is often one of the first indications of pregnancy

Post term

an infant who is greater than 42 weeks of gestational age

presumptive signs (possible)

appear early and are subjective, only noted by the woman. These symptoms could indicate a condition other than pregnancy. (Fatigue, nausea. frequent urination)

doppler

electronic stethoscope that converts ultrasonic frequencies into audible frequencies or onto a video monitor. Performed as early as 10th week.

embryo

inner cell mass will form the body tissues

amnion

inner membrane surrounding the fetus; protects it from organisms that might infect the mother's cervix

lordosis

inward curve of the lower back due to enlarging of the abdomen and shift in her center of gravity