Nclex 6/26 OB

Nagele's Rule

1st day of LMP - 3m + 7 day + 1y

premenstrual dysphoric disorder

a disorder marked by repeated episodes of significant depression and related symptoms during the week before menstruation

amenorrhea

absence of menstrual flow

Anovulation

absence of ovulation

Leiomyomas (uterine fibroids)

Benign solid masses of the uterus that develop from overgrowth of the uterine smooth muscle tissue.

Gravida = pregnant woman Gravidity = number of pregnancies Parity = the number of births carried to a viability (at least 20 weeks)Whether or not the fetus was born alive Nullipara = never given birthIncludes miscarriage or abortion prior to 20 weeks

G/PUsed in clinical setting to record the gravidity and parityOften written ie: G2/P1Someone in second pregnancy with 1 successful birth previously

Hysterectomies

If in a younger woman they try to leave the ovaries for hormones, but if in older women they take everything.

Fundus definition: the top of the uterus, palpable Used to measure the gestation based on height of Uterus Closely observed after delivery to ensure adequate postpartum recovery ie: uterus isn't filling up too much with blood causing it to be "boggy" or up higher and that it is contracting back to prepregnancy state

Measured externally in pregnancy in centimeters and should equal the gestational ageIe: 28 cm should be 28 weeks pregnant Measured post pregnancy during the postpartum recovery in "fingerbreadths" or centimetersU = its at the umbilicusU-1, U-2, U-3=it is 1,2,or 3 cm below the umbilicusU+1,U+2= it is 1, or 2 cm above the umbilicus

Rupture of Membranes PPROM preterm premature prior to 37 weeks risk for infection PROM at term 37+ SROM spontaneous full term AROM - artificial

NItrazine - vaginal swab that turns blue if ROM measures the Ph of fluid in vagina. doesn't turn blue - urine turn blue it's AF b/c of the Ph its measuring (AF more alkaline)

physiological changes Many of these changes are due to an expanding uterus (and therefore pelvis), an increase in oxygen consumption and circulating blood volume, and fluctuations in various hormones

Scheduled of prenatal visits:Q4 weeks from 8-32 weeksQ2 weeks from 32-36 weeksQ1 weeks from 36-40 weeks

Bishops score

Scoring system for determining whether or not induction of labor will be successful, based on 5 criteria (scored from 0-3): position, cervical consistency, degree of effacement, dilatation, and station; score >9 suggests that induction will be successful.

An epidural may be used for clients undergoing cesarean section. The process involves insertion of a catheter and injection of medication into the epidural space next to the spine. When anesthesia is used, the client cannot feel anything from the point of insertion down. This method is used during cesarean section so the client can remain awake during the procedure.

The medication is delivered into the space outside the spinal cord Epidurals can cause hypotension and bladder distension, so the nurse will monitor and treat for these conditions by administering IV fluids for hypotension and addressing the bladder distention after the procedure is complete. The epidural catheter remains in place for an hour or two following the birth of the baby.

The parietal areas behind the frontal bone form the top surfaces of the cranial cavity. A swelling in one of these areas that does not cross the suture line is a cephalhematoma. The frontal area is the area over the eyes. The temporal area is the area behind the ears. The occipital area is the area at the back of the head.

Where would the nurse find the area of involvement associated with parietal swelling? on top of the skull

dysfunctional uterine bleeding (DUB)

a condition characterized by abnormal bleeding often due to an imbalance in hormone level changes Anovulation may occur because of hypothalamic dysfunction or polycystic ovary syndrome. DUB most often occurs when the menstrual cycle is being established or when it draws to a close at menopause. A diagnosis of DUB is made only after all other causes of abnormal menstrual bleeding have been ruled out. The most effective medical treatment is oral or intravenous estrogen. it is most often caused by Anovulation

endometriosis

a condition in which patches of endometrial tissue escape the uterus and become attached to other structures in the pelvic cavity A chocolate cyst is seen in endometriosis as a result of old blood. With endometriosis, fluid is found in the cul-de-sac, which can be associated with ectopic pregnancy and ovarian disease.

Ease of breathing Lightening is when the fetus drops lower in the pelvis. Because of this, the pressure is off the lungs and the mother may experience easier breathing. Increased urination Lightening is when the fetus drops lower in the pelvis, which increases the pressure on the bladder.

feeling more kicks is not a side effect of lightening

Mechanisms of Labor "cardinal movements" engagement - head in the pelvis can occur up to few wks before delivery - called 'lightening or dropping' descent and flexion - chin to chest, easier for fetus to pave its way out, descent in terms of station fetus is in. internal rotation - rotating itself around to extend itself out extension - fetus extends its neck now, face aligned with maternal rectum when it extends itself external rotation - realigns its body expulsion - when body is expelled

other pieces of mechanisms of labor true labor vs false labor true contractions cervical change nothing will stop them false contractions no cervical change stop

primary dysmenorrhea

painful menstruation that begins at puberty and has no clear cause

hysterectomy

surgical removal of the uterus •Top (3) reasons: Leiomyomas, Endometriosis, Uterine Prolapse Other: Cancer, AUB, Chronic pelvic pain, PID •Risks related to surgical procedure •DVT, Hemorrhage, infection, injury surrounding organs, complications from anesthesia

premenstrual syndrome

syndrome involving physical and emotional symptoms occurring in the 10 days before menstruation