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Health Assessment - Ch. 26 - Pregnant Female

Terms

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Gynecological Age
the difference between current age and age at menarche
- 3 years or less are still completing linear growth
Pica
eating nonfood items or ice
- consumption of earth or clay can be a source of contamination
Placenta
- ovoid organ
- weighs 1/6 of fetus
- covers 1/3 of uterus
- develops from fertilized ovum


What are the functions of the placenta?
1. metabolism
2. transport of gases and nutrients
3. secretion of hormones

Gestational Age
age in weeks from the last normal menstrual period
Embryo
- from conception to 8 weeks
- before all the organs are developed
Fetus
- 8 weeks to birth
Teratogen
an agent, such as a virus, a drug, a chemical, or radiation, that causes malformation of an embryo or fetus, may induce major congenital anomalies
Viability
the point at which the fetus can survive outside the uterus
- as early as 22 weeks or 1 lb
Quickening
the fluttery initial sensations of fetal movement perceived by the mother
- felt earlier in females who have previously given birth
When does the fetal heart start beating?
22 days
When are major congenital anomalies risks the highest?
from weeks 3-8
- not during the first 2 weeks
(first 2 weeks, death and spontaneous abortion are common)

Ductus Venosus
A shunt in fetal circulation that enables the fetus to maximize oxygenation from the maternal circulation
- partially bypasses the fetal liver
Foramen Ovale
A shunt in fetal circulation before birth that connects the fetal right atrium to the fetal left atrium
Ductus Arteriosus
A shunt in fetal circulation that shunts blood into the descending aorta
- bypasses the lungs
Primigravida
female pregnant for the first time
- "show" later than someone who has been pregnant before
Muligravida
female who has been pregnant before
- "show" earlier than primigravida
McDonald's Rule
- estimating fetal growth
- after 20 weeks in pregnancy, the weeks of gestation approximately equal fundal height (cm)
Lightening
the descent of the fetal head into the pelvis
- fundal height drops slightly
- between 38-40 weeks

Hegar's Sign
softening of the region of the uterus that connects the body to the cervix
Piskacek's Sign
the irregular shape of the uterus caused by the implantation of the ovum
Amenorrhea
absence of menstruation
- one of the first signs of pregnancy
Braxton Hicks Contractions
painless and unpredicatable contractions of the uterus
- do not dilate the cervix
Ballottement
technique of palpation
- examiner's hand pushes against uterus
- detects the presence or position of a fetus by its return impact

Amniotic Fluid
- clear, slightly yellowish liquid that surrounds the fetus
Mucus Plug
a protective covering of the cervix that develops during pregnancy because of PROGESTERONE
Leukorrhea
a profuse, nonodourous, nonpainful vaginal discharge that protects against infection
An increase in ________ predisposes the mother to yeast infections
Glycogen
Goodell's Sign
An increase in cervical vascularity that contributes to the softening of the cervix
Chadwick's Sign
Vascular congestion that creates a blue-purple blemish or change in cervical colour
Ripening
sofetning of the cervix near the end of pregnancy in anticipation of birth
Effacement
Thinning of the cervix occuring near the end of pregnancy in preparation for labour
Dilation
Progessive opening of the cervix
Montgomery's Glands
(AKA Montgomery's Tubercles)
Sebaceous glands (oil) on the areola that enlarge and produce a secretion that protects and lubricates the nipples
Colostrum
Thick, yellow discharge that may leak from a pregnant woman's breasts in the month before she gives birth, in preparation for lactation
Physiological Anemia
a decrease in hemoglobin & hematocrit caused by plasma volume increase outpacing the increase in RBCs
Mammary Souffle
a murmur over the mammary vessel caused by increased blood flow and occasionally heard during pregnancy
- heart rate gradually increases 10-20 bpm during pregnancy
Supine Hypotension Syndrome
(AKA Vena Cava Syndrome)
pressure from the pregnant uterus compresses the aorta and the IVC when the female is supine, causing dizziness, fainting, and a drop in HR and BP
Linea Nigra
a dark line running from the umilicus to the pubic area
Melasma
(AKA Cholasma or the "mask of pregnancy)
occurs in butterfly pattern over the forehead, nose and cheeks
- genetics
- use of combined oral contraceptive pills

Striae Gravidarum
(AKA Stretch Marks)
pinkish-purplish skin depressions in CT
- develop in 2nd half of pregnancy
Fundal Height
size of the fundus;
after 20 weeks pregnancy, the weeks of gestation is equal to the fundal height in cm
Leopold's Manoeuvres
a special palpation sequence of the abdomen used to determine the position of the fetus after 28 weeks gestation (approx. 7 weeks)
Menarche
Age of the first menstrual period
Naegele's Rule
a formula that can be used to compute the fetus' expected date of birth (EDB) based on the mother's last menstrual period (LMP)

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