OB/PEDS Final Study Guide (combined)
Preterm
(ANS- 20-37 weeks
Term
(ANS- 37-42 weeks
Postterm
(ANS- after 42 weeks
Why is it important to know how far along you are?
(ANS- To determine viability of the fetus
How is fundal height measured and how does it correlate to the number of weeks
pregnant?
(ANS- · It tells the gestational age
· From fundus ( top of uterus) to the symphysis (bony structure of pelvis)
o Measurement should approximately equal the number of weeks pregnant
Umbilical cord vessels
(ANS- · 2 arteries (carry deoxygenated blood to fetus) and 1 vein (carries
oxygenated blood to fetus)
· There should always be THREE vessels in the cord
· AVA
Why is the number is vessels in the umbilical cord important and what does a
reduced number mean?
(ANS- o Newborns w/ only TWO vessels have 20% chance of having
cardiac/vascular defects or renal
o Document number of vessels & report abnormalities to the physician
Presumptive signs of pregnancy
(ANS- • Amenorrhea
- Nausea/Vomiting
- Breast changes (enlarged, tender, tingling, increased vascularity)
- Fatigue
- Urination frequency
- Quickening
Probably signs of pregnancy
(ANS- • Positive pregnancy test - Uterine growth and abdominal growth
- Skin Hyperpigmentation
· Melasma (mask of pregnancy): brownish pigmentation over the forehead,
temples, cheek, and/or upper lip - Goodell Sign: softening of the cervical tip
- Chadwick Sign: depend violet-blush color of cervix & vaginal mucous.
- Hegar’s Sign: softening & compressibility of lower uterus
- Braxton Hicks Contractions: fake contractions that can be relieved by walking
and are painless/irregular - Ballottement: rebound of unengaged fetus via cervical opening
Positive signs of pregnancy
(ANS- • Auscultation of the FHR w/ doppler - Observation/palpation of fetal movement by examiner after about 20 weeks
- Sonographic visualization & cardiac movement noted
- Feeling and seeing movement
Goodell’s sign
(ANS- softening of cervical tip
Chadwick’s sign
(ANS- deepened violet-blush color of cervix & vaginal mucous
Hegar’s sign
(ANS- softening and compressibility of lower uterus
Naegele’s Rule
(ANS- add 7 days to LMP, subtract 3 months, add 1 year
Normal FHR
(ANS- • 110 – 160
o FHR changes are the most important indicators of compromised blood flow
Lanugo
(ANS- o fine, downy hair that develops after 16 wks gestation
· Will decrease as fetus ages
· Back, shoulders, forehead
· Gradually falls out
· Presence and amount of lanugo assist in estimating gestational age
· Abundant lanugo may be signs of prematurity or genetic disorder
What is milia and how is it treated?
(ANS- o milk bumps : exposed sebaceous glands that resolve without treatment
· Leave alone & resolve on own
What do changes in the FHR suggest
(ANS- • Most important indicator of compromised blood flow to baby
HELLP syndrome
(ANS- • Hemolysis (H) , Elevated Liver Enzymes (EL), and low platelets (LP)
- Hemolysis (breaking down of red blood cells)
- Elevated liver enzymes
- Low platelets ( you gunna bleed out)
How to treat HELLP syndrome and what to be on the look out for afterwards
(ANS- o Correction: - Massive blood transfusion protocol
- Fresh frozen plasma
- Cryoprecipitate