Ch 31

What is the job of the Uterus?

-The womb of the infant where the fetus grows for 9 months
-Responsible for contractions during labor
-Helps to push the infant through the birth canal

What is the placenta?

-Placenta attaches to the inner lining of hte wall of the uterus and connects to the fetus by the umbilical cord
-placental barrier consists of two layers of cells
-Seperates from the uterus after birth

What is the amniotic sac?

-The fluid inside the uterus where the fetus develops
-contains about 500-1000mL of amniotic fluid
-helps insulate and protect the fetus
-released in a gush when the sac ruptures,usually at the beginning of labor

What trimeser does rapid uterine growth occur?

2nd trimester
-as the uterus grows, it pushesup on the diaphragm and displaces it
-respiratory capacity changes , with increased respiratory rates and decreasing minute volumes

What happens to the blood in a pregnant women?

-Blood volume gradually increses to:
-meet the incresaed needs of the fetus
-allow for adequate perfusion of the uterus
-prepare for the blood loss during childbirth
-Number of red blood cells will increase
-Patient able to clot faster
-Patient's heart ra

What increased likelihood might occur during the third trimester following trauma?

increased vomiting and potential aspiration
-due to change in gastrointestinal motility and the dispalcement of the stomach upward

What changes occur in the Cardiovascualr system and musculoskeletal system?

-Increase the workload of the heart
-Cardiac compromise is a life threatening possiblity
-Joints become more loose or less stable
-changes i nthe body's center of gravity increase risk of slips and falls
-weight gain

Explain first stage of pregnancy

-Begins with the onset of ctractions as the fetus enters the birth canal
-usually longest stage,lasting an aveage of 16 hours
- Uterine contractions become more regular and last about 30 to 60 seconds each
-Labor generally longer in a primigravida than in

Explain the Second stage of pregnancy

-begins when the fetus begins to encoutner the birth canal
-ends when the infant is born
-uterine contractions are usually clsoe together and last longer
-never let the motehr sit on the toilet
-Perineum will bulge significanlty ,and the top of the infant

Explain third stage of pregnancy

-Begins with the birth of hte infant and ends with the delivery of the placenta
-Placenta mus completely separate from the uterine wall

What is Preeclampsia?

Common complication
-pregnancy induced hypertension
-can develop after the 30th week of gestation
signs and systoms:
-headache
-seeing of spots
-swelling in the hands and the feet
-anxiety
-high BP

What is Eclampsia?

Charecterized by seizure that occur as a result of hypertension
treatment:
-Lie the patient on her sdie ,preferably the left
-maintain an airway
-provide supplemental oxygen
-if vomiting occurs,suction the airway
-provide rapid transport and call for ALS

What can prevent supine hypotensive syndrome?

Transporting the patinet on her left side

What is meconium?

FEtal stool
-can indicate newborn distress and it is possible for the fetus to aspirate meconium during delivery

What happens if there is a prolapse of the umbilical cord?

-must be treated in the hospital
-infants head will compress the cord and cut off circulation
-do not pus h the cord back into the vagina
-place the pregnant woman on a backboard in trendelenburg's or knee-chest position
-insert your gloved hand into the

Spina Bifida

developmental defect in which a portion of the spinal cord or meninges may protrude outsdie of the vertebrae
-easily seen on newborn's back
-cover the open area of the spinal cord with a sterile,moist dressing
-maintenance of body temperature is important

First stage of labor ends when:
the presenting part of the baby is visible
contractions are less than 10 mins apart
the mother experiences her first contraction
teh amniotic sac ruptures and labor pains begin

the presenting part of the baby is visible

A 23 year old woman,who is 24 weeks pregnant with her first baby,complains of edema to her hands, a headache , and visual disturbances. When you assess her vital signs,you note that her blood pressure is 160/90 mm Hg.She is most likely experiencing
eclamp

preeclampsia

You are transporting a woman who is 8 month pregnant.To prevent supine hypotensive syndrome , how should you position this patient?
on her right side
supine
semi-Fowler's
on her left side

on her left side

Immediately after delivery of the infant's head , you should:
suction the baby's mouth and then nose
suction the baby's nose and then mouth
assess the baby's breathing effort and skin color
check the position of the umbilical cord

Check the position of the umbilical cord

Upon delivery of the baby's head ,you note taht the umbilical cord is wrapped around its neck. You should:
immediately clamp and cut the cord
make on attempt to slide the cord over the head
keep the cord moist and transport as soon as possible
give the mo

make on attempt to slide the cord over the head

The need for and extent of the newborn resuscitation is based on:
the 1 minute Apgar score
the gestational age of the newborn
the newborn's response to oxygen
respiratory effort ,heart rate ,and color

Respiratory effort ,heart rate ,and color

The 1 mintue Apgar score of a newborn reveals that the baby has a heart rate of 90 beats/min , a pink body but blue hadns and feet, and rapid respirations. The baby cries when the soles of its feet are flicked and resists attempts to straighten its legs.

8

The most effective way to prevent cardiopulmonary arrest in a newborn is to:
rapidly increase its body temperature
allow it to remain slightly hypothermic
ensure adequate oxygenation adn ventilation
start CPR if the ehart rate is less than 100 beats/min

ensure adequate oxygenation and ventilation

While assisting a woman in labor , you visualize her vaginal area and see an arm protuding from her vagina. She tells you that she feels the urge to push. You should:
-cover the arm with a seterile towel and transport immediately
-encourage her to keep pu

cover the arm with a terile towel adn transport immediately

A newborn is considered to be "term" if it is born after __ weeks and before__ weeks
34,37
37,42
38,44
39,43

37,42