maternity exam 1 study guide
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| show | Spermatogenesis: (key word sperm)
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| show | Gametogenesis:
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| Process that gives rise to eggs. Takes place in the ovaries. | show 🗑
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| show | ovum; ejaculation
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| Sperm anatomy: (3) parts and their relevance | show 🗑
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| *Embryonic Development -Weeks 2 through 8 = -Weeks 8 through 40 = | show 🗑
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| show | Until the time he takes first breath and is viable.
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| show | 9 – 12 weeks
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| *Fetal Development by Weeks (name what weeks this happens) Nearly all structures and organs are formed and begin to function; wt I ~0.25 ounces | show 🗑
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| show | 9 – 12 weeks
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| *Fetal Development by Weeks (name what weeks this happens) All nourishment is rec’d from placenta. | show 🗑
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| Fetal Development by Weeks (name what weeks this happens) Alveoli forming | show 🗑
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| What is the survival rate at week 20? | show 🗑
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| show | WBC,skin, hear, brain. liver
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| Weeks 20-30 _____ are moving down; testosterone is being produced Blood vessels in _____ develop, lungs secrete surfactant, 1.5 pts of _____ surround her ____ produces RBCs | show 🗑
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| show | Lungs mature last=has to do with surfactant production
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| show | Weeks 31-40
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| show | Weeks 13-20
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| show | Weeks 13-20
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| show | Weeks 13-20
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| show | Weeks 13-20
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| show | Weeks 13-20
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| show | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) kidneys making urine. | show 🗑
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| show | Weeks 13-20
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| show | Weeks 13-20
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| Fetal Development by Weeks (name what weeks this happens) Lungs are ONLY major organ left to mature | show 🗑
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| Fetal Development by Weeks (name what weeks this happens) Fetus turns towards light outside uterus | show 🗑
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| Fetal Development by Weeks (name what weeks this happens) Periods of dream sleep (REM) begin | show 🗑
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| Fetal Development by Weeks (name what weeks this happens) Amniotic fluid is at its highest level | show 🗑
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| Fetal Development by Weeks (name what weeks this happens) Antibodies are being transferred | show 🗑
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| show | Weeks 31-40
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| show | b. Genetic material
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| show | False. 2-8 weeks
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| show | True
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| show | False. Lungs
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| Fetal blood vessel connecting the umbilical vein to the inferior vena cava (IVC) | show 🗑
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| show | umbilical vein to the inferior vena cava (IVC)
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| Protects lungs against circulatory overload. Allows the rt. ventricle to strengthen. Increases pulmonary vascular resistance, decreases pulmonary blood flow. Carries mostly oxygen saturated blood | show 🗑
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| Ductus Arteriosis: Protects ___ against circulatory overload. Allows the ____ to strengthen. __ pulmonary vascular resistance, ___ pulmonary blood flow. Carries mostly ___ saturated blood | show 🗑
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| show | Foramen ovale
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| show | rt. atrium to lt. atrium - right to left shunting
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| Changes at Birth Foramen ovale, ductus arteriosus and ductus venosus and umbilical vessels are ___ | show 🗑
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| Changes at Birth Ductus venosus ____ forcing blood entering the liver to go through _____. Occlusion of the placental circulation causes an immediate fall in ___ in ___ and ___ | show 🗑
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| show | Increased; increases; physiological anemia
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| Verbalize: What is physiological anemia? | show 🗑
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| show | increase; left
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| CV System *Peripheral vascular resistance ____ r/t progesterone/ prostaglandins causing smooth muscle relaxation | show 🗑
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| show | decrease; position; Supine; supine,Change mom to rt. lateral position
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| sign of hypoxic patient | show 🗑
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| T/F. The chorion villi are used for genetic testing because they contain the same genetic material as the mother. | show 🗑
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| The normal umbilical cord should have 2 veins and 1 artery | show 🗑
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| show | False. Protects umbilical cord
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| show | ductus arteriosus
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| show | False. Supine means lying down.
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| *What are the two major placental hormones? | show 🗑
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| *What's responsible for uterine growth, blood supply, uterine contractions (near term), glands/ducts for breast feeding, hyperpigmentation? | show 🗑
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| Verbalize *What maintains endometrium for fertilized ovum, *prevents spontaneous abortion? | show 🗑
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| show | Presumptive Indicators
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| show | Probable indicators
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| show | Positive indicators (only 3)
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| show | Goodell sign; Probable indicator
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| *What's the proper term for uterine consistency changes and what type of confirmation of pregnancy indicator is it? | show 🗑
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| T/F Mothers experience a slight decrease in lunch capacity r/t the diaphragm being displaced by the fetus. | show 🗑
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| T/F Maternal renal blood flow decreases during pregnancy in response to the demands of the fetus | show 🗑
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| Palmer Erythema is a common occurrence for pregnant women | show 🗑
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| show | True
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| Pregnant women’s complaints about hearing loss are considered normal during pregnancy | show 🗑
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| During pregnancy women are more susceptible to viral and fungal infections | show 🗑
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| show | Goodell
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| what should you tell pregnant women about immunization? | show 🗑
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| Name some common discomforts of pregnancy | show 🗑
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| show | (yes, please)
(maybe, if not too hot/too long)
(No, no, no!)
(no soap on nipples, wear a bra)
(be comfortable)
(yes, 30 minutes qd, be careful)
(yes, unless water has broken)
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| Questions (Cont’d) Nutrition Employment Travel Immunizations: Everything else is OK and recommended , as needed: | show 🗑
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| Maternal Psychological Responses:name the trimester -Uncertainty -Ambivalence (~51% are unintended!!) -Permanent life change -It’s all about ME | show 🗑
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| show | Second trimester
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| show | Third trimester
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| show | False. It indicates Open neural tube defects; Trisomy 21 (Downs)
Ultrasound
Further testing is needed
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| T/F Sexual intercourse can continue up until a women goes into labor | show 🗑
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| Name an immunization not recommended for a pregnant woman. | show 🗑
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| show | True
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| What blood loss is considered normal for a vaginal delivery?For a C-section delivery? | show 🗑
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| Name Barriers to Prenatal Care** (8) | show 🗑
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| show | -Financial
-Systemic
-Attitudinal
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| show | assessment with negotiation
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| show | Women may go back to old ways when pregnant
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| Name Application of the Nursing Process: Psychosocial Concerns | show 🗑
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| show | 0.4 mg in fortified foods recommended
Neural tube defects can occur with poor intake
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| Patterns of gaining weight | show 🗑
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| show | SES, adolescence, vegetarianism, lactose intolerance, nausea and vomiting of pregnancy, anemia, eating disorders, food cravings and aversions,abnormal pregnancy weight, substance abuse, multiparity and multifetal pregnancy, other risk factors
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| Factors That Influence Nutrition | show 🗑
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| Nutrition After Birth **How many cal/day should lactating mothers consume? What else should she do? | show 🗑
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| show | Return to pre-pregnancy diet. Multi-vitamin
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| *Pyrosis is related to what in pregnancy? | show 🗑
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| show | Don’t skip meals and become hungry,Get out of bed slowly—eat starchy food before getting up,Avoid fluids early in morning (watch out for coffee!),Avoid sudden movements, Avoid fat/fried foods, Cool temp foods – No aroma,
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| show | Don’t brush teeth immediately after eating (gag reflex),Salty/tart foods are best, Exercise/fiber good for constipation (too much can prevent calcium absorption), Pyrosis
Eat small, frequent meals)
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| *When do we treat anemia in pregnant women? | show 🗑
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| show | False. Analysis after assessment
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| show | False. 1 lb
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| Name 3 tips for preventing N&V | show 🗑
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| T/F Anemia during the 1st & 3rd trimesters is defined as a Hgb level <11g/dl | show 🗑
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| Lactating mothers should consume how many extra calories a day? | show 🗑
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| What is considered a pre term pregnancy? | show 🗑
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| What is considered wnl pregnancy? | show 🗑
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| What is considered a late preterm infant? | show 🗑
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| *Term for time between conception and onset of (true) labor | show 🗑
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| *Term for time from onset of labor until the birth of the infant and placenta | show 🗑
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| show | Postpartum
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| *Term for the number of weeks since the first day of the LMP | show 🗑
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| *Term for birth that occurs *before 20 weeks* gestation or birth of fetus-neonate weighing *less than 500 grams* | show 🗑
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| *Term for normal duration of pregnancy 38-42 weeks | show 🗑
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| show | Preterm/premature labor
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| *Term for any pregnancy regardless of duration including current pregnancy | show 🗑
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| show | Nulligravida
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| Term for first time pregnant | show 🗑
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| Term for birth after *20 weeks* gestation, regardless of whether infant is born alive or dead | show 🗑
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| show | Nullipara
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| Term for one who has had *one* birth at more than 20 weeks | show 🗑
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| show | Nullipara
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| show | Primipara
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| show | Multipara
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| show | Still birth
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| show | Passage, passenger, power, psyche
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| What makes up the passage of labor? | show 🗑
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| *Which one is the narrowest in the pelvic inlet? | show 🗑
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| *Which is the narrowest in pelvis outlet? | show 🗑
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| show | Gynecoid
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| show | Platypelloid – Worst for vag birth
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| show | Molding
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| show | Flexed
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| Relationship of fetal parts to one another | show 🗑
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| **Point on fetal part in relation to MOM's pelvis | show 🗑
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| The overlap of these vault cranial bones during the powers of labor | show 🗑
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| **What shape is the anterior fontanelle? | show 🗑
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| show | Smaller triangle shape
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| *The area *between* the anterior and posterior fontanelles | show 🗑
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| show | Occciput
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| show | Vertex presentation, complete flexion
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| What part is born last in breech presentation? | show 🗑
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| The 4 Ps of labor are: | show 🗑
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| T/F The True Pelvis is the best measurement for pelvic girth | show 🗑
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| show | False. Gynocoid
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| T/F The anterior fontanelles is diamond shaped | show 🗑
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| show | True
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| show | False
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| In false labor contractions increase with walking | show 🗑
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| **Physiologic Maternal Effects CV: Blood flow to placenta ______ with contraction, maternal blood vol _____. Supine hypotension. | show 🗑
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| Stages of Labor and Birth | show 🗑
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| show | from delivery of the placenta through the first 1-4 hrs after birth
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| T/F Blood flow to the placenta decreases with contractions | show 🗑
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| T/F Maternal blood flow increases during contractions | show 🗑
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| Active phase is in which stage? | show 🗑
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| Transition phase results in the cervix being totally dilated | show 🗑
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| During stage 4, the placenta is delivered | show 🗑
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| show | True
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| The fetal side of the placenta is called “Shiny” Schultze | show 🗑
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| Uterine contractions can continue after the third stage of labor | show 🗑
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| During the 4th stage of labor the uterus can be palpated at the level of the umbilicus | show 🗑
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| Compare and contrast true vs false labor. List true labor | show 🗑
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| show | =Irregular contractions
-No Δ in interval/ duration
-Sensation in abdomen
-Walking has no effect
-No dilation/ effacement
-Rest and baths lessen ctx
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| show | Prior to 37 (completed) weeks gestation
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| show | 5 min intervals and 30-40 sec duration by end of early stage
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| First labor stage: latent phase contractions | show 🗑
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| show | Contractions more intense: 2-5 min apart x 40-60 secs
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| First labor stage: transitional phase contractions | show 🗑
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| show | 3 hr
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| What if mother doesn't want fetal monitoring machine? What do you do? What's nurses concern | show 🗑
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| show | CVS- CVS is done at 10-12 weeks' gestation
Amnio- adv of early diagnosis, amniocentesis is done at 15-20 weeks' gestation, do AFP first
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| show | US- anytime and frequently
Doppler- anytime
FKT- 20 wks
AFP- 16-18 wks
Modified Biophysical Profile
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| show | Childbirth classes
Teach about diff options for meds/natural
Vaginal/C-section (risk)
Diet, exercise, lifestyle changes (smoking, drugs)
Kegels
Mom smokes- concerned about low birth weight, no O2, vasoconstrictions (preeclampsia prob)
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| Normal heart rate: | show 🗑
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| HTN= bp Infection = | show 🗑
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| GTPAL stands for | show 🗑
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| show | To decide where to place the probe for the FHR
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| show | Lighting:
Soft, indirect lighting is soothing
Temperature - Cool damp washcloths, socks, electric fans
Cleanliness:
Change sheets, offer change of gown as needed
Mouth care:
NPO, offer ice chips to reduce discomfort
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| show | Bladder: A full bladder intensifies pain and interferes w/dilation during labor,
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| show | Positioning: Encourage position changes to promote comfort, Change positions frequently, Use pillows, sheets to help move mom, Allow walking sitting if ROM has not occurred, Teachin: NOW’s the time!
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| transitory gradual decrease in FHR below baseline rate in contracting phase is called | show 🗑
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| Transitory, gradual decrease in FHR below baseline rate in contracting phase | show 🗑
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| show | Late decelerations
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| show | Late decelerations
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| show | Late decelerations
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| show | Uterine hyperactivity or hypertonicity,Maternal supine hypotension, Epidural or spinal anesthesia,Placenta previa,
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| **Verbalize causes of UPI continued | show 🗑
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| Chronic Villus Sampling: Purpose, Procedure, Advantages, and risks | show 🗑
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| show | Purpose
Ck for genetic disorders
Procedure
Belly tap
Advantages
Early diagnosis
Disadvantages
Risks to mom/fetus
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| show | Purpose
Ck fetal health
Not moving much
Mom is overdue
Suspected placental insufficiency
High risk pregnancy
Procedure
Toco & transducer to measure contractions FHR x 20-30 minutes
Risks
Negligible
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| show | Interpretation
Reactive is good; NONreactive is concerning
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| Biophysical profile: | show 🗑
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| **Biophysical profile interpretation: | show 🗑
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| Complete BPP | show 🗑
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| show | Powers
Ineffective contractions
Ineffective maternal pushing
Passenger
Fetal size
Abnormal fetal presentation/position
Multifetal pregnancy
Fetal anomalies
Passage
Blockages
Shoulder dystocia
Soft tissue
Pelvis
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| show | Psyche
Abnormal labor duration
Prolonged
Macrosomia
Malpresentation
Precipitous labor
≤4 hrs from beginning of labor to delivery
Precipitous birth
Takes place w/o medical assistance
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| Breech baby concern | show 🗑
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| show | Complications
Exhausted mom/fetus
Precipitous =
Damage to cervix/vaginal walls
PP hemorrhage
Damage to fetal head/body
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| show | Placental abnormalities
Prolapsed umbilical cord
Uterine rupture
All FAST moving, deadly, but (thankfully!) rare
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| Intrapartum Emergencies (cont’d) | show 🗑
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| show | If fully dilated; head at 0 or below: forceps
If not:
Knee-chest position
Steep Trendelenberg
Gloved hand in vagina
500-700 mL of saline in bladder
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| Uterine Rupture: Etiology, S/S, Management | show 🗑
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| Poly Hydramnios | show 🗑
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| Oligo Hyramnios | show 🗑
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| show | -Imbalanced water exchange among mother, fetus, and amniotic fluid
-Poorly controlled maternal diabetes mellitus
-Malformations of the CNC, Cardio, GI
-Chromosomal abnormalities
-Multifetal gestation
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| show | poor placental flow, preterm membrane rupture, failure of fetal kidney development, blocked urinary excretion
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| What vaccines should not be given during pregnancy | show 🗑
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| show | -Fall in progesterone levels
-Increase in prostaglandins
-Increase in oxytocin
-Increase in # of oxytocin receptors
Fetal role
-Increase in prostaglandins from fetal membranes
-Large amts of cortisol from fetus
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| show | Chadwick sign
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| Name this sign: Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion | show 🗑
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| Formation of the placenta -Sections -Parts | show 🗑
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| Genetic testing done 16 – 18 weeks and interpretation | show 🗑
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| show | 1000mg
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| Avoiding infection | show 🗑
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| show | 20-fundus located approx at the umbilicus
36-xiphoid process-highest point
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