Antepartum (AP)

Question 1

Antepartum (AP)

Answer 1

Period beginning at conception & ending before start of labor

Question 2

Gestation

Answer 2

Period of fertilization until delivery

Question 3

EDC/EDB

Answer 3

Estimated date of confinement/birth = due date

Question 4

Gravida

Answer 4

Any pregnancy regardless of duration

Question 5

Nulligravida

Answer 5

Woman who has never been pregnant

Question 6

Primigravida

Answer 6

Woman pregnant for the first time

Question 7

Multigravida

Answer 7

Woman who has been pregnant more than once

Question 8

Parity

Answer 8

Births after 20 weeks gestation, regardless of whether infant is born alive or dead

Question 9

Nullipara

Answer 9

Woman who has not completed a pregnancy by the beginning of 20 weeks

Question 10

Primipara

Answer 10

Woman who has completed one pregnancy by the beginning of 20 weeks

Question 11

Multipara

Answer 11

Has completed 2 or more pregnancies by the beginning of 20 weeks

Question 12

Gestational Age

Answer 12

Number of complete weeks of fetal development calculated from the first day of the last menstrual period (LMP)

Question 13

Term

Answer 13

Fetus born between 37-41.6 weeks gestation

Question 14

Pre-term

Answer 14

Fetus born between 20-36.6 weeks gestation

Question 15

Abortion

Answer 15

End of pregnancy from conception to 19.6 weeks
- Elective or spontaneous (miscarriage)

Question 16

GTPAL

Answer 16

Code that represents a woman’s history
- G: Gravida (# of pregnancies)
- T: Term pregnancies
- A: Abortions
- L: Current living children

Question 17

Nagele’s Rule: Calculating EDC (Estimated date of confinement)

Answer 17

1. Identify 1st day of LMP
2. Count backward 3 months
3. Add 7 days
   - Ex: LMP is November 7
   - Answer: August 14th

Question 18

Amennorrhea

Answer 18

• Absence of menstrual periods
• May be caused by strenuous experience, metabolism changes, endocrine dysfunction, medications, and psych disorders

Question 19

Presumptive Signs of Pregnancy

Answer 19

• Nausea/vomiting; subsides after 1st trimester
• Breast Changes
• Urinary Disturbances: Frequent urge; relieved in 2nd trimester, reoccurs in 3rd
• Fatigue: Due to increased metabolic needs
• Quickening: 18-20wks
• Pigment Changes: Darkening of nipples/areolas, linea nigra, chloasma

Question 20

Linea Nigra

Answer 20

Dark line that forms during pregnancy from your belly button to the suprapubic area

Question 21

Chloasma

Answer 21

• “Mask of pregnancy”
• Darker area that forms on face in mostly Native American and Black patients

Question 22

Probable Signs of Pregnancy

Answer 22

• At home pregnancy test
• Uterine enlargement: By end of week 12 fundus can be felt above the symphysis pubis
• Chadwick’s Sign
• Goodell’s Sign
• Hegar’s Sign
• Braxton Hicks Contractions
• Fetal Outline: Able to feel by week 24
• Ballottement: Rebounding of fetus by examiner’s finger at 4-5 months

Question 23

Chadwick’s Sign

Answer 23

Purplish or bluish discoloration of the cervix, vagina, vulva by increased vascular congestion

Question 24

Goodell’s Sign

Answer 24

Softening of the cervix

Question 25

Hegar’s Sign

Answer 25

Softening of the lower uterine segment just above the cervix

Question 26

Positive Signs of Pregnancy

Answer 26

• Fetal Heartbeat (US: 6wks, Doppler: 10wks, Fetoscope: 18-20wks)
• Fetal Movements
• Ultrasound (Gestational sac seen at 4-5wks, embryo visible 6-8wks)

Answer 27

• Performed 8-12 weeks after missed period
• Obtain thorough medical, family, OB history
• Physical exam - look for health deficits
• Pelvic Exam

Question 28

Pelvimetry

Answer 28

Check condition of organs and birth canal

Question 29

False Pelvis

Answer 29

Flaring wings of the iliac crests of hip bones

Question 30

1st Visit Lab Tests

Answer 30

• Repeat pregnancy test
• Urinalysis
• Blood type/Rh Factor (Rh & ABO incompatibility)
• Titers (Rubella, Varicella)
• CBC (Hgb & Hct - 12mg/dl & 35% desirable)
• Serology for Hep B, Syphilis, & HIV
• Papsmear & HPV DNA test
• Gonorrhea/Chlamydia culture

Question 31

Nursing Responsibilities 1st visit

Answer 31

• Assist with taking history and pelvic exam
• Explain procedures
• Teaching: Normal pregnancy, discomforts vs danger signs, S/S to report
• Provide support

Question 32

Prenatal Visit Assessments

Answer 32

• Vital signs
• FHR
• Fundal height measurement
• Urinalysis
• Vaginal exams

Question 33

What common problems should the nurse assess for during prenatal visits?

Answer 33

• N/V
• Edema
• Bleeding/spotting
• Constipation
• Headache
• UTI
• Yeast or Bacterial Vaginosis

Question 34

Prenatal Diet

Answer 34

• Increase of 300 cal/day
• Balanced diet will provide needed vitamins, minerals, proteins
• Routine supplements “Prenatal vitamins” prescribed
• Increase fluids, water

Question 35

Prenatal Clothing

Answer 35

• Need larger clothes by 3rd months
• Wide strap support bra
• Avoid restrictive clothing especially in pelvis & legs
• Wear comfortable, low heel shoes

Question 36

Prenatal Activity & Rest

Answer 36

• Pre-pregnancy activities usually okay
• Moderate walking, swimming, modified yoga/pilates
• Plan for rest periods
• Sit or lie with feet up for 20-30 min

Question 37

Common Discomforts of 1st Trimester

Answer 37

• Painful breasts
• Urinary urgency/frequency
• Fatigue
• N/V - low fat, high carb
• Mood swings
• Increased vaginal discharge (Yeast/BV?)
• Nasal stuffiness

Question 38

Common Discomforts of 2nd Trimester

Answer 38

• Heartburn
• Constipation: Increase fluids, fiber
• Leg Cramps: change position frequently, dorsiflex, increase calcium, don’t massage
• Varicose Veins: Compression socks, rest frequently with feet elevated, light to moderate walking
• Backache: Good posture, sleep on side, lordosis (excessive inward curve of spine)

Question 39

Common Discomforts of 3rd Trimester

Answer 39

• Varicosities worsen: Hemorrhoids, vulvar varicosities
• Dyspnea
• Hypermobility of joints: Relaxin loosens connective tissue
• Edema: Report edema of face/hands
• Backache
• Insomnia