Childbearing

Question 0

Fundal height

Answer 0

Above symphysis- 12-14 weeks
At umbilicus or 20 cm- 20 weeks
Rises 1 cm/ week until 36 weeks

Question 1

Naegeles rule

Answer 1

First day of LMP- subtract 3 months add 7 days plus 1 year.

Question 2

Gravida

Answer 2

Total number of of preg regardless of duration (include present)

Question 3

Para

Answer 3

Numb of past preg regardless of duration (included present preg)
After 20 weeks or greater then 500g

Question 4

Term

Answer 4

38-42 weeks

Question 5

Weight gain during preg

Answer 5

First trimester- 2-4 lbs
Second 12-14
Third 8-12
Total 24-28

Question 6

Chadwick’s sign

Answer 6

Chadwick’s sign- bluish color of cervix

Question 7

Striae gravidarum

Answer 7

Pink or reddish streaks

Question 8

Chloasma

Answer 8

Increased pigmentation on face

Question 9

Linea nigra

Answer 9

Dark line from umbilicus to symphysis

Question 10

Positive preg sign

Answer 10

Fetal heartbeat (8-12 weeks doptone and by 18-20 with auscultation) palpating of fetal movement

Question 11

Fetal heart rate

Answer 11

At term 120-160

Question 12

Fetal movement

Answer 12

A reg pattern of 10 movements in 20 min to 2 hours twice a day is a good indicator of fetal well being

Fewer then 3 movements in one hour should be reported

Question 13

Alpha fetal protein test

Answer 13

Afp used to predict neural tube defects
Decreased levels may predict Down syndrome
Done b/w 16-18 weeks
**High incidence of false positives

Question 14

Amniocentesis

Answer 14

At 16 weeks detects genetic disorder
At 30 weeks- determines lung maturity
Void before procedure
Ultrasound used to determine position of placenta and fetus
Complications - premature labor, infection, abrupto placentae, RH isoimmunization

Question 15

Effacement

Answer 15

Progressive thinning and shortening of cervix (0-100%)

Question 16

Dilation

Answer 16

Opening of cervix os (0-10cm) at 10 it’s ready for expulsion of baby

Question 17

Prolapsed umbilical cord

Answer 17

Symptoms
Premature rupture of membranes
Presenting part not engaged
Fetal distress
Protruding cord

Nursing care- handle things quickly, call for help
Push against presenting part
Place in trendelenburg or knee-chest position
Successful if no changes in FHT

Question 18

FHT monitoring

Answer 18

External or internal monitoring
Tachycardia- 169 Bpm lasting longer than 10 min
Early sign of fetal hypoxia
Fetal or maternal infection
Non-reassuring sign when associated with late decelerations, severe variable decelerations or absence of variability

Question 19

FHR: bradycardia

Answer 19

<110 Bpm lasting longer than 10 min
***Late sign of fetal hypoxia
Maternal drugs
Prolonged cord compression
Maternal hypotension syndrome
Non- reassuring sign when associated with loss of variability and late decelerations 

Things that decrease blood flow to baby

Question 20

Variability

Answer 20

Irregular fluctuations in the baseline of the FHR
Absent (0-2) (no variability)or decreased (3-5) associated with fetal sleep, prematurity, drugs, hypoxia, acidosis

Moderate (6-25 Bpm) deviations from baseline may be significant

Question 21

Accelerations

Answer 21

15 Bpm rise above baseline by a return
Indicates well-being
Caused by fetal movement or contractions

Occurs frequently with breeched presentations

Question 22

Decelerations- early

Answer 22

Early decelerations
Occur before peak of contraction
Inversely mirror the peak of contraction
Associated with head compression
Associated with pushing in 2nd stage if labor 
Benign

Question 23

Decelerations- late

Answer 23

Onset after contraction is established with slow return to baseline
Low point of decelerations occurs after peak of contraction
Caused by PIH, maternal diabetes, placenta prévia, abruptio placentae
Non- reassuring sign

Question 24

Nursing interventions for late decelerations

Answer 24

Position left side lying
If no change, move to other side or knee chest
Administer oxygen by mask
Start IV or increase flow rate
Disco time oxytocin

Question 25

Variable decelerations

Answer 25

Transient decrease in FHR occurring anytime during uterine contraction phase

Indicates cord compression
Relieved by change in maternal position 
If prolonged
Administer oxygen 
Discontinue oxytocin

Question 26

Lie

Answer 26

Relationship of spine of fetus to spine of mother

Longitudinal- parallel
Transverse- right angles
Oblique- slight angel off true transverse

Question 27

Presentation

Answer 27

Part of fetus it enters maternal pelvic inlet
Cephalic/vertex (3-4%)
Frank- hips flexed/ knees extended
Complete- Buddha style 
Footing
Shoulder- transverse lie (rare)

Question 28

Position

Answer 28

Relationship of fetal reference point to maternal pelvis

Fetal reference point most common presentation
-occiput (o)
-sacrum (s)
Maternal pelvis is designated right/left (R/L) anterior posterior A/P

Question 29

Station

Answer 29

Level of presenting part in relation to imaginary line between ischial spines (zero station)

-5–1- floating getting ready to come down
+1-+5 below station 0

Question 30

Contractions

Answer 30

Frequency of leas then 2 min, baby is moving down into pelvic, ready to be born

Duration of greater then 90- stressful for baby

Question 31

Stages of labor

Answer 31

Stage 1- beginning of labor to complete cervical dilation (0-10)
Stage 2- complete dilation to birth
Stage 3- birth to delivery of placenta
Stage 4- first 4 hours after delivery of placenta

Question 32

First stage of labor

Phases

Answer 32

Phase 1 (latent) 0-3 cm
Phase 2 (active) 4-7
Phase 3 (transition 8-10 contractions 45-90 sec 2-3 min apart, strong