Exam 1 Flashcards
what causes frequent urination in pregnancy?
- anatomical positioning causing the uterus to press on the bladder all the time
what is the primary mechanism to stop hemorrhage from the uterine arteries after childbirth?
contraction of the uterine smooth muscles to compress the arteries
what is considered the first day of the menstrual cycle?
first day of bleeding during menses
what does progesterone do to endometrial lining?
- causes thickening of endometrial lining to prepare for implanting of a fertilized egg
what does progesterone do to smooth muscle?
- relaxes smooth muscle to allow the uterus to grow during pregnancy
what happens to the endometrium when progesterone levels drop?
the thickened endometrium sheds in menses
what happens to BBT (basal body temp) during ovulation?
drops slightly and then spikes 1/2 a degree
what hormone spikes during ovulation?
LH
what does the cervical mucus do during ovulation?
appears thin, clear and stretches like eggs whites
- known as Spinnbarkeit Sign
which hormone decreases to trigger a period?
progesterone
what is an expected finding of dizygotic twins?
different genders
which stage of fetal development is most vulnerable to medications and chemicals?
embryonic
what finding would indicate progression of gestational hypertension to eclampsia?
- new onset of seizures
what is the priority action for painless vaginal bleeding?
obtain an ultrasound
what does the umbilical artery do?
carry stuff from the baby to the mom
what do the umbilical veins do?
carry stuff to the baby from the mom
what does a UA in pregnancy look at?
- specific gravity color
- glucose
- protein, nitrates, casts, acetone
- RBC and WBC
what are the parameters for a 3 hr glucose tolerance test?
- fasting >95
- 1 hr >180
- 2 hr> 155
- 3hr > 140
what substance within the uterus prevents compression of the umbilical cord?
amniotic fluid
what prevents the skin of the fetus from adhering to the wall of the amniotic sac?
amniotic fluid
what are 3 functions of the amniotic sac?
- protects baby
- allows baby to move
- controls baby’s temp
what substances are risk factors for placental abruptions?
- cocaine, smoking/tobacco
what type of trauma places the mother at risk for placental abruption?
penetrating or blunt abdominal trauma
what type of deficiency may lead to placental abruptions?
folate deficiency
what BP abnormality may cause a placental abruption?
hypertension
what is the primary nursing concern for a patient who has preeclampsia and develops hyperreflexia?
seizures
what is the diagnosis for a preeclamptic patient who has had a seizure?
eclampsia
what precautions are necessary for a patient who is on seizure precautions?
- pad side rails
- keep O2 nearby
- stay w/patient
- suction available
what part of the pregnancy would we screen for gestational diabetes?
24-28 weeks
what part of pregnancy would we obtain a GBS (group B strep) swab?
35-37 weeks
what med is given for a patient who is in labor and has tested positive for GBS?
ampicillin
2mg of amp is given, then 1 mg Q 4h
what is given for GBS if patient is allergic to PCN?
clindamycin
what medication is expected to be prescribed for a patient who has had recurrent miscarriages?
progesterone
what are some foods high in folic acid?
- spinach
- artichokes
- cereals, seeds, nuts
- liver
what result at 24 weeks gestation would require immediate action?
positive RPR (syphilis)
when would the next routine appointment be for a low risk mother who is 34 weeks gestation?
in 2 weeks
what is the name for the fingerlike projections that become the placenta?
chorionic villi
what is the solid ball of cells before implantation called?
morula
what is the hollow ball of cells that implants into the uterus called?
blastocyst
what do trophoblasts do?
creates placental tissue
if fertilization and implantation don’t occur, what hormone changes would trigger menses?
- decrease in progesterone
- decrease in estrogen
which period of development would be most vulnerable to effects from alcohol?
embryonic
how long should a normal pregnancy last?
about 280 days from the first day of the last normal menstrual period
a nurse is caring for a client following fetal demise. the client is crying and saying “i tried to get pregnant for so long. my partner and I wanted this baby so much. Now, what will we do?” what response should the nurse provide?
“are you feeling overwhelmed?”
what is the most common gestational complication?
hypertension
what is considered gestational hypertension?
- BP > 140/90
- onset after 20 weeks
which condition is marked by gestational hypertension (BP > 140/90) and proteinuria?
preeclampsia
which gestational complication involves preeclampsia and seizures seizures?
eclampsia
why is it important to closely monitor the mother with preeclampsia for 48 hr after birth?
1/3 of eclamptic seizures occur after delivery
what condition is characterized by hypertension that is present prior to 20 weeks gestation or that lasts longer than 12 weeks postpartum?
chronic hypertension
why may a patient with preeclampsia experience RUQ pain?
decreased liver perfusion leading to impaired liver function (elevated liver enzymes)
what do decreased/absent DTRs, decreased respirations and cardiac arrest indicate for magnesium administration?
toxicity
what is a priority action for a nurse for a patient with eclampsia having a seizure?
DO NOT leave the bedside
- padded side rails
- head to one side
- suction
what are 3 defining characteristics of hyperemesis gravidarum that differentiate it from the normal n/v that is seen in up to 80% of all pregnancies?
- weight loss
- fluid/elec imbalances
- nutritional deficits
which pregnancy abnormality causes a concern for fetal development due to insufficient space for the fetus to grow as well as extremities sticking to each other in the early stages of pregnancy?
oligohydramnios
when is polyhydramnios likely to be seen?
in pregnancies with gestational diabetes
what is a normal amniotic fluid index?
10 - 25
what point is every organ system present during fetal development?
week 8 (every organ system is present, just nit mature)
what are 3 characteristics seen on fetus at 20 weeks?
- breathing movements
- vernix caseosa
- lanugo
what term describes identical twins?
monozygotic
- 1 egg, 1 sperm
what term describes fraternal twins?
dizygotic
what is a potential problem with twins sharing the same placenta?
twin to twin transfusion syndrome (baby A gets more than baby B, so its larger)
what type of twins can twin to twin transfusion syndrome occur with?
(mono or dizygotic?)
monozygotic
what may increase the chance of the mother having dizygotic twins?
fertility drugs
what is known as the softening and compressibility of the lower uterus?
Hegar’s sign (probable)
what is chadwicks sign?
violet-bluish color of cervical and vaginal mucosa
what is known as softening of the cervical tip?
Goodell’s sign
how does naegeles rule work?
subtract 3 months form the first day of the client’s last menstrual period, add a week and 1 year
what anatomical landmark is the halfway mark for fundal height during a pregnancy?
mother’s umbilicus
what is preferred position for alleviation of supine hypotension?
left lateral
what role does progesterone have in the occurrence of heartburn/indigestion in pregnancy?
progesterone relaxes the sphincter causing food to reflux
what is chloasma?
increase of pigmentation on the face during pregnancy
what education should be provided for the mother who has developed chloasma?
- sunscreen
- shade
- sun hats
what is the linea nigra?
dark line of pigmentation from the umbilicus extending to pubic area that occurs during pregnancy
what is striae gravidarum?
stretch marks that occur during pregnancy
what is expected weight gain during pregnancy?
25-35 lbs
what may reduce n/v in pregnancy?
small frequent meals
what does polyhydramnios do to fundal height?
increases it more than what is expected
what does polyhydramnios do to pregnancy weight gain?
increases the weight gain amount
what may cause oligohydramnios?
gestational hypertension
what fetal conditions may be seen as a result of polyhydramnios?
- gastrointestinal malformations
- neurological disorders
what should be given to clients who are in labor and have tested for GBS?
prophylactic antibiotics
what should the patient do prior to amniocentesis?
empty their bladder
what is a threatened abortion?
- no dilation
- no tissue passed
- preg may continue
what is an inevitable abortion?
- dilation of cervix
- definite loss of preg
what is an incomplete abortion?
- passage of some tissue
what is considered a complete abortion?
- all tissue passed through dilated cervix
what is a missed abortion?
fetus has died
what are the manifestations of reduced cervical competence?
painless dilation through 2nd trimester
what are the diagnostic criteria for reduced cervical competence?
- Hx of 2nd trimester losses
- short cervix (<25mm)
what may a sudden gush of fluid from the vagina indicate in a patient who has had a cerclage?
possible rupture of membranes (this should be reported)
what must be avoided if patient has an unruptured ectopic pregnancy?
- avoid drinking alcohol and vitamins w/folic acid
what is a salpingotomy?
removal of ectopic pregnancy while keeping tube intact
why should serum hCG be checked weekly for 3 weeks and then monthly for 6 months following a hydatidiform mole (molar pregnancy)?
to ensure that all of the molar tissue is gone
what are 4 common symptoms of UTI in pregnancy?
- dysuria
- hematuria
- back pain (CVAT)
- contractions
why is it essential for mothers to have frequent screening for UTI during pregnancy?
UTI can induce preterm labor
does insulin pass the through the placenta from mom to baby?
no
what is the desired fetal movement counting?
ten movements within a 1-2 hr window
what subjective maternal report may indicative of fetal death?
a reported absence of fetal movement
what fetal position is preferred for birth?
OA (occiput anterior)
how many accelerations are expected within 20 mins for a non stress test?
2
what are the 5 components of the BPP?
- FHR
- breathing
- movement
- tone
- amniotic fluid amount
what does a BPP score of 4 or less indicate?
- consider immediate delivery
what should be considered for a BPP of 6?
consider delivery if at term
what is HELLP syndrome?
severe preeclampsia +
- hemolysis
- elevated liver enzymes
- low platelets
what is an expected finding for the hemoglobin of a mother who has had preeclampsia that has progressed into HELLP syndrome?
decreased hemoglobin levels (hemolysis)
The client with eclampsia has just had a tonic-clonic seizure. after turning the clients head to the side what action should the nurse take?
given oxygen 10L/min via face mask
what is an expected adverse effect of magnesium infusion?
why?
feeling of warmth all over
what assessment data is the most accurate indicator of fluid electrolyte imbalance for a client with preeclampsia?
daily weight
what are the 5 adaptations of fetal circulation?
- placenta
- umbilical vein
- ductus venosus
- foramen ovale
- ductus arteriosus
- umbilical artery
