Exam 6 OB

Question 1

what influenced early maternal practives?

Answer 1

affected by societal influences, generation Y (more interventions ex. epiderals, scheduled C/S)

Question 2

early american colonists (17th century)

Answer 2

female family members/friends provided aid/support during child birth, viewd as natural, births occured at home, lay midwifes (no formal training)

Question 3

what increased mortaility after birth in the 17th, 18th, and 19th centeries

Answer 3

postpartum fever

Question 4

maternity History in the 19th century

Answer 4

florence nightingale, durgs were availble to allievate childbirth pain, specialized knowldge (anethesiologist) which led to lithotomy position and forecps being introduced bc moms couldnt push due to Rx

Question 5

maternity history in the 20th century

Answer 5

eoidemics, to prevent spread of infection asepsis was emphasized and newborn nursing was introduced

Question 6

what affected the 20th century

Answer 6

WWII, mother-infant couplet was effected bc of shortages

Question 7

Mary Breckinridge

Answer 7

frontier nursing service provided health care to families isolated from health care

Question 8

1960’s maternity history

Answer 8

family centered nursing, lamaze & Le Boyer, breastfeeding increased, midwife assited deliveries increased

Question 9

what is the focus on todays birth experience

Answer 9

family and encouraging growth and development

Question 10

what is the most common choice/trend for birth

Answer 10

hospital birth is the most common

Question 11

LDRP

Answer 11

labor, delivery, recovery, postpartum

Question 12

birthing center

Answer 12

alternative to hospital birth, free standing center, care by midwifes, low risk pts, no epiderals done here, OB provider availble for emergency

Question 13

what is the priority with birthing centers

Answer 13

education and preparation

Question 14

Doulas

Answer 14

person trained in labor support (pt advocate), do not provide nursing care

Question 15

home births

Answer 15

increasing in popularity, prominent among amish, native americans, attended by lay midwives (no formal training), lack of emergency backup

Question 16

birth plan

Answer 16

prefences in writing, Personnel obligated to follow as long as there is no interference with safe NB and mother

Question 17

what preparation is done for childbirth

Answer 17

education is prioority due to leaving hospital quickly, education must be on-going,

Question 18

what is the prime responsibility for nurse with preparation for childbirth

Answer 18

individualized education

Question 19

home visits

Answer 19

conducted by OB nurse, provides ongoing assessment post discharge

Question 20

nurse practitioner

Answer 20

masters degree, specialize in different areas, performs clinical assessments, completes procedures, have some Rx ability

Question 21

clinical nurse specialist

Answer 21

masters degree, resource, staff education and policy making, prescriptive ability with additional certification

Question 22

nurse midwife

Answer 22

educated in nursing (RN) & midwifery, low risk maternity and GYN care

Question 23

Nurse Researcher

Answer 23

Doctoral degree, new research at universities

Question 24

death that results from pregnancy, either pregnant or 42 days post partum

Answer 24

maternal mortality

Question 25

major causes of maternal mortality

Answer 25

hemmorrhage, HTN disorders, puerpural infection (r/t childbirth), pulmonary emboli

Question 26

what are the most preventable and early identificatoin and tx is critical

Answer 26

maternal mortality

Question 27

sum of inutero & neonatal deaths

Answer 27

perinatal mortality

Question 28

any inutero death at any gestation (ex still birth, miscarriage)

Answer 28

fetal death

Question 29

any death that occurs from birth to 28 days of life

Answer 29

neonatal mortality

Question 30

fetal death & neonatal death

Answer 30

perinatal death

Question 31

death occurs after birth to 12 months of life

Answer 31

infant mortality

Question 32

all fetal/newborn/and infant stats are expressed how

Answer 32

per 1,000 births

Question 33

why do we have standards of care

Answer 33

developed to guide care

Question 34

what is the purpose of standard of care

Answer 34

consistency care, know the standards of care, ANA & WHONN est. standards

Question 35

what are the most common errors in standard of care

Answer 35

incomplete or inadequate documentation or examination, failure to act, failure to communicate changes

Question 36

increased levels or estrogen and progesterone are produced first by what until around 12-14 weeks, and then they are produced by what

Answer 36

corpus luteum then by the placenta

Question 37

when does the placenta develop

Answer 37

3rd week of embryonic development

Question 38

when does the placenta take over production of progesterone

Answer 38

10-12 weeks

Question 39

at what week does the placenta produce enough progestrone and estrogen to maintain pregnancy

Answer 39

11th week

Question 40

what is the function of the placenta

Answer 40

produces hCG, 2 steriod hormones (est. & progest), waste removal, acts as lungs

Question 41

physiologic changes in the first trimester

Answer 41

breast enlargement & tenderness (bc of estrogen), abd. cramps after orgasm, N/V, fatigue, low back pain, fear of hurting baby

Question 42

physiologic changes in the second trimester

Answer 42

period of newnewed energy, increase pelvic congestion, increase libiod, improved sexual performance, orgasmic ability, decrease breast tenderness

Question 43

physicologic changes in the third trimester

Answer 43

increase backache, physical size of abd, decrease coital frequency, increase cramping with orgasm, increase urinary frequency

Question 44

in a normal pregnancy with no risk factors, is there a need for sexual abstinence

Answer 44

no

Question 45

when would sex be contraindicated

Answer 45

uterine bleeding, Hx of abortion, Hx of preterm birth, rupture of membranes

Question 46

when should sex always be avoided

Answer 46

forceful penetration, blowing into vagina, sexual intercourse with a partner with STD

Question 47

sex during the 4th trimester (postpartum) when to avoid it

Answer 47

perineal pain, healing episiotomy, breast discomfort, concerns about pregnancy

Question 48

difficulties with intercourse during the 4th trimester

Answer 48

decrease estrogen=increase vaginal dryness, prolonged with breast discomfort, lubricants are helpful, baby creates distraction

Question 49

symptoms or changes felt by women

Answer 49

subjective or presumptive

Question 50

changes noted by healthcare provider, but alone does not diagnose

Answer 50

objective/probable signs

Question 51

positive diagnositc findings

Answer 51

Positive sign

Question 52

name some subjective/presumptive signs of pregnancy

Answer 52

amenhorrea, N/V (morning sickness), excessive gatigue (1 & 3 trimester), urinary frequency (1 & 3 trimester), breast changes, quickening

Question 53

name objective/probable signs of pregnancy

Answer 53

changes in pelvic organs, Goodell's sign, chadwicks sign, Hegars sign, McDonalds sign, skin pigment changes, fetal outlite, Ballottement