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OB Test 2 > Maternity Nursing Chap 6 > Flashcards

Maternity Nursing Chap 6 Flashcards

1
Q

_____: Pregnancy.

A

gravity

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2
Q

_____: Number of pregnancies in which the fetus(es) has (have) reached viability, not the number of fetuses (e.g., twins) born (whether the fetus is born alive or is stillborn–i.e., the fetus who shows no signs of life at birth, after viability is reached, has no effect on this numeric designation).

A

parity

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3
Q

_____: Woman who is pregnant.

A

gravida

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4
Q

_____: Woman who has never been pregnant.

A

nulligravida

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5
Q

_____: Woman who has not completed a pregnancy with a fetus (or fetuses) who has (have) reached the stage of fetal viability.

A

nullipara

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6
Q

_____: Woman who is pregnant for the first time.

A

primigravida

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7
Q

_____: Woman who has completed one pregnancy with a fetus or fetuses who have reached the stage of fetal viability.

A

primipara

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8
Q

_____: Woman who has had two or more pregnancies.

A

multigravida

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9
Q

_____: Woman who has completed 2 or more pregnancies to the stage of fetal viability.

A

multipara

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10
Q

_____: Capacity to live outside the uterus, about 22 to 24 weeks since the last menstrual period, or a fetal weight more than 500 g.

A

viability

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11
Q

_____: Term referring to a pregnancy that has reached 20 weeks of gestation but before completion of 37 weeks of gestation.

A

preterm

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12
Q

_____: Term used to describe a pregnancy from the beginning of the 38th week of gestation to the end of the 42nd week of gestation.

A

term

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13
Q

_____: Two terms used to describe a pregnancy that goes beyond 42 weeks of gestation.

A

postterm, postdate

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14
Q

_____: Substance whose presence in urine or serum results in a positive pregnancy test result.

A

hCG

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15
Q

Menstrual bleeding no longer occurring

A

amenorrhea

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16
Q

Fundal height decreased, fetal head in pelvic inlet

A

lightening

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17
Q

Cervix and vagina violet blue in color

A

chadwick sign

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18
Q

Swelling of ankles and feet at the end of the day

A

physiologic edema

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19
Q

Cervical tip softened

A

goodell sign

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20
Q

Increased hair growth on face and abdomen

A

hirsutism

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21
Q

Fetal head rebounding with gentle upward tapping through vagina

A

ballottement

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22
Q

White mucoid vaginal discharge with faint musty odor

A

leukorrhea

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23
Q

Enlarged sebaceous glands in areola on both breasts

A

montgomery tubercles

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24
Q

Plug of mucus filling endocervical canal

A

operculum

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25
Q

Pink stretch marks on breasts and abdomen

A

striae gravidarum

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26
Q

Thick, creamy fluid expressed from nipples

A

colostrum

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27
Q

Cheeks, nose, and forehead blotchy, hyperpigmented

A

chloasma (mask of pregnancy)

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28
Q

Pigmented line extending up abdominal midline

A

linea nigra

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29
Q

Varicosities around anus

A

hemorrhoids

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30
Q

Heartburn experienced after supper

A

pyrosis

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31
Q

Lumbosacral curve increased

A

lordosis

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32
Q

Paresthesia and pain in right hand radiating to elbow

A

carpal tunnel syndrome

33
Q

Spotting following cervical palpation or intercourse

A

friability

34
Q

Hematocrit decreased from 40% to 36%.

A

physiologic anemia

35
Q

Vascular spiders on neck and thorax

A

telangiectasis (angioma)

36
Q

Palms pinkish red, mottled.

A

palmer erythema

37
Q

Abdominal wall muscles separated.

A

diastasis recti abdominis

38
Q

What is the difference between presumptive, probable, and positive signs?

A
  • presumptive: breast changes, amenorrhea, nausea, vomiting, urinary frequency, fatigue, quickening
  • probable: Goodell sign, Chadwick sign, Hegar sign, positive pregnancy test, Braxton Hicks contraction, ballottement
  • positive: visual on ultrasound, FHR heard, fetal movements visible and palpated
39
Q

True or False: Pregnancy tests are based on the presence of human chorionic gonadotropin in a pregnant woman’s urine or serum.

A

True

40
Q

True or False: Most home pregnancy tests are based on enzyme linked immunosorbent assay technology.

A

True

41
Q

True or False: Drugs such as diuretics can contribute to a false positive pregnancy test result.

A

False – causes false negative

42
Q

True or False: Fetal movements palpated by an examiner are an example of a positive sign of pregnancy.

A

True

43
Q

True or False: The uterine fundus should be above the level of the symphysis pubis by the eighth week of gestation.

A

False – between the 12th and 14th week of gestation

44
Q

True or False: Evaluating abnormal Papanicolaou tests during pregnancy can be complicated.

A

True

45
Q

True or False: During pregnancy the pH of vaginal secretions decreases.

A

False – the pH drops causing the vagina to become more acidic.

46
Q

True or False: Lactation does not occur during pregnancy as a result of the inhibiting effect of high prolactin levels.

A

True

47
Q

True or False: Physiologic anemia is diagnosed in a pregnant woman when the hemoglobin value falls to 10 g/dL or less or if the hematocrit value falls to 35% or less.

A

False – When the hemoglobin value drops below 11 g/dL

48
Q

True or False: A woman is at greater risk for the development of thrombosis during pregnancy and the postpartum period as a result of increases in certain clotting factors and depression of fibrinolytic activity.

A

True

49
Q

True or False: Pregnancy is a state of respiratory alkalosis compensated by a mild metabolic acidosis.

A

True

50
Q

True or False: A supine position with head elevated is the best maternal position to increase renal perfusion.

A

False – renal function is most efficient when in the lateral recumbent position and least efficient in the supine. A side lying position increases renal perfusion, which increases urinary output and decreases edema.

51
Q

True or False: A proteinuria value of 1 is acceptable during pregnancy.

A

True

52
Q

True or False: Carpal tunnel syndrome occurs during the third trimester of pregnancy as a result of edema that compresses the median nerve beneath the carpal ligament in the wrist.

A

True

53
Q

True or False: Increased triglyceride levels as a result of higher estrogen levels might account for the development of gallstones during pregnancy.

A

False – Increased emptying time and thickening of bile caused by prolonged retention are typical changes. But together with slight hypercholesterolemia from increased progesterone levels, may account for gallstones.

54
Q

How does blood pressure change during pregnancy?

A

Systolic: slight or no decrease from prepregnancy levels
Diastolic: slight decrease to midpregnancy (24-32 weeks) and gradually returns to prepregnancy levels by the end of pregnancy

55
Q

How does heart rate and patterns change during pregnancy?

A

Increases 10-15 beats/min

56
Q

How does respiratory rate and patterns change during pregnancy?

A

Unchanged or slightly increased

-Total lung capacity unchanged to slightly decreased

57
Q

How does body temperature change during pregnancy?

A

?

58
Q

How to figure mean arterial pressure:

A

(systolic) + 2(diastolic) / 3

59
Q

How does hematocrit, hemoglobin, and white blood cell count change during pregnancy?

A
  • hematocrit: normal 12-16 / pregnant less than 11 (decreases)
  • hemoglobin: normal 37-46 / pregnant less than 33 (decreases)
  • white blood cell: normal 5000-10,000 / 5000-15,000 (increases in 2nd and 3rd trimesters)
60
Q

How does clotting factors change during pregnancy?

A

Factor VII: increase in pregnancy, return to normal in early puerperium
Factor VIII: increases during pregnancy and immediately after birth

61
Q

How does the acid-base balance values change during pregnancy?

A

Po2: increases from 80-100 to 104-108
Pco2: decreases from 35-45 to 27-32
Hco3: decreases from 21-28 to 18-31
Blood pH: slightly increases, more alkaline from 7.35-7.45 to 7.40-7.45

62
Q

How does blood glucose levels change during pregnancy?

A

Fasting: 70-105 decreases

2 hr postprandial <140 after a 100 g carbohydrate meal is considered normal

63
Q

What adaptations does the renal system occur during pregnancy?

A

slowed passage of urine and dilation of ureters as a result of progesterone increase possibility of urinary tract infections; bladder irritability, nocturia, urinary frequency and urgency (first and third trimesters after lightening)

64
Q

What happens to the bowel system during pregnancy?

A

constipation and hemorrhoids; progesterone decreases peristalsis, and enlarging uterus displaces intestines

65
Q

Parathyroid levels:

A
  • peak level of parathyroid hormone occurs between 15 and 35 weeks of gestation, when the needs for growth of the fetal skeleton are greatest.
  • levels return to normal after pregnancy
66
Q

Insulin levels:

A

Maternal blood glucose levels decrease. Maternal insulin does not cross the placenta to the fetus. Early pregnancy the pancreas decreases its production of insulin.

67
Q

Estrogen:

A
  • Cause fat to deposit in subcutaneous tissues over the maternal abdomen, bank, and upper thighs
  • promotes the enlargement of the genitals, uterus, and breasts and increases vascularity causing vasodilation
  • causes relaxation of pelvic ligaments and joints
  • alters metabolism of nutrients by interfering with folic acid metabolism, increasing the level of total body proteins, and promoting retention of sodium and water by kidney tubules
  • may decrease secretion of hydrochloric acid and pepsin, which may be responsible for digestive upsets such as nausea
68
Q

Progesterone:

A
  • essential for maintaining pregnancy by relaxing smooth muscles, resulting in decreased uterine contractility and prevention of miscarriage
  • Cause fat to deposit in subcutaneous tissues over the maternal abdomen, bank, and upper thighs
69
Q

Thyroid hormones:

A

due to increase estrogen the levels of the thyroid hormones increase but do not effect the pregnant woman

70
Q

Human chorionic gonadotropin (hCG):

A
  • level increases unit it peaks at approximately 60 to 70 days of gestation and then declines until about 80 days of pregnancy.
  • remains stable until approximately 30 weeks and then gradually increases until term
  • higher than normal levels may indicate abnormal gestation or multiple gestation
  • abnormally slow increase or decrease may indicate impending miscarriage
71
Q

Prolactin:

A
  • increases early in the first trimester and increases progressively to term
  • responsible for initial lactation
72
Q

A pregnant woman at 10 weeks of gestation exhibits the following signs of pregnancy during a routine prenatal checkup. Which one is categorized as a probable sign of pregnancy?

a. hCG in the urine
b. breast tenderness
c. morning sickness
d. fetal heart sounds

A

a. hCG in the urine

73
Q

A pregnant woman with four children reports the following obstetric history: a stillbirth at 32 weeks of gestation, triplets (2 sons and a daughter) born by cesarean section at 30 weeks of gestation, a miscarriage at 8 weeks of gestation, and a daughter born vaginally at 39 weeks of gestation. Which of the following accurately expresses this woman’s current obstetric history by using the GPTAL?

a. 5-1-4-1-4
b. 4-1-3-1-1
c. 5-2-2-0-3
d. 5-1-2-1-4

A

d. 5-1-2-1-4

74
Q

An essential component of prenatal health assessment of pregnant women is the determination of vital signs. An expected change in vital signs as a result of pregnancy would be:

a. increase is systolic BP by 30 mm Hg or more after assuming a supine position
b. increase in diastolic BP by 5 to 10 mm Hg beginning in the first trimester
c. increased awareness of the need to breathe as pregnancy progresses
d. gradual decrease in baseline pulse rate of approximately 20 beats/min

A

c. increased awareness of the need to breathe as pregnancy progresses

75
Q

A woman exhibits understanding of instructions for performing a home pregnancy test to maximize accuracy if she:

a. uses urine collected at the end of the day, just before going to bed
b. avoids using Tylenol or aspirin for a headache for about 1 week before performing the test
c. performs the test on the day after she misses her first period
d. records the day of her last menstrual period and her usual cycle length

A

d. records the day of her last menstrual period and her usual cycle length

76
Q

During an examination of a pregnant woman, the nurse notes that her cervix is soft on its tip. The nurse would document this finding as:

a. friability
b. goodell’s sign
c. chadwick’s sign
d. hegar’s sign

A

b. goodell’s sign

77
Q

What are presumptive changes felt by the woman? (first 20 weeks)

A
  • breast changes
  • amenorrhea
  • nausea, vomiting
  • urinary frequency
  • quickening
78
Q

What are the probably signs felt by the woman? (felt between week 5 and 28)

A
  • Goodell sign
  • Chadwick sign
  • Hegar sign
  • positive result of pregnancy test (blood and urine)
  • Braxton Hicks contraction
  • ballottement
79
Q

What are the positive signs felt by the woman? (felt between week 5 and 22)

A
  • visualization of fetus by ultrasound
  • fetal heart tones by ultrasound
  • fetal movements palpated
  • fetal movements visible

OB Test 2 (4 decks)

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