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MATERNAL AND CHILD NURSING > Module 02: Care of Mother and Fetus During Antenatal Period (Part 02) > Flashcards

Module 02: Care of Mother and Fetus During Antenatal Period (Part 02) Flashcards

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1
Q

When the woman is posed to pregnancy what is the normal size of the uterus?

A

(A) Normal Size - 2 by 3 inches
(B) Increases dramatically in both size and weight

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2
Q

When the woman is posed to pregnancy when is the uterus perceived to be at the umbilical level?

A

By week 20 to 22

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3
Q

When the woman is posed to pregnancy when is the uterus perceived to be at midway between the umbilicus and the xiphoid process?

A

By week 30

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4
Q

When the woman is posed to pregnancy when is the uterus perceived to be at the xiphoid process?

A

By week 36

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5
Q

These are rhythmic painless contractions of the uterus. They are characterized to begin by the end of the pregnancy.

A

Braxton Hicks Contractions

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6
Q

This is characterized as the softening of the lower uterine segment of the cervix. This occurs about the 6th week of pregnancy.

A

Hegar’s sign

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7
Q

What happens to the cervix during pregnancy?

A

(A) The glandular tissue increases in number and becomes hyperactive.
(B) The mucus plus is formed and acts a barrier to prevent ascending infection.
(C) There is an increase in blood flow in the cervix which leads to the softening of it (Goodell’s sign)>

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8
Q

What happens to the ovaries during pregnancy?

A

(A) Ovum production ceases due to high estrogen and progesterone which inhibits FSH and LH from pituitary stimulation.
(2) Corpus luteum persists and secretes progesterone until weeks 6 to 8, when the placenta is developed.

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9
Q

What happens to the breasts during pregnancy?

A

(A) The changes are brought about estrogen and progesterone.
(B) There is an increase in tenderness and the feeling of fullness or tingling. Superficial veins become more prominent.
(C) There is also an increase in pigmentation and increase in diameter of the areola and the nipple.
(D) Montgomery’s tubercles (sebaceous glands of the areola) become enlarge and protuberant due to the increase in estrogen and progesterone).

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10
Q

What happens to the colostrum during pregnancy?

A

It is produced by week 12. The colostrum is an antibody-rich forerunner of the mature breast milk.

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11
Q

When can pre-colostrum be expelled?

A

16th week

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12
Q

This is known to occur due to the persistence of the corpus luteum. Under this, ovulation is inhibited by the high levels of estrogen and progesterone.

A

Amenorrhea

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13
Q

Uterine changes are commonly influenced by what factors?

A

Due to circulatory, hormonal and related fetal growth during pregnancy.

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14
Q

This phenomenon is characterized as a purplish hue of the cervix and the vaginal mucosa.

A

Chadwick’s sign

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15
Q

This phenomenon is characterized as the whitish, gray discharge that is moderate in amount with a musty or mousy odor.

A

Leukorrhea

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16
Q

This phenomenon transpires when the mucus plug seals off the bacteria. Under this, the hormone responsible for this is progesterone.

A

Operculum

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17
Q

This is characterized as the patent softening of the lower uterine segment. In this, the uterus enlarges in size and changes in position.

A

Hegar’s sign

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18
Q

What happens to position of the uterus during the first trimester?

A

The uterus is in the pelvic cavity.

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19
Q

What happens to the position of the uterus during the second and third trimester?

A

The uterus is in the abdominal cavity before lightening occurs.

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20
Q

What happens to the ovaries during pregnancy?

A

Pregnancy is the rest period for the ovaries from producing eggs (A woman has 400,000 eggs in total).

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21
Q

What happens to the breasts during pregnancy?

A

The woman experiences a sense of fullness, tingling, soreness and darkening of the areola and the nipples due to an increase in her hormonal level.

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22
Q

What happens to the state of respiration of the mother during pregnancy?

A

The woman experiences shortness of breath because of enlarged uterus and increase in oxygen demand.

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23
Q

What should be the nursing intervention or management when the mother is experiencing shortness of breath?

A

Position the mother on the left lateral side-lying to promote the expansion of the lungs.

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24
Q

When does hyperventilation occur among mothers?

A

Due to the mother’s need to blow-off increased carbon dioxide transferred to her from the fetus.

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25
Q

Why does nasal congestion occur among mothers during pregnancy?

A

It occurs as a response to increased estrogen levels.

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26
Q

Explain the blood volume increase of the mother during pregnancy.

A

Blood volume increases about 40 to 45%.

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27
Q

Explain the cardiac output increase of the mother during pregnancy.

A

By weeks 20 to 24, cardiac output increases about 30 to 50% over pre-pregnant levels and it remains elevated fro the duration of the pregnancy.

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28
Q

How do you calculate the cardiac output?

A

Cardiac Output = Heart Rate x Stroke Volume

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29
Q

Explain the pulse rate and the blood pressure of the mother during pregnancy.

A

(A) Pulse rate increases.
(B) Blood pressure decreases slightly by 2nd trimester
RBCs, hemoglobin (NORMAL: 12 to 16 for female; 14 to 16 for male) and the plasma levels also increase.

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30
Q

What levels of hematocrit are considered normal among mothers posed to pregnancy?

A

32% to 44%

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31
Q

Explain the leukocyte levels of a mother when posed during pregnancy.

A

(A) Leukocyte production increases
(B) Pressure of enlarging uterus on vena cava can interfere with blood return to the heart.

(1) Can cause dizziness, pallor, clamminess and lowered BP (supine hypotensive syndrome/ vena caval syndrome or aortocaval compression)

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32
Q

This condition transpires when the weight of the enlarged uterus obstructs the vena cava, which decreased blood returning to the heart; therefore, decreasing the cardiac output; hence, resulting to hypotension, lightheadedness, faintness, and palpitations.

A

Supine Hypotensive Syndrome or Vena Caval Syndrome

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33
Q

What is the rationale of the lateral position for mothers when undergoing pregnancy?

A

It helps relieve pressure on the sacrum and heels in person who sit for much of the day or who are confined to bed and rest in the fowler’s or supine positions.

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34
Q

What is the area of support when assisting mothers in lateral position?

A

The head, across the chest and in between the thigh

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35
Q

Explain the heart rate among mothers when posed to pregnancy.

A

Heart rate increases 10 to 15 beats per minute. in the latter, half of the pregnancy. (Palpitation is also common)

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36
Q

This type of condition is characterized is due to the hemodilution of the blood (slight difference to the normal).

A

Physiologic anemia

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37
Q

Explain the phenomenon of physiologic anemia.

A

(A) 45-50% increase in blood volume expansion, of which about 75% is plasma and 25% is RBC

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38
Q

This type of condition is characterized to be the most common hematologic disorder. This is also known as the iron deficiency anemia among pregnant women.

A

Pathologic Anemia (Affects roughly 20% of pregnant women)

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39
Q

How do you assess pathologic anemia among patients?

A

Pallor, concave fingernails(late sign of progressive anemia) caused by chronic tissue hypoxia, and listlessness

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40
Q

How should you manage pathologic anemia among patients?

A

(1) Increased iron in diet
(2) Oral iron supplements (which are best given before meals or with an empty stomach for better absorption; however can lead to GI irritation, hence given on full stomach

41
Q

How much iron supplements should you give when managing pathologic anemia?

A

Ferrous sulfate 0.3 g 3x a day

42
Q

What are the best sources of iron?

A

Liver, lean or red meat, legumes like monggo, green leafy vegetables such as kangkong, ampalaya, spinach, and malunggay

43
Q

When is iron better absorbed?

A

Iron is better absorbed when taken with foods rich in Vitamin C such as orange juice

44
Q

What are the side effects of iron supplements?

A

(1) Constipation
(2) Black and tarry tools (monitor for hemorrhage)

45
Q

What are the normal value of HCT and HGB during the first and second semester?

A

(1) HCT: <33%
(2) HGB: <11 g/dL

46
Q

What are the normal value of HCT and HGB during the third semester?

A

(1) HCT: <32%
(2) HGB: <10.5 g/dL

47
Q

Where is venous congestion commonly noted and develop into?

A

(1) Can develop in varicosities
(2) Most commonly noted in the legs, vulva, and rectum

48
Q

How do you manage venous congestion?

A

Let the mother lie flat in bed with the feet elevated.

49
Q

What is the management for edema when found on the extremities or face?

A

When found on extremities or face, it necessitates further assessment for signs of pregnancy- induced hypertension.

50
Q

This is characterized by early morning nausea and vomiting due to increased HCG and reduction in hydrochloric acid secretion that interferes with gastric motility.

A

Morning sickness

51
Q

How do you manage morning sickness during the 1st trimester?

A

(1) getting out of bed slowly after eating a few crackers
(2) Eating frequent, small meals (afternoon nausea)
(3) Avoiding spicy or greasy foods

52
Q

This is known as the excessive vomiting during pregnancy.

A

Hyperemesis Gravidarum

53
Q

This is known as the vomiting during pregnancy.

A

Emesis Gravidarum

54
Q

This is characterized as the reflux of stomach content to the esophagus.

A

Heartburn of Pyrosis

55
Q

How do you prevent heartburn of pyrosis as a nurse?

A

(1) Eating small frequent meals
(2) Avoiding fatty and spicy goods
(3) Proper body mechanics
(4) Taking sips of milk

56
Q

What are the common causes of heartburn among pregnant women?

A

(1) Progesterone hormone relaxes the cardiac sphincter of the stomach and allows reflex or bubbling back of gastric contents into the esophagus.
(2) The pressure of the growing uterus on the stomach from about 30 to 40 weeks.

57
Q

What is the proper management for pregnant women experiencing heartburn?

A

(1) Avoid lying flat
(2) Sleeping with more pillows and lying on the right side
(3) Small frequent meals
(4) Taking antacids
(5) Taking baking soda in a glass of water is contraindicated because of the possibility of retention of sodium and subsequent edema
(6) Avoiding fried, spicy and fatty foods
(7) Avoiding citrus juices

58
Q

What kind of food cravings may occur during pregnancy?

A

Only significant if substances craved is unusual (pica). Examples vary from clay, starch, and dirt.

59
Q

This is often characterized as increased salivation caused by elevated estrogen levels.

A

Ptylasim

60
Q

What is the appropriate nursing care for ptylasim?

A

Offer mouthwash

61
Q

This is often characterized as the presence of excessive amount of gas in the stomach and intestine due to increased progesterone.

A

Flatulence

62
Q

How do you prevent flatulence?

A

Voiding intake of gas forming foods (ex. root crops and beans)

63
Q

This is often characterized as the condition in which bowel movements are infrequent or incomplete.

A

Constipation

64
Q

What are the causes of constipation?

A

(1) Hypoperistalsis
(2) Lack of habits
(3) Poor dietary habits
(4) Pressure of the enlarged uterus on internal organs
(5) Effects of progesterone on muscle and hemorrhoids

65
Q

What is the appropriate management for constipation?

A

(1) Increase oral fluids intake
(2 Eat high-fiber foods (oatmeal, papaya, pineapple, grapes, apple, watermelon, cantaloupe)
(3) Regular exercise

66
Q

This is characterized as a varicose condition of the external hemorrhoidal veins causing painful swellings at the anus.

A

Hemorrhoids

67
Q

What is the common cause of hemorrhoids?

A

Due to gravid uterine

68
Q

What are the appropriate nursing interventions for hemorrhoids?

A

(1) Warm sitz bath
(2) Sit on soft pillows
(3) High fiber diet
(4) Increased fluid intake

69
Q

This condition is characterized as the increased excretion of sugar caused by lowered renal threshold.

A

Glycosuria

70
Q

How is glycosuria determined among pregnant women?

A

Determined by Benedict’s Test

71
Q

This condition is characterized as the need to get up during the night in order to urinate, thus interrupting sleep.

A

Nocturia

72
Q

What is correct management for nocturia?

A

(1) Decreased oral fluid intake at least two hours before bedtime
(2) Side-lying or lateral position

73
Q

What are the physical changes in the skin (integumentary) and hair among pregnant women?

A

(1) Pigmentation of the areola, nipples, vulva, and linea nigra increases
(2) Striae or stretch marks may develop on the abdomen, breasts and thighs
(3) Protruding Umbilicus

74
Q

This is characterized as a butterfly-shaped area of pigmentation over the face (mask of pregnancy).

A

Facial chloasma or melasma gravidarum (usually fades after birth)

75
Q

This is often caused by enlarging uterus which causes destruction of connective tissue resulting from separation of underlying collagen which appears as irregular scars.

A

Stria Gravidarum or Stretch Marks (Do not scratch, instead apply lotion or oil)

76
Q

This is characterized as the brownish-pinkish line running from symphysis pubis to the umbilicus due to increased melanin.

A

Linea Nigra

77
Q

This is the accentuation of the lumbar curvature of the spine. This is also known as the “Pride of Pregnancy.”

A

Lordosis

78
Q

Where does softening of all ligaments and joints occur among pregnant women?

A

Symphysis and Sacroiliac joints

79
Q

This condition is caused by increased hormonal action of estrogen and relaxin.

A

Softening of all ligaments and joints

80
Q

This condition is characterized as the awkward walking due to relaxin hence, the mother becomes a candidate for falls.

A

Wedding Gait

81
Q

What is the appropriate nursing management for wedding gait?

A

Prevent falls through the wearing of low heeled or flat shoes

82
Q

This condition may occur from an imbalance of calcium (hypocalcemia) in the body and from pressure of the gravid uterus on nerves supplying the lower extremities.

A

Leg Cramps

83
Q

What is the appropriate nursing management for leg cramps among pregnant women?

A

(1) Put the affected leg in a flat surface then do dorsiflexion
(2) Milk consumption should be at least 1 pint or four cups a day or three to four servings

84
Q

What are the sources of calcium rich foods?

A

(1) Anchovies
(2) Sardines (specifically the head of the fish)
(3) Seafoods (mussles)
(4) Cheese and yogurt (dairy products)
(5) Broccoli

85
Q

What are the common causes of backache?

A

(1) May be due to muscular fatigue and strain that accompany poor body balance
(2) Due to increased lordosis during pregnancy in an effort to balance the body
(3) Pregnancy hormones sometimes soften the ligaments to such a degree that some support is needed

86
Q

What are the appropriate nursing management for backache?

A

(1) Exercise
(2) Sit with knee slightly higher than the hips
(3) Pregnant women is reassured that once birth has occurred, the ligaments will return to their pre-pregnant strength

87
Q

What are the different changes in a pregnant woman’s endocrine system?

A

(1) Elevated HCG levels which reaches peak at third month then drops
(2) Estrogen and progesterone increases and continue to be secreted from the placenta during the last six (6) months of pregnancy
(3) Thyroid activity is increased; normal pregnancy may emulate a mild hyperthyroid state
(4) Estriol labels increased

88
Q

This hormone secreted acts to inhibit uterine contractions.

A

Progesterone

89
Q

What happens when estrogen and progesterone secretion augments over time?

A

Increase in both hormones leads to sodium and water retention and muscle relaxation which leads to fatigue

90
Q

This is sometimes used as an indicator of fetal well-being.

A

Estriol labels

91
Q

This prenatal multivitamin is pivotal to prevent neural tube defects (NTD’s).

A

Folic Acid

92
Q

What are the nutritional recommendations for pregnant women based on pre-pregnancy body mass index (BMI)?

A

(1) A weight gain of 12.5 to 18kg (28-40 lbs) for underweight women (BMI<19.8)
(2) 7 to 11.5kg (15-25 lbs) for overweight women (BMI>26)
(3) 11.5 to 16kg (25-35 lbs) for women of average wight (BMI 19.8 to 26.0)

93
Q

What should be conducted among pregnant mothers?

A

Conduct nutritional assessment and emphasize knowledge on the food guide pyramid especially on high risk mothers

94
Q

What are examples of high risk mothers?

A

(1) Pregnant teenagers (Due to low compliance to health regimen)
(2) Underweight (malnourished)
(3) Overweight (pre-eclampsia and DM)
(4) Mothers with low socioeconomic status (refer to Social Workers)

95
Q

This type of vegetarian mother consumes no meat, fish, eggs and dairy; has a rigid personality and is more prone to anemia.

A

Strict Vegetarian

96
Q

This type of vegetarian mother consumes dairy products and vegetables.

A

Lactovegetarian

97
Q

This type of vegetarian mother consumes eggs and vegetables.

A

Ovo vegetarian

98
Q

This type of vegetarian consumes eggs, milk, vegetables; least prone to anemia.

A

Lacto-ovovegetarian

MATERNAL AND CHILD NURSING (5 decks)

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