NUR 238 - Exam 1 Review Flashcards
What does smoking cause?
- Low birth weight
- IUGR (Intrauterine growth restriction)
Important nurse concept with wide demograpics.
- Acknowledge different cultural practices
- Use translator when necessary
How do you avoid preterm labor?
Hydrate.
What is the range for normal weight gain in pregnancy?
25-35lbs.
What are all the phases in Stage 1 of labor?
- Latent Phase
- Active Phase
- Transitional Phase
Facts about the Latent Phase.
- Cervix: 0-3cm
- Cx frequency of 5-30mins
- Cx’s irregular
- Talkative and eager
Facts about the Active Phase.
- Cervix: 4-7cm
- Cx frequency of 3-5mins
- Rapid dilation and effacement
- Some fetal descent
- Anxiety, restlessness, helplessness
Facts about the Transitional Phase.
- Cervic: 8-10cm
- Cx frequency of 2-3mins
- Complete dilation
- Urge to push
- Nausea, vomiting
- Feeling need to have BM
- Tired, irritable, fearful
- Increased bloody show
Facts about Stage 2 of labor.
- Full dilation
- Prepare for delivery
- Do not take pt to bathroom
- Rupture of membranes
- Birth (delivery of fetus)
Facts about Stage 3 of labor.
From time the baby is born to expulsion of placenta.
Facts about Stage 4 of labor.
- Delivery of placenta
- Maternal stabilization of vitals
- Patient/newborn attachment
- Perineal assessment
What is the purpose of Amniotic Fluid?
- Maintain temperature
- Provides protection
- Allows for freedom of movement for musculoskeletal development
What is the normal amount of Amniotic Fluid?
800-1200mL.
What is the term for an Amniotic Fluid level of less than 300mL?
Oligohydramnios.
What is the term for an Amniotic Fluid level of more than 2000mL?
Polyhydramnios.
What does increased overall blood volume do to Hematocrit, etc?
Dilute the values.
When do you seek Prenatal Care?
- Before becoming pregnant
- Genetic testing for risk factors
If a patient presents with family history of spinal disorders, what is the recommendation?
Folic acid supplements.
What does Folic Acid help prevent?
Neural tube defects.
Which foods are good sources for Folic Acid?
- Leafy, green vegetables
- Dried peas
- Beans
- Seeds
- Orange juice
What is the purpose of Iron Supplements?
Increase RBC mass.
When are Iron Supplements best absorbed?
Between meals in conjunction with Vitamin C.
What is the purpose of Calcium?
Bone & teeth formation.
Which foods are good sources for Calcium?
- Milk
- Fortified soy milk
- Fortified OJ
- Nuts
- Legumes
- Dark, leafy, green vegetables
What are the goals for Healthy People 2020/30?
- Reduce infant mortality
- Decrease in SIDS
- *no co-sleeping
- *infant sleeps on back
- Increase prenatal care
- Decrease cesarean births
What is the normal Fetal Heart Rate?
110-160bpm.
What is Hyperemesis Gravidarum?
Persistent vomiting which produces weight loss, dehydration, and electrolyte imbalance.
Advice for patients with nausea?
- Avoid greasy foods
- High carbohydrate snack in AM
Signs for Presumptive Pregnancy?
- Amenorrhea
- Fatigue
- Nausea & Vomiting
- Breast changes
- Quickening
- Uterine enlargement
Signs for Probable Pregnancy?
- Hegar’s sign
- Chadwick’s sign
- Goodell’s sign
- Ballottement
- Braxton Hick’s contractions
- Positive pregnancy test
- Fetal outline
Signs for Positive Pregnancy?
- Fetal heart sounds
- Visualization of fetus by ultrasound
- Fetal movement palpated by examiner
What is Amniocentesis?
Aspiration of amniotic fluid.
What is the purpose for an Early Amniocentesis?
Test for neural tube defects (spina bifida, anencephaly).
What is the purpose for a Late Amniocentesis?
Lung maturity (L/S ratio - 2:1).
What does an increased Alpha-Fetoprotein (AFP) indicate?
Neural tube defects.
What does a decreased Alpha-Fetoprotein (AFP) indicate?
Down’s syndrome.
List of Pregnancy Discomforts.
- Mood swings
- Heartburn
- Back pain
List of Pregnancy Warning Signs.
- Tachycardia
- Dysuria
- Vaginal bleeding
- Changes in fetal movement
- Edema of hands and face
- Severe vomiting
How do you relieve back pain?
Pelvic rocking.
Regarding Kick Counts, what should you monitor before telling your provider?
Less than 3 kicks/hour, contact provider.
What is TORCH?
- Toxoplasmosis
- Other (HIV, HIB, Syphilis, Hep B)
- Rubella
- Cytomegaly
- Herpes
Which vaccine do you not give pregnant patients?
Rubella.
If the pregnant patient has herpes, what do you administer?
Valtrex.
Facts on 8-week Gestation.
Fetal heartbeat via doppler.
Facts on 12-week Gestation.
- Sonogram
- Chorionic Villus Sampling
What is Chorionic Villus Sampling (CVS)?
Assessment of placenta for chromosomal disorders.
What are the risks with CVS?
- Risk to fetus
- Risk of rupturing membrane
Facts on 16-week Gestation.
- Testing Alpha-Fetoprotein (AFP) is now possible
- Triple or quad screen
- Screening for preeclampsia
- Amniocentesis
Facts on 20-week Gestation.
- Sonogram for growth
- Fundal height measurement (equal to gestational age weeks)
Facts on 25-28 weeks Gestation.
- Glucose challenge test (1hr) for dx gestational diabetes
- Antibody testing
- Test for gestational diabetes mellitus
If the glucose levels is 130-140mg/dL or greater, what kind of test is required?
3-hour test.
What do you administer if a pregnant patient is RH negative?
Rhogam.
What vaccine can be given at 30-week gestation?
TDAP vaccine, NOT rubella.
What do you test for at 35-weeks gestation?
- Group B Strep Test
- Utilize a vaginal/rectal swab
Facts on 37-40 week Gestation.
- BPP
- Cervical Exam
- Non-Stress Test
- Contraction Stress Test (CST)
What does a Non-Stress Test do?
Assess FHR in relation to movement.
What does a Contraction Stress Test (CST) do?
- Analysis of FHR to contractions
- Indicated for non-reactive stress test
- Initiate IV oxytocin to stimulate contractions
What is Bio-Physical Profile (BPP)?
Assessment of fetal well-being by 5 variables.
What are the 5 variables assessed by the BPP?
- FHR (2 points)
- Breathing movements (2 points)
- Body movements (2 points)
- Fetal tone (2 points)
- Amniotic Fluid Volume (2 points)
If a fetus gets 8-10 points on a BPP, what is this indicative of?
Normal fetal health.
If a fetus gets 6 points on a BPP, what is this indicative of?
Follow-up with health care.
What is Lightening?
Fetal head drops into pelvis.
What is the purpose of Progesterone?
Prevents uterus from contracting.
What is the purpose of Estrogen?
Prepares uterus for implantation.
What is the purpose of an Intra-Uterine Pressure Catheter (IUPC)?
Measures contraction intensity.
How do you help a pregnant patient with calf cramps?
Flexion.
