OB exam 1 - Antepartum

Question 1

first trimester
second trimester
third trimesetr

Answer 1

1) 1-12 6/7 wks
2) 13-26 6/7 wks
3) 27+ wks

Question 2

physical changes during pregnancy: uterus

Answer 2

-enlargement d/t hypertrophy
-fibrous tissue increases
-increase in blood flow
-Braxton hicks contractions

Question 3

physical changes during pregnancy: cervical

Answer 3

-development of mucus plug
-goodell’s sign (softening of cervix)
-chadwick’s sign (bluish purple discoloration)
-hegar’s sign (softening of uterus)

Question 4

order of cervical changes

Answer 4

1st) softening of cervix
2nd) softening of uterus
3rd) discoloration

Question 5

physical changes during pregnancy: ovaries

Answer 5

-stop producing ova during pregnancy
-secretes progesterone until 7th wk to maintain the endometrium

Question 6

physical changes during pregnancy: vaginal

Answer 6

-mucosa thickens
-increase in secretions, loosening of connective tissue

Question 7

physical changes during pregnancy: breast

Answer 7

-glandular hyperplasia (adding cells) & hypertrophy
-areolae darken, superficial veins prominent
-striae may develop
-colostrum is secreted (can leak)

Question 8

physical changes during pregnancy: respiratory

Answer 8

-oxygen consumption increases
-subcostal angle and AP diameter increase
-breathing changes from abdominal to thoracic
-nasal stuffiness & epistaxis

Question 9

physical changes during pregnancy: cardiac

Answer 9

-blood volume increase 40-50%
-physiological anemia
-decrease in systemic & pulmonary vascular resistance
-increase in cardiac output
-somewhat hypercoagulable

Question 10

physical changes during pregnancy: GI

Answer 10

-N/v
-softening & bleeding of gums
-increase in salvia
-constipation
-heartburn (pyrosis)
-gallstones
-hemorrhoids

Question 11

physical changes during pregnancy: urinary

Answer 11

-pressure on bladder causes frequency
-dilatation of kidneys and ureters
-increased GFR and renal plasma flow

Question 12

physical changes during pregnancy: skin

Answer 12

-hyperpigmentation
- striae
-facial chloasma
-vascular spider nevi
-decreased hair growth
-hyperactive sweat & sebaceous glands
linea nigra: dark line down belly

Question 13

physical changes during pregnancy: MS

Answer 13

-pelvic joints relax
-center of gravity changes
-separation of rectus abdominus
-lordosis

Question 14

supine hypotensive syndrome

Answer 14

the uterus compresses the vena cava causing dizziness, lightheadedness and nausea (starts late in 2nd trimester)
1st nursing action is to turn pt off back and then check BP & fetal HR

Question 15

recommended wt gain in pregnancy based on bmi

Answer 15

underwt: 28-40
normal: 25-35
overwt: 15-25
obese: 11-20

Question 16

weight gain pattern

Answer 16

1.1-4.4 lbs during the 1st trimester then 1lb per week during the last 2

Question 17

physical changes during pregnancy: eye, cognitive & metabolic changes

Answer 17

-decreased intraocular pressure
-thickening of cornea
-reports of decreased attention, concentration & memory
-extra water, fat & protein stored
-fats are more completely absorbed

Question 18

physical changes during pregnancy: endocrine

Answer 18

-thyroid gland enlarges
-concentration of parathyroid hormone increases
-prolactin is responsible for lactation
-secretion of oxytocin & vasopressin
-increased aldosterone

Question 19

presumptive (subjective) signs of pregnancy

Answer 19

-amenorrhea
-N/v
-excessive fatigue
-urinary frequency
-breast changes
-quickening

Question 20

probable (objective) signs of pregnancy

Answer 20

-changes in the pelvic organs (cervical)
-enlargement of abdomin
-Braxton hicks
-striae
-uterine soufflé
-changes in pigmentation of the skin
-palpation of fetal outline

Question 21

positive (diagnostic) signs of pregnancy

Answer 21

-auscultation of fetal heartbeat
-fetal movement
-visualization of the fetus

Question 22

what is couvade

Answer 22

a mothers partner experiences a sympathetic pregnancy

Question 23

prenatal hx

Answer 23

-current & past pregnancies
-gynecologic history
-current & past medical hx, including substance abuse
-family medical hx
-religious, spiritual, cultural & occupational hx
-partner hx
-social history & preferences

Question 24

GTPAL

Answer 24

G: number of pregnancies including current
T: number of deliveries at 37 wks +
P: number of deliveries between 20 & 36 6/7 wks
A: number of pregnancies ending in abortion
L: number of current living children

Question 25

factors related to father’s health

Answer 25

-family hx of genetic conditions
-significant health problems
-blood type & Rh factor
-occupation
-best learning method
-attitude toward the pregnancy

Question 26

naegele’s rule

Answer 26

subtract 3 months from the last menstrual period and then add 7 days

Question 27

uterine size

Answer 27

measure from pubic synthesis to the fundus in cm
start at 20 wks & measure should be +/- 2 from the # of weeks

Question 28

what is the most accurate way to determine EDB

Answer 28

ultrasound