prenatal

Question 1

• Concept of fundal height. What are the normal assessment levels?

Answer 1

Fundus of the uterus is at symphysis pubis at 10-12 weeks gestation. Fundus at umbilicus at 20-22 weeks.

Question 2

How does fundal height correlate with gestational age?

Answer 2

1 cm per week after 20 weeks

Question 3

What is the significance if the fundus is below expected level or higher than expected level?

Answer 3

Intrauterine growth restriction or macrosomia due to various conditions

Question 4

Prior to measuring the fundal height what must the patient do?

Answer 4

void

Question 5

• Supine hypotensive syndrome. What is it?

Answer 5

Baby presses on the vena cava causing a decreased blood return to the heart. This occurs when mom is lying on her back.

Question 6

What are the signs and symptoms of Supine hypotensive syndrome

Answer 6

Decrease in blood pressure and mom becomes pale.

Question 7

What is the priority nursing intervention for Supine hypotensive syndrome

Answer 7

Have the woman lie on her left side or put a pillow under her right buttock.

Question 8

How is that intervention modify in case of surgery or a woman is unresponsive- Supine hypotensive syndrome

Answer 8

right buttock

Question 9

How do you know your nursing intervention was effective-Supine hypotensive syndrome

Answer 9

Blood pressure will return to baseline and tissue perfusion returns to pink

Question 10

• Skin changes associated with pregnancy-4

Answer 10

1. Linea Nigra line from umbilicus to symphysis pubis. 2. Mask of pregnancy (chloasma or melisma gravidarum) dark skin over cheek, nose, and forehead.
2. Striae or stretch marks may not disappear completely.
3. Vascular spider nevi, chest, neck, face and arms

Question 11

What is important to tell the mother regarding these skin changes

Answer 11

Usually disappear in 6 weeks except for striae (may just fade some)

Question 12

• Physiological anemia of pregnancy.

Answer 12

? RBC increases by 30% and plasma volume increases by 50 % which causes a decrease in the hematocrit
-iron supplements

Question 13

What are the presumptive (subjective) signs-6

Answer 13

Amenorrhea, nausea and vomiting (morning sickness), fatigue, urinary frequency, changes in breast and quickening (18-20 weeks)

Question 14

What are the probable (objective) signs-9

Answer 14

Goodells, Chadwick’s sign, Hegar’s sign, McDonalds sign ,Braxton Hicks contractions after 28 weeks, uterine soufflé, pigment skin changes, fetal outline after 24 weeks, pregnancy tests.

Question 15

Goodells

Answer 15

softening of the cervix

Question 16

Chadwick’s sign

Answer 16

bluish, purple or deep red cervix, vagina, mucous membranes

Question 17

Hegar’s sign

Answer 17

softening of the isthmus

Question 18

McDonalds sign

Answer 18

ease of flexing the cervix

Question 19

What are the positive signs-4

Answer 19

Diagnostic: fetal heartbeat Doppler 10-12 weeks, fetoscope 17-20 weeks, fetal movement at 20 weeks, visualization of the fetus at 8 weeks ultrasound

Question 20

• Psychological responses to pregnancy for mother?

Answer 20

1st trimester: Ambivalent seems unreal, 2nd trimester: feels best and may feel baby move, 3rd trimester: Discomfort, insomnia, concerned about Labor and has pride of pregnancy.

Question 21

Psychological responses to pregnancy for Father of the baby

Answer 21

1st trimester: Tends to feel left out. 2nd trimester: Fathering behaviors 3rd trimester: Involvement and attends childbirth classes

Question 22

GTPAL

Answer 22

G= gravida, T= term, P= preterm, A=abortion and L= living.

Question 23

Nagele’s rule

Answer 23

add 1 year, subtract three months and add 7 days

Question 24

timing of pregnancy appointments

Answer 24

once a month until 28 weeks, at which point she will be seen every two weeks until 36 weeks, then she will be seen every week until birth.

Question 25

• Discomforts of pregnancy 1st T-4

Answer 25

urinary frequency, nausea/vomiting, breast tenderness, vaginal discharge
-accupressure wristbands, ginger, pyridoxine (B6)

Question 26

Discomforts of pregnancy 2nd T-4

Answer 26

heartburn, varicose veins hemorrhoids, backache

-low-sodium antacid (*avoid Na bicarb and alkaseltzer), avoid bending at waist

Question 27

Discomforts of pregnancy 3rd T-2

Answer 27

hemorrhoids, backache

Question 28

• Weight gain in pregnancy

Answer 28

1T- 3.5 – 5 lbs
2T- 12-15
3T- 12-15

Question 29

weight gain based on gestation

Answer 29

4.4 1T then 1 lb per week after

Question 30

calorie intake in 2T and 3T

Answer 30

extra 300