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Nursing 120 exam 4 > Second Semester Exam 1 > Flashcards

Second Semester Exam 1 Flashcards

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1
Q

What hormone is most responsible for physiological changes in pregnancy?

A

HCG

Human Chorionic Gonadotropin

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2
Q

When placenta develops, which hormones does the placenta produce to maintain the rest of pregnancy?

A

Estrogen
Progesterone
Human placental lactogen
Relaxin

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3
Q

What is a zygote?

A

Cell formed by union of sperm and ovum

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4
Q

What is an embryo?

A

Second to eighth week of development

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5
Q

When does the fetus develop?

A

ninth week to until birth

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6
Q

What is the fetus most vulnerable to?

A 
Teratogens:
drugs
alcohol
infections, viruses
rubella
syphillis
toxoplasmosis
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7
Q

What is foramen ovale?

A

Opening between left and right atria

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8
Q

Where is the ductus arteriosus?

A

connects pulmonary artery to the aorta

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9
Q

Where is the ductus venosus?

A

Connects the umbilical vein to the inferior vena cava

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10
Q

What is the function of amniotic fluid?

A

Maintains an even temperature
Prevents the amniotic sac from adhering to the fetal skin
Allows symmetrical growth of fetus
Allows buoyancy and fetal movement
Acts as a cushion to protect the fetus and umbilical cord from injury

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11
Q

What are abnormalities of the amniotic fluid?

A

Polyhydramnios-excessive amniotic fluid

Oligohydramnios-less than expected fluid

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12
Q

What is the function of the umbilical cord?

A

Provide nutrients and oxygenation

Remove waste products

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13
Q

What is the structure of the umbilical cord?

A

AVA (Artery/Vein/Artery)
Two umbilical arteries
One umbilical vein
Wharton’s jelly

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14
Q

What are body system changes of the reproductive system during pregnancy?

A 
Reproduction System
Breasts
Increased blood supply
Increased size
Darkened pigmentation 
Ovulation and menses cease
Uterus
Increased size, weight & shape
Increased contractibility
Braxton Hicks
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15
Q

What are cardiovascular changes in body systems during pregnancy?

A 
Hypervolemia of Pregnancy
Blood volume increases by 50 % or 1500ml
Heart enlarges slightly
Heart rate increases 15 to 20 BPM
Systolic murmurs common
Physiological anemia of pregnancy
Plasma blood volume increase > RBC increase
Iron deficiency anemia
 Hgb 11.0g/dl and Hematocrit <33
Blood Pressure
Position Effects
Supine Hypotension
Increased WBCs in absence of infection
15,000 
Hypercoagulation – fibrinogen increases by 50%
Decreased risk of post partum (PP) hemorrhage
Increased risk of DVT
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16
Q

What are respiratory changes during pregnancy?

A
  • Oxygenation needs increase
  • Resp. increase 1-2/minute
  • Diaphragm displaced upwards
  • Size of maternal chest enlarges
  • Change from abdominal to thoracic breathing
  • Physiologic dyspnea common
  • Vascular engorgement
  • Nasal and sinus congestion
  • Epistaxis (nose bleeds)
17
Q

What are changes in the GI system during pregnancy?

A
  • Hormonal influences
  • Nausea and vomiting in early pregnancy
  • Food cravings, avoidance
  • Uterine enlargement
  • Stomach, liver and intestinal displacement
18
Q

What are musculoskeletal changes during pregnancy?

A
  • Low back pain
  • Ligament stretching
  • Difficulty walking -“Pregnancy Waddle”
  • Leg cramps
  • Relaxation of pelvic joints
  • Change in center of gravity
  • Balance may become an issue
19
Q

What are Urinary system changes in pregnancy?

A
  • Filtration rate increases
  • Mild proteinuria (Trace) or glucosuria normal
  • Positional variation in function
  • Left lateral recumbent optimal
  • Anatomical & hormonal changes
  • Frequency, urgency and nocturia
20
Q

Common discomforts and interventions of pregnancy?

A

Nausea and Vomiting

Heartburn

Backache

Urinary Frequency

Fatigue
Varicosities

Leg Cramps

Constipation

Hemorrhoids

21
Q

What are educational topics for pregnancy?

A

Bathing

Hot Tubs Or Saunas

Douching

Breast Care

Immunizations

Exercise

Sleep And Rest

Employment

Travel

Clothing

22
Q

Pregnancy definitions

A

Presumptive-Perceived by the woman
Probable-Perceived by the provider
Positive-Can only be attributed to the fetus

23
Q

Presumptive signs of pregnancy

A 
Subjective
Amenorrhea
Nausea and vomiting
Fatigue
Urinary frequency
Breast changes
Quickening
24
Q

Probable signs of pregnancy?

A 
Objective Signs
Goodell’s sign
Chadwick’s sign
Hegar’s sign
McDonald’s sign
Abdominal enlargement
Braxton Hicks contractions
Ballottement/fetal outline
Abdominal striae
Positive pregnancy test
25
Q

Positive signs of Pregnancy?

A 
Can only be attributed to fetus
Fetal Heart (FH) auscultation
Fetal movement and palpation noted by provider
Ultrasound (US) visualization
Positive FH noted at 4-8 weeks
26
Q

How to calculate Naegeles rule

A

Calculate estimated due date (EDD)
28-day cycle
Subtract 3 months from first day of LNMP-last normal menstrual period
Add 7 days
Don’t forget to change the year when needed
Important in the accuracy of Naegele’s rule
Regularity of periods
Length of menstrual cycle

27
Q

Name the trimesters

A

Pregnancy is divided into 3 periods
1st trimester -> First day of LMP through 14 weeks
2nd trimester –> 15 through 28 weeks
3rd trimester -> 29 through 40 weeks

Most births are within 3 weeks before or 2 weeks after EDD
(37-42 weeks = term gestation)

28
Q

Calculation of Gravida and para

A 
GTPAL
G = Number of times pregnant
Para = Births after 20 weeks gestation
T =  Number of term births
P= Number of pre-term births
A = Number of abortions
L= Number of children currently living
29
Q

Never been pregnant

A

Nulligravida

30
Q

Pregnant for the first time

A

Primigravida

31
Q

Pregnant two or more times

A

Multigravida

32
Q

Types of nutrition needed in pregnancy?

A 
Fruits
Vegetables 
Folic Acid
Lean Protein
Whole Grains
Healthy  Fats
Iron
Water
Prevent Food-borne Illnesses
33
Q

Factors Influencing proper Nutrition?

A 
Culture
Age
Nutritional knowledge
Nutritional risk factors
Socioeconomic status
Lifestyle
Adolescence
Vegetarianism
Lactose intolerance
34
Q

When to have prenatal visits?

A 
Prenatal Visits
Uncomplicated Pregnancies
Conception 28 wk….Every 4 weeks
29 wk  36 wk……………. Every 2-3 weeks
37 wk Birth…………… Every 1 week
Goals
Maintain maternal/fetal health
Accurate determination of gestational age
Implement appropriate interventions
Build rapport
35
Q

What to look for on first assessment?

A 
History – Initial visit
OB
Menstrual
Contraceptive
Medical And Surgical
Family Health
Psychosocial Health
36
Q

What are the initial labs to be taken in pregnancy?

A 
CBC
Blood Grouping
Rh Factor And Antibody Screen
VDRL
Rubella Titer
Genetic screening
Sickle cell
Tay-Sachs
Hepatitis B Antigen
HIV
PPD
Urinalysis
Urine C & S
Pap Smear
Cervical Cultures (GC & Chlamydia)
37
Q

What to be done during return assessment?

A 
Vital Signs (Blood pressure)
Weight
25-35 lb. average wt. gain recommendation 
Urinalysis Protein, Glucose, Ketones
1-hour Glucola 24-28 Wks. (Screen)
Group-B Strep Culture 35-37 weeks
HIV (3rd Trimester)
Fundal Height
Leopold’s Maneuvers

Nursing 120 exam 4 (3 decks)

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