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Nursing 3 Exam 1 > Unit 2 Pregnancy/Antepartum > Flashcards

Unit 2 Pregnancy/Antepartum Flashcards

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1
Q

What does TPAL stand for?

A

Term babies
Premature babies
Aborted babies
Living Children

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2
Q

What are Presumptive Pregnancy Signs?

A 
Breast Changes
Amenorrhea (without period)
Nausea
Vomitting 
Urinary Frequency 
Elevation of BBT
Fatigue
Quickening
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3
Q

What are Probable Pregnancy Signs?

A 
Goodell's Sign
Chadwick's Sign
Hegar's Sign
Positive Pregnancy Test
Uterine enlargement 
Uterine souffle 
Braxton Hicks contractions 
Ballottement
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4
Q

What is Goodell’s Sign?

A

Cervix becomes soft

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5
Q

What is Chadwick’s Sign?

A

Deep bluish purple color in uterus/cervix.

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6
Q

What is Hegar’s Sign?

A

Distinct feeling of upper & lower area in uterus

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7
Q

What is Uterine souffle?

A

Pulse rate in the uterus that equals woman’s heart

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8
Q

What are Braxton Hick’s?

A

8th or 9th month practice contractions

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9
Q

What is Ballottement?

A

Embryo bounces up when two fingers are taped into uterus.

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10
Q

What are Positive signs of pregnancy?

A

Visualization of fetus by ultrasound
Fetal heart tones detected by ultrasound examination
Fetal movements palpated
Fetal movements visible

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11
Q

Bigger weight babies usually come from whom?

A

Diabetics

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12
Q

Blood Volume is increased by how much during pregnancy?

A

30-50%

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13
Q

Getting pregnant just getting off birth control can cause what?

A

Twinning effect

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14
Q

At the following weeks where should the fundus be?

10-12 weeks
16 weeks
20 weeks
28 weeks
36 weeks
A

10-12: slightly above symphysis
16 weeks: halfway between symphysis and umbilicus
20 weeks: at umbilicus
28 weeks: three finger breaths above umbilicus
36 weeks: just below ensiform cartilage (xyphoid process)

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15
Q

What is the fundus?

A

top of the uterus

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16
Q

Because of the increased blood volume during pregnancy what do you want to promote and why?

A

Hydration to prevent premature labor and dehydration.

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17
Q

A measurement from the top of the symphysis pubis to the top of the fundus suggests what?

A

Weeks of gestations,

Ex: 28cm would be 28 weeks.

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18
Q

Describe fetal heartbeat at the following weeks:
10-12 weeks
17-20 weeks
20 weeks

A

10-12: heard with a doppler
17-20: heard with a stethoscope
20: can palpate fetal movements (20 weeks is known at period of viability for fetus)

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19
Q

What is the fetal HR?

A

120-160

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20
Q

When can quickening be felt?

A

Around 20 weeks

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21
Q

What is the optimal pelvis for pregnancy?

A

Gynecoid (heart shaped)

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22
Q

What is done during pelvic exam?

A
  • External and internal genitals evaluated
  • Pap obtained
  • Gonorrhea culture and chlamydia screen
  • Chadwick’s and Goodell’s Sign
  • Uterine size evaluated if appropriate for length of gestation
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23
Q

What is the purpose of an initial assessment during pregnancy?

A

To evaluate the mother for and complication from a possibility of issues such as:

  • Diabetes ( bigger babies )
  • Smoking (premature babies)
  • High blood pressure
  • Breast cancer
  • Cardiovascular disease
  • etc
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24
Q

How is pregnancy due date calculated?

A

FIRST day of the woman’s last menstrual period, count back 3 months and add 7 days.

(Pregnancy last 40 weeks/9 months)

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25
Q

At birth babies lose what percent of their body weight?

A

10%

26
Q

What are premature babies especially at risk for because of their low birth weight?

A

Neurological defects

27
Q

How many weeks is considered early premature? late premature? term? postmature?

A

Early premature- 21 weeks-33 weeks
Late premature- 34-37 weeks
Term- 38-40 weeks
Postmature- 41-43 weeks

28
Q

What does viability mean?

A

Ability to survive

29
Q

Regarding term babies (38-40 weeks) what are the different size categories and weights associated with them?

A

LGA (Large for Gestational Age) >8 lbs.
SGA (Small for Gestational Age) <5 lbs.
AGA (Appropriate for Gestational Age) 6.5-8 lbs

30
Q

What should the frequency of prenatal visits be?

A

Every 4 weeks for the first 28
Every 2 weeks to 36
Every week there after until birth

31
Q

What should the weight gain be for women during pregnancy?

A

3.5-5 lbs for the first three months then 1 lbs per week

32
Q

If Hgb is low, around 8-10, what would be an appropriate intervention?

A

Fluids and Iron

33
Q

What cardiac issues could older mothers experience in labor?

A

MI and cerebral bleeds

34
Q

When are MSAFP (Maternal serum alpha fetal protein) be taken and what do low or high levels result in?

A

Between 15-22 weeks

Low levels result in Down Syndrome
High levels result in Neural tube(spinal cord) defects

35
Q

In the first trimester what are signs of POTENTIAL complication and what do the complications refer too?

A

Severe vomiting- Hyperemesis gravidarum(Condition of severe vomiting)

Chills, fever, burning on urination- Infection

Abdominal cramping and vaginal bleeding- Miscarriage

36
Q

In the second and third trimester what are signs of POTENTIAL complications and what do they refer too?

A

Sudden discharge of vaginal fluid- Premature Rupture of Membrane

Glycosuria- Gestational diabetes

Vaginal bleeding/severe abdominal pain- Placenta previa or abruption or miscarriage

Severe backache or flank pain- Kidney infection or stones

Change in fetal movements- Intrauterine fetal death

Visual disturbances, swelling of face, headaches, muscular irritability, epigastric pain—-Hypertensive
conditions:
preeclampsia or eclampsia

37
Q

Describe briefly life in the trimesters.

A

First trimester primary organ development happens, open for insult by teratogens

Second trimester- morning sickness passes and quickening occurs

Third trimester- increasing weight and physical and psychological changes

38
Q

What is considered the pacemaker of the uterus?

A

the fundus

39
Q

What is the fundus referred to after delivery?

A

FF@U

Fundus Firm At Umbilicus

40
Q

Describe the cervix is pregnancy.

A
  • feels like cartilage in your nose, softens and shortens to feel like the lobe of your ear
  • the softening is known as Goodell’s Sign and the increased blood flow as Chadwick’s Sign (blue in color)
  • Mucous plug is formed and acts as a barrier to ascending infection
  • Cervix in labor will dilate the width of five fingers or ten centimeters (each finger tip is equal to 2 cm.)
41
Q

Describe the breasts during pregnancy.

A
  • Based on pigmentation: nipples darken
  • Breasts enlarge
  • Colostrum(first milk) production produced by week 12 as preparation for breast feeding
  • Colostrum is the precursor of human milk and contains newborns immunity base
42
Q

Describe the respiratory system during pregnancy.

A

Hyperventilation increases
Tidal volume increases
Diaphragm is elevated
Breathing changes to thoracic

43
Q

What simple intervention associated with blood volume can help stop premature labor?

A

hydration

44
Q

Describe the cardiovascular system during pregnancy.

A
  • By 20-24 weeks cardiac output increases 30 to 50 percent
  • Pulse rate increases
  • Blood pressure slightly decreases by second trimester and is near pre-pregnant levels at term

-WBC level increases to 11,000-12,000, during labor even up to 25,000

45
Q

What is vena cava syndrome or supine hypotensive syndrome and how is it corrected?

A

Pressure of enlarging uterus blocks blood return to the heart and causes fainting

Place woman on side, or lie with a wedge under right hip

46
Q

Describe the gastrointestinal system in pregnancy.

A
  • Nausea is common, vomiting occasionally
  • Ptysalism (excessive salivation)
  • Intestines and stomach displaced by uterus
  • Relaxed cardiac sphincter leads to heartburn
  • Delayed gastric emptying leads to constipation
  • Hemorrhoids

Try to think obstruction as in any medical patient obstruction leads to nausea, vomiting, constipation

47
Q

What should a pregnant woman not take when constipated and why?

A

Laxative because it will induce labor

48
Q

Describe the Urinary System during pregnancy.

A
  • Increased pressure on the bladder from the uterus leads to urinary frequency
  • Incidence of glycosuria increases which may be normal or may indicate gestational diabetes
  • Focus on no white products and no juices
  • UTI’s left untreated will induce premature labor
49
Q

What is an appropriate suggestion for early morning sickness?

A

Eat a dry carbohydrate, such as crackers, before arising

50
Q

What are ways to reduce heartburn in pregnancy?

A

Eat small frequent meals
Avoid spicy or greasy food
Refrain from laying down immediately after eating
Use low sodium antacids

51
Q

What is PICA and what does it cause?

A

Abnormal eating of foods such as clay and it creates anemia resulting in SGA (small for gestational age babies)

52
Q

What are ways to treat constipation in pregnancy?

A

Increase fluid and fiber
Exercise in moderation
Use stool softners ex: docusate (Colace)
NO LAXATIVES ex: polyethylene glycol (Murilax)

53
Q

What can Hemorrhoids be treated?

A

Ice
Sitz bath
Apply topical anesthetics

54
Q

What are suggested exercises during pregnancy?

A

Swimming
Yoga
Avoid heavy lifting

55
Q

What are interventions for varicose veins?

A

Elevate legs
Support stockings
Avoid crossing legs and standing for long perioids

56
Q

What is the recommended weight gain during pregnancy?

A

25-35 lbs
First three months 3.5-5lbs then 1 pound per week
(need only 300 extra calories)

Inadequate is 2.2lbs per month
Excessive is 6.6lbs per month

57
Q

What is nutrient is known to prevent spinal cord deviations in the newborn?

A

Folic acid

58
Q

What is a bad triple screen level and what can it contribute too?

A

low level, down syndrome and other chromosome defects

59
Q

What is the purpose of the diagonal conjugate?

A

to measure the width of the pelvis, it is measured by the symphisis pubis to the sacral promintary

60
Q

What can hypertension in pregnancy lead to?

A

preeclampsia, eclampsia

61
Q

What can hypertension in pregnancy lead to?

A

preeclampsia, eclampsia

62
Q

what is folic acid important for during pregnancy?

A

nueral tube development

Nursing 3 Exam 1 (8 decks)

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