Unit VIII - Antepartum (Prenatal) Flashcards
1
Q
Maternal Childcare Book - Chapter 6
What does GTPAL stand for?
A
The number of pregnancies:
G = Gravida (Amount of pregnancies) T = Term pregnancy P = Preterm A = Abortion L = Live birth
2
Q
Maternal Childcare Book - Chapter 6
Define gravida
A
Number of pregnancies, including present pregnancy
3
Q
Maternal Childcare Book - Chapter 6
Define Para
A
Number of deliveries after a viable age (after 24 weeks’ gestation), including infants born alive and stillborn infants.
4
Q
Maternal Childcare Book - Chapter 6
Define Preterm
A
A delivery after 24 weeks’ gestation but before 38 weeks’ gestation.
5
Q
Maternal Childcare Book - Chapter 6
Define Term
A
A pregnancy between 38 and 42 weeks’ gestation.
6
Q
Maternal Childcare Book - Chapter 6
Define Postterm
A
A delivery after 42 weeks’ gestation.
7
Q
Maternal Childcare Book - Chapter 6
Define Abortion
A
Loss of pregnancy prior to viable age (usually 24 weeks.
8
Q
Maternal Childcare Book - Chapter 6
Define Nulligravida
A
Never pregnant
9
Q
Maternal Childcare Book - Chapter 6
Define Nullipara
A
Never delivered an infant after 24 weeks’ gestation.
10
Q
Maternal Childcare Book - Chapter 6
Define Primagravida
A
First pregnancy
11
Q
Maternal Childcare Book - Chapter 6
Define Primapara
A
First delivery after 24 weeks’ gestation
12
Q
Maternal Childcare Book - Chapter 6
Define Mutligravida
A
Delivered two more more times after 24 weeks’ gestation
13
Q
Maternal Childcare Book - Chapter 6
What does GP/TPAL
A
Gravida, Para/Term, Preterm, Abortion, Live birth
14
Q
Maternal Childcare Book - Chapter 6
A highly vascular organ connecting the mother and the fetus is called the
A
placenta
15
Q
Maternal Childcare Book - Chapter 6
What does gestation mean?
A
Fetal development
16
Q
Maternal Childcare Book - Chapter 6
Define viability
A
The fetus’ ability to live outside of the uterus, usually 24 weeks (according to the Maternity Book)
17
Q
Maternal Childcare Book - Chapter 6
What are presumptive signs of pregnancy?
A
PreSUmptive = SUbjective signs (what mother experiences)
- Amenorrhea (absence of menses)
- Nausea & Vomiting
- Breast tenderness
- Urinary Frequency
- Quickening
18
Q
Maternal Childcare Book - Chapter 6
What is quickening? When does it occur?
A
A fluttering sensation felt as the fetus moves. The sensation begins between 16 and 22 weeks.
19
Q
Maternal Childcare Book - Chapter 6
What are the probable signs of pregnancy?
A
PrOBable = OBjective
- Goodell’s Sign
- Chadwick’s Sign
- Hegar’s Sign
- Abdominal enlargement
- Braxton-Hicks
- Ballottement
- Striae gravidarum
- Positive Pregnancy Test
20
Q
Maternal Childcare Book - Chapter 6
What is Goodell’s sign?
A
Softening of the cervix
HINT: Soft cervix is “GOOD”
21
Q
Maternal Childcare Book - Chapter 6
What is Chadwick’s sign?
A
A bluish-purple discoloration of the cervix, vulva and vagina
22
Q
Maternal Childcare Book - Chapter 6
What is Hegar’s Sign?
A
Softening of the lower uterine segment.
23
Q
Maternal Childcare Book - Chapter 6
What are Braxton-Hicks?
A
Painless irregular contractions that do not dilate the cervix and usually goes away after walking.
24
Q
Maternal Childcare Book - Chapter 6
What is Ballottement?
A
When the examiner pushes against the cervix/uterus and the fetus rebounds against the fingers.
25
Maternal Childcare Book - Chapter 6
What positive signs of pregnancy?
* Audible FHR (normal s/b 120-160 BPM
* Fetal movement felt by examiner
* Visualization of fetus via ultrasound
26
Maternal Childcare Book - Chapter 6
How many arteries and veins are in the umbilical cord?
2 Arteries
| 1 Vein
27
Maternal Childcare Book - Chapter 6
Name the hormones that are produced by the placenta
Human placenta lactogen (hPL)
Estrogen
Progesterone
Relaxin
28
Maternal Childcare Book - Chapter 6
What is the function of human placental lactogen (hPL)?
It stimulates changes in maternal metabolism. This change makes protein, glucose, and minerals that are readily available to the fetus.
Increased levels prepares the mother's body for lactation.
29
Maternal Childcare Book - Chapter 6
What is the function of progesterone?
Prevents uterine contractions.
30
Maternal Childcare Book - Chapter 6
What is the function of relaxin?
Causes softening in the collagen connective tissue of the symphysis pubis and sacroiliac joints.
31
Maternal Childcare Book - Chapter 6
What is Wharton's jelly?
It is white gelatinous tissue that makes up the umbilical cord. It protects and supports the arteries in veins of the umbilical cord.
32
Maternal Childcare Book - Chapter 6
What happens when Wharton's jelly comes in contact with air following delivery?
It contracts, clamping the blood vessels to prevent bleeding.
33
Maternal Childcare Book - Chapter 6
What is meconium? What is made from?
It is the first fetal stool made from amniotic fluid, bile, and epithelial cells. It is passed after delivery.
Passage prior to delivery signals some type of fetal distress.
34
Maternal Childcare Book - Chapter 6
When can you determine the sex of the fetus?
In the 12th week of development when the external male and female genitalia can be identified.
35
Maternal Childcare Book - Chapter 6
What is the normal fetal heart rate range?
120-150 bpm
36
Maternal Childcare Book - Chapter 6
When can the fetal heart rate be heard?
By 10 to 12 months
37
Maternal Childcare Book - Chapter 6
When can the fetal movement be felt by the examiner
By the 20th week.
38
Maternal Childcare Book - Chapter 6
Why is there an increase in WBCs in pregnant women. When does this increase occur?
The fetus is considered a "foreign" object; therefore, WBCs increase.
This occurs in the 2nd trimester.
39
Maternal Childcare Book - Chapter 6
Explain hyperemesis gravidarum.
It is prolonged vomiting that leads to dehydration and electrolyte imbalance.
40
Maternal Childcare Book - Chapter 6
Why does morning sickness occur?
From an increase of progesterone (the hormone that prevents uterine contractions)
41
Maternal Childcare Book - Chapter 6
What is supine hypotension as related to pregnancy? When does it occur.
It is when the heavy uterus presses on the inferior vena cava when a pregnant woman lies supine.
Occurs after the 20th weeks.
42
Maternal Childcare Book - Chapter 6
What are the signs and symptoms of supine hypotension?
* low blood pressure
* dizziness
* pale skin
43
Maternal Childcare Book - Chapter 6
In order to prevent supine hypotension, what position should the nurse encourage the expecting mother to lie?
On her left side for greater blood return.
44
Maternal Childcare Book - Chapter 6
What is the "mask of pregnancy". Where is it located?
Chloamsa. It is the darkening of the forehead, cheeks, and area around the eyes.
45
Maternal Childcare Book - Chapter 6
What is striae gravidarum?
Stretch marks.
46
Maternal Childcare Book - Chapter 6
What is a nonstress test (NST)?
Used to assess fetal movement and FHR.
47
Maternal Childcare Book - Chapter 6
What is a reactive or normal nonstress test (NST)?
When fetal movement consists of a FHR increase of 15 bpm lasting for 15 seconds. Two episodes occur in a 20-minute period.
48
Maternal Childcare Book - Chapter 6
What is a biophysical profile? What variables does it assess?
A test that assesses for fetal breathing, fetal movement, fetal tone, amniotic fluid volume, and fetal reaction.
A combination of ultrasound and nonstress test are used.
49
Maternal Childcare Book - Chapter 6
Which of the following substances produced by the placenta prevents uterine contractions?
A. human placental lactogen
B. human chorionic gonadotropin
C. progesterone
D. relaxin
C. progesterone
50
Maternal Childcare Book - Chapter 6
Which of the following statements about fetal circulation are true? Circle all that apply.
A. The fetal respiratory system oxygenates blood.
B. The ductus ateriosus is located inside the heart.
C. Osmosis is the means of blood exchange between placenta and fetus
D. The umbilical cord contains two arteries and one vein.
E. The fetal blood and maternal blood do not mix.
C. Osmosis is the means of blood exchange between placenta and fetus
D. The umbilical cord contains two arteries and one vein.
E. The fetal blood and maternal blood do not mix.
51
Maternal Childcare Book - Chapter 6
The nurse working with a pregnant woman who was eating a well-balanced diet prior to pregnancy will advise the woman to:
A. Make no changes in her diet.
B. Add two milk and one meat servings.
C. Add two vegetable and one fruit servings.
D. Decrease the amount of carbohydrates.
B. Add two milk and one meat servings.
52
Maternal Childcare Book - Chapter 6
The nurse working with a pregnant woman in the last trimester, will advise the woman to sleep on her side mainly to:
A. relieve pressure on the bladder.
B. relieve pressure on the fetus
C. facilitate sleep.
D. prevent hypotension.
D. prevent hypotension.
53
Maternal Childcare Book - Chapter 6
The earliest the nurse will be able to hear the fetal heart tones by using a Doppler is by week number:
A. 2
B. 6
C. 10
D. 20
C. 10
54
Maternal Childcare Book - Chapter 6
You are trying to determine the estimated date of delivery for a client whose last menstrual period began on May 6 and ended on May 11. The estimated date of delivery using Naegele's rule is which of the following dates in February
A. 6
B. 11
C. 13
D. 18
B. 11
55
Maternal Childcare Book - Chapter 6
Maria, a 17-year-old single woman, is 12 weeks pregnant. She says to the nurse, "I don't want to be pregnant. HOw can I take care of a baby and still do all the things I want?" The nurse should reply,
A. "I can make you an appointment for an abortion."
B. "You should have thought about that before you had unprotected sex."
C. "How can I help you problem solve what will be best for you?"
D. "You should contact a lawyer who handles adoption."
C. "How can I help you problem solve what will be best for you?"
56
Maternal Childcare Book - Chapter 6
Jaunita, 32 weeks pregnant, comes to the office stating the baby has not been moving as much as usual. All of the following must be assessed. Place them in priority order.
```
A. Report findings to the doctor.
B. Take Jaunita's vital signs.
C. Measure Juanita's weight.
D. Listen to the FHT.
E. Check Juanita's urine for glucose and protein.
```
B. Take Jaunita's vital signs. (must establish a baseline)
D. Listen to the FHT.
C. Measure Juanita's weight.
E. Check Juanita's urine for glucose and protein.
A. Report findings to the doctor.
57
Maternal Childcare Book - Chapter 6
Nancy, 34 weeks pregnant calls the clinic at 4:30 pm to say that she has had a severe headache all day. She is experiencing some blurred vision and her feet are swollen. She aks the nurse what she should do. The nurse should respond,
A. "Take two Tylenol q4h and stay in bed until your office appt. next week."
B. "Go to the hospital to be checked."
C. "Come to the office at 10:00 tomorrow morning."
D. "Call back in 30 minutes when the doctor can talk with you."
B. "Go to the hospital to be checked."
58
ATI Maternal Newborn Nursing Book - Chapter 2
A nurse is a provider's office is caring for a client who requested a pregnancy test. She states that her last menstrual was on April 8. The result of the test is positive. She has been pregnant two other times, delivering a newborn at term who is now 4 years old, and had one miscarriage at 12 weeks.
Using Nagele's rule, what is the estimated date of birth (EDB)?
January 15
59
ATI Maternal Newborn Nursing Book - Chapter 2
A nurse is a provider's office is caring for a client who requested a pregnancy test. She states that her last menstrual was on April 8. The result of the test is positive. She has been pregnant two other times, delivering a newborn at term who is now 4 years old, and had one miscarriage at 12 weeks.
Identify the client's obstetrical history using the GTPAL method
```
G-3
T-1
P-0
A-1
L-1
```
60
ATI Maternal Newborn Nursing Book - Chapter 2
A nurse is caring for a woman during a prenatal visit. The client is lying supine and suddenly reports feeling breathless. Which of the following findings should the nurse expect if the client is experiencing supine hypotension? (Select all that apply.)
```
A. Dizziness
B. Damp, cool skin
C. Facial flushing
D. Increased heart rate
E. Nausea
```
A. Dizziness
B. Damp, cool skin
D. Increased heart rate
E. Nausea
61
ATI Maternal Newborn Nursing Book - Chapter 2
A nurse is working in a prenatal clinic. When and to whom should the nurse expect to administer Rho(D) immune globulin (RhoGAM) IM?
When the mother is Rh-Negative. It should be administered at 28 weeks' gestation, then again within 72 hours after delivery, if the baby is Rh-Positive
62
ATI Maternal Newborn Nursing Book - Chapter 2
A client who is pregnant should promptly report which of teh following symptoms to the provider?
A. Vaginal bleeding
B. Swelling of the ankles
C. Heartburn after eating.
D. Faintness when lying on back
A. Vaginal bleeding
63
ATI Maternal Newborn Nursing Book - Chapter 2
A nurse is planning to obtain initial routine laboratory tests for a pregnant client at 8 weeks gestation. Which of the following should the nurse anticipate collecting at a prenatal visit?
A. Beta strep culture
B. Maternal serum alpha-fetoprotein
C. One-hour glucose tolerance
D. Venereal disease research laboratory
D. Venereal disease research laboratory
64
ATI Maternal Newborn Nursing Book - Chapter 2
A nurse is reinforcing teaching to a group of pregnant women regarding common discomforts during pregnancy. Which of the following occur during the first and third trimesters? Select all that apply.
```
A. Urinary frequency
B. Heartburn
C. Dysuria
D. Fatigue
E. Headaches
```
A. Urinary frequency
B. Heartburn
D. Fatigue
65
ATI Maternal Newborn Nursing Book - Chapter 3
A nurse is working in a prenatal clinic is providing education to a client who is pregnant. The client does not like milk. Which of the following is a good source of calcium that the nurse can recommend to the client?
A. Artichokes
B. Sweet potatoes
C. Apricots
D. Turnip greens
D. Turnip greens
66
ATI Maternal Newborn Nursing Book - Chapter 3
A nurse is reinforcing nutritional education to a client. Which of the following statements made by the client indicate a need for further teaching?
A. “I will drink 2 to 3 liters of fluid daily.”
B. “It is important to consume 600 mcg of folic acid each day.”
C. “I should eat an additional 300 calories per day in my third trimester.”
D. “My protein intake should be around 50 g each day during my pregnancy.”
C. “I should eat an additional 300 calories per day in my third trimester.”
Rationale:
Caloric needs increase during the third trimester by 452 calories/day. Therefore, this statement requires additional teaching.
67
ATI Maternal Newborn Nursing Book - Chapter 3
A nurse is reinforcing teaching with a pregnant client who is diagnosed with iron deficiency anemia and has been prescribed iron supplements. Which of the following statements made by the client indicates an understanding of the teaching?
A. “I will take the iron with ice water.”
B. “I will drink low-fat or whole milk with my iron.”
C. “I should drink tea or coffee with my medication.”
D. “I should take the medication with orange juice.”
D. “I should take the medication with orange juice.”
Rationale:
Orange juice contains vitamin C, which aids in the absorption of iron. Milk and caffeine inhibit or interferes with iron absorption. Water will not help with the absorption of iron.
68
ATI Maternal Newborn Nursing Book - Chapter 4
A nurse is aware that a Doppler ultrasound blood flow analysis is useful in which of the following situations? (Select all that apply)
```
A. Intrauterine growth restriction
B. Maternal hypertension
C. Poor placenta perfusion
D. Hyperemsis gravidarum
E. Multiple fetuses
```
A. Intrauterine growth restriction
B. Maternal hypertension
C. Poor placenta perfusion
E. Multiple fetuses
69
ATI Maternal Newborn Nursing Book - Chapter 4
A nurse in an antepartum clinic is review the medical record of a client who is in preterm labor and has undergone an amniocentesis. She also had fetal lung maturity testing to determine if her fetus will develop respiratory distress. Which of the following is a test for fetal lung maturity?
A. Alpha fetoprotein
B. Lecithin/sphingomyelin ratio
C. Kleiheuer-Betke test
D. Indirect Coombs' test
B. Lecithin/sphingomyelin ratio
70
ATI Maternal Newborn Nursing Book - Chapter 4
A nurse determines that client who is pregnant needs further instructions about an amniocentesis when the client states:
A. "I must report cramping or signs of infection to the physician."
B. "I should drink lots of fluids for the next 24 hr following the procedure."
C. "I need to have a full bladder for the procedure to be done."
D. "I know that the amniotic fluid can be tested to detect for genetic abnormalities."
C. "I need to have a full bladder for the procedure to be done."
71
ATI Maternal Newborn Nursing Book - Chapter 4
A nurse is aware that an ultrasound may be prescribed for which of the following indications?
```
A. Questionable rupture of the membranes
B. Vaginal bleeding
C. Uterine contractions
D. Preterm labor
E. Decreased fetal movement
```
A. Questionable rupture of the membranes
B. Vaginal bleeding
D. Preterm labor
E. Decreased fetal movement
72
ATI Maternal Newborn Nursing Book - Chapter 4
Which of the following findings from a client who is pregnant should indicate t the nurse that the client should undergo an amniocentesis? (Select all that apply)
A. Maternal age greater than 35 years old.
B. Previous birth with a chromosomal anomaly.
C. A family history of neural tube defects
D. Lung maturity assessment
E. Abruptio placentae
A. Maternal age greater than 35 years old.
B. Previous birth with a chromosomal anomaly.
C. A family history of neural tube defects
D. Lung maturity assessment
73
ATI Maternal Newborn Nursing Book - Chapter 4
Explain how to interpret a reactive nonstress test.
The FHR accelerates to 15/min for at least 15 seconds and occurs two more times during a 20 minute period.
74
Antepartum Powerpoint
What is placenta previa?
It is when the placenta grows over the opening of the uterus (cervix)
75
Antepartum Powerpoint
What is Pregnancy Induced Hypertension (PIH) (preeclampsia, eclampsia)? What can it lead to?
It is high blood pressure and proteinuria. It can lead to a full blown seizure
76
ATI Skills Module: Maternal Newborn Care
A nurse is assessing a patient who is at 20 weeks gestation. She instructs the patient to be sure to report headaches, blurred vision, and swelling of her hands because these are indications of which of the following complications of pregnancy?
A. Gestational diabetes
B. Preeclampsia
C. Hyperemesis gravidarum
D. Abrutio placentae
B. Preeclampsia
77
ATI Skills Module: Maternal Newborn Care
A nurse is assessing a patient at a routine antepartum visit. For a rough estimate of the number of gestational weeks the patient is at, the nurse should measure the number of cm between which two anatomical landmarks?
A. The mons pubis and the xiphoid process
B. The top of the fundus and the umbilicus
C. The symphysis pubis and the top of the fundus
D. The mons pubis and the umibilicus
C. The symphysis pubis and the top of the fundus
