Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NURS ADN004 Maternity > Week 2 Chapters 11 and 12 > Flashcards

Week 2 Chapters 11 and 12 Flashcards

1
Q

Pregnant woman and number of pregnancies incurred regardless of length or outcome

A

Gravida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Viable outcomes of pregnancy described as term, preterm, and living

A

Parity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Fetal loss before the age of viability, either spontaneous or therapeutic

A

Abortion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Woman pregnant for the first time

A

Primigravida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Woman who has been pregnant two or more times

A

Multigravida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Woman who has been pregnant for 5 or more times and delivered all

A

Grand Multipara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Woman who has never given birth to a viable fetus

A

Nullipara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Woman who has given birth to one viable fetus

A

Primipara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Woman who has given birth to two or more viable fetuses

A

Multipara

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

GTPAL

A

G: Refers to number of pregnancies
T: Number of term deliveries for this patient
37-42 weeks
P: Preterm Delivery 22- 36 weeks
A: Number of aborted gestations for this patient @ 1-21 weeks(includes elective terminations, ectopic pregnancies)
L: Living children

  • Deliveries refers to the number of times a patient delivers, not the number of infants delivered at a time, if a patient deliver twins

ex: 1 delivery, 2 living children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

EDC is calculated by taking the first day of the LMP, subtracting 3 months and adding 7 days

A

Nagele’s Rule

Term Pregnancy= 40 weeks from LMP

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

_______________________ can be used to calculate the due date. Use it by, place the last “menses” arrow on the date of the woman’s LMP. Then read the EDB at the arrow labeled 40.

A

EDB Wheel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

1 to 12 weeks is

A

1st Trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

13 to 28 weeks

A

2nd Trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

29-40 weeks is

A

3rd Trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Initial Prenatal Visit

A

Assessment
S/S of Pregnancy
History
Personal Traits
Habits
Lab Data
Physical Assessment
Psychological Assessment
Sociological Assessment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Changes felt by the woman; amenorrhea, nausea and vomiting, fatigue, breast tingling

A

Presumptive Signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Signs observed by the examiner, Hegar’s sign, Chadwick’s sign, ballottement, pregnancy tests

A

Probable Signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Signs attributed to fetal presence; audible fetal heart tones, visualization of fetus by US, palpation of fetal movement by a trained practitioner

A

Positive Signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Bluish- purple coloration of the vaginal mucosa and cervix

A

Chadwick Sign

  • Sign of Pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Softening of the cervix

A

Goodell Sign

  • Sign of pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Softening of the lower uterine segment or isthmus

A

Hegar Sign

  • Sign of pregnancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Postural changes during pregnancy does occur by what?

A

Increasing lordosis of the lumbosacral spine and increasing curvature of the thoracic area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Softening of the isthmus of the uterus, can be determined by the examiner during a vaginal examination

A

Hegar’s Sign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Visits are generally monthly for the first what?

A

28-30 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Visits at least twice a month is done at what weeks?

A

30-32 weeks and until 35 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

35-36 weeks, visits are done ?

A

Weekly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

High risk pregnancies generally have more frequent visits, and may be seen weekly or twice weekly depending upon the problems.

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

High risk pregnancies may be followed by antepartum testing, weekly or biweekly, depending upon the problem and the severity of the complication.

A

True

Information is collected at each visit and recorded on the prenatal record

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

11-13% mg measurement of oxygen carrying ability of RBC

A

Hemoglobin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

35-40% mg measurement of RBC concentration

A

Hematocrit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Done to identify possible maternal- fetal incompatibilities and identifications for the possible transfusion after delivery

A

Blood Types

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Measurement of a protein factor( D antigen) on RBC

A

Rh factor Positive or negative

rh negative clients need RhoGAM shot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Measurement of Blood Group related antibodies in a random sample, examples are antibodies

Positive finding could indicate fetal RBC hemolysis

Normal is negative

A

Antibody Screen
Indirect Coombs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Titer will indicate immunity to rubella

A

> 1:10, Rubella

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Various tests to measure syphilis

Normal is negative

A

Serology
VDRL
RPR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Negative surface for antigen

Measure for infectious hepatitis b; presence of antibody but no antigen indicates prior disease but not currently infections

A

Hep B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Measures presence of gonnorhea done from vaginal/cervical secretions

Normal negative

A

GC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Measure of a sexually transmitted disease which can cause neonatal pneumonia and eye infections

Normal is Negative

A

Chlamydia Culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Measurement of normal morphology of cervical cells and may see Class II during pregnancy

Normal is Class I

A

Pap Smear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Positive levels of GBS may cause neonatal sepsis and contribute to neonatal mortality

Prophylactic antibiotics are used in labor to decrease neonatal susceptibility. Neonate may not be dismissed from nursery until after 48 hours and may require lab work

A

Group B Strep

Normal is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Positive during pregnancy

Measurement of HCG which should only be present in a pregnant individual

A

Urine Pregnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Negative for
Glucose
Ketones
Protein
Blood

A

Urinalysis

Measure of serum glucose level, possible diabetes
Measurement of cellular nutrition
Measurement of renal function, PIH
Measurement of renal function, bleeding, infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Blood test done between 15 and 20 weeks of gestation to determine presence of neural tube defects (High Value) or Down’s Syndrome ( Low Value)

A

AFP

Normal is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Measurement of exposure of TB or active disease

If positive, may be followed by X RAY

A

TB Skin Test

Normal is negative

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Normal is lower than norm standards

Testing for gestational diabetes; measures of blood sugar after measurable glucose level

A

Glucose Tolerance Testing

Normal is lower than norm standards

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Use of sound waves to and resultant echo detect and measure objects

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Obstetrical Use

A

1st Trimester- Number, size, and location of gestational sacs, fetal cardiac and body movement, uterine and/ or adnexal mass, pregnancy dating (BPD, crown- rump length)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Fetal growth, age and viability fetal anomalies/ amnio amniotic fluid volume, uterine and/ or adnexal anomalies, placental location and maturity, biophysical profile

A

2nd Trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Fetal growth, age and viability, fetal anomalies, uterine and/ or adnexal anomalies, placental location and maturity, biophysical profile ( w/ AFI), lung maturity ( amniocentesis)

A

3rd Trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Involves a transabdominal puncture of the amniotic sac to obtain a sample of amniotic fluid for analysis

A

Amniocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

When is amniocentesis performed?

A

Second trimester usually between 15 and 20 weeks gestation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Increases of 20 weeks usually for

A

Fetal Lung Maturity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Scanning permits visualization of the fetus in the utero

A

Ultrasound

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Inform patient of procedure and consent if needed

Patient needs full bladder for placenta location

Position supine with head pillow and hip bump

Allow patient to watch and provide explanation
Point out fetus and fetal parts
Assist to sitting position
Assist to restroom as soon as possible

A

Nursing Interventions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

Prenatal Nursing Assignments Include

A

History
Interviewing techniques
Determination of EDC
Menstrual History
Obstetrical History
Family History
Medical- Surgical History
Personal Traits

Habits
- Smoking
- Caffeine
- Alcohol
- Cocaine
- Heroin
- Methamphetamine

Laboratory Data
- Pregnancy testing
- Screening and diagnostic tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Physical Assessment
- Physiological adaption of pregnancy
- Physical Exam
- Pelvic Exam
- Nursing Role
- Review of Findings

A

Prenatal Assessments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Psychological Assessments

Sociocultural Assessment
- Cultural norms
- Primary language
- expectations of prenatal care
- view of pregnancy state

Spiritual influences
Community Resources
Current issues/ trends

A

Prenatal Nursing Assessments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

Implementation of Nursing Care
- Compile a plan of management for the antepartal family for each trimester of pregnancy

Initial Visit
- Nutritional needs and nursing management

A

Prenatal Nursing Assessments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

Common concerns and nursing management employment

  • Physical Activity
  • Dental Care
  • Medications
  • Substance Use
    Sexuality
A

Prenatal Nursing Assessments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

Danger Signs of Prenatal Assessments

A

Nausea, vomiting, anorexia
Abdominal pain, bleeding
Fever, chills, malaise
S/S UTI
Diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

Schedule of Care of Prenatal Nursing Care

A

Every 4 weeks from 28-32 weeks

Every 2 weeks from 32-36 weeks

Every week from 37- delivery at 40-42 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

Prenatal Nursing Assessments for 1st Trimester

A

Screening for problems
Interview
Resolution of previous problems
Appearance of danger signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

Prenatal Nursing Assessments

A

Assessments
- B/P
- Urinalysis
- Weight
- Edema
- Assessment of fundal height
- Auscultation of fetal heart

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

Second Trimester Nursing Management

A

Screening for problems ( same as the 1st trimester plus those noted below)
Interview
Appearance of danger signs
S/S Pre eclampsia ( HA, right upper gastric pain, edema)
Leaking water
- Cramping, contractions
- Resolution of previous problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

Second Trimester Physical Assessments

A
  • B/P
  • weight
  • urinalysis
  • edema
  • Fundal Height
  • Auscultation of fetal heart
  • Palpation of fetal movement
  • Common discomforts and nursing management
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

Common concerns of 2nd Trimester

A

Clothing
Physical Activity
Sexuality
Danger Signs- as before but include no fetal movement after quickening
- Infant feeding method
- Breast -feeding preparation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

Prenatal Nursing Assessments Third Trimester

A

Third Trimester
- Screening for problems
- Interview
- Appearance of danger signs
- as in first two trimesters, but include loss of fetal movement, ROM, uterine contractions
- Resolution of previous problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

Palpation of fetal position

A

Leopold’s Maneuver

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Common discomforts and nursing managements

A

Prenatal Nursing Assessments
- Common Concerns
- Danger Signs- preterm- same as 1st and 2nd trimester plus decrease or change in fetal activity
- Signs of labor
- Education of childbirth
- Sexuality
- Learning Needs weeks 29-40 and nursing management
- Summary of nursing care

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Prenatal Nursing Assessments

A

Physical Assessments
- B/P
- Weight
- Edema
- Urinalysis
- Fundal Height
- Fetal Heart tones
-Leopold’s Maneuver
- Vaginal Exam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

Substance Abuse includes

A

Smoking- There is a well established relationship between maternal smoking and low birth weight infants and respiratory problems in infants and children

Alcohol- Alcohol intake during pregnancy can result in a variety of neonatal neurological disorders including Fetal Alcohol Syndrome (FAS), Fetal Alcohol Exposure Syndrome (FAEs), Learning disabilities and behavioral problems

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

Substance Abuse

A

Drugs of Abuse
Management of the substance abuse client
Neonatal management

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

CNS stimulant also known as speed, meth or crank; easy to manufacture

A

Methamphetamines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Physiological effects of Substance Abuse

A

Tachycardia of mother and fetus
Tachypnea
Seizures, violent behaviors, difficulty staying in bed
Preterm Labor
Addicted when born usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

Methamphetamines

A

Psychological Effects
- Paranoia, delusions

Neonatal Effects
- Altered sleep patterns
- Irritability high pitch cry
- Uncoordinated reflex activity
( Suck swallow reflex)
Convulsions (seizures)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

Management of Antepartal Substance Abuse Clients

A

Assessment
Screening includes
- History of substance use/ abuse
- Start with over the counter drugs; prescription medications, alcohol, smoking, then street drugs
Ask about amount and the frequency of use
Important to be non- threatening and non judgmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

Management of Antepartal Substance Abuse Clients

A

Assessment
- Screening includes
- History of substance abuse/ use
- Start with over the counter drugs; prescription medications, alcohol, smoking, then “ street drugs”
- Ask amount and frequency of use
- Important to be non threatening and non judgmental

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

Management of Antepartal Substance Abuse Clients

A

Related History Items
- History of late, inconsistent or absent prenatal care in prior pregnancies
- Late onset of care or no prenatal care in this pregnancy
- Poor obstetrical history: SAB, preterm labor, multiple gynecological and urinary tract infections, hepatitis, positive HIV, small fetal size, poor pregnancy weight gain
- History of multiple pregnancies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Physiological Adaptation by

A

Hormones

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

Initial enlargement of the uterus
- Increase in uterine blood supply
- Enlargement of the breast
- Growth of glandular tissue ducts, alveoli and nipples
- Increased thyroid activity
- Promotes sodium and water retention by kidney tubules
- Increases coagulability
- Decreases fibrinolytic activity
- Stimulates melanin- stimulating hormone

A

Estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

Hormone that promotes the development of decidual cells of endometrium
Decreases contractility of the gravid uterus
Promotes the development of the secretory portion of the lobular ductal system
Increases sensitivity of the respiratory to CO@

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

Reduces tone of smooth muscle
- Decreases gastric motility
- Relaxes gastric sphincter
- Reduces tone of the bladder
- Decreases vascular tone
- Decreases colonic activity
- Decreases tone in the gallbladder
- Raises body temperature 0.5 degrees C

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

Maintains the corpus luteum in early pregnancy
May cause allergic response
May have immunologic properties

A

HCG

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

Myometrial changes; changes from thick walled muscular structure to thin walled sac at term

A

Uterus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

_________ keeps the smooth muscle relaxed and “quiet” during pregnancy

A

Progesterone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

Uterine growth occurs at a predictable pattern and rate

A

True

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

Uterine enlargement in 1-20 weeks increase due to

A

Estrogen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

Uterine enlargement 20-40 weeks increase due to what?

A

Fetal Distension

Now fetus is pushing the uterus up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

Growth is primarily due to?

A

Hypertrophy of existing muscle fibers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

Growth norm at 7 weeks

A

Size of the Hen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

Growth norm at 10 weeks

A

Size of orange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

Growth norm at 12 weeks

A

Size of grapefruit

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

Growth norm at 12- 13 weeks

A

Fundus at symphysis pubis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

Growth norm at 20 weeks

A

Fundus at umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

Growth norms at 36 weeks

A

Fundus at xyphoid process

96
Q

Growth norms at 13- 40 weeks

A

Measurement from symphysis pubis to fundus measurement in cm should equal weeks of gestation with normal deviation +/- 1-2 weeks

97
Q

What contractions may facilitate uterine blood flow?

A

Braxton- Hicks Contractions

98
Q

Increased blood flow through the dilated uterine arteries can be _______________; called the

A

auscultated, uterine souffle

Swish Swish Sound

99
Q

Uterine lining is called what after implantation?

A

Decidua
- Endometrial changes

100
Q

____________ layer is maintained during pregnancy due to high levels of __________ and ___________ resulting in amenorrhea

A

Decidua

Estrogen; Progesterone

101
Q

Cervical change that is bluish color of cervix due to increased vascularity

A

Chadwick’s Sign

102
Q

Cervical change due to increased tendency for cervical tissue to bleed due to increased vascularity

A

Friability

103
Q

Softening of the cervix later part of pregnancy

A

Goodell’s Sign

104
Q

Closes the cervix and protects the uterus from infection

A

Mucous Plug

105
Q

Vaginal discharge that is common with pregnancy

A

Leukorrhea

106
Q

Mucosa thickens and becomes more vascular under influence of__________ and ____________.

A

Vagina/Vulva

Estrogen and progesterone

107
Q

Increased tissue and sloughing plus increased cervical mucus causes formation of copious white discharge called

A

Leukorrhea

108
Q

Gravid women are more prone to ?

A

Monilial Vaginitis - Yeast infections

Due to the vaginal epithelial cells contain more glycogen than in non-pregnant state

109
Q

Increased relaxation of vaginal walls to allow for

A

Marked distention during delivery of the fetus

110
Q

External structures enlarge and become ?

A

More vascular and relaxed

111
Q

The labial edema, varicosities increase and “flabbiness” to perineal area common

A

True

112
Q

Perineal tissues relax to allow for distention during delivery

A

True

113
Q

High levels of estrogen and progesterone secreted first from corpus luteum then from the placenta suppress hypothalamic- pituitary- ovarian axis

A

Ovaries

114
Q

Increased ___________ and increased_________ cause decreased secretion of releasing hormone from _____________.

A

Estrogen, progesterone

Hypothalamus

115
Q

Decreased ____ and ____ from the _______ ________.

A

FSH and LH
Anterior Pituitary
No follicular development, maturation, and ANOVULATION.

116
Q

The corpus luteum remains viable until week?

A

Week 10.

Then degenerates since placenta can now take over estrogen and progesterone production.

117
Q

Breast changes occur to prepare for?

A

Lactation post-delivery

118
Q

Changes occur due to influence of

A

Estrogen and progesterone

119
Q

Estrogen is

A

Mediated adaptation.

120
Q

Breast enlargement due to growth of

A

Alveolar cells and secreting ducts

121
Q

Increased prominence of Montgomery tubercles

A

Darkening of areola

Vasodilation of vessels supplying breast tissue

122
Q

Progesterone mediated Adaptation

A

Development of secretory lobular alveolar system resulting in increased breast size and “lumpy” consistency.

123
Q

Progesterone Mediated Adaptation helps with production

A

Colostrum

124
Q

Creamy white to yellow pre milk fluid produced from 16 weeks

A

Colostrum

Present at birth to nourish neonate until breast milk is established

125
Q

Breast milk usually not produced until what?

A

Estrogen levels drop after delivery of the placenta

126
Q

Estrogen inhibits what?

A

Prolactin

From binding to alveolar cells in the breast thus initiating the lactation process

127
Q

Estrogen causes increased production of

A

Melanotropin resulting in increased pigmentation

128
Q

Lupus like pigmentation on face

A

Chloasma

129
Q

Dark pigmented extended from the symphysis pubis to the umbilicus and/or fundus

A

Linea Nigra

130
Q

Formed arterioles, appear 2nd to 5th month, generally disappear after pregnancy may or may not

A

Angiomas Vascular Spiders

131
Q

Diffuse mottling/ blotches on palmar surface of hands

A

Palmer Erythema

132
Q

Integumentary System Progesterone- Mediated Adaptation

A

Increased perspiration
Striae gravidarum

133
Q

Occurs due to separation of collagen under skin which fills in with scar tissue
Will lighten in color but will never disappear
Familial Tendency

A

Striae Gravidarum

134
Q

Caused by fluid retention mediated by estrogen and decreased vascular tone mediated by progesterone

A

Edema

135
Q

Caused by vessel wall relaxation mediated by progesterone

Increased blood volume

A

Varicose Veins

136
Q

Most neurological problems are caused by ?

A

Mechanical pressures and hormonal influences

137
Q

Compression of median nerve in wrist from edema

A

Carpel Tunnel Syndrome

138
Q

Symptoms include

Burning/ tingling in hand, pain, and numbness

A

Carpel Tunnel Syndrome

139
Q

Neurologic problem more prone to

A

Vertigo, syncope, lightheadedness due to vasomotor changes and/or hypoglycemia

140
Q

Leg pain due to compression of

A

Pelvic Nerves
Vascular Stasis

141
Q

DTRs should remain

A

2+ normal

142
Q

Cardiovascular system anatomic adaptation with slight….

A

Slight cardiac enlargement due to increased blood volume

Shift in Heart position

Hemodynamic adaptation

143
Q

What type of murmur may be heard?

A

Grade I/II due to increased blood flow

144
Q

Increased cardiac output in response to increased …

A

Tissue demands for oxygen probably secondary to increased vascular volume

145
Q

___________ relaxes smooth muscle present in arterial vessel walls thus creating a state of generalized vasodilation to a accommodate the increased blood volume

A

Progesterone `

146
Q

B/P changes for 1st trimester

A

Normal BP

147
Q

2nd Trimester BP changes

A

Decrease due to arteriolar relaxation

148
Q

3rd Trimester BP changes

A

BP returns to pt norm due to increased blood volume
BP highest when patient is sitting, lowest when in left lateral recumbent position
Supine hypotension/vena cava syndrome
Orthostatic hypotension

149
Q

Gravid and heavy uterus puts pressure on the vena cava reducing venous return and causing hypotension

A

Supine Hypotensive Syndrome

150
Q

At 32-34 weeks blood volume is increased by

A

40%

151
Q

Purpose of increase blood volume

A

Hydrate and oxygenate maternal and fetal tissue
Protect from blood loss at delivery
Maintain BP up

152
Q

Plasma component increases more than RBCs resulting in

A

Hemodilution

Observed on CBC report as decrease in:
hemoglobin and hematocrit levels known as
(pseudo-anemia) at 28-32 weeks

153
Q

RBC production increases up to

A

30%

Provide hemoglobin for maternal and fetal tissue oxygenation

154
Q

Fetus is dependent upon adequate maternal blood volume, adequate hg level, and adequate blood pressure to meet oxygen level needs

A

True

155
Q

Maternal Hg releases ______ more readily during pregnancy.

A

Oxygen

Coagulation changes

156
Q

_____________ causes increased tendency to __________ during pregnancy

A

Estrogen; coagulate

May result in increased tendency to clot during the postpartal period

157
Q

Respiratory system anatomic adaptation increased

A

Antero-posterior diameter to facilitate lung expansion

Increased vascularity of upper respiratory tract with resultant edema

158
Q

Causes of resultant edema

A

Nasal and Sinus stuffiness
Epistaxis
Earaches, feeling of fullness in ears, decreased hearing

159
Q

___________ causes a mild ___________ during pregnancy resulting in ___________ ____________.

A

Progesterone

Hyperventilation

Respiratory Alkalosis

160
Q

Decreased concentration of ______ ___________ in alveoli.

A

Carbon Dioxide

161
Q

Respiratory changes to increase_____________ to maternal and fetal tissues and facilitate ________ ___________ removal.

A

Oxygen
Carbon dioxide

162
Q

GI system is ______ mediated adaptation

A

Estrogen and Progesterone mediated

163
Q

Increased vascularity to gums resulting in

A

Edema and bleeding

Decreased secretion of HCL

164
Q

Progesterone mediated adaptation

A

Heartburn due to esophageal regurgitation and decreased gastric motility

Constipation from decreased peristalsis

165
Q

_____________ from relaxation of vessel walls and increased pressure

A

Hemorrhoids

166
Q

Increased incidence of gallstones from _____________ of gallbladder

A

Hypotonicity

167
Q

Excessive salivation

A

Ptyalism

168
Q

Slight increase in size pregnancy
BMR is increased during pregnancy
Parathyroid Gland
Pituitary Gland/ Placenta
Adrenal Gland
Pancreas

A

Endocrine System

Thyroid Gland

169
Q

Pregnancy places additional demands for insulin production upon the pancreas which may result in _________ _____________.

A

Pancreas

Gestational Diabetes

170
Q

Endocrine system in pregnancy include

A

HCG, estrogen, and progesterone

Prostaglandins

171
Q

GU system changes anatomically due to

A

Hormonal influence and mechanical pressure

172
Q

______________ of renal pelvis and ureters

A

Dilatation
Decreased bladder tone

173
Q

Due to above urinary stasis and increased risk of ____ exist during normal pregnancy.

A

UTI

Increased vascularity of bladder

174
Q

Urinary frequency due to

A

Bladder compression and inability to fully empty due to pressure will resolve usually after 12 weeks then comes back again after lightening occurs at 36 weeks

175
Q

Increased _____ from increased blood volume

A

GFR

176
Q

Decreased effectiveness of filtration system resulting in increased secretion of small molecule substances such as

A

Sodium and glucose

177
Q

Increased _______ retention to maintain increased _______ volume and can be hampered by sodium intake and use of diuretics

A

Sodium

Blood

178
Q

What hormone will promote ________ and _____ retention?

A

Estrogen

Sodium and fluid

179
Q

Enlarging uterus causes what?

A

Diastasis of rectus abdominus muscles, change in center of gravity and hypertrophy and increased stress of uterine supportive ligaments

180
Q

Which ovarian hormone causes decreased muscle tone of ligaments and increased mobility of pelvic joints

A

RELAXIN

Pelvic joints including - symphysis pubis and Sacro-iliac) resulting in pelvic instability

181
Q

Symptoms of pelvic instability are

A

Waddling gait
Lower back pain, leg pain, and difficulty walking

182
Q

What are considered crisis events since they require adjustment of previously developed roles and development of new roles ?

A

Pregnancy, childbirth, and early parenting

183
Q

Pregnancy affects the entire family, both nuclear and extended

A

True

184
Q

Nursing management must encompass ____ members of the pregnant family

A

ALL

185
Q

Most research has been done on whom?

A

White, middle class families, and it may not be applicable to other cultural groups

186
Q

Maternal task of Psychological Adaptation

A

Pregnancy Validation

187
Q

Typical Behaviors 1st trimester psychological adaptation

A

Ambivalence regarding pregnancy
Concern with body image and appearance
Concern with formation of “mother” identify ( client’s mother response to pregnancy is important)

188
Q

Sexuality concerns 1st trimester psychological adaptation

A

Nausea and vomiting, fatigue, and breast tenderness may decrease sexual desire

Important for both partners to know this is normal and usually temporary

189
Q

Maternal Psychological Adaptation

A

Stress Normalcy of mood swings and dependency of both partners

Encourage verbalization of concerns regarding sexual activity

Client usually interested in appearance and abilities of the fetus

Good time to use pictures of fetus in utero

Can start to include fetal needs in client education ( nutrition)

190
Q

2nd Trimester Maternal Psychological Adaptation

A

Maternal task is FETAL DISTINCTION

191
Q

Typical behaviors of 2nd trimester of maternal psychological adaptation

A

Experience quickening- 1st maternal perception of fetal movement

18-20 weeks for primigravida
16-18 weeks for multigravida

Easier to perceive fetus as a unique individual after quickening

Emotional lability; mood swings

Introversion

Increased emotional dependency

192
Q

Usually more interested in sexual activity because feeling better

Increased vascularity and sensitivity of genitalia may allow for stronger and quicker orgasm

Fear of pregnancy gone and no need for contraception so better spontaneity

A

Sexuality Concerns of Maternal Adaptation

193
Q

Stress normalcy of mood swings and dependency to both partners

Encourage verbalization of concerns regarding sexual activity

Client usually interested in appearance and abilities of fetus inside

Good time to use pictures of fetus in utero

Can start to include fetal needs in client education ( nutrition, balance, fluids.)

A

Client teaching of Maternal Psychological Adaptation

194
Q

3rd Trimester of Maternal Psychological Adaptation

A

Maternal Tasks: Fetal Separation and Role Transition

195
Q

Typical Behaviors of 3rd trimester Maternal Psychological Adaptation

A

Concern with body image, feeling large

Frequently express being “ tired of being pregnant”

May have fears regarding labor and delivery

Dream about labor and infant

Sexuality Concerns - May have decreased desire due to discomfort, fetal movement, fear or harming infant

196
Q

Maternal Psychological Adaptation Client Teaching

A

Good time to begin labor preparation classes

Discuss plans for delivery

Discuss preparation for infant

Discuss alternatives to meet sexuality needs

Discuss signs of labor

197
Q

Main role of partner is to nurture and respond to partner’s feelings of vulnerability

A

True

198
Q

Changes occur for expectant fathers during each trimester but usually occur when?

A

LATER

199
Q

Paternal Adaptation 1st Trimester

A

Difficulty at times conceiving of pregnancy since can not see physical changes

Frequently have concerns with economic demands and role changes.

May have difficulty dealing with sexual response, or lack of it, from partner

200
Q

Paternal Adaptation of 2nd Trimester

A

Validation of pregnancy and fetus facilitated by feeling fetus move and hearing heartbeat

Encourage father to accompany partner to prenatal appointments

May experience weight gain or nausea and vomiting

Some partners feel “left out” since most attention is directed toward female

May experience difficulty dealing with partner’s mood swings and dependency

201
Q

Paternal Adaptation of 3rd trimester includes

A

Dream about infant usually as a toddler

Fears about losing partner or infant during labor

May have concerns about sexual activity ( fetal movement during coitus makes it seem like there is a third part; “making love to the mother.”

Encourage participation in labor participation classes; needs a role in delivering this infant

202
Q

Sibling adaptation of preparation is

A

Age related

Many families want their children present during the delivery

Important child is prepared for this experience by Sibling Preparation Classes

203
Q

Why do we not recommend not to tell toddlers pregnancy too soon?

A

No true concept of time and will expect infant immediately

Plan moves out of crib and toilet training well in advance of the expected delivery to decrease normal sibling rivalry and possible regressive behaviors

204
Q

Preschoolers sibling adaptation concept

A

Poor concept of time but may enjoy looking at pictures of infants and fetal heartbeat

Allowed at some deliveries with appropriate preparation and responsible adult present to care for them

205
Q

School age children and sibling adaptation

A

Interested in the pregnancy

How did it get there?

May be present ar delivery with right preparation

206
Q

Adolescents sibling adaptation include

A

Difficulty dealing with evidence of parental sexual activity

Frequently present at delivery

May have difficulty dealing with intensity of labor and genetalia with birth process

207
Q

The grandparental adaptation may desire

A

Active role in both pregnancy and delivery

208
Q

Client often desires who during labor process?

A

Mother

Especially true in many cultural groups

209
Q

May have to deal with misconceptions and dated knowledge regarding childbirth

Try not to discredit these individuals since they are important support to your client

A

True

210
Q

Maternal psychological Adaptation for 1st trimester is

A

Pregnancy Validation

211
Q

Maternal psychological Adaptation for 2nd trimester is

A

Fetal distinction

212
Q

Maternal psychological Adaptation for 3rd trimester is

A

Fetal Separation and Role Transition

213
Q

Psychological Adaptation for Paternal Adaptation 1st trimester

A

Difficult to conceive of pregnancy

214
Q

Psychological Adaptation for Paternal Adaptation 2nd trimester

A

Validation of Pregnancy

215
Q

Psychological Adaptation for Paternal Adaptation 3rd trimester

A

Dreams, fears, and concerns

216
Q

1st, 2nd, 3rd trimester fruit daily intake

A

2 cups daily

217
Q

Veggies daily intake1st trimester

A

2.5 cups

218
Q

Veggies daily intake 2nd and 3rd trimester

A

3 cups daily

219
Q

Whole grains 1st trimester intake

A

6oz

220
Q

Whole grains intake 2nd and 3rd trimester

A

8oz

221
Q

Protein daily intake 1st trimester

A

5.5 oz

222
Q

Protein daily intake 2nd and 3rd trimester

A

6.5 oz

223
Q

Dairy daily intake 1st trimester

A

3 cups daily

224
Q

Dairy daily intake 2nd and 3rd trimester

A

3 cups daily

225
Q

Essential for maternal and fetal tissue development, maternal and fetal blood formation and vascular fluid control

A

Protein

226
Q

___________ contains __________ which is essential for tissue development

A

Protein, nitrogen

227
Q

Protein is also good sources of

A

Calcium
Iron
B vitamins
Fiber

228
Q

___ % of pregnancy diet should consist of protein foods

A

20

229
Q

These proteins contain all 8 essential amino acids

A

Complete Proteins

230
Q

Protein molecules are too large to perfuse, intact, across the placenta molecule is broken down into

A

Separate Amino Acids on the maternal side of placenta and perfuse across in that form

231
Q

Fetus then takes each separate amino acid to reconstruct a

A

Protein Molecule which is then used for tissue development

232
Q

If insufficient number of amino acids are available

A

The fetus will be unable to form adequate tissue

233
Q

If 2 or more incomplete proteins are ingested at same meal, what happens?

A

Net result should be ingestion of a sufficient number of amino acids to facilitate tissue development

234
Q

Primary energy source of the body

Needed to spare proteins for tissue development

A

Carbohydrates

235
Q

CHOs should be about % of diet?

A

50%

Ex: breads, cereals, fruits, veggies, milk

236
Q

Increased need also due to what? CHOs

A

Increased BMR

237
Q

Needed for energy

A

Fats

Supply free fatty acids and fat soluble vitamins

Ex: Butter, Margarine, oils, nuts, ice cream, whole milk

238
Q
A

NURS ADN004 Maternity (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions