OB Exam 1 Nursing Care During Pregnancy 51 Questions with Verified Answers
Pregnancy is how long? - CORRECT ANSWER 9 months or 10 lunar months (40
... [Show More] weeks)
What is the first trimester weeks?
Second trimester?
Third trimester? - CORRECT ANSWER 1st - 1 to 13th week
2nd - 13th week and 6 day (14th week to 26th week)
3rd - 26th week and 6th day (27th week) to 40 weeks
Total number of pregnancies is called what? - CORRECT ANSWER Gravidity (Gravida)
Total number of pregnancies that reached 20 weeks gestation? - CORRECT ANSWER Parity (Para)
What does GTPAL stand for? - CORRECT ANSWER Gravida
Term (pregnancies 37+ weeks)
Preterm (pregnancy 20-37 weeks)
Abortion (spontaneous miscarriage or planned below 20 weeks)
Living children
How do you use Nagele's rule? - CORRECT ANSWER Subtract 3 months and add 7 days
If last menstrual cycle was December 29, when will due date be? - CORRECT ANSWER October 6
Overall adaptation of mom depends on what three things? - CORRECT ANSWER 1. emotional makeup
2. cultural/socioeconomic background
3. acceptance or rejection of pregnancy
Maternal steps of adaptation:
(1) accepting the pregnancy - CORRECT ANSWER may have ambivalence (mixed feeling -- normal in early pregnancy...if persists needs assessed)
Maternal steps of adaptation:
(2) identifying with the mother role - CORRECT ANSWER May have looked forward to being a mother for a long time or may have never considered it
Maternal steps of adaptation:
(3) reordering personal relationships - CORRECT ANSWER Mother -- often develops a different relationship w/ her mother or mother figure -- someone to talk to and relate to
Spouse or partner: can be a time when couple grows closer as they assume new roles.
Maternal steps of adaptation:
(4) establishing relationship w/ fetus.
What 3 phases? - CORRECT ANSWER 1. "I'm pregnant"
2. "I am going to have a baby"
3. "I am going to be a mom"
Maternal steps of adaptation:
(5) Preparing for childbirth - CORRECT ANSWER read books, attend classes, seek best prenatal care, anxiety over well-being of fetus, then towards end become inpatient for delivery
Paternal steps for adaptation: 3 phases - CORRECT ANSWER 1. announcement phase
2. moratorium phase - task is to accept pregnancy
3. focusing phase - becomes more involved and thinks of himself as a father
Traditional prenatal visit schedule:
1. First visit: ?
2. 16-29 weeks: ?
3. 29-36 weeks: ?
4. 36 weeks-delivery: ? - CORRECT ANSWER -first visit is within first trimester (12 weeks)
-16 to 29 weeks = monthly
-29-36 weeks = every 2 weeks
-weekly from 36 weeks to delivery
Centering (group) prenatal care:
1. First visit: ?
2. 16-28 weeks: ?
3. 29-40 weeks? - CORRECT ANSWER first visit -- within first 12 weeks
16-28 weeks -- every 4 weeks
29-40 -- every 2 weeks
List some things that make up a comprehensive assessment at prenatal visit - CORRECT ANSWER 1. physical exam
-VS, height and weight, breast
2. lab tests (pregnancy test, CBC, urine, HGB, HCT, kidney function test
3. sickle cell for african american and asian
4. Blood type and Rh
5. Rubella titer (needs to greater than 1:8)
6. HIV testing
7. Hepatitis B
8. Vaginal cultures for STIs
-RPR and VDRL for syphylis
-gonorrhe and chlamydia
9. Family dynamics
10. Gynceologic assessment -- pelvic exam, pap smear, pelvic size, cultures)
11. Past medical history
12. Nutritional Hx
13. Medication and herbal use history
14. Family history (both medical and perinatal)
15. Social, occupational, and experiential history
16. Physical abuse history
17. Pregnancy history (next slide)
Pregnancy history - CORRECT ANSWER Gravida and parity or GTPAL
Contraceptive history
Sexual partners and STIs
Calculate EDC
Subsequent prenatal visits: weight gain.
How much each trimester? - CORRECT ANSWER 1st = 2.2-2.5 lbs total
2nd = 0.9 lbs per week
Total weight gain = 24-35 pounds or less if pt. is overweight prior to pregnancy
You should begin checking fundal height after first trimester. The bladder should be empty. What weeks should the fundal height be equal to weeks gestation? - CORRECT ANSWER Weeks 18-32
(note: this is inaccurate with multifetal pregnancy)
What is urine sample used for at subsequent prenatal visists? - CORRECT ANSWER Protein, glucose, leukocytes, keytones, and nitrate
Will check FHR at each subsequent visit. An additional test would be a glucose 1 hr test. Drink 50g of sugar and check glucose level in 1hr. It needs to be less than what? - CORRECT ANSWER 140
If greater than 140, they will have mom come back for 3hr glucose screening where they will drink 100g and the glucose is tested when? - CORRECT ANSWER 1hr, 2hr, and 3 hr
To diagnose based off sugar, what do they need? - CORRECT ANSWER 2 elevated readings
(note: Will do PPD tuberculosis screening if high risk population).
Look at discomforts vs dangers of pregnancy in ATI book - CORRECT ANSWER
What can FHR be heard by first 10-12 weeks (First trimester)? - CORRECT ANSWER Doppler
Once uterus starts to grow, what can FHR be heard with for 15-20 weeks? - CORRECT ANSWER Doppler or fetoscope
Once further along than 20 weeks, what can FHR be heard with? - CORRECT ANSWER Doppler
Fetoscope
Electronic fetal monitor (EFM)
Helps detect down syndrome (trisomy 21), trisomy 18, neural tube defects (ancephaly or spina bifida), abdominal wall defects (gastroschesis and omphalocele) and Smith Lemli Opitz syndrome - CORRECT ANSWER SIS (Sequential integrated screening)
What is the most widely used SIS due to accuracy? when is it done? - CORRECT ANSWER Quad Marker test at 15-20 weeks
SIS: explain the sequence (1st, 2nd, 3rd) - CORRECT ANSWER 1st: blood analysis for 2 biochemical markers (PAPP-A and B-CG) at 10-13 weeks
2nd: ultrasound at 11-14 weeks
Final: blood for the quad marker test at 15-20 wks
What are some causes of inaccurate results for the SIS test? - CORRECT ANSWER Multifetal gestation, mother's weight and age, diabetes
(note: as woman ages, she is at higher risk for having down syndrome babies)
When do women take the 1 hour glucose intolerance test? - CORRECT ANSWER at 24-28 weeks (3 hr if fail)
When is test for group beta streptococcus done? - CORRECT ANSWER 35-37 weeks (culture sample from vagina and rectum -- if positive treat with Penicillin G during labor or clindamycin if allergic to penicillin)
What test can you use for genetic testing for disorders and to detect infection? - CORRECT ANSWER Amniocentesis
What are signs and symptoms of supine hypotension? - CORRECT ANSWER Pallor
Dizziness, faintness, breathlessness
Tachycardia
Nausea
Clammy skin; sweating
Intervention: position woman on her side until her signs and symptoms subside and vital signs stabilize within normal limits
Preparing for breast feeding: ___________ test - CORRECT ANSWER Pinch test to determine if nipples invert or evert (protrude). Breast shells can be worn in last trimester for 1-2 hrs daily
Exercise for pregnant woman - CORRECT ANSWER Pelvic tilt (rock)
Kegel exercises
Appropriate for pregnant women
Safety during pregnancy
What does smoking cause - CORRECT ANSWER Vasoconstriction
What does caffeine interfere with - CORRECT ANSWER iron absorption
What immunizations are safe during pregnancy? - CORRECT ANSWER Dead virus vaccines like (tetanus, diptheria, recombinant help B, and inactivated flu)
What immunizations are not safe during pregnancy? - CORRECT ANSWER Live viruses (rubella, rubeola, chicken pox, mumps, oral polio)
Preterm labor occurs 26th-36th week. Should be reported to HCP. How can you recognize pre term labor? - CORRECT ANSWER Uterine contractions every 10 minutes or more often for 1 hour
Bloody spotting or leaking of fluid from vagina
Low back pain
Painful cramps
Increased pelvic pressure
Rupture of membranes (ROM) can stimulate contractions to start
Pregnant adolescents are automatically what? - CORRECT ANSWER High risk clients
(HTN, third trimester bleeding, preeclampsia, ecplampsia, cephalopelvic disproportion, abruptio placenta, multiple socioeconomic factors)
Advanced maternal age are women 35 or greater. Multiparous = more than one pregnancy. What is primaparous? - CORRECT ANSWER First time pregnancy after 25 years old (increased risk)
What's different about prenatal visits for multifetal pregnancy? - CORRECT ANSWER Visits every two weeks in the second trimester instead of every month
List some problems of multifetal pregnancy - CORRECT ANSWER extreme distention of uterus leading to premature ROM
premature births r/t extra weight on cervix and added amniotic fluid
pressure on visceral organs
diastasis recti
increased strain on heart
placenta previa with large size placenta or two or more placentas
congenital malformations common in identical twins
twin to twin transfusion
mother requires greater nutrition with 2 or more fetuses
Battering in pregnancy - CORRECT ANSWER Often escalates during pregnancy or it may start then
psychological or physical abuse
target areas one cannot see = abdomen, vagina
abuser accompanies woman to clinic visits
signs of abuse: disheveled, anemic, subdued, unhappy, smokes/drinks heavily
Someone that is trained to help a woman in labor -- they do not deliver babies - CORRECT ANSWER Doula
Lay midwife vs nurse midwife - CORRECT ANSWER lay midwife typically delivers in home
Breathing techniques - CORRECT ANSWER Lamaze [Show Less]