UPDATED HESI EXAM PREPARATION NOTES, HINTS, AND STUDY GUIDE
FOR MATERNAL EXAMS
The Menstraul Cycle
• The menstrual phase varies in length in most
... [Show More] women.
• Ovulation occurs approximately 14 days before the next menstrual cycle.
• To avoid pregnancy a woman should abstain from unprotected sexual intercourse during
her fertile days. The most fertile days for pregnancy are the day before
ovulation and the day of ovulation. The fertile period begins 4-5 days prior to ovulation and
ends 24-48 hours after ovulation. A couple must avoid unprotected intercourse for several days
before an anticipated ovulation and for 3 days after ovulation to prevent pregnancy because
sperm can live in a woman’s body approximately 4 to 5 days and eggs live approximately
24-48 hours after being released.
• Some women do not realize they are pregnant because they experience implantation bleeding
and spotting
Antepartum Nursing Care
• Signs of healthy psychosocial maternal-fetal bonding include massaging the
abdomen, nicknaming the fetus, and talking to the fetus in utero.
• For many women, battering (emotional or physical abuse) begins during pregnancy. Women
should be assessed for abuse in private, away from the partner, by a nurse
who is familiar with local resources and knows how to determine the safety of the client.
• Practice determining gravidity and parity. A woman who is 6 weeks pregnancy has the following
maternal history
o Has healthy 2-year old fraternal twins.
o Miscarried at 22 weeks.
o Had an elective abortion at 6 weeks, 5 years earlier.
o With this pregnancy she is gravida 4, para 2, only 2 deliveries after 20 weeks’
gestation, and twins are two living
o GTPAL is 4-1-1-1-2l (G-4 pregnancies (twin’s miscarriage, elective abortion, current
pregnancy), T-1 (twins count as one birth), P-1 (22-week miscarriage); A-1 (elective abortion at
6 weeks); L-2 (twins)
• Practice calculating EDB. If the first day of a woman’s last normal menstrual period was
December 9, what is her EDB, using the Nagele rule?
o Answer: September 16th
. Count back 3 months and add 7 days.
• At approximately 28-32 weeks’ gestation, a plasma volume increase of 25% to 40% occurs,
resulting in normal hemodilation of pregnancy and Hct values above 38% or hemoglobin
levels above 13g/dL are associated with gestational hypertension. High
Hct values may look good, but in reality they represent a gestational hypertension disorder
and a depleted vascular space.
• Hgb and Hct data can be used to evaluate nutritional status. Example: a 22 year old primigravida at
12 weeks’ gestation has a Hgb of 9.6 g/dL and an Hct of 31%. She has
gained 3 pounds during the first trimester. A weight gain of 907.18 to 1814.4 g. (2-4 lbs.)
during the first trimester is recommended. Since the client is anemic supplemental iron and a
diet higher in iron are needed.
• Food high in iron:
o Fish and red meats
o Cereal and yellow vegetables
o Green leafy vegetables and citrus fruits [Show Less]