Antepartum

Question 1

What are the 3 stages of human development?

Answer 1

1. Fertilized Ovum=Zygote
   -Conception to day 14 or wk 4 from LMP
   -Blastocyst/trophoblast outer by day 5 within uterus
   -Implantation day 7-10 complete
2. Embryo
   -End ovum day, starts 15-18 wks
3. Fetus
   -8-40 wks

Question 2

What is an ovum?

Answer 2

An ovum is an egg.

Question 3

What is a zygote?

Answer 3

A zygote is a fertilized egg.

Question 4

How many cells do blastocyst have by day 5?

Answer 4

70-100 cells

Question 5

When does implantation begin?

Answer 5

Day 5 or 6

Question 6

In what stage is the least vulnerable to malformations?

Answer 6

Once its a fetus, it’s the least vulnerable but it can still impair or damage organs such as the heart, lungs, kidneys, liver, gallbladder, etc.

Question 7

At how many weeks are all major organs formed?

Answer 7

8wks

Question 8

Is it normal for the baby’s heart rate to be fast?

Answer 8

Yes, it is. The heart rate can go up to 180

Question 9

At how many weeks is there enough surfactant in the alveoli?

Answer 9

32 wks

Question 10

What does surfactant do in the lungs?

Answer 10

The surfactant lowers surface tension at the air-liquid interface and therefore preventing alveolar collapse at end-expiration.

Question 11

At how many wks do the bronchi enlarge?

Answer 11

16-24 wks

Question 12

When do the alveoli form?

Answer 12

16-24 wks

Question 13

What is used to measure fetal lung maturity?

Answer 13

Lecithin/Sphingomyelin ratio 2:1

Question 14

What conditions accelerate lung maturity?

Answer 14

Maternal BP, infection

Question 15

Do twins mature faster or slower?

Answer 15

Twins mature faster because the uterus sometimes can’t handle having two or more babies for a long time.

Question 16

Why is wk 1-2 insensitive to teratogens?

Answer 16

Its not connected to the mom.

Question 17

What is TORCH syndrome?

Answer 17

It is caused by infections.
T-oxoplasmosis: protozoa (cate feces)
O-ther: Hep A, B virus
R-ubella virus
C-ytomegalovirus: CMV (baby lived less than 6 months)
H-erpes Simplex virus type 2

Question 18

Varicella syndrome

Answer 18

Short limbs, 30% mortality, scars, neuro and ophthalmic conditions
Pneumonia most common effect in mother
Fetus high transmission if first 16 wks

Question 19

When does a woman know she is pregnant?

Answer 19

About 4 wks

Question 20

Physical changes in pregnancy?

Answer 20

Endocrine system
-increase thyroid gland activity, but does not result in hyperthyroidism
-oxytocin(posterior pituitary) increase amounts as fetus matures. Higher levels of progesterone prevent oxytocin from finding receptor sites in uterus and stimulating uterine contractions
-Prostaglandins responsible for relaxation of ligaments, soften and ripen cervix(open for labor)
-Parathyroid hormone controls Ca and Mg metabolism
-Pancreatic enzymes and insulin
-Adrenals circulating cortisol regulates CHO and Pro metabolism, increase due to estrogen hormone

Question 21

What is the honeymoon phase?

Answer 21

24-48 hrs postpartum

Question 22

First trimester discomforts?

Answer 22

Nasal stuffiness, epistaxis, breast chg, urgency/frequency, fatigue, NV, ptyalism

Question 23

Second trimester discomforts?

Answer 23

Heart burn, contipation, varicose veins, food cravings, backache, round ligament pain, leukorrhea

Question 24

Third trimester discomforts?

Answer 24

Leg cramps, ankle edema, dypnea, Braxton -Hicks, insomnia, urgency, hemorroids, moods

Question 25

What type of immunizations should pregnant women not get?

Answer 25

Live vaccines such as MMR, chickenpox, mumps, bacilli calmette

Question 26

What prenatal assessments should be done at each visit?

Answer 26

VS, dip ua, wt, edema(wouldn’t expect edema in early visits), fht after 10 wks, fundal ht after 14 wks

Question 27

What is a non-stress test?

Answer 27

This test measures the baby’s HR before birth

Question 28

Strongly associated with maternal death:

Answer 28

Age below 20 and over 35, no prenatal care, low educational attainment, unmarried status, nonwhite race

Question 29

SG #1 Hyperemesis Gravidarum

Answer 29

Vomiting during pregnancy so severe it leads to dehydration

Question 30

SG #2 What clinical manifestations should tell the nurse the client has preeclampsia versus preeclampsia with severe factors?

Answer 30

Severe preeclampsia will show a BP of 160-180/110, protein 3-4+, hyperreflexia, clonus
Preeclampsia will show a BP of >140/90, protein 1-2+

Question 31

SG #3 What to teach pt regarding self care and what to report with patient diagnosed with preeclampsia?

Answer 31

Teach how to take BP, stay hydrated, calm environment, encourage relaxation

Question 32

SG #4 What nursing interventions should be done immediately when pt is identified with severe preeclampsia?

Question 33

SG #5 What order are you anticipating with eclampsia?

Answer 33

Magnesium sulfate

Question 34

SG #6 What infections are important?

Answer 34

Group Beta Streptococcus (GBS) could be UA or vaginal
STI(Chlamydia, syphilis, gonorrhea, herpes)
TORCH
Assess for signs of fever and sepsis
Effect on fetus: preterm, stillborn, anomalies(facial, eyes, limbs, CNS, hearing, heart)
Prevention: wash hands, don’t touch cat litter,

Question 35

SG #7 Maternal comorbidities as risk in the prenatal record?

Answer 35

Hypertension, diabetes, obesity, malnutrition

Question 36

SG #8 Risk factors for preterm labor?

Answer 36

Infection, multiple gestations, past PTL, ethnicity, substance abuse, age

Question 37

SG #9 Nursing assessment, interventions/monitoring of PROM

Question 38

SG #10 Nursing assessments for preterm labor?

Answer 38

Cramping, low back pain, pelvic abdomen pressure, mucous/watery or bloody discharge, uterine contractions <38 weeks, defining criteria is UC 8/hr with cervical change

Question 39

SG #11 Nursing responsibilities for substance abuse

Answer 39

Educate on consequences of substance abuse, monitor physical signs of substance abuse, monitor withdrawal