Karens portion

Question 1

Normal speech for a two-year-old (receptive vs expressive)

Answer 1

Receptive language is more advanced than expressive

Question 2

Chadwick’s sign

Answer 2

Bluish, purple coloration of vaginal mucosa, sign of pregnancy

Question 3

How to come up with an EDD

Answer 3

Last day of menstrual period 
subtract 3 months 
add 7 days 
add 1 year
date will be with in +/- wks

Question 4

Concrete operation

Answer 4

i. Learns by manipulating concrete objects
ii. Lacks ability to think abstractly
iii. Learns that certain characteristics of objects remain constant
iv. Understands concept of time
v. Engages in serial ordering, addition, and subtraction
vi. Classifies or groups objects by their common elements
vii. Understands relationships among objects
viii. Starts collections of items
ix. Can reverse thought process
BEGINS TO FORM LOGIC

Question 5

How does amniotic fluid serve the fetus

Answer 5

Transported from maternal blood and fetal urine

Maintain a constant body temperature for the fetus, permit symmetric growth and development, cushion the fetus from trauma, allow the umbilical cord to be relatively free from compression, and promote fetal movement to enhance musculoskeletal development

Alkaline

Adequete volume nessacary

Question 6

Expected behavior from 26mo old

Answer 6

Negativisim

Question 7

Positive signs of pregnancy

Answer 7

a. Agglutination inhibition test (urine)
b. Immunoradiometric assay (blood)
c. Enzyme-linked immunosorbent assay- ELISA (blood or urine)

Question 8

Vital supplements during pregnancy

Answer 8

folic acid and iron

Question 9

Theorist we associate with moral development

Answer 9

Kholberg

Question 10

Craving of things except for food

Answer 10

pica

Question 11

urinary system changes during pregnancy

Answer 11

Glomerular filtration rate (GFR) increases in the kidneys by 40-60%

b. Increase in urine flow and volume, substances delivered to kidneys, and filtration and excretion of urea, uric acid, creatinine, water, and solutes.
c. Anatomically kidneys increase in length b 1-1.5 cm and increase in weight
d. Predominant structural change is dilation of the renal pelvis and uterus.

Question 12

Healthy people 2030 objectives related to maternal-infant child

Answer 12

a. Increase the proportion of pregnant women who receive early and adequate prenatal.
b. Increase the proportion of women of childbearing age who have optimal red blood cell folate concentrations
c. Increase the proportion of women delivering a live birth who has a healthy weight prior to pregnancy

Question 13

first feeling of fetal movement

Answer 13

second trimester

Question 14

safe during first trimester

Answer 14

sexual relations

Question 15

Not safe during first trimester

Answer 15

i. Hot tubs (lab discussion)
ii. Changing kitty litter (lab discussion)
iii. Alcohol (Pg. 382)
iv. Smoking (Pg. 382)
v. Other teratogens

Question 16

critical time for exposure to teratogens

Answer 16

The period of greatest environmental sensitivity and consequent risk to the embryo is days 17-56 after conception, usually before the first prenatal appointment and before the woman knows they’re pregnant”.

Question 17

Presumptive signs of pregnancy

Answer 17

a. Fatigue
b. Breast tenderness
c. Nausea and vomiting
d. Urinary frequency
e. Hyperpigmentation
f. Uterine/breast enlargement
g. Quickening
h. Amenorrhea

Question 18

Fundal height and how to recognize abnormal

Answer 18

a. Top of pubic bone to the top of uterus while laying on back
b. If growth curve flattens it could indicate presence of FGR
c. If fetal height is greater than 4cm from estimated gestational age further evaluation is warranted

Question 19

Goals for someone 8wks pregnant

Answer 19

a. Urinary frequency
i. Pelvic floor exercises
ii. Empty bladder at first sensation
iii. Avoid caffeinated drinks
iv. Reduce fluid intake after dinner
b. Fatigue
i. Attempt to get a full nights sleep without interruptions
ii. Eat a healthy, balanced diet
iii. Schedule a daily afternoon nap
iv. Pause and rest when tired
c. Nausea and vomiting
i. Avoid an empty stomach at all times
ii. Eat dry crackers/toast in bed before arising
iii. Eat several small meals throughout day
iv. Avoid brushing teeth immediately after eating to avoid gag reflex
v. Accupressure wristbands can be worn daily
vi. Drink fluid between meals rather than with them
vii. Avoid odorous or greasy, fatty foods
d. Backache
i. Avoid standing or sitting in one position for long periods
ii. Apply a heating pad on low setting to small of the back
iii. Support lower back with pillows when sitting
iv. Use proper body mechanics for lifting anything
v. Avoid excessive bending, lifting, or walking without rest periods
vi. Wear supportive, low-heeled shoes. Not high heels
vii. Stand with shoulders back to maintain correct posture
e. Leg cramps
i. Elevate legs above heart frequently throughout the day
ii. If you get a cramp, straighten both legs and flex feet toward body
iii. Ask provider about calcium supplements, may reduce leg spasms
f. Varicosities
i. Walk daily to improve circulation in extremities
ii. Elevate legs above heart while resting
iii. Wear compression stockings
iv. Avoid standing in one position for long periods of time
v. Don’t wear constrictive socks or shoes
vi. Don’t cross legs when sitting for long periods
g. Hemorrhoids
i. Establish a regular time for daily bowel elimination
ii. Avoid constipation and straining during defecation
iii. Exercise daily, eat fiber-rich foods, drink plenty of water
iv. Use warm sitz baths and cool witch hazel compresses for comfort
h. Constipation
i. Increase intake of fiber rich foods and drink minimum of 8, 8oz glasses of water daily
ii. Ingest prunes/prune juice for natural laxatives
iii. Consume warm liquids on rising to stimulate peristalsis
iv. Exercise each day to promote movement through the intestines
v. Reduce the amount of cheese consumed

Question 20

Reportable complications of pregnancy

Answer 20

During the first trimester: spotting or bleeding which can indicate miscarriage, painful urination which can indicate infection, severe persistent vomiting, fever higher than 100 degrees Fahrenheit or 37.7 degrees Celsius, and lower abdominal pain with dizziness and accompanied by shoulder pain which indicates a ruptured ectopic pregnancy.

During the second trimester: regular uterine contractions which may indicate preterm labor, pain in calf often increased with foot flexion which may indicate DVT, sudden gush or leakage of fluid from vagina which may be a sign of pre labor rupture of membranes, an absence of fetal movement for more than 12 hours which may indicate fetal distress or demise.

During the third trimester: sudden weight gain in in form of periorbital or facial edema, Severe upper abdominals pain, or headache with visual changes which may indicate guess stational hypertension and/or preeclampsia, and a decrease in fetal daily movement for more than 24 hours which may be indicative of possible demise. Also any of the first and second trimester warning signs and symptoms can be present in the third trimester.

Question 21

quickening

Answer 21

First perception of fetal movement by the mother, it is often described as a gentle fluttering.

Question 22

Multigravida

Answer 22

Pregnant at least 3rd time

Question 23

Promipara

Answer 23

Women who has gien birth at least once 20wks after pregnancy

Question 24

Gravida

Answer 24

Total times a women has been pregnant

Question 25

Prenatal visit schedule

Answer 25

Every 4 wks up to 28 wks

Every 2wks 29 to 36wks

Every wk from 37wks

Question 26

Bindings tasks

Answer 26

Seeking acceptance of self in maternal role to infant. (“Binding in”)

First trimester: mother accepts idea of pregnancy but not of infant

Second Trimester: with sensation of fetal movement (quickening), mother acknowledges fetus as a separate entity within her

Third trimester: mother longs to hold infant and becomes tired of being pregnant

Question 27

1st pregancy teaching

Answer 27

Common discomforts in the first trimester, and what they can do to ease them. See Q/A 18.

Discomforts include nausea vomiting, nasal stiffness, urinary frequency, breast tenderness, and physiologic leukorrhea

Question 28

Physicologic changes during pregnancy

Answer 28

Breast tenderness

Fatigue

Nausea and vomiting

Urinary frequency/incontinence

Nasal stuffiness, bleeding gums, and nosebleeds (epistaxis)

Cravings

Backache

Leukorrhea (increased vaginal discharge)

Backache

Leg cramps

Varicosities

Hemorrhoids

Flatulence and bloating

Heartburn/indigestion

Dependent edema

Braxton hicks contractions

Question 29

Objective signs of pregnancy

Answer 29

Hegar sign – softening of lower uterine segment or isthmus

Goodell sign – softening of cervix

Chadwick sign – bluish purple coloration of vaginal mucosa and cervix

Changes in shape and size of uterus

Abdominal enlargement

Braxton hicks

Ballottement – examiner pushes on cervix during pelvic exam and feels rebound from floating fetus

Question 30

IPV during pregnancy

Answer 30

Pregnancy is a time of unique vulnerability to intimate partner violence (IPV) victimization because of changes in the womans physical, social, emotional, and economic needs during this period.

Question 31

IPV myths

Answer 31

Physical abuse is just in lower socio-economic classes

Substance abuse can cause the violence

Physical abuse is not a crime, men have the right to abuse partner

Violence occurs only in a small percentage of women

Intimate partner violence (IPV) is typically a one-time isolated event.

Women can easily choose to leave an abusive relationship

Only men with mental health problems commit violence against women.

Pregnant women are protected from abuse by their partners

Women provoke their partners to abuse them

Violent tendencies have gone on for generations and are accepted

IPV is only a heterosexual issue

Question 32

IPV facts

Answer 32

Violence occurs in all socioeconomic classes

Violence is a learned behavior, can be changed. Substance abuse can make a bad problem worse

In the past the patriarchal legal system afforded men the right to physically chastise their wives. No longer the case, It’s a crime in every state now.

1 out of 4 women will be victims of violence in their lifetime

IPV is a pattern and is repeated using a number of tactics, including threats, intimidation, physical injury, economic deprivation, isolation, and sexual abuse.

Women stay in abusive relationships because they feel they have no options, frequently leaving presents the greatest risk to the women’s life.

Abusers often seem normal, and don’t appear to be suffering from mental illness

1 in 5 women is physically abused during pregnancy, effects of violence on infant can be preterm delivery, fetal distress, low birth weight, and child abuse.

Women may be willing to blame themselves for someone else’s bad behavior

IPV is socially unacceptable and it is now a crime

There is much IPV in the LGBTI population as in heterosexual relationships.