MATERNAL 28-39

Question 1

The average length of pregnancy is

Answer 1

280 days (40
weeks), 10 lunar months, or 9 calendar months),

Question 2

To calculate the EDD by Naegele’s rule

Answer 2

count
backward 3 calendar months from the month in
which the last menstrual period occurred. Using
the date of the first day of this menses, add 7
days. Change the year, if necessary

Question 3

The following are ways to date the pregnancy
when LMP is unknown.

Question 4

inspection and palpation of the breasts for normal

Questionable changes include

Answer 4

recent lumps or
masses that feel hard or fixed, dimpling,
redness, edema, ulceration and nipple
retraction or elevation.

Question 5

Subsequent prenatal assessments, pregnancy, prenatal
visits are scheduled every ___weeks for the first 28 weeks

Answer 5

4

Question 6

Subsequent prenatal assessments, pregnancy, prenatal
visits are scheduled every _ weeks from 28 to 36 weeks, and then weekly until
delivery

Answer 6

2

Question 7

During the course of the pregnancy, a total
weight gain of ____ lb. is recommended

Answer 7

24 to 30

Question 8

A normal pattern of weight gain is lb. in the
first 10 weeks,
lbs. at 20 weeks,
lbs. by 30
weeks, and
lbs. by 40 weeks.

Answer 8

1.5
9
19
27.5

Question 9

(excessive salivation) occurs, probably as
a local reaction to the influence of estrogen

Answer 9

Ptyalism

Question 10

(increased vaginal discharge that is
white in color) results from the increased activity
of vaginal epithelial cells as they prepare for
distention during the birth process.

Answer 10

Leukorrhea

Question 11

Ankle Edema

Answer 11

Rest your feet elevated. Avoid standing for long periods Avoid restrictive garments on the lower half of your body-

Question 12

Backache

Answer 12

Apply local heat. Avoid long periods of standing. Stoop to pick up objects.
Paracetamol in usual adult dose may help. Wear low-heeled shoes

Question 13

Breast tenderness

Answer 13

Wear a supportive bra. Decrease the amount of caffeine and carbonated beverages ingested.

Question 14

Constipation

Answer 14

Increase fiber in your diet.
Drink additional fluids.
Have regular time for bowel movements

Question 15

Difficulty sleeping

Answer 15

Drink a warm, caffeine -free drink before bed and practice relaxation techniques.

Question 16

Fatigue

Answer 16

Schedule a rest period daily. Have a regular bedtime routine.
Use extra pillows for comfort.

Question 17

Faintness

Answer 17

Move slowly. Avoid crowds. Remain in a cool environment.
Lie on your left side when at rest.

Question 18

Headache

Answer 18

Avoid eye strain. Visit your eye doctor. Rest with a cool cloth on your forehead. Take Paracetamol in regular adult dose, as needed. Report frequent

Question 19

Heartburn

Answer 19

Eat small, frequent meals each day. Avoid overeating, as well as spicy, fatty and fried foods.

Question 20

Hemorrhoids

Answer 20

Avoid constipation and straining with a bowel movement take a sitz bath. Apply a witch hazel compress

Question 21

Leg cramps

Answer 21

Avoid pointing your toes. Straighten your leg and dorsiflex your ankle.

Question 22

Nausea

Answer 22

Eat six small meals per day rather than three. Eat a piece of dry toast or some crackers before getting out of bed. Avoid foods or situations that worsen the nausea. If it persists, report the problem to your primary care provider.

Question 23

Some expectant fathers develop a cluster of
signs and symptoms of pregnancy similar to the
mother. This is called

Answer 23

couvade syndrome.

Question 24

• noted at 20 weeks in Primi & 16 weeks in
  multigravidas

Answer 24

Quickening

Question 25

Three periods of three months each. Months are the first trimester Months are the second trimester Months are the third trimester

Answer 25

1 - 3 4 - 6 7 - 9

Question 26

Prenatal development is often measured in

Answer 26

lunar months

Question 27

Each lunar month consists of days, organized into four weeks of seven days each.

Answer 27

28

Question 28

a pregnancy is lunar months long

Answer 28

10

Question 29

Assessment of Fundic Height McDonald’s Rule

Answer 29

Fundic height (cm) x 2/7 = AOG in lunar months Fundic Height (cm) x 8/7 = AOG in weeks

Question 30

another symphysis-fundal height measurement (not thoroughly reliable) is an easy method of determining mid pregnancy growth.

Answer 30

McDonald’s Rule

Question 31

Estimates AOG by the position of the uterus in the abdominal cavity

Answer 31

Bartholomew’s Rule

Question 32

Bartholomew’s Rule 12 weeks

Answer 32

symphysis pubis

Question 33

Bartholomew’s Rule 16 weeks

Answer 33

halfway bet. Umbilicus & SP

Question 34

Bartholomew’s Rule 20 weeks

Answer 34

level of umbilicus

Question 35

Bartholomew’s Rule 24 weeks

Answer 35

2 FB above umbilicus

Question 36

Bartholomew’s Rule 30 weeks

Answer 36

half way bet umbilicus & xiphoid process

Question 37

Bartholomew’s Rule 36 weeks

Answer 37

level of xiphoid process

Question 38

Bartholomew’s Rule 40 weeks

Answer 38

just below xiphoid process

Question 39

Estimates the weight of fetus in grams relative to height of the fundus Fetal weight = fundic height (cm) – N x K K – 155 (constant) N – 12 if engaged, 11 if not yet engaged

Answer 39

Johnson’s Rule

Question 40

To determine the length of fetus in cm. 1st half of pregnancy (1 to 5 lunar months ) - square the no. of months 2nd half of pregnancy (6 to 10 lunar months) - multiply the no. of months by 5

Answer 40

Hasse’s Rule

Question 41

FH = 34 cm 34cm multiply by 8 divided by 7 Ans. = 38 to 39 weeks 34cm multiply by 2 divided by 7 Ans.= 9 to 10 lunar months

Answer 41

MC Donald’s Rule

Question 42

Women train for the role of expectant parent and interact with babies and children. B. Psychosocial Stages of Pregnancy

Answer 42

Anticipatory stage

Question 43

Women fully assume the pregnancy role and initially may seek help from family members, B. Psychosocial Stages of Pregnancy

Answer 43

Honeymoon stag

Question 44

The pregnancy role is fully exercised; the expectant parent validates the adequacy of the current role. B. Psychosocial Stages of Pregnancy

Answer 44

Plateau stage

Question 45

The termination stage precedes and includes termination of the pregnancy role (i.e. Labor and birth of the infant (although the pregnancy role may terminate in other ways)) B. Psychosocial Stages of Pregnancy

Answer 45

Disengagement

Question 46

Common emotional reactions of the woman or the couple to pregnancy include the following: Ambivalence, fear, fantasies, or anxiety

Answer 46

First trimester.

Question 47

Common emotional reactions of the woman or the couple to pregnancy include the following: Well-being, increased need to learn about fetal growth and development, narcissism, passivity, or introversion (may seem egocentric and self-centered)

Answer 47

Second trimester

Question 48

Common emotional reactions of the woman or the couple to pregnancy include the following: Feels awkward, clumsy, unattractive; becomes more introverted; or reflects on own childhood.

Answer 48

Third trimeste

Question 49

refers to the medical and nursing care given to the pregnant woman between conception and the onset of labor

Answer 49

Antepartum care

Question 50

The total energy cost of pregnancy is __ calories.

Answer 50

85, 000

Question 51

Protein requirements increase to provide sufficient amino acids for fetal development, increased blood volume, and breast and uterine tissue growth; the recommended daily allowance is ____ more than nonpregnant needs

Answer 51

30 g/d

Question 52

Commonly recommended prenatal nutritional supplements contain vitamins

Answer 52

B6, D, E, and C; folic acid; pantothenic acid; iron; calcium; magnesium; zinc, and copper

Question 53

causes relaxation of the smooth muscle, including the gastrointestinal tract, and reduced motility, allowing more nutrients to be absorbed

Answer 53

Progesterone c

Question 54

increases water retention.

Answer 54

Estrogen

Question 55

is implicated in nausea

Answer 55

HCG

Question 56

FHR usually is auscultated at the __ region with a Doppler ultrasound transducer at 10 to 12 weeks’ gestation.

Answer 56

midline suprapubic

Question 57

An FHR of ____ beats per minute can be distinguished from the slower maternal heart rate by palpating the mother’s pulse while auscultating the FHR.

Answer 57

120 to 160

Question 58

Serial sonograms provide useful information when assessing fetal growth and well being.

Answer 58

Ultrasonography (sonograms)

Question 59

Measurement of fundal height (Mcdonald rule) Assessment begins during the ___ trimester when the fundus is palpable at the level of the umbilicus

Answer 59

second

Question 60

Measurement of fundal height (Mcdonald rule) Assessment begins during the second trimester when the fundus is palpable at the level of the umbilicus (at _weeks) and continues until it reaches the xiphoid process (at _weeks)

Answer 60

20 36

Question 61

Measurement of fundal height (Mcdonald rule) Measurement involves using a nonelastic, flexible measuring tape, placing the zero point on the ___border of the ____, and stretching the tape across the abdomen at the midline to the top of the __

Answer 61

superior , symphysis pubis fundus.

Question 62

In primigravida (first-time mothers), quickening normally is detected between _ gestation.

Answer 62

18 and 20 weeks’

Question 63

In multigravidas, quickening may occur as early as __ week

Answer 63

16

Question 64

is typically described as a light fluttering feeling; it may be mistaken for flatus

Answer 64

Quickening

Question 65

may be used during the antepartum period to evaluate fetal status. It can demonstrate fetal heart rate changes in response to fetal movement and spontaneous or induced uterine contractions .

Answer 65

EFHM

Question 66

Common EFHM studies are the

Answer 66

nonstress test (NST) and the contraction stress test (CST).

Question 67

This test would not be performed until about 38+ weeks and only if there were other indications of a problem like the biophysical profile or MSAFP

Answer 67

Contraction Stress Test (CST)

Question 68

Other procedures also referred to as “kick counts” assessed by the mother, and a is placed on the monitor strip. Fetal heart rate in relation to fetal movement is explained. There should be a slight rise in fetal heart rate immediately before movement

Answer 68

Fetal activity determination

Question 69

Other procedures help monitor fetal status For example, serum human chorionic gonadotropin indicates a viable fetus, and serum estriol and human placental lactogen reflect fetal homeostasis.

Answer 69

Routine maternal urinalysis & serum assays

Question 70

Other procedures Includes MSAFP, human chorionic gonadotropin, and unconjugated estriol. Together they increase the detection of trisomy 18 and trisomy 21 performed between 15 and 22 weeks and are considered positive, if all three markers are low. Further testing for karyotyping is usually offered.

Answer 70

Triple screening

Question 71

Other procedures a first trimester (10 to 12 weeks) alternative to amniocentesis for prenatal diagnosis of genetic abnormalities. accomplished by needle aspiration of a sample of chorionic villi, either by the transcervical on transabdominal route.

Answer 71

CVS

Question 72

Other procedures can determine fetal maturity, and detect certain birth defects (eg. Down syndrome or spina bifida), hemolytic disease of the newborn, and sex and chromosomal abnormalities

Answer 72

Amniocentesis

Question 73

Other procedures also called cordocentesis may be performed in the second or third trimesters to investigate or treat conditions requiring direct access to the fetal vascular system

Answer 73

Percutaneous umbilical blood sampling (PUBS)

Question 74

Other procedures enables direct fetal visualization through a fetoscope; a fiberoptic optical instrument, inserted through the abdominal and uterine walls to identify fetal developmental abnormalities. The fetoscope can retrieve tissue and blood samples to detect hemophilia or other disorders and may be used for some types of fetal surgery

Answer 74

Fetoscopy