Maternity Nursing

Question 1

First Trimester:

Answer 1

Week 1 -13

Question 2

Presumptive signs of pregnancy:

Answer 2

amenorrhea, N/V, frequency, and breast tenderness

Question 3

what is the name of the hormone that causes amenorrhea?

Answer 3

Progesterone

Question 4

Probable signs of pregnancy:

Answer 4

positive pregnancy test, goodell, chadwick, hegar, uterine enlargement, braxton hicks contractions, pigmentation/changes of skin

Question 5

Goodell’s Sign

Answer 5

softening of the cervix, second month

Question 6

Chadwick’s sign

Answer 6

Bluish color of vaginal mucosa and cervix; week 4

Question 7

Hegar’s Sign

Answer 7

softening of the lower uterine segment; 2nd/3rd month

Question 8

Braxton Hicks contractions

Answer 8

throughout pregnancy; move blood through placenta

Question 9

Pigmentation/Changes of Skin

Answer 9

Lina Nigra (dark line down abdomen), abdominal striae (stretch marks), facial chloasma (mask of pregnancy), darkening of areola

Question 10

Positive Signs of Pregnancy

Answer 10

Fetal heartbeat (10-12 wks), Fetoscope (17-20wks), fetal movement, ultrasound

Question 11

Gravidity:

Answer 11

number of times someone has been pregnant

Question 12

Parity:

Answer 12

number of pregnancies in which fetus reaches 20 weeks

Question 13

Viability

Answer 13

24 plus weeks= infant has ability to live outside uterus

Question 14

Nutrition Teaching:

Answer 14

4 food groups, increase calories by 300 per day after 1st trimester, adolescent: increase calories by 500 after 1st trimester, increase protein 60g per day

Question 15

Weight gain first trimester?

Answer 15

gain 4 pounds in first trimester

Question 16

Why don’t women like to take iron?

Answer 16

Causes constipation and GI upset

Question 17

You should take iron with what vitamin?

Answer 17

Vitamin C helps absorb

Question 18

Folic acid prevents what defect?

Answer 18

Neural Tube Defect

Question 19

Daily dose of vitamin?

Answer 19

400 mcg/day

Question 20

Danger signs:

Answer 20

sudden gush of vaginal fluid, bleeding, persistent vomiting, severe headache, abd pain, increased temps, edema, no fetal movement

Question 21

Common discomforts:

Answer 21

N/V, breast tenderness, frequency, tender gums, fatigue, heartburn, increased vaginal secretions, nasal stuffiness, varicose veins, ankle edema, hemorrhoids, constipation, backache, leg cramps

Question 22

Weight gain second trimester?

Answer 22

4 pounds per month

Question 23

What is quickening?

Answer 23

Fetal movement

Question 24

Expected weight gain third trimester?

Answer 24

no more than 1 pound a week

Question 25

How is fetal position/presentation determined?

Answer 25

Leopold's maneuver

Question 26

If pt is having contractions, should maneuvers be done during or between contractions?

Answer 26

Between

Question 27

Signs of Labor:

Answer 27

Lightening, engagement, fetal stations, braxton hicks contractions, softening of cervix, bloody show, sudden burst of energy (nesting), diarrhea, rupture of membranes

Question 28

What are we worried about if membranes rupture?

Answer 28

prolapsed cord

Question 29

Non-stress test

Answer 29

Want to see two or more accelerations of 15 beats/min or more w/fetal movement, each increase should last for 15 secs and recorded for 20 min, and want it to be reactive

Question 30

Accerlation:

Answer 30

FHR has an abrupt increase from baseline

Question 31

Biophysical Profile Test

Answer 31

done in last trimester, but can be done at 32-34 weeks in high risk pregnancy (high risk pregnancy may have BPP every week or twice week in 3rd trimester); measurements done by u/s, each parameter counts 2 pmts (10/10 great); BPP measurement (HR, muscle tone, movement, breathing, amniotic fluid); observation time is 30 min, results evaluated

Question 32

Contraction Stress Test (CST): Oxytocin Challenge Test

Answer 32

done when NST is nonreactive, performed on high risk pregnancies, determines if baby can handle stress of uterine contraction

Question 33

Uterine contraction causes what?

Answer 33

decrease blood flow to uterus and placenta

Question 34

What is deceleration?

Answer 34

blood flow decreases enough to cause hypoxia in fetus fetal heart rate will decrease from baseline HR

Question 35

Do not want to see late decelerations?

Answer 35

uteroplacental insufficiency (placenta weakening)

Question 36

Do you want a positive or negative CST?

Answer 36

negative

Question 37

Early Decelerations

Answer 37

caused by physiological hypoxia from fetal head compression

Question 38

Late Decelerations

Answer 38

caused by uteroplacental insufficiency

Question 39

True Labor

Answer 39

Regular contractions, increase contraction frequency and duration, discomfort in back and radiates to abdomen, pain level increases w/activity

Question 40

False Labor

Answer 40

irregular contractions, discomfort in just front abdomen, pain decreases w/activity

Question 41

Epidural Position

Answer 41

Lie on left side, legs flexed, not as arched as w/lumbar puncture

Question 42

When do you give an epidural?

Answer 42

Stage 1 at 3-4 cm dilation

Question 43

Major complication w/epidural?

Answer 43

hypotension (monitor BP)

Question 44

What should you give with epidural to help fight hypotension?

Answer 44

IVFS: Bolus w/1000mL of NS or LR

Question 45

What position to prevent vena cava compression?

Answer 45

semi-folwers on side (alternate side by side hourly)

Question 46

When should oxytocin be discontinued?

Answer 46

contractions are too often, contractions last too long, fetal distress

Question 47

What position should client receiving oxytocin be placed?

Answer 47

any position except flat on their back, if fetal HR is unreassuring then put on left side to enhance uterine perfusion

Question 48

What should be done w/infusion if late decelerations occur?

Answer 48

turn off