NUR 238 - Exam 1 Review

Question 1

What does smoking cause?

Answer 1

• Low birth weight

- IUGR (Intrauterine growth restriction)

Question 2

Important nurse concept with wide demograpics.

Answer 2

• Acknowledge different cultural practices

- Use translator when necessary

Question 3

How do you avoid preterm labor?

Answer 3

Hydrate.

Question 4

What is the range for normal weight gain in pregnancy?

Answer 4

25-35lbs.

Question 5

What are all the phases in Stage 1 of labor?

Answer 5

• Latent Phase
• Active Phase
• Transitional Phase

Question 6

Facts about the Latent Phase.

Answer 6

• Cervix: 0-3cm
• Cx frequency of 5-30mins
• Cx’s irregular
• Talkative and eager

Question 7

Facts about the Active Phase.

Answer 7

• Cervix: 4-7cm
• Cx frequency of 3-5mins
• Rapid dilation and effacement
• Some fetal descent
• Anxiety, restlessness, helplessness

Question 8

Facts about the Transitional Phase.

Answer 8

• Cervic: 8-10cm
• Cx frequency of 2-3mins
• Complete dilation
• Urge to push
• Nausea, vomiting
• Feeling need to have BM
• Tired, irritable, fearful
• Increased bloody show

Question 9

Facts about Stage 2 of labor.

Answer 9

• Full dilation
• Prepare for delivery
• Do not take pt to bathroom
• Rupture of membranes
• Birth (delivery of fetus)

Question 10

Facts about Stage 3 of labor.

Answer 10

From time the baby is born to expulsion of placenta.

Question 11

Facts about Stage 4 of labor.

Answer 11

• Delivery of placenta
• Maternal stabilization of vitals
• Patient/newborn attachment
• Perineal assessment

Question 12

What is the purpose of Amniotic Fluid?

Answer 12

• Maintain temperature
• Provides protection
• Allows for freedom of movement for musculoskeletal development

Question 13

What is the normal amount of Amniotic Fluid?

Answer 13

800-1200mL.

Question 14

What is the term for an Amniotic Fluid level of less than 300mL?

Answer 14

Oligohydramnios.

Question 15

What is the term for an Amniotic Fluid level of more than 2000mL?

Answer 15

Polyhydramnios.

Question 16

What does increased overall blood volume do to Hematocrit, etc?

Answer 16

Dilute the values.

Question 17

When do you seek Prenatal Care?

Answer 17

• Before becoming pregnant

- Genetic testing for risk factors

Question 18

If a patient presents with family history of spinal disorders, what is the recommendation?

Answer 18

Folic acid supplements.

Question 19

What does Folic Acid help prevent?

Answer 19

Neural tube defects.

Question 20

Which foods are good sources for Folic Acid?

Answer 20

• Leafy, green vegetables
• Dried peas
• Beans
• Seeds
• Orange juice

Question 21

What is the purpose of Iron Supplements?

Answer 21

Increase RBC mass.

Question 22

When are Iron Supplements best absorbed?

Answer 22

Between meals in conjunction with Vitamin C.

Question 23

What is the purpose of Calcium?

Answer 23

Bone & teeth formation.

Question 24

Which foods are good sources for Calcium?

Answer 24

• Milk
• Fortified soy milk
• Fortified OJ
• Nuts
• Legumes
• Dark, leafy, green vegetables

Question 25

What are the goals for Healthy People 2020/30?

Answer 25

- Reduce infant mortality - Decrease in SIDS * *no co-sleeping * *infant sleeps on back - Increase prenatal care - Decrease cesarean births

Question 26

What is the normal Fetal Heart Rate?

Answer 26

110-160bpm.

Question 27

What is Hyperemesis Gravidarum?

Answer 27

Persistent vomiting which produces weight loss, dehydration, and electrolyte imbalance.

Question 28

Advice for patients with nausea?

Answer 28

- Avoid greasy foods | - High carbohydrate snack in AM

Question 29

Signs for Presumptive Pregnancy?

Answer 29

- Amenorrhea - Fatigue - Nausea & Vomiting - Breast changes - Quickening - Uterine enlargement

Question 30

Signs for Probable Pregnancy?

Answer 30

- Hegar's sign - Chadwick's sign - Goodell's sign - Ballottement - Braxton Hick's contractions - Positive pregnancy test - Fetal outline

Question 31

Signs for Positive Pregnancy?

Answer 31

- Fetal heart sounds - Visualization of fetus by ultrasound - Fetal movement palpated by examiner

Question 32

What is Amniocentesis?

Answer 32

Aspiration of amniotic fluid.

Question 33

What is the purpose for an Early Amniocentesis?

Answer 33

Test for neural tube defects (spina bifida, anencephaly).

Question 34

What is the purpose for a Late Amniocentesis?

Answer 34

Lung maturity (L/S ratio - 2:1).

Question 35

What does an increased Alpha-Fetoprotein (AFP) indicate?

Answer 35

Neural tube defects.

Question 36

What does a decreased Alpha-Fetoprotein (AFP) indicate?

Answer 36

Down's syndrome.

Question 37

List of Pregnancy Discomforts.

Answer 37

- Mood swings - Heartburn - Back pain

Question 38

List of Pregnancy Warning Signs.

Answer 38

- Tachycardia - Dysuria - Vaginal bleeding - Changes in fetal movement - Edema of *hands and face* - Severe vomiting

Question 39

How do you relieve back pain?

Answer 39

Pelvic rocking.

Question 40

Regarding Kick Counts, what should you monitor before telling your provider?

Answer 40

Less than 3 kicks/hour, contact provider.

Question 41

What is TORCH?

Answer 41

- Toxoplasmosis - Other (HIV, HIB, Syphilis, Hep B) - Rubella - Cytomegaly - Herpes

Question 42

Which vaccine do you not give pregnant patients?

Answer 42

Rubella.

Question 43

If the pregnant patient has herpes, what do you administer?

Answer 43

Valtrex.

Question 44

Facts on 8-week Gestation.

Answer 44

Fetal heartbeat via doppler.

Question 45

Facts on 12-week Gestation.

Answer 45

- Sonogram | - Chorionic Villus Sampling

Question 46

What is Chorionic Villus Sampling (CVS)?

Answer 46

Assessment of placenta for chromosomal disorders.

Question 47

What are the risks with CVS?

Answer 47

- Risk to fetus | - Risk of rupturing membrane

Question 48

Facts on 16-week Gestation.

Answer 48

- Testing Alpha-Fetoprotein (AFP) is now possible - Triple or quad screen - Screening for preeclampsia - Amniocentesis

Question 49

Facts on 20-week Gestation.

Answer 49

- Sonogram for growth | - Fundal height measurement (equal to gestational age weeks)

Question 50

Facts on 25-28 weeks Gestation.

Answer 50

- Glucose challenge test (1hr) for dx gestational diabetes - Antibody testing - Test for gestational diabetes mellitus

Question 51

If the glucose levels is 130-140mg/dL or greater, what kind of test is required?

Answer 51

3-hour test.

Question 52

What do you administer if a pregnant patient is RH negative?

Answer 52

Rhogam.

Question 53

What vaccine can be given at 30-week gestation?

Answer 53

TDAP vaccine, NOT rubella.

Question 54

What do you test for at 35-weeks gestation?

Answer 54

- Group B Strep Test | - Utilize a vaginal/rectal swab

Question 55

Facts on 37-40 week Gestation.

Answer 55

- BPP - Cervical Exam - Non-Stress Test - Contraction Stress Test (CST)

Question 56

What does a Non-Stress Test do?

Answer 56

Assess FHR in relation to movement.

Question 57

What does a Contraction Stress Test (CST) do?

Answer 57

- Analysis of FHR to contractions - Indicated for non-reactive stress test - Initiate IV oxytocin to stimulate contractions

Question 58

What is Bio-Physical Profile (BPP)?

Answer 58

Assessment of fetal well-being by 5 variables.

Question 59

What are the 5 variables assessed by the BPP?

Answer 59

- FHR (2 points) - Breathing movements (2 points) - Body movements (2 points) - Fetal tone (2 points) - Amniotic Fluid Volume (2 points)

Question 60

If a fetus gets 8-10 points on a BPP, what is this indicative of?

Answer 60

Normal fetal health.

Question 61

If a fetus gets 6 points on a BPP, what is this indicative of?

Answer 61

Follow-up with health care.

Question 62

What is Lightening?

Answer 62

Fetal head drops into pelvis.

Question 63

What is the purpose of Progesterone?

Answer 63

Prevents uterus from contracting.

Question 64

What is the purpose of Estrogen?

Answer 64

Prepares uterus for implantation.

Question 65

What is the purpose of an Intra-Uterine Pressure Catheter (IUPC)?

Answer 65

Measures contraction intensity.

Question 66

How do you help a pregnant patient with calf cramps?

Answer 66

Flexion.