NR327 Maternal-Child Exam #1 Study Guide
Please note that not everything on the exam will be on the study guide. This is to be used as a guide to assist with studying. You are responsible to know all of the topics th
...
NR327 Maternal-Child Exam #1 Study Guide
Please note that not everything on the exam will be on the study guide. This is to be used as a guide to assist with studying. You are responsible to know all of the topics that are covered in the textbook. This study guide will serve as a tool to narrow down the otherwise broad topics and areas of study. I hope this helps! Happy studying.
o If they are non-immune, we have to give her the MMR within 72
hrs of delivery. Because the MMR is a live virus, we should educate patients that they should not attempt to get pregnant from one to three months.
• Yields positive benefits and should consist of 30 min of moderate
exercise (walking or swimming) daily if not medically or obstetrically contraindicated.
■ Avoid the use of hot tubs or saunas.
■ Consume at least 2 to 3 L of water each day from food and beverage sources.
o consist of performing external palpations of the maternal uterus
through the abdominal wall to determine the following: Number of fetuses Presenting part, fetal lie, and fetal attitude.
o Heard over the fetal back
• Probable, presumptive, positive signs of pregnancy
-Presumptive Signs: (changes felt by the women, signs but not prof)
- Probable Signs: (observed by nurse and are more reliable signs)
- Positive Signs:
• Fundal height measurements and palpate
o The fundal height first day after birth should be 1 cm below the umbilicus, should be midline and firm immediately after delivery (decreases about 1 com per day)
• Amniocentesis preparation and procedure (identifying conditions)
o With the use of ultrasound, a sterile needle is inserted through the abdominal wall into the amniotic sac. Small amount of fluid is withdrawn. Fetal cell and amniotic fluid is separated (chemical, DNA and Chromosomal)
• NST preparation and what to expect (nonreactive vs. reactive)
o Evaluate fetal heart rate with fetal activity, looking for acceleration occur with fetal movements, interpretation
o REACTIVE: 2 or more FHR accelerations of at least 15 bpm with a duration of at least 15 seconds in a 20-minute interval
o NONREACTIVE: Reactive criteria not met within 30 minutes
o “NNN” NON_REACTIVE, NON_STRESS TEST IS NOT GOOD!!
• Signs preceding labor
o Backache, Weight Loss, Lightening (fetal head has dropped), Contractions, Increased Vagal Discharge, Energy Burst, GI changes, Cervical Ripening (cervix becomes soft, partially effaced), Assessment of the amniotic fluids.
• Black cohosh
o Can be used to terminate a pregnancy, and can be taken to induce labor and should not be taken by women in the first or second trimesters. Causes GI discomfort, headache.
• Nutritional intake during pregnancy
o The patient should have a diet journal with. 340 calories per day in second trimester, 462 calories per day increased in third trimester.
o Folic Acid foods: beef, red meats, dried peas, cereals and breads.
o Iron Supplements: Best absorbed between meals and with Vitamin C (MILK AND CAFFEINE INTERFERE).
o Calcium: 1,000 mg/day
o Fluid: 8 to 10 glasses of water per day.
o Limit coffee to 200 mg of coffee per day
o PKU: foods that are high in protein should be avoided.
• Urinary frequency during pregnancy (what to expect)
o The extra blood flow increases the urine and the weight of the fetus.
• Serum alpha fetoprotein indications (Who should get it, etc.)
o Part of the triple test, during 14th to 22nd week of pregnancy.
o FOR WOMEN WHO: have family history of birth defects, 35 or older, medications during pregnancy and diabetes.
o Looking for possible genetic disorder, high levels show a neural tube defect such as spina bifida or anencephaly.
o Low levels can indicate that there is a trisomy 21 or 18 defect.
o Once the embryo reaches the blastocyst stage, approximately five to six days after fertilization, it hatches out of its zona pellucida and begins the process of implantation in the uterus
o Heartburn may occur during the second and third trimesters due
to the stomach being displaced by the enlarging uterus and a slowing of gastrointestinal tract motility and digestion brought about by increased progesterone levels. The client should eat small frequent meals, not allow the stomach to get too empty or too full, sit up for 30 min after meals, and check with her provider
prior to using any over-the-counter antacids.
o Inevitable: If the cervix becomes dilated, the bleeding increases and there is pain.
o Threatened: Vaginal bleeding before 24 weeks gestation when there is a viable fetus without cervical dilation and pain
• Vaginal secretions during pregnancy
o Lochia Rubra: Dark Red will last 3 – 4 days after delivery, blood and fetal membranes
o Lochia Serosa: Pinkish Brown will last 4 – 10 days, less red blood cells and more white cells
o Lochia Alba: Whitish Yellow will last 10 – 28 days and is white fluid
• Skin changes during pregnancy (linea nigra, chloasma, striae gravidarum)
o Linea Nigra: Dark Line of pigmentation from umbilicus to the pubic area
o Chloasma: an increase in pigmentation on the face
o Strie Gravidarum: Stretch marks
• Nutritional requirements during lactation (Zinc)
o Protein increased, vitamins A, E, C
• Physiologic changes during pregnancy (lordosis)
o
• Immunizations during pregnancy (influenza)
o HEP A and HEP B, Influenza, Tdap, Tentanus, Meninococcal and Pneumoccocal both if indicated (no live)
• Order of changes (amenorrhea, goodell’s sign, quickening, lightening); what comes first etc.
o
• PKU while pregnancy (foods to avoid)
o
• Rhogam injections (Rh incompatibility complications, ex. Hydrops)
• Exercise during pregnancy
• BPP (What is being evaluated?)
• Kegel exercises
• Smoking during pregnancy (risks for newborn)
• True labor vs. False labor
• Signs of labor
• Pattern-paced breathing (hyperventilation)
• Crowning (which station?)
• Supine hypotension
• Cord prolapse (what to do)
• Decelerations and interventions
• Station
• Fetal position in relation to where to find FHT’s
• Backache in labor in relation to OP
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