NURSING 2139 - Exam 1 Review.

Test 1 Notes

Reproduction

 Conception
o Joining of egg and sperm
 Gestation
o Embryo grows
o How long the pregnancy lasts
o 40 weeks
 Childbirth
o Actual laboring process

Physiology

 Pelvis
o Gynecoid pelvis- women (ideal for childbirth)
o Android pelvis- men
 Reproductive cycle
o Menstruation-uterus shedding (usually 28 days)
o Ovarian cycle- egg is mature (follicle) (usually a week)
 Uterus
 Fallopian tubes
 Ovaries

Risk for Altered reproduction

 Female
o Hysterectomy
o Amenorrhea
o Dysfunctional periods
o HTN and diabetes
o Age- after 35 eggs are diminished
o Endometriosis- uterine lining forms on inside and outside
o STDs
 Lack of treatment makes you sterile
o PCOS- polycystic ovarian syndrome and you have cysts
o Congenital deformities
o Drug abuse
 Smoking
 Reduces egg production
 Male
o Drug use
o Temperature
 Lower than body temperature
 Testicles twist, testes don’t drop
o Sterility

,Assessment

 Health history
 Physical examination
o Ovarian function
o Pelvic organs (fallopian tubes, ovary, uterus)
o Pap smear
 Cancer cells
 Inflammation
o Cervical cultures- to rule out STI’s
o Ultrasound to visualize fallopian tubes and ovaries Hysterosalpingography
o Endometriosis
 Laparoscopy

Labs and diagnostics

 Ovulation predictor kits
 Urinary LH levels-need this hormone to get pregnant and maintain pregnancy
 Clomiphene citrate challenge test
o How many eggs available to mature
 Hysterosalpingography
o Views fallopian tubes, ovaries, uterus
 Semen analysis- for men to see about sperm count, motility and shape

Management of reproduction

 Contraception
o Abstinence- do not have sex 100% guaranteed way
o Fertility awareness based methods- do not have sex when ovulating
o Barrier methods- condoms
o Hormonal methods- birth control, shots, IUD, pills
o Sterilization- tubal ligation, vasectomy

Other concepts

 Family
o Family dynamics
o Stressful or joyous
 Nutrition
o Must be healthy
o Increase vitamins

,Prenatal/Antepartum

 Before you find out your pregnant until the labor phase
 Box 11.1




 BOX 11.1
SIGNS AND SYMPTOMS OF PREGNANCY

Presumptive (Time Probable (Time of Positive (Time of Occurrence)
of Occurrence) Occurrence)
Fatigue (12 wks) Braxton Hicks contractions (16– Ultrasound verification of embryo or fetus (4
Breast tenderness (3–4 wks) 28 wks) wks)
Nausea and vomiting (4–14 Positive pregnancy test (4–12 Fetal movement felt by experienced clinicia
wks) wks) (20 wks)
Amenorrhea (4 wks) Abdominal enlargement (14 wks) Auscultation of fetal heart tones via Dopple
Urinary frequency (6–12 wks) Ballottement (16–28 wks) (10–12 wks)
Hyperpigmentation of the skin Goodell’s sign (5 wks)
(16 wks) Chadwick’s sign (6–8 wks)
Fetal movements (quickening; Hegar’s sign (6–12 wks)
16–20 wks)
Uterine enlargement (7–12
wks)
Breast enlargement (6 wks)


Probable signs of pregnancy

 Hagar’s sign- softening of the low part of the uterus
 Goodells sign- softening of the cervix
 Chadwick sign- blackish bluish color of the vaginal mucosa in the cervix
 Braxton Hicks- false labor

Trimesters

 1st- first 12 weeks
o Drastic chance of miscarriage
nd
 2 - 13 to 20 weeks
 3rd -28 to birth

Prenatal visits

 1st and 2nd you will go to the dr monthly
 29-36 you will go twice a week
 37 weeks you go every week
 History and physical
 How many children do you have
 Measure fundal height at 2nd trimester
 Medications
 STDs

,  Drug use
 Mental health history
 Family history- genetic disorders
 Diabetes, hypertension
 Culturally sensitive care
 Occupation

Pharmacology

 Prenatal vitamins
o Folic acid- for brain development
 Anti-emetics
o Zofran- usually does not give in first trimester
o Phenergan
 Iron supplements
o Take with food and drink plenty of water
o Or cook in a cast iron skillet
 Acetaminophen
 Music therapy
 Relaxion
 Tocolytics- prevents pre-term labor
o Indomethacin
o Nifedipine
o Terbutaline
 Rhogam
o RH negative moms and RH positive babies
o Amniocentesis
o First dose at 28 weeks
o Second dose 72 hours after delivery to protect future pregnancies

Medical history

 Congenital diseases
 Medications
 Drug use
 Mental health history
o Psych drugs
 Occupational history
 Religious/ cultural history

GTPAL system

 G- gravida (how many times you have been pregnant)
 T- term- (infants born b/t 38-42 weeks)
 P- preterm- (born after 20 weeks but before 38 weeks whether living or stillborn)
 A- abortion- (birth that occurs before 20 weeks of viability or fetus weighing less than 500 grams)
 L- living- number of currently living children
 Gravita- # of pregnancies
 Para- number of deliveries after 28 weeks gestation
 Gestation- any pregnancy

Nagele’s Rule