N 335 Exam 1 study guide topics
Antepartum
Terminology & GTPAL nomenclature
Diagnosis of pregnancy & signs: presumptive, probable & positive
Nutrition during pregnancy & sources of nutrients: iron, carbs, protein, calcium
Hormonal influences during pregnancy
Fundal height progression
EDD calculation: Nagele’s rule
A&P of pregnancy-structure and functions
Diagnostic testing during pregnancy: NST, CST, BPP
Body changes during pregnancy
PIH, Pre-eclampsia: s/s, diagnosis & treatment
GDM: s/s, diagnosis & treatment
Placenta previa & abruptio placentae
Gyn
Contraception options: mechanism, effectiveness, STI protection, precautions
Menstrual complications: s/s, treatment, patient education
Women’s health promotion: PAP, Mammo frequency
Here are some questions you could use to guide studying:
Antepartum Part 1
1. What is the typical amount of amniotic fluid in a healthy pregnancy?
- Increases weekly during pregnancy
- 800-1200mL(cc) at birth
- Oligohydramnios—too little fluid (<300mL of amniotic fluid)
2. What are the functions of amniotic fluid?
- Maintains fetal body temp
- Freedom of movement for musculoskeletal development
- Prevents fetus from tangling up in cord
- Cushioning for fetus
3. What is the function of the umbilical cord? What is the typical anatomy and
physiology?
- 1 vein, 2 arteries (AVA)
o Arteries = deoxygenated blood
o Vein = oxygenated blood
4. What is the function of the placenta?
- Metabolic connection between mom & fetus
- Endocrine organ for mom – secretes hormones
, - Oxygen + nutrients etc. to baby – baby’s lifeline
5. Describe some of the milestones in human development before birth.
- 3-5 wks: Neuro development
- 9-10 wks: pivotal in organ development
- 16+ wks: everything should be developed & continue to grow
6. What is unique about fetal circulation? What is the purpose of these differences?
- Fetal arteries carry deoxygenated blood
- Fetal veins carry oxygenated blood
o This is opposite of normal
- Three shunts permit most of the blood to bypass the liver & lungs
o Ductus Venosus – brings oxygenated blood from placenta R atrium
o Foramen Ovale – Between R & L atrium
o Ductus Arteriosus – closes ~24hrs after birth
- Poorly oxygenated blood returns to the placenta for oxygen & nutrients thru
umbilical arteries
7. Approximately when in gestation do fetal lungs mature? How does this occur?
- 24 wks birth = lungs still developing
- 32 wks = sufficiently developed
o Pulmonary surfactants: Lecithin & Sphingomyelin – phospholipids that
decrease surface tension on the alveoli in the lungs allows them to expand
& take up O2
w/o – like trying to blow up a balloon but can’t
8. Know GTPAL and G/P meanings
- GTPAL
o G (Gravida) = # of pregnancies
o T = # term births (after 37wks)
o P = # preterm births (between 22-37wks)
o A = # abortions/miscarriages
o L = # living children
- G/P
o Gravida/Para = pregnancies/births
9. When does each trimester begin and end?
- First: 1-13wks
- Second: 14-26wks
- Third: 27-40wks
10. How early can you diagnose pregnancy?
- As early as 7 days after conception
11. How can you diagnose pregnancy?
- HCG (Human Chorionic Hormone) testing
12. How do you calculate estimated due date? What is Nagele’s rule? Practice calculating
due dates.
- 1st day of LMP, subtract 3mo, add 7 days + 1yr
, 13. What are the differences between presumptive, probable, and positive signs of
pregnancy?
- Presumptive: changes felt by the woman
- Probable: changes observed by examiner
- Positive: signs attributable only to the presence of a fetus
14. What are the typical changes to the uterus during pregnancy?
- Changes in shape, size, & position (looks like an upside-down pear)
o Hegar sign – softening of lower uterine segment – uterus sits on the bladder
- Changes in contractability
o Braxton Hicks sign – can feel at 4mo – increase w/ activity
- Uteroplacental blood flow
o Uterine souffle – sound made by uterine arteries (same as maternal pulse)
o Funic souffle – sound made by umbilical vessels (same as FHR)
- Goodell sign: Cervix softens – more friable
- Changes related to presence of fetus
o Ballottement – feeling the cervix bounce back
o Quickening – first recognition of fetal movement
15. What is fundal height, what is its significance?
- Distance from the pubic bone to the top of the uterus (the fundus)
o Provides info on… baby’s growth & development, size, position
Is baby growing normally?
o Can also tell how much amniotic fluid is in there
Too much or too little = BAD
16. What changes to the vagina, vulva, and breast might you see during pregnancy?
- Vagina & Vulva:
o Chadwick sign – violet blue color due to increased blood flow to area
o Leukorrhea – thick, white vaginal discharge from progesterone
o Vagina lengthens
- Breasts:
o Areolas become larger, nipples erect, breasts increase in size & weight
o Montgomery’s tubercles – hypertrophy of sebaceous glands on nipples
o Colostrum – 1st milk, appears as early as 16wks
Body system Typical changes during pregnancy
Cardiovascular system -Blood pressure (decrease towards end of
preg)
-Blood volume & composition – increase
volume by 30-50% - mostly in plasma, rest in
RBCs
-Cardiac output increases
Circulation & coagulation times – waaaay
more coagulable (at risk for DVTs)
Respiratory system -Pulmonary function – dyspnea at rest later in
Antepartum
Terminology & GTPAL nomenclature
Diagnosis of pregnancy & signs: presumptive, probable & positive
Nutrition during pregnancy & sources of nutrients: iron, carbs, protein, calcium
Hormonal influences during pregnancy
Fundal height progression
EDD calculation: Nagele’s rule
A&P of pregnancy-structure and functions
Diagnostic testing during pregnancy: NST, CST, BPP
Body changes during pregnancy
PIH, Pre-eclampsia: s/s, diagnosis & treatment
GDM: s/s, diagnosis & treatment
Placenta previa & abruptio placentae
Gyn
Contraception options: mechanism, effectiveness, STI protection, precautions
Menstrual complications: s/s, treatment, patient education
Women’s health promotion: PAP, Mammo frequency
Here are some questions you could use to guide studying:
Antepartum Part 1
1. What is the typical amount of amniotic fluid in a healthy pregnancy?
- Increases weekly during pregnancy
- 800-1200mL(cc) at birth
- Oligohydramnios—too little fluid (<300mL of amniotic fluid)
2. What are the functions of amniotic fluid?
- Maintains fetal body temp
- Freedom of movement for musculoskeletal development
- Prevents fetus from tangling up in cord
- Cushioning for fetus
3. What is the function of the umbilical cord? What is the typical anatomy and
physiology?
- 1 vein, 2 arteries (AVA)
o Arteries = deoxygenated blood
o Vein = oxygenated blood
4. What is the function of the placenta?
- Metabolic connection between mom & fetus
- Endocrine organ for mom – secretes hormones
, - Oxygen + nutrients etc. to baby – baby’s lifeline
5. Describe some of the milestones in human development before birth.
- 3-5 wks: Neuro development
- 9-10 wks: pivotal in organ development
- 16+ wks: everything should be developed & continue to grow
6. What is unique about fetal circulation? What is the purpose of these differences?
- Fetal arteries carry deoxygenated blood
- Fetal veins carry oxygenated blood
o This is opposite of normal
- Three shunts permit most of the blood to bypass the liver & lungs
o Ductus Venosus – brings oxygenated blood from placenta R atrium
o Foramen Ovale – Between R & L atrium
o Ductus Arteriosus – closes ~24hrs after birth
- Poorly oxygenated blood returns to the placenta for oxygen & nutrients thru
umbilical arteries
7. Approximately when in gestation do fetal lungs mature? How does this occur?
- 24 wks birth = lungs still developing
- 32 wks = sufficiently developed
o Pulmonary surfactants: Lecithin & Sphingomyelin – phospholipids that
decrease surface tension on the alveoli in the lungs allows them to expand
& take up O2
w/o – like trying to blow up a balloon but can’t
8. Know GTPAL and G/P meanings
- GTPAL
o G (Gravida) = # of pregnancies
o T = # term births (after 37wks)
o P = # preterm births (between 22-37wks)
o A = # abortions/miscarriages
o L = # living children
- G/P
o Gravida/Para = pregnancies/births
9. When does each trimester begin and end?
- First: 1-13wks
- Second: 14-26wks
- Third: 27-40wks
10. How early can you diagnose pregnancy?
- As early as 7 days after conception
11. How can you diagnose pregnancy?
- HCG (Human Chorionic Hormone) testing
12. How do you calculate estimated due date? What is Nagele’s rule? Practice calculating
due dates.
- 1st day of LMP, subtract 3mo, add 7 days + 1yr
, 13. What are the differences between presumptive, probable, and positive signs of
pregnancy?
- Presumptive: changes felt by the woman
- Probable: changes observed by examiner
- Positive: signs attributable only to the presence of a fetus
14. What are the typical changes to the uterus during pregnancy?
- Changes in shape, size, & position (looks like an upside-down pear)
o Hegar sign – softening of lower uterine segment – uterus sits on the bladder
- Changes in contractability
o Braxton Hicks sign – can feel at 4mo – increase w/ activity
- Uteroplacental blood flow
o Uterine souffle – sound made by uterine arteries (same as maternal pulse)
o Funic souffle – sound made by umbilical vessels (same as FHR)
- Goodell sign: Cervix softens – more friable
- Changes related to presence of fetus
o Ballottement – feeling the cervix bounce back
o Quickening – first recognition of fetal movement
15. What is fundal height, what is its significance?
- Distance from the pubic bone to the top of the uterus (the fundus)
o Provides info on… baby’s growth & development, size, position
Is baby growing normally?
o Can also tell how much amniotic fluid is in there
Too much or too little = BAD
16. What changes to the vagina, vulva, and breast might you see during pregnancy?
- Vagina & Vulva:
o Chadwick sign – violet blue color due to increased blood flow to area
o Leukorrhea – thick, white vaginal discharge from progesterone
o Vagina lengthens
- Breasts:
o Areolas become larger, nipples erect, breasts increase in size & weight
o Montgomery’s tubercles – hypertrophy of sebaceous glands on nipples
o Colostrum – 1st milk, appears as early as 16wks
Body system Typical changes during pregnancy
Cardiovascular system -Blood pressure (decrease towards end of
preg)
-Blood volume & composition – increase
volume by 30-50% - mostly in plasma, rest in
RBCs
-Cardiac output increases
Circulation & coagulation times – waaaay
more coagulable (at risk for DVTs)
Respiratory system -Pulmonary function – dyspnea at rest later in
