NUR 4130: STUDY GUIDE FOR OB FINAL EXAM Winter 2018

NUR 4130: STUDY GUIDE FOR OB FINAL EXAM Winter 2018 The OB portion of the examination will contain 50 multiple questions. Time allotted for this portion of the exam will be 75 minutes. The following study guide is intended to assist you in preparing for the examination and may not contain ALL information included on the exam. Please review Chapter’s 10, 11, 12, 13, 14, 15, 16, & 21 including PowerPoints, pre-class quizzes and worksheets at the end of each chapter. Just review the information, focus on what we discussed in class! Please review: Blood Types and Rh Factor/RhoGAM -determines woman’s blood type and Rh status to rule out any blood incompatibility issues early; Rh-negative mother would likely receive RhoGam (at 28 wks gestation) and again within 72 hrs after childbirth, if she is Rh sensitive Gravida/Parity/TPAL/Estimated due date/Nagele Rule - Gravida: total # of times a woman has been pregnant regardless of whether the pregnancy resulted in termination or if multiple infants were born from a pregnancy (THE CURRENT PREGNANCY INCLUDED) Term: number of pregnancies ending 37 weeks gestation, at term Preterm: the number of pregnancies ending 20 weeks or viability but before completion of 37 weeks Abortions: the number of pregnancies ending before 20 weeks or viability, spontaneous abortion or by choice Living Children Gravida- The total number of times a woman has been pregnant. regardless of whether the pregnant resulted in a termination or if multiple infants were born from a pregnancy Parity- The number of pregnancies, NOT the number of FETUSES, carried to the point of viability, regardless of the outcome. Primigravida: a woman pregnant for the first time MultiGravida: a woman pregnant for atleast the 3rd time Nagele’s Rule -use first day of last normal menstrual period -subtract 3 months -add 7 days -add 1 year -ex: LNMP: 11/21/17  subtract 3 mos 8/21/17  add 7 days 8/28/17  add 1 year 8/28/18= EDB Determining Expected Date of Delivery (EDD) -ultrasound is the best method of dating a pregnancy (Ex based on size of baby) -gestational or birth calculator wheel Physiological & psychological adaptions of pregnancy (study week 1 PPT slides 32-53) Fundal height measurements -Fundal Height: the distance in cm measured with a tape measure from the top of the pubic bone to the top of the uterus (fundus) with the client lying on her back with her knees slightly flexed, fundal height typically increases as the pregnancy progresses, it reflects fetal growth and provides a gross estimate of the duration of pregnancy. between 12-14 weeks: the fundus can be palpated above the symphysis pubis 20 weeks: the fundus reaches the level of the umbilicus at approximately 20 cm  after 36 weeks, the fundal height drops due to lightening and may no longer correspond with the week of gestation fundal measurement should approximately equal the number of weeks of gestation until week 36. Ex: fundal height of 24cm suggests a fetus at 24 weeks  if growth curve flattens or stays stable it may indicate the presence of FGR  if the fundal height is greater than 4cm from the estimated gestational age, further eval is warranted if a multifetal gestation has not been diagnosed or hydramnios has not been ruled out Weight gain/Exercise in pregnancy - Maternal Weight Gain Normal/underweight/overweight -normal/Healthy weight BMI: 25 to 35 lb  first trimester: 3.5-5lb  second and third trimesters: 1lb/wk -underweight/BMI 19.8: 28-40 lb  first trimester: 5lb  second and thirs trimesters: 1+ lb/wk -overweight/BMI 25: 15-25lb  first trimester: 2lb  second and third trimesters: 2-3 lb/wk -obese/BMI 30: 11-20lb - Exercise in pregnancy -consume liquids before, during and after -ask HCP before starting a new exercise -avoid exercise in hot, humid weather or when you have a fever -stop if you experience vaginal bleeding, dizziness, chest pain, HA, muscle weakness, calf pain or swelling, uterine contractions, decreased fetal movement, or fluid leaking from the vagina -exercise 3 or 4 times each week, not sporadically -engage in brisk walking, swimming, biking, or low impact aerobics, these are …………………………..CONTINUED…………………………