NURSING NURS 306 OB Final Exam Study Guide – Complete Guide to Score 100% (2023/2024)

NURSING NURS 306 OB Final Exam Study Guide – Complete Guide to Score 100% (2023/2024) Nurse role and relevance of genetics to childbearing families • Common genetic (inherited) conditions that you would counsel and screen patients either prior to pregnancy or at their first prenatal visit • Testing women of advanced maternal age (AMA) (who is considered AMA) and increased risk of chromosomal abnormalities • Teratogens and at what crucial time exposure will cause the most damage o Look at each and understand what risks/complications it may pose to baby or pregnancy o Fetal alcohol syndrome § Causes? Fetal characteristics? o TORCH § Look at each and understand mode of transmission, is there treatment for it? Do we screen for it during prenatal care? How might it affect the pregnancy and baby? § What about viruses and placenta? § How long is zika in male system for? What can zika lead to in newborn who is affected by it? Menstrual Cycle • Consists of two cycles working simultaneously (ovarian and endometrial) è what are levels and roles of estrogen and *progesterone in each cycle • When is a woman most fertile? o What is considered a woman’s LMP (know that this is Day #1 of her cycle) o What happens at time of ovulation (typically what day during the cycle, what the ovaries are doing, the hormone levels, and what the endometrial lining is doing) o What day does conception occur? o When does implantation occur? What part of the blastocyst is involved in implantation? Where does implantation usually happen? What will happen if implantation occurs too early? Embryonic and Fetal Development • When to expect to see fetal cardiac activity on ultrasound • Summary of fetal development - table 3-4, p. 49. • What is considered a term pregnancy? • Difference between identical and fraternal twins • Fetal circulations (ductus venosus, foramen ovale, ductus arteriosis) • Basic concepts of placenta physiology and its purpose o Hormones produced by the placenta (what roles do these hormones play? Which is used to diagnose pregnancy? Which hormone is responsible for regulating glucose availability in the newborn? • Purposes of amniotic fluid • Normal structure of the umbilical cord Infertility • Definition of infertility • Common causes of infertility • Basic work up for infertility Chapter 4 Prenatal Care • What is goal and purpose of prenatal care? • Diagnosing pregnancy o Most likely cause of amenorrhea? (Pregnancy) o Know presumptive, probable and positive signs of pregnancy § Definition of Goodell’s Sign, Chadwick’s sign, Hegar’s sign, quickening § Know what symptoms could possibly attributed to something else versus what actually gives you the diagnosis pf pregnancy o When can I hear baby’s heartbeat with an ultrasound, with a hand held Doppler o When can mom feel quickening? (baby moving)…is there a difference b/w 1st and 2nd time pregnancies? o Where am I expecting to find the fundus at during different gestational ages?…Where would I palpate the fundus at 24 weeks? At 28 weeks? What is normal deviation from this finding? § IF I have finding larger than expected, what might be reasons? § IF I have finding smaller than expected, what might be reasons? • Nutrition- prevention of neural tube defects- ie. spina bifida • Weight gain in pregnancy o Recommended weight gain for underweight, normal, overweight and morbidly obese (box 4-2, pg 83) o Basic nutritional requirements (calories needed and what extra vitamins and minerals are needed) o Maternal weight gain distribution (box 4-3, pg 83) • Schedule of prenatal visits o Know what is done in first trimester, 2nd trimester, 3rd trimester during visits (what tests are done? What is screened for? What vaccines can be given, and which can’t?) • What happens at a first prenatal visit- procedures and work up (know all the prenatal labs that need to be drawn) • Naegele’s Rule in calculating a due date (need LMP) o What is most accurate dating of gestational age? • What to expect the fundal height to be based on the number of weeks gestation= McDonald’s Rule • Definitions of gravida and para, and the TPAL system of term, preterm, abortions and living. Physiological changes of pregnancy (table 4-1, pg 58-62) & Self-Care/Relief Measures (Table 4-5, pg. 88-93) • Go through EACH system and look at the right side of the table with clinical s/s and know what those are and then make sure you know WHY you are seeing those s/s … as in, what change is happening physiologically that is resulting in the clinical s/s the client will be reporting? THEN once you know/understand this, be able to tell client that what they report is normal and what they can do about it (table 4-5). o N/V during pregnancy, fatigue, insomnia, emotional lability, tender/enlarged breasts, Braxton Hicks contractions, increased cervical/vaginal secretions (yeast infections), dyspareunia, supine and orthostatic HTN, anemia, dependent edema, varicosities, hyperventilation and dyspnea, nasal and sinus congestion, bleeding gums, flatulence, heartburn, constipation, hemorrhoids, low back pain, round ligament spasms and pain, leg cramps, stretch marks, skin hyperpigmentation, acne, headaches. o Make sure you understand physiological adaptations of pregnancy especially CARDIAC (how does the body prepare to prevent PPH, physiologically). Re-read pg. 63, 64, 65, 66 and 67.