UPDATED HESI EXAM PREPARATION NOTES, HINTS, AND STUDY GUIDE FOR MATERNAL EXAMS

UPDATED HESI EXAM PREPARATION NOTES, HINTS, AND STUDY GUIDE FOR MATERNAL EXAMS The Menstraul Cycle • The menstrual phase varies in length in most women. • Ovulation occurs approximately 14 days before the next menstrual cycle. • To avoid pregnancy a woman should abstain from unprotected sexual intercourse during her fertile days. The most fertile days for pregnancy are the day before ovulation and the day of ovulation. The fertile period begins 4-5 days prior to ovulation and ends 24-48 hours after ovulation. A couple must avoid unprotected intercourse for several days before an anticipated ovulation and for 3 days after ovulation to prevent pregnancy because sperm can live in a woman’s body approximately 4 to 5 days and eggs live approximately 24-48 hours after being released. • Some women do not realize they are pregnant because they experience implantation bleeding and spotting Antepartum Nursing Care • Signs of healthy psychosocial maternal-fetal bonding include massaging the abdomen, nicknaming the fetus, and talking to the fetus in utero. • For many women, battering (emotional or physical abuse) begins during pregnancy. Women should be assessed for abuse in private, away from the partner, by a nurse who is familiar with local resources and knows how to determine the safety of the client. • Practice determining gravidity and parity. A woman who is 6 weeks pregnancy has the following maternal history o Has healthy 2-year old fraternal twins. o Miscarried at 22 weeks. o Had an elective abortion at 6 weeks, 5 years earlier. o With this pregnancy she is gravida 4, para 2, only 2 deliveries after 20 weeks’ gestation, and twins are two living o GTPAL is 4-1-1-1-2l (G-4 pregnancies (twin’s miscarriage, elective abortion, current pregnancy), T-1 (twins count as one birth), P-1 (22-week miscarriage); A-1 (elective abortion at 6 weeks); L-2 (twins) • Practice calculating EDB. If the first day of a woman’s last normal menstrual period was December 9, what is her EDB, using the Nagele rule? o Answer: September 16th . Count back 3 months and add 7 days. • At approximately 28-32 weeks’ gestation, a plasma volume increase of 25% to 40% occurs, resulting in normal hemodilation of pregnancy and Hct values above 38% or hemoglobin levels above 13g/dL are associated with gestational hypertension. High Hct values may look good, but in reality they represent a gestational hypertension disorder and a depleted vascular space. • Hgb and Hct data can be used to evaluate nutritional status. Example: a 22 year old primigravida at 12 weeks’ gestation has a Hgb of 9.6 g/dL and an Hct of 31%. She has gained 3 pounds during the first trimester. A weight gain of 907.18 to 1814.4 g. (2-4 lbs.) during the first trimester is recommended. Since the client is anemic supplemental iron and a diet higher in iron are needed. • Food high in iron: o Fish and red meats o Cereal and yellow vegetables o Green leafy vegetables and citrus fruits