Maternal Newborn Exam 1

Maternal Newborn Exam 1 What immunization can you NOT have during pregnancy? - CORRECT ANSWERRubella (live virus) How many extra calories does a mom need if she has a normal-weight BMI? - CORRECT ANSWER-about 300 calories (a bagel) What is a psychosocial assessment? - CORRECT ANSWER-history of emotional or physical abuse history of emotional problems Support systems acceptance of pregnancy, plans for care feeding preference for baby How long are trimesters? - CORRECT ANSWER-13 weeks what is nagele's Rule? - CORRECT ANSWER-First day of last menstrual period- 3 months + 7 days= EDD antepartum is considered when? - CORRECT ANSWER-conception to labor Intraparum is considered when? - CORRECT ANSWER-active labor until 2 hrs after baby is born Postpartum is considered when? - CORRECT ANSWER-2 hrs after baby is born to 6 weeks How often should prenatal visits be scheduled for a mom from conception to 28weeks? - CORRECT ANSWER-Every 4 weeks How often should a prenatal visit be scheduled for a mom thats 29-36 weeks? - CORRECT ANSWER-every 2-3 weeks How often should a mom have a prenatal visit between 37 weeks to birth? - CORRECT ANSWER-Every week Nulligravida - CORRECT ANSWER-never been pregnant primigravida - CORRECT ANSWER-woman who is pregnant for the first time multigravida - CORRECT ANSWER-woman who is pregnant for at least the 2nd time para - CORRECT ANSWER-given birth to one or more children who are passed age of "viability" which is 20 weeks (twins count as 1) abortion - CORRECT ANSWER-termination of pregnancy before viability of 20 weeks; induced or spontaneous term - CORRECT ANSWER-37 weeks or greater (para) Preterm - CORRECT ANSWER-20-36.6 weeks (para) GTPAL(M) - CORRECT ANSWER-Gravida Term Preterm Abortions Living Multiple what are some danger signs of pregnancy? - CORRECT ANSWER-gush of fluid from vagina vaginal bleeding abdominal pain fever over 100.4 blurred vision, dizziness, spots before eyes persistent vomiting pre-tibial edema muscular convulsions RUQ pain (liver) un-relievable headaches oliguria/dysuria decrease/absence of fetal movement umbilical cord contains which vessels and how many? - CORRECT ANSWER-one vein and two arteries (always 3 vessels) the umbilical arteries carry which kind of blood? - CORRECT ANSWER-deoxygenated blood What type of blood does the umbilical vein carry? - CORRECT ANSWER-oxygenated blood what is the normal length of the umbilical cord? - CORRECT ANSWER-55cm What is the substance that protects the umbilical cord? - CORRECT ANSWERwharton's jelly, protects from compression or breakage How does the fetus breath in uteuro? - CORRECT ANSWER-placenta supplies oxygen and allows fetus to excrete CO2 into the maternal blood stream. What are the three fetal shunts? - CORRECT ANSWER-foramen ovale ductus venosus ductus arteriosus how do these shunts work? - CORRECT ANSWER-Fetal circulation. Blood leaves the placenta and enters the fetus through the umbilical vein. After circulating through the fetus, the blood returns to the placenta through the umbilical arteries. The ductus venosus, the foramen ovale, and the ductus arteriosus allow the blood to bypass the fetal liver and lungs Fetal hemoglobin and oxygen compared to mother? - CORRECT ANSWER-fetal hemoglobin carries 20-30% more oxygen, 50% more hemoglobin, and higher CO per weight how old does a fetus have to be to be called a "fetus"? - CORRECT ANSWER-9 weeks what is amennorhea? - CORRECT ANSWER-absence of blood quickening - CORRECT ANSWER-first awareness of fetal movement= 18weeks what are presumptive signs of pregnancy? - CORRECT ANSWER-subjective data, what the mom tells us What are probable signs of pregnancy - CORRECT ANSWER-physiological and anatomical changes that can be perceived by the health care provider... (objective data) linea nigra - CORRECT ANSWER-line up mideline of stomach due to collagen overgrowth what are positive signs of pregnancy? - CORRECT ANSWER-auscultation of fetal heartbeat fetal movement observed/palpated by examiner visualization of the fetus on ultrasound (objective data that only relates to fetus) Physiologic changes in the reproductive system of the mom - CORRECT ANSWERincreased estrogen and progesterone 20x enlargement of uterus Expanded circulatory volume Acid pH of vagina what can a UTI cause in a pregnant mom? - CORRECT ANSWER-preterm labor What does progesterone due for circulation? - CORRECT ANSWER-vasodilation to fetal circulation, relaxes everything what is a nullipara cervix? - CORRECT ANSWER-not had baby yet, round. multipara cevix - CORRECT ANSWER-had baby 20 weeks or older, elongated what is mcdonalds rule? - CORRECT ANSWER-the fundus to symphysis distance in cm is equal to the week of gestation between the 20-31st week of pregnancy (probable sign=fundal height measurement) what is the top of the uterus called? - CORRECT ANSWER-fundus when is the placenta fully developed to take over baby's hormones and such? - CORRECT ANSWER-21 weeks What does hCG do? - CORRECT ANSWER-caused by increase of estrogen and progesterone. stops sperm from fertilizing another egg hormone tested in pregnancy tests goes away after placenta development where would you expect the top of the fundus to be located at 20 weeks? - CORRECT ANSWER-umbilicus supine hyptension - CORRECT ANSWER-aka vena cava syndrome weight of uterus compresses vena cava, decreasing blood return to mom. Happens when they lay flat on back pseudoanemia - CORRECT ANSWER-fluid part of blood increases more than RBC component and gives hemodilution. palpatations - CORRECT ANSWER-increases in thoracic pressure w/ sudden movement why do pregnant women waddle? - CORRECT ANSWER-relaxin causes round ligaments to be compressed, causing waddling when should nausea and vomiting subside? - CORRECT ANSWER-by the second trimester what causes morning sickness and constipation? - CORRECT ANSWER-hCG how does human placental lactogen (HPL) effect glucose levels? - CORRECT ANSWER-its an insulin antagonist, increases glucose levels; causes gestational diabetes what causes eye and cognitive changes in pregnant women? - CORRECT ANSWERestrogen thickens cornea pituitary enlarges and causes blurred vision and slight memory loss what is couvade? - CORRECT ANSWER-when father has same cravings as mother and gains weight with her what is nuchal translucency testing looking for? - CORRECT ANSWER-trisomy 21 (down syndrome); combo of ultra sound and serum test; nuchal translucency is the extra padding behind neck of baby what does triple and quad screening look for? - CORRECT ANSWER-AFT, hCG, and estriol levels to detect trisomies and neural tube defects, quad screens inhibin A to increase detection of trimsomys what is chorionic villi sampling? - CORRECT ANSWER-looking for genetic disorders, takes a portion of placenta to test villi what is a amniocentesis? - CORRECT ANSWER-prenatal genetic screening, lung maturity, and infection from sample of amniotic fluid what is an ectopic pregnancy? - CORRECT ANSWER-where fetus grows outside of uterus, usually in fallopian tube non stress test - CORRECT ANSWER-electronic fetal monitoring to observe acceleration of FHR in relation to movement what does a reactive non stress test mean? - CORRECT ANSWER-2 or more accelerations in 20 minutes (15bpm x 15 secs) 32 weeks; means baby's nervous system is intact and healthy Non reactive non stress test - CORRECT ANSWER-lacks insufficient FHR accelerations over 40 mins. no accelerations contraction stress test - CORRECT ANSWER-FHR in relation to uterine contractions. Negative results- good thing. theres no abnormal late decelerations during contraction Positive results- abnormal decelerations what do late decelerations mean? - CORRECT ANSWER-uteroplacental insufficiency what is a biophysical profile? - CORRECT ANSWER-non stress test (showing intact nervous system) and amniotic fluid volume index (reflecting kidney perfusion)............ *FHR acceleration, fetal breathing, fetal movements, fetal tone, and amniotic fluid* what is a toco? - CORRECT ANSWER-fetal monitoring that is put on fundus to assess contractions how is intensity assessed for contractions? - CORRECT ANSWER-palpation intrauterine pressure catheter that measures intensity in mmHg right occiput anterior (ROA) - CORRECT ANSWER-fundus is at right lower quadrant. babies back is facing that way left occiput anterior (LOA) - CORRECT ANSWER-babies back is facing left and forward, put monitor on left lower quadrant early deceleration intervention - CORRECT ANSWER-reassure the parents that everything is fine what is a variable? - CORRECT ANSWER-cord compression by fetal head nursing intervention for a variable - CORRECT ANSWER-reposition mom to the left, amniofusion What is an uteroplacental insufficiency (UPI) invention? - CORRECT ANSWER-stop patocene (or reduce) if being used for induction. start IV bolus, turn mom to left to open up vena cava, non rebreather at 10L, how long is a prolonged acceleration? - CORRECT ANSWER-2-10 mins the five P's of labor and birth - CORRECT ANSWER-passageway (birth canal) passenger (fetus and placenta) powers (contractions) position (maternal) psychological response how is the baby supposed to be positioned? - CORRECT ANSWER-flexed attitude, longitudinal, occiput (head first) fetal lie - CORRECT ANSWER-relationship of long axis of fetus to long axis of mother (longitudinal or transverse) fetal station - CORRECT ANSWER-relationship to ischial spines fetal attitude - CORRECT ANSWER-relationship of fetal body parts to each other (should be flexed) what is a full breech? - CORRECT ANSWER-feet or butt first footling breech - CORRECT ANSWER-single or double, foot comes out transverse presentation - CORRECT ANSWER-shoulder first what is considered mal-presentation? - CORRECT ANSWER-any others than ROA or LOA frank breech - CORRECT ANSWER-baby holding legs and butt comes out first military position - CORRECT ANSWER-head not flexed or extended what can OP positions cause in mom? - CORRECT ANSWER-back pain due to boney head pressing on sacral nerves, labor prolongs because soft part of head is pushing on cervix but it isn't enough pressure How do you write fetal positions? - CORRECT ANSWER-1. facing right or left 2. presenting part (occiput, mentrum, sacrum) 3. anterior or posterior what is a 0 station? - CORRECT ANSWER-head is at ischial spine frequency of contraction - CORRECT ANSWER-amount of time between contractions duration - CORRECT ANSWER-amount of time contraction lasts (60-90 secs) at how many weeks does the baby drop into the pelvic cavity? - CORRECT ANSWER36 weeks what does estrogen do during labor? - CORRECT ANSWER-stimulates contractions, causes effacement, increases progesterone during labor - CORRECT ANSWER-decreases, increases myometrial activity due to the decrease 100% effacement means - CORRECT ANSWER-thinnest stage of cervix full cervical dilation marks the beginning of what stage? - CORRECT ANSWER-stage 2 what is true labor? - CORRECT ANSWER-contractions are at regular intervals, shortened intervals between contractions, increasing intensity with walking, *cervical dilation and effacement occur* false labor - CORRECT ANSWER-contractions are irregular, no change in frequency, duration, and walking has no effect. No change in dilation or effacement what are braxton hicks contractions - CORRECT ANSWER-regular and strong