OB/Maternity HESI
Ovulation occurs how many days before the next menstrual period? (AKA between ovulation &
beginning of next menstrual cycle, there are how many days?) - ANS14
To prevent pregnancy, a couple must avoid unprotected sex for ______days before anticipated
ovulation & for ___ days after ovulation to prevent pregnancy - ANSSeveral days before
antcipated ovulation & 3 days after ovulation
---sperm live approx 3 days
---eggs live about 24 hrs
Because some women experience _____ or _____, they do not know they are pregnant -
ANSimplantation bleeding OR spotting
Signs of maternal-fetal bonding in utero? - ANStalking to fetus in utero
massaging abdomen
nicknaming fetus
For women, battering (emotional/physcial abuse) begins during preg. How should women be
assessed for abuse? - ANSIn private, away from male partner, by nurse who is familiar w/ local
resources & knows how to determine safety of the client
A women who is 6 wks preg has the following maternal history: -healthy 2 yo daughter
-miscarriage at 10 wks
-elective abortion at 6 weeks
-5 years earlier
(what is her GTPAL?) - ANS4-1-0-2-1
gravida 4, para 1 (only 1 delivery after 20 wks gestation)
What is EBD using Nagele's rule?
--Woman's last menstrual period Oct. 17 - ANSCount back 3 months +7 days
--July 24
When does plasma volume increase during preg? - ANSAt approx 28 to 32 weeks, plasma
volume increase 25-40%, resulting in hemodilution of Hct values 32-42%
--High Hct values may look good, BUT in reality they represent a gestational HTN disorder &
depleted vascular space
Foods high in iron - ANS-fish & red meats
-cereals & yellow vegetables
-green leafy vegetables & citrus fruits
-egg yolks and dried fruits
,What position increases perfusion to uterus, placenta, and fetus? - ANSL side-lying
Changes in ______ are the 1st & most important indicators of compromised blood flow to fetus,
& these changes require action! - ANSchanges in FHR
--fetal well-being determined by fundal height, fetal heart tones & rate, and uterine activity
(contractions)
Possible indications of preeclampsia & eclampsia are? - ANS-*visual disturbances*
-*swelling of face, fingers, or sacrum*
-*severe, continuous headache*
-*persistant vomiting*
-*epigastric pain*
-infection signs (*chills, temp >100.4, dysuria, pain in abd*)
-*fluid discharge* or *bleeding from vagina* (anything besides norm leukorrhea)
-*change in fetal movement* or *increased FHR*
Nurse's responsibility regarding prenatal vitamins? - ANSTeach about proper diet & about taking
prescribed vitamins as they have been prescribed by HCP
---only HCP can prescribe prenatal vitamins (aka ensure client receives adequate intake of
vitamins)
What should preg women eat to ensure daily calcium needs are met to help alleviate leg
cramps? - ANSequivalent of 3 cups of milk or yogurt per day
Name major discomforts of 1st trimester & suggestions to help relieve each - ANS-N/V: crackers
before rising
-fatigue: rest periods & naps & 7-8 hrs sleep at night
At 20 weeks gestation, the fundal height would be___; the fetus would weight approx ____ and
would look like ____ - ANSat umbilicus; 300-400g; a baby (w/ hair, lanugo, & vernix, BUT w/o
any subq fat)
Norm psychological responses to preg in 2nd trimester - ANS-ambivalence wanes & acceptance
of pregnancy occurs
-preg becomes "real"
-signs of maternal-fetal bonding occur
Hemodilution of preg peaks at ____ weeks & result in an ____ in a women's Hct? - ANS28-32
weeks; decrease
3 principles relative to pattern of weight gain in preg - ANS-average 25-35 pounds
-gain should be consistent throughout preg
-an avg of 1lb/week in 2nd & 3rd trimesters
, During preg woman should add ____ cals & drink ____ cups of milk per day? - ANS300 cals; 3
cups
FHR can be auscultated by Doppler at ____ wks gestation - ANS10 to 12 weeks
Describe schedule of prenatal visits for low-risk preg woman - ANS-Once every 4 wks until 28
wks
-Every 2 wks from 28 to 36 wks
-Once per wk until delivery
In some states, screening for neural tube defects by testing either _____ or _____ is mandated
by state law. This screening test is highly associated w/ both false positives & false negatives -
ANSmaternal serum alphafetoprotein (AFP) or amniotic fluid AFP levels
When amniocentesis is done early in preg, bladder must be ____ vs done late bladder must be
_____ - ANS*Early in preg:* bladder must be full to help support the uterus & help push uterus
up into abd for easy access
*Late in preg:* bladder must be empty to avoid puncture
Early decels, caused by _____ & ______, usually occur _____& ______ - ANSCaused by head
compression & fetal descent
Usually occur btw 4 and 7 cm & in 2nd stage of labor
---check for labor progress if early decels are noted
If cord prolapse is detected, what should examiner do? - ANSPosition mother knee-to-chest (or l
lateral) to relieve pressure on cord
OR
Push the presenting part off the cord until immediate c/s can be accomplished
Late decels indicate ___ & are associated w/ what conditions? - ANS*indicate UPI*
-associated w/ conditions such as: *post maturity, preeclampsia, diabetes mellitus, cardiac
disease, & abruptio placentae*
When decels patterns (late or variable) are associated w/ decreased or absent variability &
tachycardia, the situation is _____ & requires what? - ANSSituation is ominous (potentially
disastrous) & requires immediate intervention & fetal assessment
A decrease in uteroplacental perfusion results from ____. Cord compression results from
_____. Nursing interventions include? - ANS-*⬇ uteroplacental perfusion = late decels*
(uniform shape, return to baseline after contraction, depth doesn't indicate severity, rarely falls
below 100 bpm)
-*cord compression = variable decels* (severe variable = below 70 bpm lasting longer than
30-60 sec & slow return to baseline)
Ovulation occurs how many days before the next menstrual period? (AKA between ovulation &
beginning of next menstrual cycle, there are how many days?) - ANS14
To prevent pregnancy, a couple must avoid unprotected sex for ______days before anticipated
ovulation & for ___ days after ovulation to prevent pregnancy - ANSSeveral days before
antcipated ovulation & 3 days after ovulation
---sperm live approx 3 days
---eggs live about 24 hrs
Because some women experience _____ or _____, they do not know they are pregnant -
ANSimplantation bleeding OR spotting
Signs of maternal-fetal bonding in utero? - ANStalking to fetus in utero
massaging abdomen
nicknaming fetus
For women, battering (emotional/physcial abuse) begins during preg. How should women be
assessed for abuse? - ANSIn private, away from male partner, by nurse who is familiar w/ local
resources & knows how to determine safety of the client
A women who is 6 wks preg has the following maternal history: -healthy 2 yo daughter
-miscarriage at 10 wks
-elective abortion at 6 weeks
-5 years earlier
(what is her GTPAL?) - ANS4-1-0-2-1
gravida 4, para 1 (only 1 delivery after 20 wks gestation)
What is EBD using Nagele's rule?
--Woman's last menstrual period Oct. 17 - ANSCount back 3 months +7 days
--July 24
When does plasma volume increase during preg? - ANSAt approx 28 to 32 weeks, plasma
volume increase 25-40%, resulting in hemodilution of Hct values 32-42%
--High Hct values may look good, BUT in reality they represent a gestational HTN disorder &
depleted vascular space
Foods high in iron - ANS-fish & red meats
-cereals & yellow vegetables
-green leafy vegetables & citrus fruits
-egg yolks and dried fruits
,What position increases perfusion to uterus, placenta, and fetus? - ANSL side-lying
Changes in ______ are the 1st & most important indicators of compromised blood flow to fetus,
& these changes require action! - ANSchanges in FHR
--fetal well-being determined by fundal height, fetal heart tones & rate, and uterine activity
(contractions)
Possible indications of preeclampsia & eclampsia are? - ANS-*visual disturbances*
-*swelling of face, fingers, or sacrum*
-*severe, continuous headache*
-*persistant vomiting*
-*epigastric pain*
-infection signs (*chills, temp >100.4, dysuria, pain in abd*)
-*fluid discharge* or *bleeding from vagina* (anything besides norm leukorrhea)
-*change in fetal movement* or *increased FHR*
Nurse's responsibility regarding prenatal vitamins? - ANSTeach about proper diet & about taking
prescribed vitamins as they have been prescribed by HCP
---only HCP can prescribe prenatal vitamins (aka ensure client receives adequate intake of
vitamins)
What should preg women eat to ensure daily calcium needs are met to help alleviate leg
cramps? - ANSequivalent of 3 cups of milk or yogurt per day
Name major discomforts of 1st trimester & suggestions to help relieve each - ANS-N/V: crackers
before rising
-fatigue: rest periods & naps & 7-8 hrs sleep at night
At 20 weeks gestation, the fundal height would be___; the fetus would weight approx ____ and
would look like ____ - ANSat umbilicus; 300-400g; a baby (w/ hair, lanugo, & vernix, BUT w/o
any subq fat)
Norm psychological responses to preg in 2nd trimester - ANS-ambivalence wanes & acceptance
of pregnancy occurs
-preg becomes "real"
-signs of maternal-fetal bonding occur
Hemodilution of preg peaks at ____ weeks & result in an ____ in a women's Hct? - ANS28-32
weeks; decrease
3 principles relative to pattern of weight gain in preg - ANS-average 25-35 pounds
-gain should be consistent throughout preg
-an avg of 1lb/week in 2nd & 3rd trimesters
, During preg woman should add ____ cals & drink ____ cups of milk per day? - ANS300 cals; 3
cups
FHR can be auscultated by Doppler at ____ wks gestation - ANS10 to 12 weeks
Describe schedule of prenatal visits for low-risk preg woman - ANS-Once every 4 wks until 28
wks
-Every 2 wks from 28 to 36 wks
-Once per wk until delivery
In some states, screening for neural tube defects by testing either _____ or _____ is mandated
by state law. This screening test is highly associated w/ both false positives & false negatives -
ANSmaternal serum alphafetoprotein (AFP) or amniotic fluid AFP levels
When amniocentesis is done early in preg, bladder must be ____ vs done late bladder must be
_____ - ANS*Early in preg:* bladder must be full to help support the uterus & help push uterus
up into abd for easy access
*Late in preg:* bladder must be empty to avoid puncture
Early decels, caused by _____ & ______, usually occur _____& ______ - ANSCaused by head
compression & fetal descent
Usually occur btw 4 and 7 cm & in 2nd stage of labor
---check for labor progress if early decels are noted
If cord prolapse is detected, what should examiner do? - ANSPosition mother knee-to-chest (or l
lateral) to relieve pressure on cord
OR
Push the presenting part off the cord until immediate c/s can be accomplished
Late decels indicate ___ & are associated w/ what conditions? - ANS*indicate UPI*
-associated w/ conditions such as: *post maturity, preeclampsia, diabetes mellitus, cardiac
disease, & abruptio placentae*
When decels patterns (late or variable) are associated w/ decreased or absent variability &
tachycardia, the situation is _____ & requires what? - ANSSituation is ominous (potentially
disastrous) & requires immediate intervention & fetal assessment
A decrease in uteroplacental perfusion results from ____. Cord compression results from
_____. Nursing interventions include? - ANS-*⬇ uteroplacental perfusion = late decels*
(uniform shape, return to baseline after contraction, depth doesn't indicate severity, rarely falls
below 100 bpm)
-*cord compression = variable decels* (severe variable = below 70 bpm lasting longer than
30-60 sec & slow return to baseline)
