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Exam (elaborations)

NUR2005 Exam Latest Update

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NUR2005 Exam Latest Update
Main physiological changes that occur during pregnancy and postpartum - Answer
Nausea and vomiting (digestive system)

Frequency of micturition (passing urine), especially at night (renal/reproductive system)

Quickening- signs of fetal movements felt as 'gentle flutter or butterflies'

Fatigue and insomnia

Common signs and symptoms of labour - Answer Contractions and cervix dilation, lower
back pain, water breaks, urge to vomit, loose bowl motions.

Three stages of labour and how to care/support women during birth - Answer 1) Dilation:
women first has contractions and starts to dilate until she reaches 10cm

2) Birth: begins pushing, gives brith to baby

3) Afterbirth delivery: the women expels the placenta

4) Afterbirth care: the aftercare also postpartum period

What happens to blood during pregnancy? - Answer Increase plasma and RBC volume,
as well as anemia

What happens to respiratory system during pregnancy? - Answer Increased respiratory
centre stimulation --> Increase in RR, Increase tidal volume and decrease residual
volume

What happens to cardiovascular system during pregnancy? - Answer Increase HR,
decrease arterial pressure, increase cardiac output, decrease peripheral vascular
resistance

What happens to the genital system during pregnancy? - Answer Decrease vaginal pH,
increase glycogen in vaginal epithelium

Oxytocin theory - Answer A hypothesis regarding the cause of labor - the hormone
causes the uterus to contract, some people believe that a rise in these levels may be
responsible for initiating labor

Prostaglandins theory - Answer Research finding vary as to whether the concentration
of prostaglandins increase in amniotic fluid and maternal bloodstream before labour but
certainly are high during and after labour.

Prostaglandins may be used to induce labour, particularly to ripen the cervix in
preparation for induction of labour with Oxytocics.

Fetal steroids theory - Answer Fetal adrenal glands secrete corticosteroids that trigger

,labour

Corticosteroids release the precursor to Prostaglandins- Oestrogen and Progesterone-
levels of both hormones regulate concentrations of Oxytocin receptors in the uterus

Animal studies show a decrease in Progesterone levels with the onset of labour,
however, this has not been demonstrated in humans

Emotional changes to occur during pregnancy - Answer Women may become:

bored, poor memory, negative thoughts, impatient, sensitive, may struggle with body
image, have presence of sleep disorders and sexual function/well being disorders

Maternal postnatal check includes: - Answer Access blood loss (amount, colour, clots
and odour)

Palpating uterine height, position and tone

Check perineum/caesarean wound and document observations

Common Postpartum changes: - Answer Endometritis - inflammation/infection of uterine
lining

Perineal injury/trauma

Pelvic floor dysfunction/incontinence

Caesarean section wound infection

Mastitis: inflammation of breast can lead to infection

Postnatal mental health: baby blues, depression and psychosis

Degrees of perineal injury/trauma - Answer Perineal injury/trauma includes:

- first-degree tear = injury to perineal skin and/or vaginal mucosa, can heal on their own

- second-degree = injury to perineum muscles, but not anal sphincter (requires suturing)

- third-degree = injury to perineum involving anal sphincter complex (External (EAS) and
Internal (IAS)) (requires suturing in operating room/anaesthetic)

- fourth-degree = injury to perineum involving anal sphincter complex and anorectal
mucosa (requires suturing in operating room/anaesthetic)

Assessment of newborn - Answer Involves APGAR score:

Appearance - skin colour

Pulse - heart rate

Grimace - reflexes

, Activity - muscle tone

Respiration - breathing rate and effort

Initial management for healthy newborns - Answer Access the babies response to brith

Attach name bands x2 and check with mother

Perform APGAR assessment at 1 min and 5 min

Mum and baby stay together and encourage breast feeding (especially if baby
mouthing/rooting reflex)

Documentation

Newborn measurements - Answer Weight

Length

Head Circumference

blinking reflex - Answer stimulation = flash of light/puff of air

infants response = close both eyes

Babinski reflex - Answer stimulation = sole of foot stroked

infants response = fans out toes, twist foot in

Grasping reflex (palmar reflex) - Answer stimulation = palms touched

infants response = grasps tightly



Moro reflex (startle reflex) - Answer stimulation = sudden stimulation (i.e. loud
noise/being dropped)

infants response = startles, arches back, throws head back, flings out arms and legs,
and then rapidly closes them to centre of body



Rooting reflex - Answer stimulation = cheeked stroked or side of mouth touched

infants response = turns head, opens mouth, begins suckling



stepping reflex - Answer stimulation = infant held above surface and feet lowered to
touch surface

infants response = moves feet as if to walk

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