NR602 FINAL EXAM
Presumptive signs of pregnancy ANS; Subjective signs. Amenorrhea, nausea, vomiting, increased urinary
frequency, excessive fatigue, breast tenderness, quickening at 18-20 weeks.
Probable signs of pregnancy ANS; Objective Signs. Goodell sign (softening of cervix), Chadwick sign
(cervix is blue/purple), Hegar's sign (softening of lower uterine segment), uterine enlargement, Braxton
Hicks contractions (may be plapated by 28 weeks), uterine souffle (soft blowing sound due to blood
pulsating through the placenta), integumentary pigment changes, ballottement, fetal outline definable,
positive pregnancy test (could be hydatidiform mole, choriocarcinoma, increased pituitary
gonadotropins at menopause).
Positive signs of pregnancy ANS; Diagnostic. Fetal heart rate auscultated by fetoscope at 17-20 weeks or
by Doppler at 10-12 weeks, Palpable fetal movement after 20 weeks, visualization of fetus with cardiac
activity by ultrasound (fetal parts visible by 8 weeks).
Pregnancy and fundal height measurement ANS; As pregnancy progresses, the fundus rises out of the
pelvis. At 12 weeks gestation, the fundus is located at the level of the symphysis pubis and the
umbilicus. By 20 weeks gestation, the fundus is at the same height as the umbilicus. Until term, the
fundus enlarges 1 cm per week. As the time for birth approaches, the fundal height drops slightly. This
process is called lighting and occurs mostly for primigravida and may not occur for woman who are
multigravida until she goes into labor.
Naegele's rule ANS; The EDB for women with 28 day cycles ANS; Nagele's rule ANS; Add 7 days to LMP
then subtract 3 months.
Example: 4/23 LMP of April 23 + 7 days = 4/30 (April 30th) ANS; 3 months = January 30th (following
year)
Hematological changes during pregnancy ANS; During pregnancy, the heart is displaced upward and to
the with withing the chest cavity by the gravid uterus's pressure on the diaphragm. As pregnancy
progresses, the risk for inferior vena cava and aortic compression leading to supine hypotension
increases when the woman lies in a supine position. Advice pregnant women to lie left lateral position.
Cardiac output in pregnancy increases by 30-50%. Peaks in early third trimester and maintained until
,birth. Stroke volume is also increased during pregnancy by 20-30% which allows for the 30% increase in
oxygen consumption observed during pregnancy. Heart rate and heart sounds changes. Volume of the
first heart sound may be increased with splitting. 3rd heart sound may be detected. Systolic murmurs
may be detected. Increase of 15-20 beats/min by 32 weeks gestation. BP decreases by 5-15 mm Hg due
to peripheral vascular resistance. 1st and 3rd trimester should be pre-pregnancy values. Blood volume
increases by 30-50% and peaks at 30-34 weeks gestation. 75% of the increase of blood volume is
plasma. Blood volume changes results in anemia due to the hemodilution. Clotting factors increase as
well creating a risk for clotting during pregnancy.
Indications and contraindications for prescribing combined estrogen birth control ANS; Combined
Estrogen ANS; Take everyday, has hormone free intervals of 7 days,
Indications ANS; Safe for healthy women. Studies show a decrease in the possibility of endometrial or
cervical cancer not found with the mini pill or POP.
Contraindications ANS; direct effects of the hormonal ingredient, as in breast cancer, or
thromboembolism.
Indications and contraindications for prescribing progesterone-only birth control ANS; Progesterone-
only ANS; Mini pill ANS; must take every day at the same time and there are no hormone free intervals.
These pills only thicken the cervical mucus to prevent pregnancy. Make the mucus thick for 22 hours so
it needs to be taken constantly to avoid the mucus to return to regular consistency.
Indications ANS; POPs are a safe method for many women who cannot take estrogen for medical
reasons. POPs are preferable to COCs for lactating women because they do not cause adverse effects on
the volume or quality of breastmilk.
Contraindications ANS; almost none.
menarche ANS; The initiation of menstruation, called menarche, usually happens between the ages of
12 and 15
Influenza (flu)a ANS; Women who are pregnant are at increased risk for flu-related complications.
Any gestation when the injection is available
, Tetanus, diphtheria, pertussis (Tdap) ANS; After maternal vaccination, antibodies cross the placenta and
decrease the risk of pertussis infection in the newborn.
Third trimester (ideally 27-36 weeks' gestation)
Hepatitis B ANS; If the woman is at risk for acquiring HBV, she should be vaccinated. Indications include
risk of occupational exposure to blood, treatment for a sexually transmitted infection, more than 1 sex
partner in the past 6 months, recent intravenous drug use, and HBsAg-positive sex partner. 3 injections
beginning at any point in gestation
Measles, mumps, rubella ANS; This live virus vaccine has a (theoretical) risk to the fetus.
Varicella ANS; This live virus vaccine has a (theoretical) risk to the fetus.
Sperm can live for up to 5 days in the female reproductive tract, and pregnancy can occur with
intercourse 5 days prior to ovulation. The highest risk of pregnancy is... ANS; in the 48 hours
immediately preceding ovulation
Tier 1 methods of contraception and efficacy ANS; Most effective ANS; less than 1 per 100 pregnancies
ANS; Vasectomy, implant, tubal occlusion, and IUD. After procedure, little or nothing to do or remember
Vasectomy: Use another method for first 3 months.
Tier 2 methods of contraception and efficacy ANS; 4-7 pregnancies per 100 woman ANS; Injectable: Get
repeat injections on time Pills: Take a pill each day Patch, ring: Keep in place, change on time.
Tier 3 methods of contraception and efficacy ANS; Least effective ANS; Condoms, sponge, withdrawal,
spermicides, diaphragm: Use correctly every time you have sex Fertility awareness-based methods:
Abstain or use condoms on fertile days. Newer methods (Standard Days, Natural Cycles, and
Symptothermal may be easier to use and consequently more effective).
most common cause of amenorrhea ANS; Ovarian function abnormalities are the most common cause
of amenorrhea, and estrogen production is the most reliable measure of ovarian function
Presumptive signs of pregnancy ANS; Subjective signs. Amenorrhea, nausea, vomiting, increased urinary
frequency, excessive fatigue, breast tenderness, quickening at 18-20 weeks.
Probable signs of pregnancy ANS; Objective Signs. Goodell sign (softening of cervix), Chadwick sign
(cervix is blue/purple), Hegar's sign (softening of lower uterine segment), uterine enlargement, Braxton
Hicks contractions (may be plapated by 28 weeks), uterine souffle (soft blowing sound due to blood
pulsating through the placenta), integumentary pigment changes, ballottement, fetal outline definable,
positive pregnancy test (could be hydatidiform mole, choriocarcinoma, increased pituitary
gonadotropins at menopause).
Positive signs of pregnancy ANS; Diagnostic. Fetal heart rate auscultated by fetoscope at 17-20 weeks or
by Doppler at 10-12 weeks, Palpable fetal movement after 20 weeks, visualization of fetus with cardiac
activity by ultrasound (fetal parts visible by 8 weeks).
Pregnancy and fundal height measurement ANS; As pregnancy progresses, the fundus rises out of the
pelvis. At 12 weeks gestation, the fundus is located at the level of the symphysis pubis and the
umbilicus. By 20 weeks gestation, the fundus is at the same height as the umbilicus. Until term, the
fundus enlarges 1 cm per week. As the time for birth approaches, the fundal height drops slightly. This
process is called lighting and occurs mostly for primigravida and may not occur for woman who are
multigravida until she goes into labor.
Naegele's rule ANS; The EDB for women with 28 day cycles ANS; Nagele's rule ANS; Add 7 days to LMP
then subtract 3 months.
Example: 4/23 LMP of April 23 + 7 days = 4/30 (April 30th) ANS; 3 months = January 30th (following
year)
Hematological changes during pregnancy ANS; During pregnancy, the heart is displaced upward and to
the with withing the chest cavity by the gravid uterus's pressure on the diaphragm. As pregnancy
progresses, the risk for inferior vena cava and aortic compression leading to supine hypotension
increases when the woman lies in a supine position. Advice pregnant women to lie left lateral position.
Cardiac output in pregnancy increases by 30-50%. Peaks in early third trimester and maintained until
,birth. Stroke volume is also increased during pregnancy by 20-30% which allows for the 30% increase in
oxygen consumption observed during pregnancy. Heart rate and heart sounds changes. Volume of the
first heart sound may be increased with splitting. 3rd heart sound may be detected. Systolic murmurs
may be detected. Increase of 15-20 beats/min by 32 weeks gestation. BP decreases by 5-15 mm Hg due
to peripheral vascular resistance. 1st and 3rd trimester should be pre-pregnancy values. Blood volume
increases by 30-50% and peaks at 30-34 weeks gestation. 75% of the increase of blood volume is
plasma. Blood volume changes results in anemia due to the hemodilution. Clotting factors increase as
well creating a risk for clotting during pregnancy.
Indications and contraindications for prescribing combined estrogen birth control ANS; Combined
Estrogen ANS; Take everyday, has hormone free intervals of 7 days,
Indications ANS; Safe for healthy women. Studies show a decrease in the possibility of endometrial or
cervical cancer not found with the mini pill or POP.
Contraindications ANS; direct effects of the hormonal ingredient, as in breast cancer, or
thromboembolism.
Indications and contraindications for prescribing progesterone-only birth control ANS; Progesterone-
only ANS; Mini pill ANS; must take every day at the same time and there are no hormone free intervals.
These pills only thicken the cervical mucus to prevent pregnancy. Make the mucus thick for 22 hours so
it needs to be taken constantly to avoid the mucus to return to regular consistency.
Indications ANS; POPs are a safe method for many women who cannot take estrogen for medical
reasons. POPs are preferable to COCs for lactating women because they do not cause adverse effects on
the volume or quality of breastmilk.
Contraindications ANS; almost none.
menarche ANS; The initiation of menstruation, called menarche, usually happens between the ages of
12 and 15
Influenza (flu)a ANS; Women who are pregnant are at increased risk for flu-related complications.
Any gestation when the injection is available
, Tetanus, diphtheria, pertussis (Tdap) ANS; After maternal vaccination, antibodies cross the placenta and
decrease the risk of pertussis infection in the newborn.
Third trimester (ideally 27-36 weeks' gestation)
Hepatitis B ANS; If the woman is at risk for acquiring HBV, she should be vaccinated. Indications include
risk of occupational exposure to blood, treatment for a sexually transmitted infection, more than 1 sex
partner in the past 6 months, recent intravenous drug use, and HBsAg-positive sex partner. 3 injections
beginning at any point in gestation
Measles, mumps, rubella ANS; This live virus vaccine has a (theoretical) risk to the fetus.
Varicella ANS; This live virus vaccine has a (theoretical) risk to the fetus.
Sperm can live for up to 5 days in the female reproductive tract, and pregnancy can occur with
intercourse 5 days prior to ovulation. The highest risk of pregnancy is... ANS; in the 48 hours
immediately preceding ovulation
Tier 1 methods of contraception and efficacy ANS; Most effective ANS; less than 1 per 100 pregnancies
ANS; Vasectomy, implant, tubal occlusion, and IUD. After procedure, little or nothing to do or remember
Vasectomy: Use another method for first 3 months.
Tier 2 methods of contraception and efficacy ANS; 4-7 pregnancies per 100 woman ANS; Injectable: Get
repeat injections on time Pills: Take a pill each day Patch, ring: Keep in place, change on time.
Tier 3 methods of contraception and efficacy ANS; Least effective ANS; Condoms, sponge, withdrawal,
spermicides, diaphragm: Use correctly every time you have sex Fertility awareness-based methods:
Abstain or use condoms on fertile days. Newer methods (Standard Days, Natural Cycles, and
Symptothermal may be easier to use and consequently more effective).
most common cause of amenorrhea ANS; Ovarian function abnormalities are the most common cause
of amenorrhea, and estrogen production is the most reliable measure of ovarian function
