Nursing 434: Exam 2 Questions With Complete Solutions
Physical signs of pregnancy (presumptive)
deals with personal experiences
breast changes, n/v, amenorrhea, urinary frequency, fatigue,
quickening (baby movement)
Physical signs of pregnancy (probable) (probably of pregnant)
involves a health provider's examination
goodell sign (softening of the cervix)
chadwick sign (discoloration of the vagina ((blue))
hegar sign (softening of the lower uterine segment)
positive pregnancy test (looks at the presence of HCG levels)
Braxton hick contractions
ballottement (how does the uterus feels)
Physical signs of pregnancy (positive) (def pregnant)
visualization of fetus by real-time ultrasound, fetal heart tones,
fetal movements palpated by examiner, fetal movements visible
to examiner
Methods for assessing due date and gestational age (naegele's
rule)
1. naegele's rule
2. ultrasound
,3. fetal heartbeat
4. uterine sizing
5. fundal height measurement (really estimates weeks of
gestation)
Naegele's Rule
Last menstrual period - 3 months + 7 days
looks at gestational age
what test identifies potential pregnancy
HCG levels - biochemical marker
-detected as early as 7-8 days after conception
-double every 48-72 until 60-70 days after fertilization and
continue to increase till day 100-120 (if this term is doubled it
can indicate a molar pregnancy, and if it is lower than expected
it can indicate a miscarriage or ectopic pregnancy)
common pregnancy concerns/discomfort and how to manage
common concerns and discomfort: typical s/s of pregnancy
management:
1. primary prevention: educate about nutrition, physical activity
(30 minutes), self-management of pregnancy discomforts, and
psychosocial impact of pregnancy
2. secondary prevention: screening for risk factors
, pregnancy history: obstetric history using 5 digit system
G: Gravidity: number of pregnancies (including current)
T: Term Births: birth at 37 days (0 days and beyond)
P: Preterm: pregnancies that ended in preterm births (20 weeks,
0-36 weeks, 6 days of gestation)
A: Abortion: number of pregnancies that ended before 20 weeks
spontaneously or electively terminated
L: Live at time of birth: number of living children
(go to parties and live)
prenatal assessment: maternal and fetal (initial, continuing,
frequency)
1. initial visit: determine estimated DOB, baseline weight and
signs, flu vaccine, lab tests, education, referral, head to toe
assessment, and pelvic exam, nutrition, family history, meds,
substance abuse, psychosocial history, abuse history (building
trust is important here)
2. continuing visits: weight, BP, manage common discomforts,
monitor fetal development and well-being by looking at fetal
heart tones (FHT), fundal height in the second trimester, fetal
movement at 16 weeks gestation
3. Frequency: monthly until 28th week, bi-weekly from 28-36
weeks, weekly from 36 weeks to DOB (increased frequency if
pregnancy is high-risk)
warning signs
Physical signs of pregnancy (presumptive)
deals with personal experiences
breast changes, n/v, amenorrhea, urinary frequency, fatigue,
quickening (baby movement)
Physical signs of pregnancy (probable) (probably of pregnant)
involves a health provider's examination
goodell sign (softening of the cervix)
chadwick sign (discoloration of the vagina ((blue))
hegar sign (softening of the lower uterine segment)
positive pregnancy test (looks at the presence of HCG levels)
Braxton hick contractions
ballottement (how does the uterus feels)
Physical signs of pregnancy (positive) (def pregnant)
visualization of fetus by real-time ultrasound, fetal heart tones,
fetal movements palpated by examiner, fetal movements visible
to examiner
Methods for assessing due date and gestational age (naegele's
rule)
1. naegele's rule
2. ultrasound
,3. fetal heartbeat
4. uterine sizing
5. fundal height measurement (really estimates weeks of
gestation)
Naegele's Rule
Last menstrual period - 3 months + 7 days
looks at gestational age
what test identifies potential pregnancy
HCG levels - biochemical marker
-detected as early as 7-8 days after conception
-double every 48-72 until 60-70 days after fertilization and
continue to increase till day 100-120 (if this term is doubled it
can indicate a molar pregnancy, and if it is lower than expected
it can indicate a miscarriage or ectopic pregnancy)
common pregnancy concerns/discomfort and how to manage
common concerns and discomfort: typical s/s of pregnancy
management:
1. primary prevention: educate about nutrition, physical activity
(30 minutes), self-management of pregnancy discomforts, and
psychosocial impact of pregnancy
2. secondary prevention: screening for risk factors
, pregnancy history: obstetric history using 5 digit system
G: Gravidity: number of pregnancies (including current)
T: Term Births: birth at 37 days (0 days and beyond)
P: Preterm: pregnancies that ended in preterm births (20 weeks,
0-36 weeks, 6 days of gestation)
A: Abortion: number of pregnancies that ended before 20 weeks
spontaneously or electively terminated
L: Live at time of birth: number of living children
(go to parties and live)
prenatal assessment: maternal and fetal (initial, continuing,
frequency)
1. initial visit: determine estimated DOB, baseline weight and
signs, flu vaccine, lab tests, education, referral, head to toe
assessment, and pelvic exam, nutrition, family history, meds,
substance abuse, psychosocial history, abuse history (building
trust is important here)
2. continuing visits: weight, BP, manage common discomforts,
monitor fetal development and well-being by looking at fetal
heart tones (FHT), fundal height in the second trimester, fetal
movement at 16 weeks gestation
3. Frequency: monthly until 28th week, bi-weekly from 28-36
weeks, weekly from 36 weeks to DOB (increased frequency if
pregnancy is high-risk)
warning signs
