Correct Solutions.
Routine Tests - Answer CBC
Rubella Antibody Titre-if the woman is non-immune (titre of less than 10) she should avoid
exposure to rubella during pregnancy and be immunized once she has delivered.
Blood type-ABO - to rule out blood incompatibilities early and also to determine the Rhesus(Rh)
factor with antibody screen.
Hepatitis B and C surface antigen (HBsAg or HCsAG)
HIV screen, requires treatment with antiretroviral medications to prevent transmission to fetus
Midstream Urine for culture at 12-18 wks-to check for bacteruria
Urinalysis for protein and glucose
Pelvic exam and cervical smear to screen for cervical Ca and STIs and other infections, such as
Group B Streptococcus
VDRL (Venereal Disease Research Laboratory) screening-detects STIs such as syphilis, herpes,
human papillomavirus, and gonorrhea so treatment can prevent transmission to the fetus
Vaginal screen for C+S (eg. Bacterial vaginosis)
Informed Consent - Answer Consent for what nurses do
Participating in the consent process for other care providers
CNPS - Answer A not-for-profit society that can offer legal advice and assistance to Registered
Nurses
Was created by nurses, for nurses RN's can seek out council from the CNPS regarding any
incidence that comes up Canada-wide except for Quebec
Presumptive Signs of Pregnancy - Answer breast changes, amenorrhea, N/V, urinary
frequency, fatigue, quickening
Probable Signs of Pregnancy - Answer Goodell's sign
Chadwick's sign
Hegar's sign
Positive pregnancy test
,Detection of fetal heart tones
Fetal movement by examiner
Goodell's sign - Answer softening of the cervix
Chadwick's sign - Answer Bluish purple discoloration of the cervix, vagina, and labia during
pregnancy as a result of increased vascular congestion.
Hegar's sign - Answer softening of the lower uterine segment
Ballottement - Answer a sharp upward pushing against the uterine wall with a finger inserted
into the vagina for diagnosing pregnancy by feeling the return impact of the displaced fetus
Gestation - Answer 40 weeks, or 280 days - from the first day of the last menstrual period.
37 to 42 weeks is considered term
3 trimesters divided into 13 weeks
Described in both weeks and days (Ex. 32 2/7 wks gest)
Changes in Uterus - Answer Increases x 20
Weight ↑ from 50-70 gm to 1100gm due to hypertrophy and hyperplasia of myometrial cells
Capacity ↑ from 10mL to 5000 mL
Shape changes from an inverted pear to a large watermelon
Changes in Cervix - Answer Endocervical glands secrete a thick mucus to form an operculum
Goodell's sign: Softening of the cervix
Changes in Ovaries - Answer Cessation of ovulation due to high levels of estrogen &
progesterone, which blocks secretion of follicle-stimulating hormone (FSH) and luteinizing
hormone (LH) from the anterior pituitary
Changes in Vagina - Answer Increased vascularity of the vaginal mucosa
Chadwick's Sign
, Superficial veins more prominent, nipples more erectile, and areola darkens
Montgomery Tubercles: Sebaceous glands of the areola, become enlarged and protuberant
Colostrum: antibody- rich, yellowish milky substance may begin to flow in the last trimester.
Changes in Skin and Hair - Answer Pigmentation of the skin increases primarily in areas that
are already hyperpigmented
Facial chloasma or melasma
Striae
Vascular spider nevi
Rate of hair growth decreases, sharply increases
Sweat and sebaceous glands frequently hyperactive
Changes in Respiratory System - Answer Tidal volume increases by 30- 40%
O2 consumption needs increase by 15-20%
Rib cage flare
Diaphragm elevates because of enlarging uterus
Nasal stuffiness due to increased vascularity, epistaxis common
Changes in Cardiovascular System - Answer Growing uterus pushes up the diaphragm, which
pushes the heart up & to the left
Plasma volume ↑ by 40-60%, 1500 mls
HR up 10 to 15 bpm, Cardiac output ↑ by 30-50%
Increased RBC mass as the RBC production increases by 20-30%
BP can lower as a result of peripheral vasodilation caused by progesterone
Increased femoral venous pressure causing edema, varicose veins, hemorrhoids
Leukocyte production increases
Fibrin and plasma fibrinogen may increase
Clotting factors are increased so the pregnant person is in a hypercoagulable state
Folic acid supplement needed to prevent maternal megaloblastic anemia, which is linked to
increase risk of neural tube defects (0.4 mg/day)
Iron supplement of 16-20 mg/day often advised