OB FINAL EXAM CONCEPT GUIDE (LATEST 2025/2026) UPDATE | TERMS & COMPLETELY DEFINED ANSWERS 

OB FINAL EXAM CONCEPT GUIDE (LATEST 2025/2026) UPDATE | TERMS & COMPLETELY DEFINED ANSWERS  Chapter 1 Trends and Issues  Fertility Rate PP slide 4 o Definition: total number of live births, regardless of age of mother, per 1000 women of reproductive age (15-44)  2017: U.S. fertility rate = 1.87%, population is decreasing in size and growing older (Book)  2019: U.S. fertility rate = 1.7 (Current CDC)  Birth Rate PP slide 4 o Definition: number of live births per 1000 people  1960 – 2017 U.S. birth rate decreased 47% (23.7 to 12.5). Florida birth rate: 10.3 (2019) from 10.6.  Why ? Contraception, delayed reproduction for careers, legalization and or availability of abortions, rising cost of raising children.  Neonatal Birth Weights PP slide 9 o Definitions for:  Very low birth weight (VLBW): < 1500 grams (3lbs 5oz) stable  Low birth weight (LBW): grams   Normal birth weight: 2500 – 3999 grams (5lbs 8oz to 8lbs 13oz)  High birth weight: 4000 grams or greater (8lbs 14 oz)  Infant Mortality PP slide 15 o Risks of smoking during pregnancy:  Tobacco use = LBW, IUGR, miscarriage, abruptio placenta, premature birth, SIDS, respiratory illness.  Nicotine cigarettes – dangerous to pregnant women and the fetus (impairs brain and lung development).  e-Cigarettes – not regulated, contain carcinogens.  Chapter 2 Ethics  Ethics in Nursing Practice PP slides 5-6 o Ethical Principles:  Autonomy is the right to self-determination.  Respect for others is the principle that all persons are equally valued.  Beneficence is the obligation to do good.  Nonmalificence is the obligation to do no harm.  Justice is the principle of equal treatment of others or that others be treated fairly.  Fidelity refers to the faithfulness or obligation to keep a promise.  Veracity is the obligation to tell the truth.  Utility is the greatest good for the individual or an action that is valued.  Chapter 4 Physiological Aspects of Antenatal Care  Diagnosis of Pregnancy (power point slides 20-24) o Presumptive Signs: all subjective signs/changes perceived by the woman herself: amenorrhea, nausea and vomiting, breast changes (increase in size, sensation, vascularity), fatigue, urinary frequency. All sigs could be caused by something other than pregnancy. o Probable Signs  Objective signs seen by health care provider: • Chadwick’s sign: bluish color of vaginal mucosa, cervix (6-8 weeks) • Goodell’s sign: softening of the cervix and increased leukorrheal discharge (8 weeks) • Hegar’s sign: softening of the lower uterine segment (6 weeks) • Increase in uterine size  What is Linea Nigra? Dark line from the umbilicus to pubis. o Positive/ Practical Signs (signs only attributed to fetus)  Auscultation of the fetal heart rate (FHR) (10-12 weeks)  Observation and palpation of fetal movement by the HCP (20 weeks)  Sonographic visualization of fetus  Cardiac movement noted at 4-8 weeks  Quickening (PP slide 21): Awareness of fetal movements; 18-20 wks primigravidas, 1416 wks multigravidas.  Supine Hypotension o Definition: Decrease in maternal BP when laying in supine position. o What causes it? When the woman is in the supine position, as the enlarging uterus can compress the inferior vena cava, leading to a drop in cardiac output/BP, feeling dizzy/faint.  Estimated Date of Delivery: EDD (PP slide: 25) o Naegele’s rule  What does it determine: Determine EDD.  How is it determined/formula: First day of LMP – 3 months + 7 days.  Terminology Gravida/Para (PP slide 26) o What is Gravid? Being pregnant  What does G, P, T, L, A tell you about the patient’s pregnancy history? G = total number of times pregnant T = number of term infants born (between 38 and 42 weeks) P = number of preterm infants born (between 20-37 weeks) A = number of abortions (before 20wks or less than 500 grams at birth) L = number of children currently living  Components of Prenatal Care o Trimesters (3) (PP slides 27-28)  Screenings, diagnostic tests and exams done in each trimester: • First trimester: Labs, STI screen, EDD, IPV screen, H&P, Genetic screen, Pap/Pelvic exam, Utz, nutrition assessment, FHR, visits Q4 wks. • Second trimester: Quad screen (Downs), Utz, Gest Diab screen, Rhogam as needed, FHR, visits Q4 wks. • Third trimester: GBS screen, Gest Diab screen, Repeat screening labs, pelvic exam as needed, FHR, Kick counts, visits Q2 wks to weekly.  Chapter 6 Antepartum Testing  Screening and Diagnostic testing (PP slide 6) o What is the difference between a screening test and a diagnostic test? Know names of different screening and diagnostic tests.  Screening tests: Identify those not affected. Types: AFI, BPP, Kick count, NST, *Ultrasound, Nuchal Translucency.  Diagnostic tests: Identify a disease or problem. (high risk pregs) Types: Amnio, CVS, MRI, *Ultrasound.  Ultrasonography (PP slide 9) o What type of test is it? Most common diagnostic test. Is the use of high-frequency sound waves to produce an image of an organ or tissue. o Who interprets it? HCP, OB, Radiologist, Midwife. o What are the benefits of having this test? Noninvasive, fetal and placental condition, and no risks. Fetal structures and status, accurate assessment (fetal growth, placental abnormalities).  Tests of Fetal Status and Fetal Well Being (PP slides 21-26): Daily Fetal Movement Count; NonStress Test (NST); Contraction Stress Test (CST); Amniotic Fluid Index (AFI); Biophysical Profile (BPP).  Daily Fetal Count Kick o What is this? Have been proposed as a primary method of fetal surveillance for all pregnancies after 28 weeks’ gestation. Count kicks for 1-2 hrs. 10 movements in 2 hrs (normal and reassuring).  NST Non-Stress Test (PP. slide 21-26) o When is it done? 32+ weeks; third trimester. o What does it assess? FHR for fetal activity. o What is a reactive NST? FHR increase 15 beats for 15 seconds twice or more in 20 minutes (32+ weeks). o What is a non-reactive NST? Without sufficient reactivity – requires further evaluation. If not seen in 40 mins.  Contraction Stress Test  What is this? Screening tool that assess fetal well-being with a nonreactive NST at term gestation. Monitor for 20 minutes, if no spontaneous UCs: nipple stim or IV Pitocin until 3 UCs in 10-20 minutes, lasting 40 seconds. o What makes it successful? Negative CST = good outcomes. o What is a negative CST? Normal no significant variable decels or late decels. o What is a nonreactive CST assessing for? To identify a fetus that is at risk for compromise through observation of the fetal response to intermittent reduction in utero placental blood flow associated with stimulated uterine contractions (UCs). o What is a positive CST? Positive (not normal) late decels with 50% of UCs, minimal vari. (I added this one, it was not on the guide).  Chapter 7 High-Risk Antepartum Nursing Care