1
MATERNAL EXAM 1 STUDY GUIDE CONCEPTS
OF NURSING PRACTICE I ACTUAL 2026
SITTING EXAM STUDY GUIDE TIPS
Parts of the uterus
1. Cervix- tube that connects vagina and uterus
a. External os (opening) dips into vagina, and internal os opens to
uterine isthmus
2. Uterine isthmus- narrow opening that connects the cervix to main body of
uterus during birth aka-lower uterine segment
a. Thinnest portion of uterus
b. Does not participate in muscular contractions
i. **most likely to rupture during childbirth
3. Corpus and fundus- corpus is main body; fundus is top section(dome)
a. Wall of both have 3 layers
i. Perimetrium- tough outer layer of connective tissue-supports
uterus
ii. Myometrium- muscular layer -contractions
1. Fibers wrap around uterus 3 directions
a. Obliquely, laterally and longitudinally
Physiologic changes during pregnancy
1. Uterus
a. Weight increases 1.5-2 x prepregnancy
b. Cavity capacity increases
c. Structure and shape changes, enlarges to fill abdominal cavity
2. Breasts
a. Tender, enlarged, darkened areola with increased projections of
Montgomery glands
3. Blood
a. Volume increases, RBC increases
b. Plasma volume increases 30-50%
c. Hematocrit decreases-especially in 3rd trimester
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d. WBC increases to 16000mm3
e. Anemia-increase in plasma > RBC increase; hemoglobin 12.5
i. **Hgb<11.0 in late pregnancy is abnormal
4. Coagulation
a. Fibronogen, factors II, VII. VIII, X, XII and XIII increase
b. Decrease in anticoagulant factor-protein S
c. **pregnancy is time of hypercoagulability
5. Heart
a. BP decreases slightly, mostly 2nd trimester
b. HR increases by 10-30 bpm
c. Cardiac output increases
d. Systemic vascular resistance decreases
6. Respiratory
a. Stuffiness and epistaxis, increased O2 requirement,
b. Physiologic dyspnea-gradual onset of dyspnea throughout pregnancy
7. Renal
a. Increased kidney size, increased renal plasma flow and perfusion
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b. Increased glomerular filtration rate (GFR)
c. Dilation of renal pelvises leading to urinary stasis
i. Could lead to pyelonephritis
d. Half pregnant women - glycosuria via dipstick - not diabetes but
decreased glucose reabsorption
e. Decrease in bladder volume-enlarged uterus.
Hematologic changes
1. Blood volume increases by 40-45% by end of 3rd trimester.
a. Blood plasma increase-50%, and RBC’s increases 30%
b. hemodilution=decrease in hemoglobin and hematocrit
i. Hemoglobin-at term is 12.5g/dL
1. If <11g/dL-abnormal
c. **if iron deficient-RBC only increases by 18% instead of 30%
2. Clotting factors-fibrogen-increase **hypercoagulable state
a. Clotting times and bleeding times remain normal
b. Enlarged uterus inhibits blood return from lower extremities=venous
stasis
i. **combo of venous stasis and hypercoagulability places
woman at risk for venous thrombosis.
3. Increased blood volume and hypercoagulability=protective functions
a. Increased blood volume meet the needs of enlarged uterus
b. Protects mom and baby from decreased venous return when mom is
standing or lying supine
c. Enhances exchange of nutrients and respiratory gasses between mom
and baby
d. Protect from normal blood loss
Nutritional requirements
1. Energy requirements
a. First trimester-weight gain should be 1-4 lbs
b. Remainder of pregnancy-1lb/week; additional 300 calories per day
needed
i. Total weight gain-normal BMI-25-35 lbs
ii. Underweight- gain 28-40 lbs
iii. Overweight- 15-25 lbs
1. If less than 16 lbs is gained, increased risk low birth
Downloaded by mo kudus ()
MATERNAL EXAM 1 STUDY GUIDE CONCEPTS
OF NURSING PRACTICE I ACTUAL 2026
SITTING EXAM STUDY GUIDE TIPS
Parts of the uterus
1. Cervix- tube that connects vagina and uterus
a. External os (opening) dips into vagina, and internal os opens to
uterine isthmus
2. Uterine isthmus- narrow opening that connects the cervix to main body of
uterus during birth aka-lower uterine segment
a. Thinnest portion of uterus
b. Does not participate in muscular contractions
i. **most likely to rupture during childbirth
3. Corpus and fundus- corpus is main body; fundus is top section(dome)
a. Wall of both have 3 layers
i. Perimetrium- tough outer layer of connective tissue-supports
uterus
ii. Myometrium- muscular layer -contractions
1. Fibers wrap around uterus 3 directions
a. Obliquely, laterally and longitudinally
Physiologic changes during pregnancy
1. Uterus
a. Weight increases 1.5-2 x prepregnancy
b. Cavity capacity increases
c. Structure and shape changes, enlarges to fill abdominal cavity
2. Breasts
a. Tender, enlarged, darkened areola with increased projections of
Montgomery glands
3. Blood
a. Volume increases, RBC increases
b. Plasma volume increases 30-50%
c. Hematocrit decreases-especially in 3rd trimester
Downloaded by mo kudus ()
,2
d. WBC increases to 16000mm3
e. Anemia-increase in plasma > RBC increase; hemoglobin 12.5
i. **Hgb<11.0 in late pregnancy is abnormal
4. Coagulation
a. Fibronogen, factors II, VII. VIII, X, XII and XIII increase
b. Decrease in anticoagulant factor-protein S
c. **pregnancy is time of hypercoagulability
5. Heart
a. BP decreases slightly, mostly 2nd trimester
b. HR increases by 10-30 bpm
c. Cardiac output increases
d. Systemic vascular resistance decreases
6. Respiratory
a. Stuffiness and epistaxis, increased O2 requirement,
b. Physiologic dyspnea-gradual onset of dyspnea throughout pregnancy
7. Renal
a. Increased kidney size, increased renal plasma flow and perfusion
Downloaded by mo kudus ()
, 3
b. Increased glomerular filtration rate (GFR)
c. Dilation of renal pelvises leading to urinary stasis
i. Could lead to pyelonephritis
d. Half pregnant women - glycosuria via dipstick - not diabetes but
decreased glucose reabsorption
e. Decrease in bladder volume-enlarged uterus.
Hematologic changes
1. Blood volume increases by 40-45% by end of 3rd trimester.
a. Blood plasma increase-50%, and RBC’s increases 30%
b. hemodilution=decrease in hemoglobin and hematocrit
i. Hemoglobin-at term is 12.5g/dL
1. If <11g/dL-abnormal
c. **if iron deficient-RBC only increases by 18% instead of 30%
2. Clotting factors-fibrogen-increase **hypercoagulable state
a. Clotting times and bleeding times remain normal
b. Enlarged uterus inhibits blood return from lower extremities=venous
stasis
i. **combo of venous stasis and hypercoagulability places
woman at risk for venous thrombosis.
3. Increased blood volume and hypercoagulability=protective functions
a. Increased blood volume meet the needs of enlarged uterus
b. Protects mom and baby from decreased venous return when mom is
standing or lying supine
c. Enhances exchange of nutrients and respiratory gasses between mom
and baby
d. Protect from normal blood loss
Nutritional requirements
1. Energy requirements
a. First trimester-weight gain should be 1-4 lbs
b. Remainder of pregnancy-1lb/week; additional 300 calories per day
needed
i. Total weight gain-normal BMI-25-35 lbs
ii. Underweight- gain 28-40 lbs
iii. Overweight- 15-25 lbs
1. If less than 16 lbs is gained, increased risk low birth
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