OB/Maternity HESI Exam

OB/Maternity HESI Exam Ovulation occurs how many days before the next menstrual period? (AKA between ovulation & beginning of next menstrual cycle, there are how many days?) - ANS-14 To prevent pregnancy, a couple must avoid unprotected sex for ______days before anticipated ovulation & for ___ days after ovulation to prevent pregnancy - ANS-Several days before antcipated ovulation & 3 days after ovulation ---sperm live approx 3 days ---eggs live about 24 hrs Because some women experience _____ or _____, they do not know they are pregnant - ANS-implantation bleeding OR spotting Signs of maternal-fetal bonding in utero? - ANS-talking to fetus in utero massaging abdomen nicknaming fetus For women, battering (emotional/physcial abuse) begins during preg. How should women be assessed for abuse? - ANS-In private, away from male partner, by nurse who is familiar w/ local resources & knows how to determine safety of the client A women who is 6 wks preg has the following maternal history: -healthy 2 yo daughter -miscarriage at 10 wks -elective abortion at 6 weeks -5 years earlier (what is her GTPAL?) - ANS-4-1-0-2-1 gravida 4, para 1 (only 1 delivery after 20 wks gestation) What is EBD using Nagele's rule? --Woman's last menstrual period Oct. 17 - ANS-Count back 3 months +7 days --July 24 When does plasma volume increase during preg? - ANS-At approx 28 to 32 weeks, plasma volume increase 25-40%, resulting in hemodilution of Hct values 32-42% --High Hct values may look good, BUT in reality they represent a gestational HTN disorder & depleted vascular space Foods high in iron - ANS--fish & red meats -cereals & yellow vegetables -green leafy vegetables & citrus fruits -egg yolks and dried fruits What position increases perfusion to uterus, placenta, and fetus? - ANS-L side-lying Changes in ______ are the 1st & most important indicators of compromised blood flow to fetus, & these changes require action! - ANS-changes in FHR --fetal well-being determined by fundal height, fetal heart tones & rate, and uterine activity (contractions) Possible indications of preeclampsia & eclampsia are? - ANS--*visual disturbances* -*swelling of face, fingers, or sacrum* -*severe, continuous headache* -*persistant vomiting* -*epigastric pain* -infection signs (*chills, temp >100.4, dysuria, pain in abd*) -*fluid discharge* or *bleeding from vagina* (anything besides norm leukorrhea) -*change in fetal movement* or *increased FHR* Nurse's responsibility regarding prenatal vitamins? - ANS-Teach about proper diet & about taking prescribed vitamins as they have been prescribed by HCP ---only HCP can prescribe prenatal vitamins (aka ensure client receives adequate intake of vitamins) What should preg women eat to ensure daily calcium needs are met to help alleviate leg cramps? - ANS-equivalent of 3 cups of milk or yogurt per day Name major discomforts of 1st trimester & suggestions to help relieve each - ANS--N/V: crackers before rising -fatigue: rest periods & naps & 7-8 hrs sleep at night At 20 weeks gestation, the fundal height would be___; the fetus would weight approx ____ and would look like ____ - ANS-at umbilicus; 300-400g; a baby (w/ hair, lanugo, & vernix, BUT w/o any subq fat) Norm psychological responses to preg in 2nd trimester - ANS--ambivalence wanes & acceptance of pregnancy occurs -preg becomes "real" -signs of maternal-fetal bonding occur Hemodilution of preg peaks at ____ weeks & result in an ____ in a women's Hct? - ANS-28-32 weeks; decrease 3 principles relative to pattern of weight gain in preg - ANS--average 25-35 pounds -gain should be consistent throughout preg -an avg of 1lb/week in 2nd & 3rd trimesters During preg woman should add ____ cals & drink ____ cups of milk per day? - Continues...