NUR 2633 Maternal Child Health Exam 1 Study Guide.

1. Women’s health encompasses breast care, GYN exams, and assessments. Be comfortable with the parameters of education for Self breast exams, and what is normal for a woman to note when doing breast exam. Know normal menstrual cycle - what is the most common complaint with the menstrual cycle, and complications; (dysmenorrhea) Know STI’s and risks. 2. If a patient finds a breast lump how will you advise her? 3. What is your role in the GYN exam 4. Contraception - Forms of birth control – good subject for your postpartum patients as well – know them, know the risks and some of the educational points to share with them regarding each type. Remember birth control choice should be based on a patient’s lifestyle – if she cannot swallow pills do not offer oral contraception – right? Etc… 5. Emergency contraception – know education. 6. Preconceptual care is provided for a means to identify risks and provide nutrition – not to establish who should become pregnant. 7. Pregnancy – understand the structure and function of the external and internal genitalia. Know the purpose of each in the process of pregnancy. You must understand the changes that occur to each system – 8. Please identify pregnancy history – G, F, P, A, L – know how to complete this given each women’s obstetrical history. 9. What is fetal well- being and how do we measure it. Can you date a pregnancy using Naegele’s Rule? Can you measure fundal height? Know the normal parameters of fetal growth. When are fetal heart tones audible with a Doppler? What are the parameters and what does it mean if the fetus falls outside those parameters? 10. Fetal development from the conception through the embryonic (critical) period, to the placental development and beyond. – It is all about the placenta. What risk factors will impede placental perfusion to the baby? 11. Know normal discomforts of pregnancy and what is not normal and how do nurses educate their patients on the difference. Look at each system. What a normal change means to her and what education you would give. 12. What activity is appropriate for the pregnant patient? 13. Placenta is the ‘work horse’ organ of pregnancy – what does it provide/what it doesn’t provide. 14. Amniotic fluid what is the purpose? What is the issue with oligohydramnios, and polyhydramnios. 15. Nutrition is a key factor in pregnancy outcome – what is essential to include. What do most women need additional supplements for? Explore the vegetarian diet. Explore the problem of generalized nausea and vomiting – not severe – explore food fads. What are the risks to the fetus if mom does not gain weight or does not eat properly? And keep in mind the questions regarding the use of alcohol in pregnancy – it is never acceptable. 16. Prenatal testing - multiple tests are completed - recognize the difference between a screening exam and a diagnostic exam. Include diagnostic tests such as ultrasounds too. When do we provide them and why? Specifically the labs drawn in the early pregnancy – MSAFP – or the Triple screen when and why drawn, and we know Folic Acid is used to help prevent the development of the Neural Tube and the absence of openings, also the existence of some chromosomal abnormalities – ie: Down syndrome. a. ) 17. Complications of pregnancy – bleeding can be normal or abnormal – what are the causes of both? Know the difference between placenta previa/ placental abruption. What are the risk factors for both? Ectopic pregnancy is another issue – know signs and symptoms, know management. 18. Preterm labor – know signs and symptoms, treatment, nursing interventions. Know the drugs – that are used as a tocolytic (a drug that stops preterm labor) 19. Pre – eclampsia – know signs and symptoms (subjective and objective), treatment and nursing interventions. 20. Know the medications used in pregnancy both the normal supplementation and those used to manage preterm labor and pre-eclampsia. 21. Know specifically magnesium sulfate since it is used for both reasons – preterm labor and pre-eclampsia due to the effect – it is a smooth muscle relaxant – hence the uterus is a smooth muscle and will respond well to the drug – your blood vessels and the tissue surrounding relax hence having a hypotensive response if using Mag. Please know magnesium well. It is the first line defense in pre-eclampsia….not to prevent hypertension but to……..?? Also know the nursing interventions to be monitored closely. 22. What is the effect on the baby of the risk factors that may impede placental perfusion? 23. Diabetes in pregnancy is a big problem. Know the differences of fetal surveillance with Type 1 vs Type 2, vs Gestational DM – what is the risk to the baby. 24. Hyperemesis Gravidarum - a problem of extreme nausea and vomiting causing electrolyte imbalance , dehydration and severe weight loss – what is the nursing intervention? 25. Do you understand the concept of perfusion, oxygenation, the hormone feedback system, and the responses of the body under the hormone influences? You will do well. 26. Rhogam – understand how it works and who should receive Rhogam under what circumstances. a. 27. Have you heard of supine hypotension? Do you know why and how to prevent? 28. Terminology – look at it, please add this word – tocolytic – this is the medications used for preterm labor “I will start tocolytic therapy”