NUR 113 Exam 1 Content UPDATED ACTUAL Questions and
CORRECT Answers
)
Apply the nursing process to the care of the - Reason for seeking care
antepartum client. (First visit) - Reproductive history (including current and past pregnancies)
- Detailed health history including: immunizations, dental health, nutrition,
substance use
- Social and occupational history
- Physical exam, including a pelvic exam
- Ultrasound for confirmation and dating of pregnancy
- Labs: ABO/Rh, CBC, syphilis, gonorrhea/chlamydia, hepatitis B titer,
varicella/titers, UA for C&S, Hgb electrophoresis if appropriate, and CF
screening offered
- Prescribe medications
- Immunization administration (No live vaccines)
Apply the nursing process to the care of the - Vitals
antepartum client. (Every visit) - Weight
- Fundal height measurement
- UA
- Safety evaluation
Apply the nursing process to the care of the 2nd Trimester:
antepartum client. (2nd and 3rd trimesters) - Monthly visits
- Anomaly screen ultrasound between 18-20 weeks gestation
- Begin to develop birth plan and choose pediatrician
3rd Trimester:
- 28-week labs with 1 hour glucose screen
- Antibody screen, H&H
- RhoGAM given to Rh negative mother
- Seen Q2 weeks, then weekly starting at 36 weeks
- Fetal assessment with NST if indicated
- Labor/breastfeeding classes
- GBS culture
,Apply the nursing process to the care of the - Modified bedrest
antepartum client. (Preterm labor) - Avoid sexual intercourse
- Left lateral positioning
- Hydration
- Treating infections if applicable
- Monitor fetal well being
- Medication administration
Medications for Preterm Labor Nifedipine: An oral calcium channel blocker that prevents the influx of
extracellular calcium ions into the myometrial cells of smooth muscles within
the pregnant uterus.
Magnesium Sulfate: An IV electrolyte solution that works by reducing the
amount of calcium in the uterine muscles, which results in relaxation and
decreased contractions.
Terbutaline: A subcutaneous, selective beta2-receptor agonist that produces
relaxation of smooth muscle found principally in bronchial, vascular and
uterine tissues. Can be used temporarily as a tocolytic.
Indomethacin: An NSAID that inhibits the release of prostaglandins that relax
the cervix, inhibiting the progression of labor. This medication can be
administered orally or rectally for up to 48 hours.
Betamethasone: A potent corticosteroid given IM that promotes the release of
fetal surfactant, allowing for further lung maturation before delivery.
Apply the nursing process to the care of the - Nursing care is dependent upon gestational age, if there is evidence of
antepartum client. (Premature rupture of membranes) infection, or if there's maternal and/or fetal compromise
- Prepare for birth if indicated
- Obtain vaginal/rectal cultures for GBS
- Obtain vaginal cultures for gonorrhea/chlamydia
- Limit vaginal exams (INTRODUCES BACTERIA)
- Provide reassurance
- Assess vitals Q2 hours and notify provider for temperature >100 degrees F (38
degrees C)
- Monitor FHR and uterine contractions
- Encourage hydration
- Obtain CBC
- Anticipate Rx for 7-day course of broad-spectrum antibiotics
Discuss the process of confirming pregnancy and Nagele's rule for estimated date of birth:
estimating the date of birth. LMP - 3 months, then add 7 days and 1 year
What if LMP is unknown?
Transvaginal ultrasounds can date and verify the status of pregnancy.
, Determine gravidity and parity by using the two-digit • 2-digit system:
and five-digit systems. ○ Gravidity: number of pregnancies
§ Nulligravida: woman that has never been pregnant
§ Primigravida: woman in her first pregnancy
§ Multigravida: woman that has had 2 or more pregnancies
○ Parity: number of pregnancies that reached 20 weeks regardless of outcome,
including current one
§ Nullipara: no pregnancy beyond the stage of viability
§ Primipara: has completed one pregnancy to the stage of viability
§ Multipara: has completed 2 or more pregnancies to the stage of viability
5-digit system:
○ G - Gravida: # of pregnancies, including present one
○ T - Term: # of full term deliveries (37 weeks or later)
§ Multiples aren't factored in
○ P - Pre-term: # of pre-term deliveries (20-36 weeks)
§ Multiples aren't factored in
○ A - Abortions: # of abortions (spontaneous and elective)
○ L - Living: # of live births
§ Multiples are factored in
Outline the assessments of the pregnant woman - Transvaginal ultrasound: dating pregnancy, CRL (crown-rump length), fetal
specific to each trimester. (First Trimester) heart rate, locating pregnancy
- External abdominal ultrasound: Not as reliable during the 1st trimester
because the uterus is smaller than the 2nd and 3rd trimesters
- Fundal height measurement: Tracks growth of the uterus
Outline the assessments of the pregnant woman - Anomaly screen ultrasound: performed between 18 and 20 weeks gestation
specific to each trimester. (Second Trimester) to assess for anomalies
- Fundal height measurement: Tracks growth of the uterus
- Amniocentesis: Involves the aspiration of amniotic fluid to assess for neural
tube defects, chromosomal disorders, or congenital abnormalities
Outline the assessments of the pregnant woman - 28-week labs: CBC and 1 hour glucose tolerance test to screen for anemia
specific to each trimester. (Third Trimester) and gestational diabetes
- Non-stress test (NST): A non-invasive procedure that monitors the response
of the FHR in response to fetal movement. The test is reactive if there are 2
accelerations (increase in FHR of at least 15 bpm for at least 15 seconds). The
test is non-reactive if there are not at least 2 accelerations.
Biophysical profile (BPP): A real-time ultrasound combined with FHR
monitoring to assess 5 variables of fetal well-being (FHR, fetal breathing
movements, gross body movements, fetal tone, qualitative amniotic fluid
volume).
Contraction stress test: Contractions are stimulated either by nipple
stimulation or IV oxytocin (Pitocin) and FHR is analyzed in response to
contractions. This is a test to see if a fetus will be able to tolerate labor.
- Fundal height measurement: Tracks growth of the uterus
Differentiate among presumptive, probable, and Signs felt or observed by the pregnant woman, which include:
positive signs of pregnancy. (Presumptive) ○ Amenorrhea
○ Nausea and vomiting
○ Morning sickness
○ Frequent urination
○ Breast tenderness
○ Extreme fatigue
CORRECT Answers
)
Apply the nursing process to the care of the - Reason for seeking care
antepartum client. (First visit) - Reproductive history (including current and past pregnancies)
- Detailed health history including: immunizations, dental health, nutrition,
substance use
- Social and occupational history
- Physical exam, including a pelvic exam
- Ultrasound for confirmation and dating of pregnancy
- Labs: ABO/Rh, CBC, syphilis, gonorrhea/chlamydia, hepatitis B titer,
varicella/titers, UA for C&S, Hgb electrophoresis if appropriate, and CF
screening offered
- Prescribe medications
- Immunization administration (No live vaccines)
Apply the nursing process to the care of the - Vitals
antepartum client. (Every visit) - Weight
- Fundal height measurement
- UA
- Safety evaluation
Apply the nursing process to the care of the 2nd Trimester:
antepartum client. (2nd and 3rd trimesters) - Monthly visits
- Anomaly screen ultrasound between 18-20 weeks gestation
- Begin to develop birth plan and choose pediatrician
3rd Trimester:
- 28-week labs with 1 hour glucose screen
- Antibody screen, H&H
- RhoGAM given to Rh negative mother
- Seen Q2 weeks, then weekly starting at 36 weeks
- Fetal assessment with NST if indicated
- Labor/breastfeeding classes
- GBS culture
,Apply the nursing process to the care of the - Modified bedrest
antepartum client. (Preterm labor) - Avoid sexual intercourse
- Left lateral positioning
- Hydration
- Treating infections if applicable
- Monitor fetal well being
- Medication administration
Medications for Preterm Labor Nifedipine: An oral calcium channel blocker that prevents the influx of
extracellular calcium ions into the myometrial cells of smooth muscles within
the pregnant uterus.
Magnesium Sulfate: An IV electrolyte solution that works by reducing the
amount of calcium in the uterine muscles, which results in relaxation and
decreased contractions.
Terbutaline: A subcutaneous, selective beta2-receptor agonist that produces
relaxation of smooth muscle found principally in bronchial, vascular and
uterine tissues. Can be used temporarily as a tocolytic.
Indomethacin: An NSAID that inhibits the release of prostaglandins that relax
the cervix, inhibiting the progression of labor. This medication can be
administered orally or rectally for up to 48 hours.
Betamethasone: A potent corticosteroid given IM that promotes the release of
fetal surfactant, allowing for further lung maturation before delivery.
Apply the nursing process to the care of the - Nursing care is dependent upon gestational age, if there is evidence of
antepartum client. (Premature rupture of membranes) infection, or if there's maternal and/or fetal compromise
- Prepare for birth if indicated
- Obtain vaginal/rectal cultures for GBS
- Obtain vaginal cultures for gonorrhea/chlamydia
- Limit vaginal exams (INTRODUCES BACTERIA)
- Provide reassurance
- Assess vitals Q2 hours and notify provider for temperature >100 degrees F (38
degrees C)
- Monitor FHR and uterine contractions
- Encourage hydration
- Obtain CBC
- Anticipate Rx for 7-day course of broad-spectrum antibiotics
Discuss the process of confirming pregnancy and Nagele's rule for estimated date of birth:
estimating the date of birth. LMP - 3 months, then add 7 days and 1 year
What if LMP is unknown?
Transvaginal ultrasounds can date and verify the status of pregnancy.
, Determine gravidity and parity by using the two-digit • 2-digit system:
and five-digit systems. ○ Gravidity: number of pregnancies
§ Nulligravida: woman that has never been pregnant
§ Primigravida: woman in her first pregnancy
§ Multigravida: woman that has had 2 or more pregnancies
○ Parity: number of pregnancies that reached 20 weeks regardless of outcome,
including current one
§ Nullipara: no pregnancy beyond the stage of viability
§ Primipara: has completed one pregnancy to the stage of viability
§ Multipara: has completed 2 or more pregnancies to the stage of viability
5-digit system:
○ G - Gravida: # of pregnancies, including present one
○ T - Term: # of full term deliveries (37 weeks or later)
§ Multiples aren't factored in
○ P - Pre-term: # of pre-term deliveries (20-36 weeks)
§ Multiples aren't factored in
○ A - Abortions: # of abortions (spontaneous and elective)
○ L - Living: # of live births
§ Multiples are factored in
Outline the assessments of the pregnant woman - Transvaginal ultrasound: dating pregnancy, CRL (crown-rump length), fetal
specific to each trimester. (First Trimester) heart rate, locating pregnancy
- External abdominal ultrasound: Not as reliable during the 1st trimester
because the uterus is smaller than the 2nd and 3rd trimesters
- Fundal height measurement: Tracks growth of the uterus
Outline the assessments of the pregnant woman - Anomaly screen ultrasound: performed between 18 and 20 weeks gestation
specific to each trimester. (Second Trimester) to assess for anomalies
- Fundal height measurement: Tracks growth of the uterus
- Amniocentesis: Involves the aspiration of amniotic fluid to assess for neural
tube defects, chromosomal disorders, or congenital abnormalities
Outline the assessments of the pregnant woman - 28-week labs: CBC and 1 hour glucose tolerance test to screen for anemia
specific to each trimester. (Third Trimester) and gestational diabetes
- Non-stress test (NST): A non-invasive procedure that monitors the response
of the FHR in response to fetal movement. The test is reactive if there are 2
accelerations (increase in FHR of at least 15 bpm for at least 15 seconds). The
test is non-reactive if there are not at least 2 accelerations.
Biophysical profile (BPP): A real-time ultrasound combined with FHR
monitoring to assess 5 variables of fetal well-being (FHR, fetal breathing
movements, gross body movements, fetal tone, qualitative amniotic fluid
volume).
Contraction stress test: Contractions are stimulated either by nipple
stimulation or IV oxytocin (Pitocin) and FHR is analyzed in response to
contractions. This is a test to see if a fetus will be able to tolerate labor.
- Fundal height measurement: Tracks growth of the uterus
Differentiate among presumptive, probable, and Signs felt or observed by the pregnant woman, which include:
positive signs of pregnancy. (Presumptive) ○ Amenorrhea
○ Nausea and vomiting
○ Morning sickness
○ Frequent urination
○ Breast tenderness
○ Extreme fatigue
