Maternity Nursing Exam 1 Study Guide

Maternity Nursing Exam 1 Study Guide 1. Antepartum – prenatal care and care of both mother and baby during pregnancy 2. Intrapartum – care of mother and baby during birthing process 3. Post partum – care of mother after birth 4. Birthrate—number of live births per 1000 5. Infant mortality rate—number infant deaths/ 1000 live births (2x in African Americans) 6. Neonatal mortality rate – number of infant deaths under 28 days old per 1000 live births 7. Maternal mortality rate – number of deaths/100,000 births (4x in African Americans) 8. Conception—union of egg and sperm at the beginning of pregnancy 9. Fertilization – in the ampulla of uterine tube, takes 3-4 days to travel to uterus 10. Implantation—6-10 days after conception, can have implantation bleeding 11. Anatomy Review a. Vagina—functions to discharge menstrual flow, pass the fetus, and sex i. Rugae are vaginal folds b. Uterus – muscular upside down pear shaped where implantation of fertilized ovum occurs (at the FUNDUS) and later contracts to expel fetus i. Fundus—dome shape at top of uterus where implantation should occur c. Cervix – connective tissue allows for stretching, opening where baby comes through into the vagina or where sperm pass through to get to fallopian tubes d. Uterine tubes (Fallopian Tubes) – where fertilization occurs e. Ovaries – almond shaped organs on each side of uterus that produce estrogen, progesterone, and androgen, they house the maturing eggs f. Bony Pelvis – protects pelvis structures and accommodates growing fetus during pregnancy, anchors pelvic support ligaments and structures i. Gynecoid pelvis—normal female pelvis, most favorable for labor and birth ii. Anthropoid pelvis iii. Android pelvis—resembles a male pelvis, not favorable for labor/birth iv. Platypelloid pelvis—flat shape making labor and birthing difficult g. Breasts—secrete milk (lactation) i. Estrogen and progesterone – stimulate milk sac and duct growth ii. Prolactin – stimulates milk production iii. Oxytocin—lets down milk (ejects milk) and causes contractions (ejects baby) iv. Montgomery Tubercles – sebaceous glands in areola h. Colostrum – 1st milk with all needed immunoglobulins needed for infant 12. Menstruation—normal menstrual cycle is 28 days with day 14 being ovulation a. BBT—basal body temperature, way to track ovulation by temperature spike b. Spinbarkeit—thinning cervical mucous so sperm can pass through c. Mittleschmerz – pain some women feel during ovulation d. Endometrial Cycle – deals with shedding 2/3 of the endometrium i. Proliferative Phase -- Rapid growth during day 5-14 ii. Secretory phase – from ovulation (day 14) until 3 days before next period 1. Progesterone iii. Ischemic phase – estrogen and progesterone rapidly decrease, necrosis occurs iv. Menstrual phase – shedding of 2/3 of endometrial lining e. Hypothalamic- Pituitary Cycle – low levels of estrogen and progesterone at end of cycle i. Hypothalamus secretes Gonadotropin Releasing Hormone (GnRH) to release ovum ii. Anterior pituitary secretes Follicle Stimulating Hormone (FSH) before ovulation and Luteinizing hormone (LH) after ovulation f. Ovarian Cycle – primary follicle matures, ovulation at day 14, followed by estrogen levels dropping g. Luteal Phase – where the corpus luteum is maintained by progesterone 13. Abortion – either elective or therapeutic (due to maternal/fetal health) termination of a pregnancy a. First trimester abortion – surgical aspiration (8-12 weeks), medication Mifepristone (RU486) (up to 9 weeks by blocking progesterone) or Methotrexate and misoprostol (to block folic acid then cause dilation), safer and less complex than later, watch for excessive bleeding (more than 1 large pad/hr. x4hrs) b. Second trimester abortion – dilation and evacuation up to 20 weeks c. Follow up care—contraceptives, Rhogam if needed, avoid strenuous activity, bleeding for 1-2 weeks, no tampons or sex for 1-3 weeks, watch for excessive bleeding, be nonjudgmental