1
NUR 2633: Maternal Child Health
1. Dysmenorrhea – a common complaint with women – what are the non-pharmacological
and pharmacological treatments.
• Dysmenorrhea- painful menses
• Non pharmacological-heat, exercise, increase calcium
• Pharmacological- NSAIDs
2. Obstetrical issues – pregnancy risks - Know Naegle’s Rule – to establish gestational age
• Naegle’s Rule is first day of last missed period subtract 3 months add 7 days and add
one year
• Fundal height(14 weeks just above the symphysis), 12 weeks embryonic stage organ
development, 10-12 weeks heart tones, movement starts at 16 weeks multigravida,
18 weeks primigravida
3. Poor nutrition, drugs, HTN, DM are all issues of perfusion – what will the fetal result be.
• IUGR are large head skinny not much brown fat had poor perfusion
• Small for gestational are proportional have brown fat
• Macrosomic- body as big as head, worried about birth injuries they usually come from
uncontrolled diabetic, Poor lung maturity, hypoglycemic(jittery, lethargy)
• Meconium staining- post dates because of stress
4. Anemia becomes a problem in pregnancy – can you discuss the maternal and fetal risks
• Most pregnant women have anemia, normal phenomenon, plasma volume goes up
not RBC volume so women become anemic, iron supplements
• Constipation- they are already constipated and then the iron supplements make
them even more, exercise water calcium orange juice no laxatives fiber stool
5. Hypertension – preeclampsia has specific symptoms – please know these as well as
treatment
softener
• HTN, edema, proteinuria. Subjective signs are headache, gastric pain, swelling,
blurred vision. Organs effected are brain, hear, liver and kidneys.
• Nursing interventions- DTRs, vitals every hour, respiratory rate, lung sounds,
urine output, put Foley in, bedrest
• Magnesium sulfate is used to relax muscles, vessels. The blood vessels are tight and
the blood pressure goes up. If we don’t treat this seizures will happen. Hypoxia, IUGR,
small baby.
6. Pre- term labor – define it; signs and symptoms, treatment modalities and nursing interventions.
• Labor that begins before 37 weeks, regular contractions that cause cervical change
• Nursing interventions- bedrest, hydration(500ml LR bolus), fetal monitor, left side,
UA(UTI can cause uterine irritability)
Page 1 of 23
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• 2cm 80% effaced what should the doctor order? Terbutaline, a tocolytic that stops
contractions and delays the labor process, side effects- maternal tachycardia, baby’s
HR goes up too. If this is not working, we then use Magnesium sulfate. Mag is given to
relax
the uterus, smooth muscle relaxant, give her 4g bolus over a 15-20 min timeframe,
then 2g maintenance dose.
Page 2 of 23
, 1
• If we send her home-pelvic rest nothing in the vagina, this can stimulate
contractions. Semen is prostaglandin, which can start labor.
• Betamethasone is for lung maturity, we need 24 hours for it to work.
7. Diabetes Mellitus – Type 1, Type 2 and Gestational DM all have issues that are common to
all and specific to each. Note the concerns specific to each, management and fetal
surveillance
• Type 1- no insulin production, fetal anomalies, risk to baby developing, insulin levels go
down in the first trimester, the need rapidly increases
• Type 2- usually diet controlled, if not she needs insulin, macrosomic baby because
sugar crosses the placenta insulin does not
• GDM- diabetes only in pregnancy
8. Define Macrosomia – and what are the risks
• Risks of Macrosomia are birth injury, lung immaturity, hyperglycemia.
9. During fetal development a nurse can recognize well- being of the fetus through 3 things?
• Fetal heart tones, fetal movement, fundal height
• Fundal height at 32 weeks should be 28-34cm, 1 cm per gestational week give or take 2
weeks
10. How do you determine EDD?
• Naegele’s Rule is first day of last missed period subtract 3 months add 7 days and
add one year
11. What is an NST, and a BPP for whom would you recommend these tests?
• NST- Non-stress test, to look for fetal activity
• BPP- Bio physical profile, ultrasound that looks at 4 different markers. Scored 0-2, 8
being the best. A 6 they are probably keeping mom to watch her and baby, 4 and under
delivering baby.
1. Full body fetal movement
2. Fetal tone
3. Amniotic fluid amount- need to see 500ml fluid or its oligohydramnios
4. Breathing movement- intercostals moving, chest
expansions 12. Amniocentesis: when and for what reason?
• We do amniocentesis to check for chromosomal anomalies including Down Syndrome
and Trisomy 18. Only other time is at end of pregnancy when we are checking lung
maturity(L/S ratio).
13. Amniotic fluid surrounds the baby and has 5 functions – oligohydramnios means?
Polyhydramnios- what are you thinking?
• Functions
Page 3 of 23
NUR 2633: Maternal Child Health
1. Dysmenorrhea – a common complaint with women – what are the non-pharmacological
and pharmacological treatments.
• Dysmenorrhea- painful menses
• Non pharmacological-heat, exercise, increase calcium
• Pharmacological- NSAIDs
2. Obstetrical issues – pregnancy risks - Know Naegle’s Rule – to establish gestational age
• Naegle’s Rule is first day of last missed period subtract 3 months add 7 days and add
one year
• Fundal height(14 weeks just above the symphysis), 12 weeks embryonic stage organ
development, 10-12 weeks heart tones, movement starts at 16 weeks multigravida,
18 weeks primigravida
3. Poor nutrition, drugs, HTN, DM are all issues of perfusion – what will the fetal result be.
• IUGR are large head skinny not much brown fat had poor perfusion
• Small for gestational are proportional have brown fat
• Macrosomic- body as big as head, worried about birth injuries they usually come from
uncontrolled diabetic, Poor lung maturity, hypoglycemic(jittery, lethargy)
• Meconium staining- post dates because of stress
4. Anemia becomes a problem in pregnancy – can you discuss the maternal and fetal risks
• Most pregnant women have anemia, normal phenomenon, plasma volume goes up
not RBC volume so women become anemic, iron supplements
• Constipation- they are already constipated and then the iron supplements make
them even more, exercise water calcium orange juice no laxatives fiber stool
5. Hypertension – preeclampsia has specific symptoms – please know these as well as
treatment
softener
• HTN, edema, proteinuria. Subjective signs are headache, gastric pain, swelling,
blurred vision. Organs effected are brain, hear, liver and kidneys.
• Nursing interventions- DTRs, vitals every hour, respiratory rate, lung sounds,
urine output, put Foley in, bedrest
• Magnesium sulfate is used to relax muscles, vessels. The blood vessels are tight and
the blood pressure goes up. If we don’t treat this seizures will happen. Hypoxia, IUGR,
small baby.
6. Pre- term labor – define it; signs and symptoms, treatment modalities and nursing interventions.
• Labor that begins before 37 weeks, regular contractions that cause cervical change
• Nursing interventions- bedrest, hydration(500ml LR bolus), fetal monitor, left side,
UA(UTI can cause uterine irritability)
Page 1 of 23
, 1
• 2cm 80% effaced what should the doctor order? Terbutaline, a tocolytic that stops
contractions and delays the labor process, side effects- maternal tachycardia, baby’s
HR goes up too. If this is not working, we then use Magnesium sulfate. Mag is given to
relax
the uterus, smooth muscle relaxant, give her 4g bolus over a 15-20 min timeframe,
then 2g maintenance dose.
Page 2 of 23
, 1
• If we send her home-pelvic rest nothing in the vagina, this can stimulate
contractions. Semen is prostaglandin, which can start labor.
• Betamethasone is for lung maturity, we need 24 hours for it to work.
7. Diabetes Mellitus – Type 1, Type 2 and Gestational DM all have issues that are common to
all and specific to each. Note the concerns specific to each, management and fetal
surveillance
• Type 1- no insulin production, fetal anomalies, risk to baby developing, insulin levels go
down in the first trimester, the need rapidly increases
• Type 2- usually diet controlled, if not she needs insulin, macrosomic baby because
sugar crosses the placenta insulin does not
• GDM- diabetes only in pregnancy
8. Define Macrosomia – and what are the risks
• Risks of Macrosomia are birth injury, lung immaturity, hyperglycemia.
9. During fetal development a nurse can recognize well- being of the fetus through 3 things?
• Fetal heart tones, fetal movement, fundal height
• Fundal height at 32 weeks should be 28-34cm, 1 cm per gestational week give or take 2
weeks
10. How do you determine EDD?
• Naegele’s Rule is first day of last missed period subtract 3 months add 7 days and
add one year
11. What is an NST, and a BPP for whom would you recommend these tests?
• NST- Non-stress test, to look for fetal activity
• BPP- Bio physical profile, ultrasound that looks at 4 different markers. Scored 0-2, 8
being the best. A 6 they are probably keeping mom to watch her and baby, 4 and under
delivering baby.
1. Full body fetal movement
2. Fetal tone
3. Amniotic fluid amount- need to see 500ml fluid or its oligohydramnios
4. Breathing movement- intercostals moving, chest
expansions 12. Amniocentesis: when and for what reason?
• We do amniocentesis to check for chromosomal anomalies including Down Syndrome
and Trisomy 18. Only other time is at end of pregnancy when we are checking lung
maturity(L/S ratio).
13. Amniotic fluid surrounds the baby and has 5 functions – oligohydramnios means?
Polyhydramnios- what are you thinking?
• Functions
Page 3 of 23
