NR327 Maternal-Child
Exam #1 Study Guide
Please note that not everything on the exam will be on the study
guide. This is to be used as a guide to assist with studying. You are
responsible to know all of the topics that are covered in the textbook. This
study guide will serve as a tool to narrow down the otherwise broad topics
and areas of study. I hope this helps! Happy studying.
● Rubella titer and immunity (when vaccine is needed)
o If they are non-immune, we have to give her the MMR within 72
hrs of delivery. Because the MMR is a live virus, we should
educate patients that they should not attempt to get pregnant
from one to three months.
Nutritional needs to reduce the risk of neural tube defects (folic acid)
Quickening (when to experience)
oWeeks 13 to 16
First trimester and exercise
● Yields positive benefits and should consist of 30 min of moderate
exercise (walking or swimming) daily if not medically or obstetrically
contraindicated.
■ Avoid the use of hot tubs or saunas.
■ Consume at least 2 to 3 L of water each day from food and beverage
sources.
Expectations in the first trimester
o
Leopold maneuvers (locate where to auscultate FHT’s)
o consist of performing external palpations of the maternal uterus
through the abdominal wall to determine the following: Number
of fetuses Presenting part, fetal lie, and fetal attitude.
oHeard over the fetal back
Probable, presumptive, positive signs of pregnancy
-Presumptive Signs: (changes felt by the women, signs but not prof)
orning Sickness, Amenorrhea, Change in breast, Fatigue, Lack of Energy, Urinary Frequency and Qui
Probable Signs: (observed by nurse and are more reliable signs)
the cervix), Braxton Hicks Contractions (painless contractions), Positive pregnancy test, Chadwick’s
Positive Signs:
Fetal Heart Rate: Normal 120 – 160 bpm, fetal movement by 20 weeks, fetal outline via ultrasou
Fundal height measurements and palpate
, o The fundal height first day after birth should be 1 cm below the
umbilicus, should be midline and firm immediately after delivery
(decreases about 1 com per day)
● Amniocentesis preparation and procedure (identifying conditions)
o With the use of ultrasound, a sterile needle is inserted through
the abdominal wall into the amniotic sac. Small amount of fluid is
withdrawn. Fetal cell and amniotic fluid is separated (chemical,
DNA and Chromosomal)
● NST preparation and what to expect (nonreactive vs. reactive)
o Evaluate fetal heart rate with fetal activity, looking for
acceleration occur with fetal movements, interpretation
o REACTIVE: 2 or more FHR accelerations of at least 15 bpm with a
duration of at least 15 seconds in a 20-minute interval
o NONREACTIVE: Reactive criteria not met within 30 minutes
o “NNN” NON_REACTIVE, NON_STRESS TEST IS NOT GOOD!!
● Signs preceding labor
o Backache, Weight Loss, Lightening (fetal head has dropped),
Contractions, Increased Vagal Discharge, Energy Burst, GI
changes, Cervical Ripening (cervix becomes soft, partially
effaced), Assessment of the amniotic fluids.
● Black cohosh
o Can be used to terminate a pregnancy, and can be taken to
induce labor and should not be taken by women in the first or
second trimesters. Causes GI discomfort, headache.
● Nutritional intake during pregnancy
o The patient should have a diet journal with. 340 calories per day
in second trimester, 462 calories per day increased in third
trimester.
o Folic Acid foods: beef, red meats, dried peas, cereals and breads.
o Iron Supplements: Best absorbed between meals and with
Vitamin C (MILK AND CAFFEINE INTERFERE).
o Calcium: 1,000 mg/day
o Fluid: 8 to 10 glasses of water per day.
o Limit coffee to 200 mg of coffee per day
o PKU: foods that are high in protein should be avoided.
● Urinary frequency during pregnancy (what to expect)
o The extra blood flow increases the urine and the weight of the
fetus.
● Serum alpha fetoprotein indications (Who should get it, etc.)
th nd
o Part of the triple test, during 14 to 22 week of pregnancy.
o FOR WOMEN WHO: have family history of birth defects, 35 or
older, medications during pregnancy and diabetes.
o Looking for possible genetic disorder, high levels show a neural
tube defect such as spina bifida or anencephaly.
o Low levels can indicate that there is a trisomy 21 or 18 defect.
Exam #1 Study Guide
Please note that not everything on the exam will be on the study
guide. This is to be used as a guide to assist with studying. You are
responsible to know all of the topics that are covered in the textbook. This
study guide will serve as a tool to narrow down the otherwise broad topics
and areas of study. I hope this helps! Happy studying.
● Rubella titer and immunity (when vaccine is needed)
o If they are non-immune, we have to give her the MMR within 72
hrs of delivery. Because the MMR is a live virus, we should
educate patients that they should not attempt to get pregnant
from one to three months.
Nutritional needs to reduce the risk of neural tube defects (folic acid)
Quickening (when to experience)
oWeeks 13 to 16
First trimester and exercise
● Yields positive benefits and should consist of 30 min of moderate
exercise (walking or swimming) daily if not medically or obstetrically
contraindicated.
■ Avoid the use of hot tubs or saunas.
■ Consume at least 2 to 3 L of water each day from food and beverage
sources.
Expectations in the first trimester
o
Leopold maneuvers (locate where to auscultate FHT’s)
o consist of performing external palpations of the maternal uterus
through the abdominal wall to determine the following: Number
of fetuses Presenting part, fetal lie, and fetal attitude.
oHeard over the fetal back
Probable, presumptive, positive signs of pregnancy
-Presumptive Signs: (changes felt by the women, signs but not prof)
orning Sickness, Amenorrhea, Change in breast, Fatigue, Lack of Energy, Urinary Frequency and Qui
Probable Signs: (observed by nurse and are more reliable signs)
the cervix), Braxton Hicks Contractions (painless contractions), Positive pregnancy test, Chadwick’s
Positive Signs:
Fetal Heart Rate: Normal 120 – 160 bpm, fetal movement by 20 weeks, fetal outline via ultrasou
Fundal height measurements and palpate
, o The fundal height first day after birth should be 1 cm below the
umbilicus, should be midline and firm immediately after delivery
(decreases about 1 com per day)
● Amniocentesis preparation and procedure (identifying conditions)
o With the use of ultrasound, a sterile needle is inserted through
the abdominal wall into the amniotic sac. Small amount of fluid is
withdrawn. Fetal cell and amniotic fluid is separated (chemical,
DNA and Chromosomal)
● NST preparation and what to expect (nonreactive vs. reactive)
o Evaluate fetal heart rate with fetal activity, looking for
acceleration occur with fetal movements, interpretation
o REACTIVE: 2 or more FHR accelerations of at least 15 bpm with a
duration of at least 15 seconds in a 20-minute interval
o NONREACTIVE: Reactive criteria not met within 30 minutes
o “NNN” NON_REACTIVE, NON_STRESS TEST IS NOT GOOD!!
● Signs preceding labor
o Backache, Weight Loss, Lightening (fetal head has dropped),
Contractions, Increased Vagal Discharge, Energy Burst, GI
changes, Cervical Ripening (cervix becomes soft, partially
effaced), Assessment of the amniotic fluids.
● Black cohosh
o Can be used to terminate a pregnancy, and can be taken to
induce labor and should not be taken by women in the first or
second trimesters. Causes GI discomfort, headache.
● Nutritional intake during pregnancy
o The patient should have a diet journal with. 340 calories per day
in second trimester, 462 calories per day increased in third
trimester.
o Folic Acid foods: beef, red meats, dried peas, cereals and breads.
o Iron Supplements: Best absorbed between meals and with
Vitamin C (MILK AND CAFFEINE INTERFERE).
o Calcium: 1,000 mg/day
o Fluid: 8 to 10 glasses of water per day.
o Limit coffee to 200 mg of coffee per day
o PKU: foods that are high in protein should be avoided.
● Urinary frequency during pregnancy (what to expect)
o The extra blood flow increases the urine and the weight of the
fetus.
● Serum alpha fetoprotein indications (Who should get it, etc.)
th nd
o Part of the triple test, during 14 to 22 week of pregnancy.
o FOR WOMEN WHO: have family history of birth defects, 35 or
older, medications during pregnancy and diabetes.
o Looking for possible genetic disorder, high levels show a neural
tube defect such as spina bifida or anencephaly.
o Low levels can indicate that there is a trisomy 21 or 18 defect.
