Introduction to Maternity and Pediatric Nursing ch. 3-4

Introduction to Maternity and Pediatric Nursing ch. 3-4 Where does the zygote typically implant? Ans- The upper section of the posterior uterine wall After implantation the endometrium is called the ______________ Ans- Decidua The functions of the amniotic fluid are ________________ Ans- 1. Maintains an even temperature 2. Prevents the amniotic sac from adhering to the fetal skin 3. Allows for symmetrical growth 4. Allows for buoyancy and fetal movement 5. Acts as a cushion to protect the fetus The 3 basic stages of prenatal growth are ______________ and what timeframe do they exist? Ans- 1. Zygote - Fertilization to 2nd week 2. Embryo - 2nd-8th week 3. Fetus - 9th week till birth What milestone occurs at 20 weeks? Ans- Lungs have matured enough for the fetus to survive outside of the womb Age of Viability Folic acid during pregnancy prevents most _________________ Ans- Neural tube defects what are the 4 placental hormones? Ans- 1. Estrogen 2. Progesterone 3. hGC 4. hPL What does progesterone do during pregnancy? Ans- 1. Maintains uterine lining for implantation 2. Reduces uterine contractions 3. Prepares the glands of the breast for lactation 4. Stimulates teste production of testosterone in the male fetus What does estrogen do during pregnancy? Ans- 1. Stimulates uterine growth 2. Increases the blood flow to the uterine vessels 3. Stimulates the development of the breast ducts to prepare for lactation What does estrogen do not directly related to pregnancy? Ans- 1. Increases skin pigmentation 2. Vascular changes of the mucus membranes of the nose and mouth 3. Increases salivation What does hCG do during pregnancy? Ans- It signals the corpus luteum to continue producing estrogen and progesterone Which hormone is the basis of most pregnancy test? Ans- hCG What does hPL do during pregnancy? Ans- It decrease the insulin sensitivity and utilization of glucose by the mother, making more insulin available to the fetus How many vessels are in the umbilical cord? Ans- 3 (2 arteries and 1 vein) _______________ carries blood to the fetus and _______________ carries blood away. Ans- 1 Vein and 2 Arteries What are the 3 fetal circulatory shunts Ans- 1. Ductus venosus 2. Foramen ovale 3. Ductus arteriosus The 5 major roles of the nurse during prenatal care include _______________ Ans- 1. Collecting data 2. Identifying and reevaluating risk factors 3. educating self-care 4. Providing nutritional counseling 5. Promoting family adaptation The history collected should include what 7 things? Ans- 1. Obstetric history 2. Menstrual history 3. Contraceptive history 4. Medical and surgical history 5. Family history of the woman and the partner 6. Health history of the woman and her partner 7. Psychosocial history of the woman and her partner How often should prenatal visits occur? Ans- Conception to 28 weeks = q 4 weeks 29 to 36 weeks = q 2 weeks 37weeks to birth = weekly Gravida Ans- any pregnancy, regardless of duration, including present pregnancy primigravida Ans- a woman who is pregnant for the first time para Ans- A woman who has given birth to one or more children who reached the age of viability, regardless of the number of fetuses delivered and regardless if they are now living abortion Ans- Termination of pregnancy before viability, either spontaneous or induced gestational age Ans- the age of the fetus between conception and birth To determine due date, use _____________ rule Ans- Nagele's How do you use Nagele's rule? Ans- Subtract 3 months from LNMP and add 7 days 3 general groups of signs of pregnancy are ___________ Ans- 1. Presumptive 2. Probable 3. Positive Presumptive signs of pregnancy include ________________ Ans- 1. Amenorrhea 2. Nausea 3. Breast tenderness 4. Deepening pigmentation 5. Urinary frequency 6. Quickening Probable signs of pregnancy include ________________ Ans- 1. Goodell's sign 2. Chadwick's sign 3. Hegar's sign 4. McDonald's sign 5. Abdominal enlargement 6. Braxton-Hicks contractions 7. Ballottement 8. Striae 9. Positive pregnancy test Positive signs of pregnancy include ________________ Ans- 1.Audible heart beat 2. Fetal movement felt by examiner 3. Ultrasound visualization What is quickening Ans- Fetal movement felt by the mother When is quickening first felt Ans- 16-20 weeks Goodell's sign Ans- softening of the cervix Chadwick's sign Ans- Bluish purple discoloration of the cervix, vagina, and labia during pregnancy as a result of increased vascular congestion. Hegar's sign Ans- softening of the lower uterine segment McDonald's sign Ans- an ease in flexing the body of the uterus against the cervix Braxton Hicks contractions Ans- intermittent painless uterine contractions that begin in the 2nd trimester Ballottement Ans- a sharp upward pushing against the uterine wall with a finger inserted into the vagina for diagnosing pregnancy by feeling the return impact of the displaced fetus When can the fetal heartbeat be detected by a doppler device? Ans- As early s 10 weeks What is the typical FHR? Ans- 110 bpm-160 bpm When can the identification of the embryo or fetus by ultrasound be possible? Ans- As early as 4-5 weeks Oxygen consumption increases by _____________ during pregnancy Ans- 15% What is lightening and when does it occur? Ans- Relieving the upward pressure on the diaphragm. Happens during weeks 38-40 (baby drops into pelvis) supine hypotensive syndrome Ans- compression of vena cava by the uterus when a woman lays supine S/S of supine hypotensive syndrome Ans- 1. Faintness 2. Lightheadedness 3. Dizziness 4. Agitation How should you help relieve supine hypotensive syndrome Ans- Turn the patient to the left to displace the uterus and relieve the pressure An increase in clotting factors during pregnancy may lead _________________