MVU NURS 629 EXAM 1 WITH COMPLETE
SOLUTION LATEST UPDATE(A+ exam)
Three trimesters of pregnancy
1st: week 1-13
2nd: weeks 14-27
3rd: weeks 28 to delivery
Naegeles rule of EDB
First day of LMP- subtract 3 months, add 7 days and one year
Ultrasound to determine EDB
1st trimester: accurate within 7 days
2nd trimester: accurate within 10-14 days
The sooner a woman gets an ultrasound the better estimate we can give for weeks
gestation and tracking of fetal growth and development.
Prenatal visit schedule for low-risk pregnancies
-Preconception visit: up to 1 yr before conception
-1st prenatal visit: 6-8wks after missed menses
Up to 28 weeks- every 4 weeks
28 to 36 weeks - every 2 weeks
36 weeks and on -every week or more as necessary
First prenatal visit should include
· Confirmation of pregnancy
1. Pregnancy test and ultrasound
· History
· Menstrual history (LMP) and obstetric history
· Past medical history
· Nutrition and habits: tobacco, alcohol, drugs
· Genetic history: mom, father and 1st relative
· Social history including work, abuse, coping
· Current symptoms
· Physical exam and labs
1. Pelvic exam and pap smear
,2. Blood type and antibody screen
3. Rubella and hepatitis B titer
4. GC, RPR, HIV, Hep C
5. CBC
6. Urinalysis with culture
7. UDS (?)
Prenatal visits 12-21 weeks
Quad Marker screening, discuss newborn feeding options
Prenatal visit 18-22 weeks
Anatomy OB ultrasound
Prenatal visit 24-28 weeks
1 hour glucose test, RH neg type and screen
Prenatal visit 28-34 weeks
RhoGam administration, STI testing if indicated, review newborn feeding discussion,
administer Tdap, preterm labor assessment and education at each visit
Prenatal visit 34-36 weeks
Group B strep swab, review s/s of labor and review labor plan
Prenatal visit 36-40+ weeks
fetal position assessment, cervical exam, review s/s of false labor vs true contractions
Quad screening
Test performed at 16-18 weeks. Tests levels of Inhibin A, MSAFP, unconjugated estriol,
and HCG. Has increased accuracy in screening for DS for women under 35.
1st trimester typical symptoms
, · Breast pain, enlargement, and changes in pigmentation: wear a supportive bra, avoid
caffeine use
· Constipation: large amount of circulating progesterone cause decreased GI motility -
use bulk-forming laxatives or Colace, exercise regularly, elevate feet on a stool while
defecating to prevent straining, high fiber foods, increase fluids, drink warm fluids
· Excessive salivation (ptyalism) and bad taste in mouth: good oral hygiene, good diet
and adequate hydration, suck hard candy, breath mints, chewing gum
· Fatigue: supplemental iron if anemic (30mg/day if not anemic, 120mg/day if anemic for
at least 6 weeks), adequate sleep and rest, mild exercise
· Flatulence: avoid constipation, avoid smoking, avoid large meals
· Headaches: usually tension, Tylenol, avoid stress, smoking, blinking lights, sleeping
late, neck and shoulder massage, regular balanced diet, stay hydrated
· Hemorrhoids: OTC topical anesthetics (Preparation H, Anusol), avoid constipation,
warm or cool sitz baths with Epsom salts, tucks witch hazel pads, ice packs or cool
compresses, Kegel exercises
· Nausea and vomiting: may use Benadryl, Dramamine, Compazine, Phenergan, reglan,
Zofran, avoid triggers (certain foods), rest, avoid stress, avoid tight clothing, hypnosis,
acupuncture, relaxation techniques, small frequent meals, high carb, sipping carbonated
drinks, eating crackers on arising, drinking fluids between meals, avoid spicy and fatty
foods, sit upright after eating, adequate hydration, vitamin B6, ginger
· Urinary frequency and incontinence: resting and sleeping in the lateral recumbent
position, kegals, adequate water intake, decrease water intake 2-3 hours before bed
· Varicosities of vulva and legs: support hose and compression stockings, lie flat and
raise legs to drain veins, avoiding crossing legs, elevate the legs as much as possible,
kegals, mild exercise, warm tub baths
2cd trimester typical symptoms
· Backache: enlarging uterus causes lordosis - Tylenol, good posture, low-heeled shoes,
pelvic tilt exercises, proper body mechanics, avoid heavy lifting, twisting, maternity
girdle or belt, good bra, avoid gaining excessive weight, pregnancy pillow
· Dyspnea - no constrictive clothing, sit up straight, raise arms over head while taking a
breath, elevate head with pillows
SOLUTION LATEST UPDATE(A+ exam)
Three trimesters of pregnancy
1st: week 1-13
2nd: weeks 14-27
3rd: weeks 28 to delivery
Naegeles rule of EDB
First day of LMP- subtract 3 months, add 7 days and one year
Ultrasound to determine EDB
1st trimester: accurate within 7 days
2nd trimester: accurate within 10-14 days
The sooner a woman gets an ultrasound the better estimate we can give for weeks
gestation and tracking of fetal growth and development.
Prenatal visit schedule for low-risk pregnancies
-Preconception visit: up to 1 yr before conception
-1st prenatal visit: 6-8wks after missed menses
Up to 28 weeks- every 4 weeks
28 to 36 weeks - every 2 weeks
36 weeks and on -every week or more as necessary
First prenatal visit should include
· Confirmation of pregnancy
1. Pregnancy test and ultrasound
· History
· Menstrual history (LMP) and obstetric history
· Past medical history
· Nutrition and habits: tobacco, alcohol, drugs
· Genetic history: mom, father and 1st relative
· Social history including work, abuse, coping
· Current symptoms
· Physical exam and labs
1. Pelvic exam and pap smear
,2. Blood type and antibody screen
3. Rubella and hepatitis B titer
4. GC, RPR, HIV, Hep C
5. CBC
6. Urinalysis with culture
7. UDS (?)
Prenatal visits 12-21 weeks
Quad Marker screening, discuss newborn feeding options
Prenatal visit 18-22 weeks
Anatomy OB ultrasound
Prenatal visit 24-28 weeks
1 hour glucose test, RH neg type and screen
Prenatal visit 28-34 weeks
RhoGam administration, STI testing if indicated, review newborn feeding discussion,
administer Tdap, preterm labor assessment and education at each visit
Prenatal visit 34-36 weeks
Group B strep swab, review s/s of labor and review labor plan
Prenatal visit 36-40+ weeks
fetal position assessment, cervical exam, review s/s of false labor vs true contractions
Quad screening
Test performed at 16-18 weeks. Tests levels of Inhibin A, MSAFP, unconjugated estriol,
and HCG. Has increased accuracy in screening for DS for women under 35.
1st trimester typical symptoms
, · Breast pain, enlargement, and changes in pigmentation: wear a supportive bra, avoid
caffeine use
· Constipation: large amount of circulating progesterone cause decreased GI motility -
use bulk-forming laxatives or Colace, exercise regularly, elevate feet on a stool while
defecating to prevent straining, high fiber foods, increase fluids, drink warm fluids
· Excessive salivation (ptyalism) and bad taste in mouth: good oral hygiene, good diet
and adequate hydration, suck hard candy, breath mints, chewing gum
· Fatigue: supplemental iron if anemic (30mg/day if not anemic, 120mg/day if anemic for
at least 6 weeks), adequate sleep and rest, mild exercise
· Flatulence: avoid constipation, avoid smoking, avoid large meals
· Headaches: usually tension, Tylenol, avoid stress, smoking, blinking lights, sleeping
late, neck and shoulder massage, regular balanced diet, stay hydrated
· Hemorrhoids: OTC topical anesthetics (Preparation H, Anusol), avoid constipation,
warm or cool sitz baths with Epsom salts, tucks witch hazel pads, ice packs or cool
compresses, Kegel exercises
· Nausea and vomiting: may use Benadryl, Dramamine, Compazine, Phenergan, reglan,
Zofran, avoid triggers (certain foods), rest, avoid stress, avoid tight clothing, hypnosis,
acupuncture, relaxation techniques, small frequent meals, high carb, sipping carbonated
drinks, eating crackers on arising, drinking fluids between meals, avoid spicy and fatty
foods, sit upright after eating, adequate hydration, vitamin B6, ginger
· Urinary frequency and incontinence: resting and sleeping in the lateral recumbent
position, kegals, adequate water intake, decrease water intake 2-3 hours before bed
· Varicosities of vulva and legs: support hose and compression stockings, lie flat and
raise legs to drain veins, avoiding crossing legs, elevate the legs as much as possible,
kegals, mild exercise, warm tub baths
2cd trimester typical symptoms
· Backache: enlarging uterus causes lordosis - Tylenol, good posture, low-heeled shoes,
pelvic tilt exercises, proper body mechanics, avoid heavy lifting, twisting, maternity
girdle or belt, good bra, avoid gaining excessive weight, pregnancy pillow
· Dyspnea - no constrictive clothing, sit up straight, raise arms over head while taking a
breath, elevate head with pillows
