NURS 230 OB EXAM I STUDY GUIDE REVIEW 2022
Terminology:
Gestation- age of pregnancy
Trimester- segment of pregnancy (13
weeks) Antepartum- total time of
pregnancy Intrapartum, labor and birth
Postpartum- 6 weeks after birth
Gravidity-number of pregnancies (no matter the outcome)
Para- number of viable deliveries, < 20 weeks
Term- 38-42 weeks
Viability- 22-24 weeks
Assessing Gravidity GTPAL:
1. Gravidity
2. T-Total number of term births
3. P- Total number of preterm births
4. A-Total number of abortions (spontaneous or elective)
5. L- Total number of living
children Signs of Pregnancy:
• Presumptive signs- subjective, could be caused by other conditions
(Braxton hicks, amenorrhea, n/v, fatigue, quickening, breast changes, urinary frequency)
• Probable- objective indicators but could still be possibly caused by other conditions
(Uterine enlargement, Goodwells soft cervix, positive pregnancy test, HCG in urine, deep blue violet vagina)
• Positive- can be felt, seen, heard
(fetal movement felt, FHR heard on
monitor) The initial client assessment :
• OB/GYN history
• Medical and family history
• Social, experiential, and drug/alcohol history
• Review of symptoms
• Immunizations
• Medications and allergies
• Determine Expected Date of Delivery (EDD)
Date of LMP + 7 days to date and subtract 3 months
Example: LMP= 01/12 12+7=19 Jan- 3 months= Oct EDD- 10/19
• Urinary or blood human chorionic gonadotropin to diagnose a
pregnancy Physical Exam:
• BP, Ht , WT
• Breast and cervix exam
• Baseline pelvic
exam Lab tests:
• CBC- blood test to screen for anemia, clotting disorders and infections
• Blood typing
• Rh status- If Rh + fetal blood crosses into the maternal blood it can cause isoimmunization
• Rubella, and varicella- test for immunity. THIS VACCINE WILL NOT BE GIVEN DURING PREGNANCY!!!!
• STI’s and Herpes- culture
swab F/U visits:
Monthly- initial to 28 weeks; Q2 weeks- 29-36 weeks; Weekly- 37-40 weeks
• Fundal Ht – measured from pubic symphysis to the highest point of uterus (33 weeks should measure 33 cm +/- 2 cm)
• 15-18 weeks – triple and quad screen via blood test
• 15-26 weeks – amniocentesis via amniotic fluid sample
• 24-28 weeks – GTT (glucose testing) and antibody screen (required if Rh-)
1 hour testing (not fasting), if failed procced with 3-hour testing (with fasting) Alternatives for
drinking sugar drink are eating jellybeans, or monitor BG with check 4 times daily for 2 weeks
• 35-37 weeks -strep and herpes screen, via swab
• Between 18-40 weeks, abnormalities can be seen via
US Signs and Symptoms to report immediately:
• Sudden gush of fluid from vagina
, NURS 230 OB EXAM I STUDY GUIDE REVIEW 2022
• Bleeding of any kind from vagina
• Severe, persistent HA
• Dizziness, blurred vision, spots before eyes
• Swelling of hands, feet, legs, or face
• Abdominal pain, or gastric pain
• Persistent vomiting
• Dysuria, oliguria
• No fetal movement for prolonged
period Adolescent pregnancies:
Risks: anemia, preeclampsia, preterm
birth Advanced maternal age:
Risks: vaginal bleeding, preeclampsia, multiple gestation, gestational DM, preterm labor, dysfunctional labor, c-section.
Greater risk for low birth wt, macrosomia, chromosomal defects, congenital malformations
Cultural considerations:
• Hispanic-American
Pregnancy desired soon after marriage; Strongly influenced by mother or mother-in-law; Loud behavior in labor
Postpartum: Avoid cold foods, Bedrest by 3 days, 40 day restriction on intercourse, Mother may wipe her face with baby’s first
wet diaper to make “mask of pregnancy’ go away
Newborn: May not breastfeed until colostrum gone, colostrum considered “filthy” or “spoiled”, Female infant’s ears pierced,
Protect from “evil eye
• African American
Picture during pregnancy may cause stillbirth or reaching will cause cord to wrap around the neck
Craving for chicken and greens, and nonfood substances such as clay, starch, or dirt (pica)
Emotional support during pregnancy is often provided by own mother
Postpartum: Tub baths & shampooing of hair prohibited, Sassafras tea thought to have healing power
Newborn: “good” baby eats well, Early introduction of solid food, Belly band to prevent umbilical hernia, Abundant use of oil on
baby’s scalp and skin
• Asian-American
Happiness in body when pregnant
Prefers female health care
provider Belief in theory of hot
and cold
May omit soy sauce to prevent dark skinned
baby Milk usually avoided
Sexual intercourse in last 2 months of pregnancy is restricted
Father does not often participate in labor
Postpartum: Protect from cold sources (yin) for 30 days, Shower & bathing prohibited for 10 days, Warm room, warm fluids to
drink
Newborn: Father head of household, mother is subordinate, May delay naming child
• Native American
Late prenatal care
Herb teas encourage
Birth may be attended by whole
family Squatting position
Herbal teas used to stop bleeding
postpartum Baby not feed colostrum
Babies not handled often
Ultrasound
Uses of Ultrasound
Transabdominal and transvaginal ultrasound, according to the American College of Obstetricians and Gynecologists, is used for a
wide variety of normal and abnormal conditions.
• Assess fetal growth
• Determination of gestational age
• Placenta placement
• Fetal heartbeat and anatomy
• Fetal tone, movements, and breathing
• Amniotic fluid index
BPP Ultrasound exam
Terminology:
Gestation- age of pregnancy
Trimester- segment of pregnancy (13
weeks) Antepartum- total time of
pregnancy Intrapartum, labor and birth
Postpartum- 6 weeks after birth
Gravidity-number of pregnancies (no matter the outcome)
Para- number of viable deliveries, < 20 weeks
Term- 38-42 weeks
Viability- 22-24 weeks
Assessing Gravidity GTPAL:
1. Gravidity
2. T-Total number of term births
3. P- Total number of preterm births
4. A-Total number of abortions (spontaneous or elective)
5. L- Total number of living
children Signs of Pregnancy:
• Presumptive signs- subjective, could be caused by other conditions
(Braxton hicks, amenorrhea, n/v, fatigue, quickening, breast changes, urinary frequency)
• Probable- objective indicators but could still be possibly caused by other conditions
(Uterine enlargement, Goodwells soft cervix, positive pregnancy test, HCG in urine, deep blue violet vagina)
• Positive- can be felt, seen, heard
(fetal movement felt, FHR heard on
monitor) The initial client assessment :
• OB/GYN history
• Medical and family history
• Social, experiential, and drug/alcohol history
• Review of symptoms
• Immunizations
• Medications and allergies
• Determine Expected Date of Delivery (EDD)
Date of LMP + 7 days to date and subtract 3 months
Example: LMP= 01/12 12+7=19 Jan- 3 months= Oct EDD- 10/19
• Urinary or blood human chorionic gonadotropin to diagnose a
pregnancy Physical Exam:
• BP, Ht , WT
• Breast and cervix exam
• Baseline pelvic
exam Lab tests:
• CBC- blood test to screen for anemia, clotting disorders and infections
• Blood typing
• Rh status- If Rh + fetal blood crosses into the maternal blood it can cause isoimmunization
• Rubella, and varicella- test for immunity. THIS VACCINE WILL NOT BE GIVEN DURING PREGNANCY!!!!
• STI’s and Herpes- culture
swab F/U visits:
Monthly- initial to 28 weeks; Q2 weeks- 29-36 weeks; Weekly- 37-40 weeks
• Fundal Ht – measured from pubic symphysis to the highest point of uterus (33 weeks should measure 33 cm +/- 2 cm)
• 15-18 weeks – triple and quad screen via blood test
• 15-26 weeks – amniocentesis via amniotic fluid sample
• 24-28 weeks – GTT (glucose testing) and antibody screen (required if Rh-)
1 hour testing (not fasting), if failed procced with 3-hour testing (with fasting) Alternatives for
drinking sugar drink are eating jellybeans, or monitor BG with check 4 times daily for 2 weeks
• 35-37 weeks -strep and herpes screen, via swab
• Between 18-40 weeks, abnormalities can be seen via
US Signs and Symptoms to report immediately:
• Sudden gush of fluid from vagina
, NURS 230 OB EXAM I STUDY GUIDE REVIEW 2022
• Bleeding of any kind from vagina
• Severe, persistent HA
• Dizziness, blurred vision, spots before eyes
• Swelling of hands, feet, legs, or face
• Abdominal pain, or gastric pain
• Persistent vomiting
• Dysuria, oliguria
• No fetal movement for prolonged
period Adolescent pregnancies:
Risks: anemia, preeclampsia, preterm
birth Advanced maternal age:
Risks: vaginal bleeding, preeclampsia, multiple gestation, gestational DM, preterm labor, dysfunctional labor, c-section.
Greater risk for low birth wt, macrosomia, chromosomal defects, congenital malformations
Cultural considerations:
• Hispanic-American
Pregnancy desired soon after marriage; Strongly influenced by mother or mother-in-law; Loud behavior in labor
Postpartum: Avoid cold foods, Bedrest by 3 days, 40 day restriction on intercourse, Mother may wipe her face with baby’s first
wet diaper to make “mask of pregnancy’ go away
Newborn: May not breastfeed until colostrum gone, colostrum considered “filthy” or “spoiled”, Female infant’s ears pierced,
Protect from “evil eye
• African American
Picture during pregnancy may cause stillbirth or reaching will cause cord to wrap around the neck
Craving for chicken and greens, and nonfood substances such as clay, starch, or dirt (pica)
Emotional support during pregnancy is often provided by own mother
Postpartum: Tub baths & shampooing of hair prohibited, Sassafras tea thought to have healing power
Newborn: “good” baby eats well, Early introduction of solid food, Belly band to prevent umbilical hernia, Abundant use of oil on
baby’s scalp and skin
• Asian-American
Happiness in body when pregnant
Prefers female health care
provider Belief in theory of hot
and cold
May omit soy sauce to prevent dark skinned
baby Milk usually avoided
Sexual intercourse in last 2 months of pregnancy is restricted
Father does not often participate in labor
Postpartum: Protect from cold sources (yin) for 30 days, Shower & bathing prohibited for 10 days, Warm room, warm fluids to
drink
Newborn: Father head of household, mother is subordinate, May delay naming child
• Native American
Late prenatal care
Herb teas encourage
Birth may be attended by whole
family Squatting position
Herbal teas used to stop bleeding
postpartum Baby not feed colostrum
Babies not handled often
Ultrasound
Uses of Ultrasound
Transabdominal and transvaginal ultrasound, according to the American College of Obstetricians and Gynecologists, is used for a
wide variety of normal and abnormal conditions.
• Assess fetal growth
• Determination of gestational age
• Placenta placement
• Fetal heartbeat and anatomy
• Fetal tone, movements, and breathing
• Amniotic fluid index
BPP Ultrasound exam
