NURS 320 FINAL EXAM STUDY GUIDE 023
UPDATE
1. Fetal development
a. Function of the yolk sac
-Develops at 8-9 days after conception
-Essential for transfer of nutrients during 2nd-3rd week of gestation
-Atrophies & is incorporated into umbilical cord
-Important for development of RBCs & nutrients
-Hematopoiesis: RBC formation in wall of yolk sac up till 8 weeks
gestation when liver takes over to produce RBCs
b. Blood transport through fetal circulation
-Heart begins to beat & circulate blood by the end of week 3
-Ductus Venous: bypasses liver & enters inferior vena cava
-Foramen Ovale: right & left atria to supply blood to head, upper,
& lower extremities
-Ductus arteriosus: returning blood bypasses the lungs
c. Why does the fetus have a low PO2
-To keep ducts open & maintain fetal circulation
-Fetal hemoglobin contains a lot of oxygen so low PO2 is okay
d. Time the fetus most vulnerable to teratogens
-First 8 weeks, after 13 weeks can cause IUGR
e. TORCH
-All cross placenta
i. What are the components of TORCH
-Toxoplasmosis (raw/undercooked meat, cat feces), Other (Hep B,
syphilis, HIV), Rubella (contact, rash), Cytomegalovirus (droplet in
seamen), Herpes Simplex (contact, oral/genital)
ii. How does the patient protect themselves
-Cook meat, avoid cat feces, get Hep B & Rubella vaccines, & use
protection
f. At what gestational week will mom feel baby move or feel
QUICKENING
-20 weeks (feels like butterflies)
g. Function of the amniotic fluid
-Protects & cushion fetus
-Maintain normal body temp
-Promote symmetrical growth
-Allows for freedom of movement
-Essential for fetal lung development (baby practices
swallowing which helps lungs to develop & chest wall muscles)
h. Events of fetal development that occur at 16-20 weeks
-16 weeks (teeth, kidney shape, gender, intestines, meconium,
hair)
-20 weeks (brown fat, practice sucking/swallowing, lanugo)
-24 weeks (surfactant)
,NURS 320 FINAL EXAM STUDY GUIDE 023
UPDATE
2. Menstruation
a. Phases of the uterine cycle and when do they
occur Uterine Phase: Ovarian
Phase:
1. Menstrual Phase, 1-6 days Follicular phase
2. Proliferative Phase, 7-14 days Follicular phase
3. Secretory Phase, 12-28 days Luteal phase
3. Prenatal Assessment-Uncomplicated Pregnancy
a. Naegle’s Rule
-Add a year, subtract three months, & add seven days
b. Normal lab values for a pregnant patient
-Hemoglobin 11-13
-Hematocrit 33-39
-RBC 3.8-4.4
-WBC 5.0-12.0
-Platelets 150,000-200,000
-Fibrinogen (levels increase late in pregnancy, prevent PPH)
normal non- pregnant 200-400
c. Screening for domestic violence and priority assessments
-Screening for intimate partner violence should be done at the
first prenatal appointment, at least once every trimester, & at the
postpartum follow up
-Assess for bruises, low weight, HTN, infections, affect, appearance
d. Positive, Presumptive and Probable signs of pregnancy
Presumptive (subjective):
-Amenorrhea
-N/V/F
-Breast changes
-Frequent urination
-Quickening
-Uterine contractions
Probable:
-Chadwick’s sign: bluish/purple discoloration of cervix/vagina
-Goodell’s sign (identified below)
-Hegar’s sign (identified below)
-Operculum: mucus plug seals cervical canal & helps to prevent
vertical transmission
-Braxton hick’s contractions: no change in cervix, practicing
-Ballottement: tap finger on uterus causes baby to rise + come
back down
-Positive pregnancy test
Positive:
-Sonogram visualization of fetus, & cardiac movement at 4-8
weeks
-Auscultation of fetal heart tones at 10-12 weeks with doppler
-Observation & palpation of fetal movement after 20 weeks
e. What is the rationale for a first trimester ultrasound?
, NURS 320 FINAL EXAM STUDY GUIDE 023
UPDATE
-Confirm viability & gestational age of pregnancy
-Number, size, & location of sacs
UPDATE
1. Fetal development
a. Function of the yolk sac
-Develops at 8-9 days after conception
-Essential for transfer of nutrients during 2nd-3rd week of gestation
-Atrophies & is incorporated into umbilical cord
-Important for development of RBCs & nutrients
-Hematopoiesis: RBC formation in wall of yolk sac up till 8 weeks
gestation when liver takes over to produce RBCs
b. Blood transport through fetal circulation
-Heart begins to beat & circulate blood by the end of week 3
-Ductus Venous: bypasses liver & enters inferior vena cava
-Foramen Ovale: right & left atria to supply blood to head, upper,
& lower extremities
-Ductus arteriosus: returning blood bypasses the lungs
c. Why does the fetus have a low PO2
-To keep ducts open & maintain fetal circulation
-Fetal hemoglobin contains a lot of oxygen so low PO2 is okay
d. Time the fetus most vulnerable to teratogens
-First 8 weeks, after 13 weeks can cause IUGR
e. TORCH
-All cross placenta
i. What are the components of TORCH
-Toxoplasmosis (raw/undercooked meat, cat feces), Other (Hep B,
syphilis, HIV), Rubella (contact, rash), Cytomegalovirus (droplet in
seamen), Herpes Simplex (contact, oral/genital)
ii. How does the patient protect themselves
-Cook meat, avoid cat feces, get Hep B & Rubella vaccines, & use
protection
f. At what gestational week will mom feel baby move or feel
QUICKENING
-20 weeks (feels like butterflies)
g. Function of the amniotic fluid
-Protects & cushion fetus
-Maintain normal body temp
-Promote symmetrical growth
-Allows for freedom of movement
-Essential for fetal lung development (baby practices
swallowing which helps lungs to develop & chest wall muscles)
h. Events of fetal development that occur at 16-20 weeks
-16 weeks (teeth, kidney shape, gender, intestines, meconium,
hair)
-20 weeks (brown fat, practice sucking/swallowing, lanugo)
-24 weeks (surfactant)
,NURS 320 FINAL EXAM STUDY GUIDE 023
UPDATE
2. Menstruation
a. Phases of the uterine cycle and when do they
occur Uterine Phase: Ovarian
Phase:
1. Menstrual Phase, 1-6 days Follicular phase
2. Proliferative Phase, 7-14 days Follicular phase
3. Secretory Phase, 12-28 days Luteal phase
3. Prenatal Assessment-Uncomplicated Pregnancy
a. Naegle’s Rule
-Add a year, subtract three months, & add seven days
b. Normal lab values for a pregnant patient
-Hemoglobin 11-13
-Hematocrit 33-39
-RBC 3.8-4.4
-WBC 5.0-12.0
-Platelets 150,000-200,000
-Fibrinogen (levels increase late in pregnancy, prevent PPH)
normal non- pregnant 200-400
c. Screening for domestic violence and priority assessments
-Screening for intimate partner violence should be done at the
first prenatal appointment, at least once every trimester, & at the
postpartum follow up
-Assess for bruises, low weight, HTN, infections, affect, appearance
d. Positive, Presumptive and Probable signs of pregnancy
Presumptive (subjective):
-Amenorrhea
-N/V/F
-Breast changes
-Frequent urination
-Quickening
-Uterine contractions
Probable:
-Chadwick’s sign: bluish/purple discoloration of cervix/vagina
-Goodell’s sign (identified below)
-Hegar’s sign (identified below)
-Operculum: mucus plug seals cervical canal & helps to prevent
vertical transmission
-Braxton hick’s contractions: no change in cervix, practicing
-Ballottement: tap finger on uterus causes baby to rise + come
back down
-Positive pregnancy test
Positive:
-Sonogram visualization of fetus, & cardiac movement at 4-8
weeks
-Auscultation of fetal heart tones at 10-12 weeks with doppler
-Observation & palpation of fetal movement after 20 weeks
e. What is the rationale for a first trimester ultrasound?
, NURS 320 FINAL EXAM STUDY GUIDE 023
UPDATE
-Confirm viability & gestational age of pregnancy
-Number, size, & location of sacs
