Maternity Nursing: Pregnancy and
childbirth
15x15 Window - ANS-The fetal heart accelerates at least 15 bpm above the baseline for at
least 15 seconds. Used as the basis for NST.
\4 Positive Signs of Pregnancy - ANS-Visualization on US, fetal heart sounds, palpable fetal
movements, visible fetal movements
\4 Presumptive Signs of Pregnancy - ANS-Breast changes (swelling, tingling, soreness),
amenorrhea, morning sickness, urinary frequency
\8 Probable Signs of Pregnancy - ANS-Presence of hCG in blood, presence of hCG in the
urine, uterine growth, Braxton Hicks, allotment of fetus, Chadwick's sign, Hegar's sign,
Goodell's sign.
\Affect of pregnancy on vital signs - ANS-Pulse increases by about 10-15bpm on average
BP normally decreases slightly
Respirations may increase due to SOB as a result of hormones in the firs trimester and the
expanding uterus in the third trimester
\All previous pregnancies a woman has had, regardless of outcome. - ANS-Gravida
\Anticipatory signs of labor - ANS-2 weeks prior: presenting part may settle into pelvic cavity
("baby has dropped", "lightening"). Often not experienced in multiparity
Braxton-Hicks contractions begin occurring more frequently and may become
uncomfortable, resulting in a feeling called "false labor." Decrease in intensity with walking or
position changes.
GI disturbances
Mucus plug expulsion/bloody show
Burst of energy 24-48 hrs before onset of labor; may have energy and desire to take on
large projects in preparation for baby's arrival ("nesting"). Caution her not to over-exert
herself because she'll need that energy during labor
\At what stage in gestation can the fundus be palpated halfway between the symphysis
pubis and the umbilicus? - ANS-16 weeks gestation
\Attitude in which fetus is neither flexed nor hyperextended; larger head diameter presents -
ANS-Military presentation
\Attitude of full extension, forehead presents first - ANS-Face presentation
\Attitude of partial extension - ANS-Brow presentation
\Belief that the way to make childbirth an enjoyable experience is to copy what animals do
naturally duing the birthing process. This includes darkness and solitude, quiet atmosphere,
physical comfort and relaxation, controlled breathing and closed eyes with the appearance of
sleep. - ANS-Bradley Method
\Bluish-purplish color of the cervix, vagina and perineum - ANS-Chadwick's sign, a probable
sign of pregnancy
\Bony passageway through which fetus must travel during delivery, including the inlet,
midpelvis and outlet - ANS-True pelvis
\Causes symptoms similar to the common cold during pregnancy - ANS-Vasocongestion
\Clinical signs of impending labor - ANS-Dilation
Effacement
, \Clotting during pregnancy - ANS-Hypercoagulable state due to increased production of
fibrinogen (protective mechanism for childbirth). Can lead to DVT.
\Combines Dick-Read Method with Pavlov's theory of conditioned response. The goal is to
have the woman respond during labor with the conditioned responses to pain, rather than
natural responses like holding her breath and tensing. Also encourages birthing partner
support during labor with things like praise and encouragement, position changes and
comfort measures. - ANS-Lamaze Method
\Communicates the outcome of previous pregnancies - ANS-Parity, or "para". Includes any
delivery after twenty weeks, living or stillborn. Counts multiples as one single pregnancy.
\Contraction Stress Test - ANS-Monitors fetal response to contractions. Goal is to have 3
contractions of at least 40 seconds in a 10 minute period. If there are no "late decelerations"
(decelarations after the contractions), CST is negative, which is reassuring.
\Cravings for non-food items associated with iron-deficiency anemia - ANS-Pica; some
women develop this during pregnancy, but the cravings cease after delivery
\Cretinism - ANS-Congenital condition marked by stunted growth and mental retardation.
R/T severe iodine deficiency during pregnancy (such as in hypothyroidism)
\Describe Fetal Kick Counts. - ANS-A healthy fetus moves and kicks regularly, and can be
felt by the mother after around 16-20 weeks gestation. The mother should be instructed to
monitor her baby's movements on a daily basis; pick a quiet time when she can relax and
count the number of times she feels the baby move. Using a blank sheet of paper, have her
write the time at the top, tally each time she feels a movement until she reaches ten tally
marks, and note the end time when she feels the tenth movement. A healthy fetus will move
at least ten times in two hours. If it takes longer than 2 hours or if the mother doesn't feel her
baby move at all, she should immediately contact her PCP. The PCP will then order tests to
determine the well-being of the fetus.
\Duration of contractions - ANS-Interval of beginning of contraction until its end
\Fetal attitude - ANS-The variants of presentation; relationship of fetal parts to one another.
For example, cephalic presentation has four different attitudes: vertex, military, brow and
face.
\Fetal Lie - ANS-Position of long axis of fetus in relation to long axis of mother. The basic
way fetus can lie: Longitudinal, Transverse and Oblique
\Fetal Position - ANS-Compares relationship of reference point on presenting part of fetus to
quadrants of the maternal pelvis.
Noted as:
First Designation: the side of the maternal pelvis in which the reference point is found (R or
L)
Second Designation: The reference point
Occiput (O), Frontum/brow (Fr), Mentum/chin (M), Sacrum/breech (S), Scapula/shoulder
(Sc)
Third Designation: Front (A), back (P) or side (T) of maternal pelvis.
Record as you look at the birth canal from the end of the bed...so you will record Right when
it is actually the mother's left.
\Fetal presentation - ANS-Foremost part of the fetus that enters the inlet
\First pregnancy - ANS-Primigravida
childbirth
15x15 Window - ANS-The fetal heart accelerates at least 15 bpm above the baseline for at
least 15 seconds. Used as the basis for NST.
\4 Positive Signs of Pregnancy - ANS-Visualization on US, fetal heart sounds, palpable fetal
movements, visible fetal movements
\4 Presumptive Signs of Pregnancy - ANS-Breast changes (swelling, tingling, soreness),
amenorrhea, morning sickness, urinary frequency
\8 Probable Signs of Pregnancy - ANS-Presence of hCG in blood, presence of hCG in the
urine, uterine growth, Braxton Hicks, allotment of fetus, Chadwick's sign, Hegar's sign,
Goodell's sign.
\Affect of pregnancy on vital signs - ANS-Pulse increases by about 10-15bpm on average
BP normally decreases slightly
Respirations may increase due to SOB as a result of hormones in the firs trimester and the
expanding uterus in the third trimester
\All previous pregnancies a woman has had, regardless of outcome. - ANS-Gravida
\Anticipatory signs of labor - ANS-2 weeks prior: presenting part may settle into pelvic cavity
("baby has dropped", "lightening"). Often not experienced in multiparity
Braxton-Hicks contractions begin occurring more frequently and may become
uncomfortable, resulting in a feeling called "false labor." Decrease in intensity with walking or
position changes.
GI disturbances
Mucus plug expulsion/bloody show
Burst of energy 24-48 hrs before onset of labor; may have energy and desire to take on
large projects in preparation for baby's arrival ("nesting"). Caution her not to over-exert
herself because she'll need that energy during labor
\At what stage in gestation can the fundus be palpated halfway between the symphysis
pubis and the umbilicus? - ANS-16 weeks gestation
\Attitude in which fetus is neither flexed nor hyperextended; larger head diameter presents -
ANS-Military presentation
\Attitude of full extension, forehead presents first - ANS-Face presentation
\Attitude of partial extension - ANS-Brow presentation
\Belief that the way to make childbirth an enjoyable experience is to copy what animals do
naturally duing the birthing process. This includes darkness and solitude, quiet atmosphere,
physical comfort and relaxation, controlled breathing and closed eyes with the appearance of
sleep. - ANS-Bradley Method
\Bluish-purplish color of the cervix, vagina and perineum - ANS-Chadwick's sign, a probable
sign of pregnancy
\Bony passageway through which fetus must travel during delivery, including the inlet,
midpelvis and outlet - ANS-True pelvis
\Causes symptoms similar to the common cold during pregnancy - ANS-Vasocongestion
\Clinical signs of impending labor - ANS-Dilation
Effacement
, \Clotting during pregnancy - ANS-Hypercoagulable state due to increased production of
fibrinogen (protective mechanism for childbirth). Can lead to DVT.
\Combines Dick-Read Method with Pavlov's theory of conditioned response. The goal is to
have the woman respond during labor with the conditioned responses to pain, rather than
natural responses like holding her breath and tensing. Also encourages birthing partner
support during labor with things like praise and encouragement, position changes and
comfort measures. - ANS-Lamaze Method
\Communicates the outcome of previous pregnancies - ANS-Parity, or "para". Includes any
delivery after twenty weeks, living or stillborn. Counts multiples as one single pregnancy.
\Contraction Stress Test - ANS-Monitors fetal response to contractions. Goal is to have 3
contractions of at least 40 seconds in a 10 minute period. If there are no "late decelerations"
(decelarations after the contractions), CST is negative, which is reassuring.
\Cravings for non-food items associated with iron-deficiency anemia - ANS-Pica; some
women develop this during pregnancy, but the cravings cease after delivery
\Cretinism - ANS-Congenital condition marked by stunted growth and mental retardation.
R/T severe iodine deficiency during pregnancy (such as in hypothyroidism)
\Describe Fetal Kick Counts. - ANS-A healthy fetus moves and kicks regularly, and can be
felt by the mother after around 16-20 weeks gestation. The mother should be instructed to
monitor her baby's movements on a daily basis; pick a quiet time when she can relax and
count the number of times she feels the baby move. Using a blank sheet of paper, have her
write the time at the top, tally each time she feels a movement until she reaches ten tally
marks, and note the end time when she feels the tenth movement. A healthy fetus will move
at least ten times in two hours. If it takes longer than 2 hours or if the mother doesn't feel her
baby move at all, she should immediately contact her PCP. The PCP will then order tests to
determine the well-being of the fetus.
\Duration of contractions - ANS-Interval of beginning of contraction until its end
\Fetal attitude - ANS-The variants of presentation; relationship of fetal parts to one another.
For example, cephalic presentation has four different attitudes: vertex, military, brow and
face.
\Fetal Lie - ANS-Position of long axis of fetus in relation to long axis of mother. The basic
way fetus can lie: Longitudinal, Transverse and Oblique
\Fetal Position - ANS-Compares relationship of reference point on presenting part of fetus to
quadrants of the maternal pelvis.
Noted as:
First Designation: the side of the maternal pelvis in which the reference point is found (R or
L)
Second Designation: The reference point
Occiput (O), Frontum/brow (Fr), Mentum/chin (M), Sacrum/breech (S), Scapula/shoulder
(Sc)
Third Designation: Front (A), back (P) or side (T) of maternal pelvis.
Record as you look at the birth canal from the end of the bed...so you will record Right when
it is actually the mother's left.
\Fetal presentation - ANS-Foremost part of the fetus that enters the inlet
\First pregnancy - ANS-Primigravida
