NUR2633 Exam 1 Focused Review
• Rhogam and its indication for use
- Rhogam shot given if the mother is RH negative and baby is RH positive.
- Prevents the antibodies from attacking the fetus.
- Only lasts 3 months
- Only if potential mix of blood
• Quickening during pregnancy
- Butterflies, small kicks. (17-20 weeks)
• Assessment of the fundus
- Fundus: rounded area on an organ
- How far along and postpartum
- Firm during birth
- Postpartum massage
- NEVER soft boggy uterus.
- Fundal height and it’s indications***
• Anatomy and physiology of the umbilical cord
- AVA (2 arteries and 1 vein)
- artery to baby from mom
- vein from mom to baby
- Protected by Wharton’s jelly (protects it from compression)
- Placenta does not provide nutrition
• Breast exams in women- normal vs abnormal findings
- Annual exams by a trained professional
- Perform 1 week after period.
- Inflammatory breast cancer: may cause swelling and redness (often does not show up on
mammography).
- Check for dimpling, puckering, retraction, lesions, changes in upper extremity mobility.
- Inspect underneath breast for yeast infections and skin nodules
- Supine position: deeper palpation beginning at clavicle adjacent to the arm pit (vertical strips over
the breast).
- Check underlying ribs and costal cartilage.
• Activity and exercise during pregnancy (p.312)
- Walk
- Do not overdo it
- Nothing strenuous
• GTPAL system: pregnancy rating scale
- Gravita: number of pregnancies (including this one)
- T: Term
- P: Premature
, - A: Abortion (spontaneous included)
- L: Living children
• Types of contraception
- Abstinence: 100% effective
- Pullout (withdrawal)
- Shots
- IUD (hormones and non)
- Spermicides
- Condoms
- Most reliable
- Risk factors
- Oral: signs and symptoms, blood clots, stroke, pulmonary embolism, heart attack, take at same
time every day.
• Lab testing during pregnancy
- ABO and Rh
- CBC
- HIV
- Maternal serum alpha feto-protein and QUAD screening: used to chromosomal abnormalities.
(especially after the age of 35)
- Group B Strep
- Amnio (2nd trimester)
- Blood sugar (24-28 weeks)
• Domestic violence in pregnancy
- RADAR
Routinely screen every patient
Ask directly
Document your findings
Assess patient’s safety
Review options & provide referrals
• Fetal heart tones
- 4 weeks, ultrasounds (transvaginal)
- 10-12 weeks, Doppler
- 17-19 weeks, fetal stethoscope
- Baseline fetal HR at term: 110-160 bpm
-Tachycardia: 160+
-Bradycardia: 110-
- Most clearly heard over the fetal upper back
• Common problems associated with pregnancy and teaching - constipation, nausea and vomiting,
stretch marks, edema
-N/V: 70-85% of women and usual resolves by week 16. ; avoid trigger foods, rest, small frequent
meals of dry & bland foods, high-protein snacks.
• Dangerous complications of pregnancy
- Preeclampsia
- Gestational diabetes
- Placenta previa: complete, partial, marginal. Covers cervical opening
• Rhogam and its indication for use
- Rhogam shot given if the mother is RH negative and baby is RH positive.
- Prevents the antibodies from attacking the fetus.
- Only lasts 3 months
- Only if potential mix of blood
• Quickening during pregnancy
- Butterflies, small kicks. (17-20 weeks)
• Assessment of the fundus
- Fundus: rounded area on an organ
- How far along and postpartum
- Firm during birth
- Postpartum massage
- NEVER soft boggy uterus.
- Fundal height and it’s indications***
• Anatomy and physiology of the umbilical cord
- AVA (2 arteries and 1 vein)
- artery to baby from mom
- vein from mom to baby
- Protected by Wharton’s jelly (protects it from compression)
- Placenta does not provide nutrition
• Breast exams in women- normal vs abnormal findings
- Annual exams by a trained professional
- Perform 1 week after period.
- Inflammatory breast cancer: may cause swelling and redness (often does not show up on
mammography).
- Check for dimpling, puckering, retraction, lesions, changes in upper extremity mobility.
- Inspect underneath breast for yeast infections and skin nodules
- Supine position: deeper palpation beginning at clavicle adjacent to the arm pit (vertical strips over
the breast).
- Check underlying ribs and costal cartilage.
• Activity and exercise during pregnancy (p.312)
- Walk
- Do not overdo it
- Nothing strenuous
• GTPAL system: pregnancy rating scale
- Gravita: number of pregnancies (including this one)
- T: Term
- P: Premature
, - A: Abortion (spontaneous included)
- L: Living children
• Types of contraception
- Abstinence: 100% effective
- Pullout (withdrawal)
- Shots
- IUD (hormones and non)
- Spermicides
- Condoms
- Most reliable
- Risk factors
- Oral: signs and symptoms, blood clots, stroke, pulmonary embolism, heart attack, take at same
time every day.
• Lab testing during pregnancy
- ABO and Rh
- CBC
- HIV
- Maternal serum alpha feto-protein and QUAD screening: used to chromosomal abnormalities.
(especially after the age of 35)
- Group B Strep
- Amnio (2nd trimester)
- Blood sugar (24-28 weeks)
• Domestic violence in pregnancy
- RADAR
Routinely screen every patient
Ask directly
Document your findings
Assess patient’s safety
Review options & provide referrals
• Fetal heart tones
- 4 weeks, ultrasounds (transvaginal)
- 10-12 weeks, Doppler
- 17-19 weeks, fetal stethoscope
- Baseline fetal HR at term: 110-160 bpm
-Tachycardia: 160+
-Bradycardia: 110-
- Most clearly heard over the fetal upper back
• Common problems associated with pregnancy and teaching - constipation, nausea and vomiting,
stretch marks, edema
-N/V: 70-85% of women and usual resolves by week 16. ; avoid trigger foods, rest, small frequent
meals of dry & bland foods, high-protein snacks.
• Dangerous complications of pregnancy
- Preeclampsia
- Gestational diabetes
- Placenta previa: complete, partial, marginal. Covers cervical opening
