Maternal Child Test 3

Front 1

What size is the uterus before pregnancy?

Back 1

Pear shaped

Front 2

Give dimentions and wt of uterus before pregnancy

Back 2

7.5cmx5cmx2.5cm
60 grams (2 oz)

Front 3

Give capacity range for the uterus during pregnancy

Back 3

10ml to 5000ml (500x's more than normal!)

Front 4

At how many weeks is uterus at belly button?

Back 4

20 wks

Front 5

At delivery where is the uterus?

Back 5

xiphoid process

Front 6

Purple coloration (stretch marks) which turn silver colored after delivery are called what?

Back 6

Stria

Front 7

Describe Colostrum

Back 7

anitbody rich, yellow secretion that converts to mature milk during the first few days after delivery

Front 8

The cervix secretes thick tenacious mucus and accumulates to produce a _______________

Back 8

mucus plug

Front 9

An increase in mucus is referred to ______________ or ____________ (pertaining to cervix)

Back 9

mucorrhea
lucorrhea

Front 10

Blue purple discoloration of the cervix is ___________

Back 10

Chadwick's sign

Front 11

Softening of lower uterine segment found on palpation in the second or third month of pregnancy is which sign?

Back 11

Hegar's Sign

Front 12

Enlarging of the uterus may put pressure on which vessels?

Back 12

Vena Cava

Front 13

How do you relieve pressure on the vena cava?

Back 13

have woman turn to her side

Front 14

What nursing intervention should be performed with a woman expierencing vena cava symdrome?

Back 14

have pt turn to L) side and recheck BP in 5min (right side is also ok but L) is better)

Front 15

True or False
BP is affected by positions during pregnancy.

Back 15

True

Front 16

A resp system function that is modified throughtout pregnancy is _____________:estrogen induced edema & vascular congestion of nasal tissue

Back 16

nasal stuffiness

Front 17

CV system changes
Physiologic anemia
--dilution of hemoglobin concentration
--increase in plasma =50%
--erythrocytes do not increase

Back 17

no answer just memorize

Front 18

CV system changes
iron assists with anemia
--iron may produce constipation
--need increase in fluid intake

Back 18

no answer just memorize

Front 19

Vascular system increases by ________% in pregnancy

Back 19

45-50%

Front 20

Why does the vascular system increase during pregnancy?

Back 20

to provide adequate perfusion for fetus via the placenta

Front 21

List 3 ways to prevent venous stasis during pregnancy

Back 21

--rest often with legs elevated
--do not cross legs
--if going to wear elastic stockings put them on after arising in the morning

Front 22

Leg cramps are common discomfort during pregnancy, list 1 way to relieve leg cramps

Back 22

--dorsiflex the foot
---do NOT massage affected leg muscle

Front 23

What is nausea and vomiting associated with?

Back 23

hCG secretion

Front 24

Glycosuria is the inhibited absorption of minerals or gestational diabetes. Is this a variation of normal?

Back 24

possibly

Front 25

An increase in progesterone and melanocytes causes

Back 25

pigmentation of areola, nipples, vulva, perineal area, and the linea alba Linea nigra (the line down the belly)

Front 26

Chloasma of the face and neck can be a skin change during pregnancy, what is it?

Back 26

The discoloring of face and neck, referred to as a mask sometimes

Front 27

List 4 skin and hair changes that can occur during pregnancy

Back 27

---striae
--vascular spider nevi
--slowed hair growth
--sweat glands increase secretion

Front 28

List 5 Subjective signs of pregnancy

Back 28

--amenorrhea
--N/V
--urinary freq
--breast tenderness
--quickening

Front 29

--changes in pelvic organs (goodells, chadwick and Hagars sign)
--uterus enlargement
--enlargement of abdomen
--uterus scuffle
--skin pigmentation
--abdominal striae
--pregnancy tests
--palpation of outline
All of these are _____________signs of pregnancy

Back 29

objective

Front 30

Name a nursing intervention if pt c/o severe lower back pain

Back 30

observe posture and body mechanics

Front 31

List 3 diagnostic (postive) changes of pregnancy

Back 31

--fetal heart tones (17th-20th wk)
--fetal movement
--visualization of fetus by ultrasound

Front 32

---vaginal bleeding, with or without discomfort
--rupture of membranes
--swelling of the fingers, puffiness of the face or around the eyes
--continuous, pounding h/a
--visual disturbances (blurred vision, dimness, spots)
--persistent or severe abdominal pain (may mean preterm labor or serious placenta abnormalities)
--chills or fever
--painful urination
--persistent vomiting
--changes in freq or strength of fetal movements
are all _________ signs of pregnancy

Back 32

DANGER

Front 33

Why should women in their first trimester visit doc every 4wks?

Back 33

--allows condition of mother & fetus to be monitored
--ensures that problems are identified early

Front 34

Give an example of ambbivalence (a psychological response to pregnancy)

Back 34

"I wanted to become pregnant, but I am scared about becoming a mother"

Front 35

What should you do if a mother expresses concern that something is going to happen to her baby (this is under 3rd trimester but I think it would apply at any trimester)

Back 35

--ask her about her concerns
--always encourage the pt to discuss feelings
--the nurse should not belittle or disregard feelings

Front 36

Mimicry refers to the observation and coping behaviors of other mothers, give examples

Back 36

--wearing maternity clothes before they are needed
--helps the expectant mother "feel" what it is like to be obviously prego

Front 37

What is grief work?

Back 37

---women experiences sadness as she realizes that she must give up certain aspects of her previous self
--she can no longer go back

Front 38

Development of attachment with the baby begins in first trimester and continues throughout the neonate period is it the process of

Back 38

commitment
attachment
interconnection

Front 39

A father will "try on" fatherly behaviors such as

Back 39

coaching a little league baseball team

Front 40

First trimester emotional response is

Back 40

uncertainty

Front 41

First trimester physical validation is

Back 41

no obvious signs of fetal growth

Front 42

First trimester role is

Back 42

may begin to seek safe passage for self and fetus

Front 43

____of grandparent may determine response

Back 43

age

Front 44

True or False
A grandparents response may be postive or negative

Back 44

true
may need to negotiate grandparents role

Front 45

What can you do encourage grandmother's participation in infant care?

Back 45

look for advice such as "the baby is spitting up alot, what should i do"

Front 46

What should you do with your toddler shortly before birth?

Back 46

Spend focused time with them (Their time with mom)

Front 47

__________children may believe the infant will be a new playmate

Back 47

older

Front 48

________children should be envolved in baby prep

Back 48

schoolage

Front 49

___________may vary to be indifferent, embarrassment or wish to be highly involved

Back 49

adolescents

Front 50

Multiparity (twins, triplets, etc) parents may need...........

Back 50

help at home!

Front 51

Lower socioeconomic status parents may focus on what relating to health care needs?

Back 51

meeting health care needs as they occur---they focus on present needs rather than future goals

Front 52

What nursing care is important in the first & second trimester?

Back 52

coping with the common discomforts of pregnancy

Front 53

Is childbirth class recommended for parents who have previous had children?

Back 53

yes if more than 2 years has elapsed b/w last prepared child birth class, refresher course

Front 54

What is the nurses role regarding nutrition during pregnancy?

Back 54

ongoing nutrition edu for the mother's concerns
--how much wt will i gain
--do i need to go on a diet to lose wt
--when is the wt gain to much
--when is wt gain too little
--what is good for the baby

Front 55

What decreases the risk of neural tube defects?

Back 55

folic acid

Front 56

What does complex carbs provide for the pregnant woman?

Back 56

--vitamins
--minerals
--fiber

Front 57

For a woman that is normal wt, what is the ave wt gain during pregnancy?

Back 57

25-35 pounds

Front 58

What may occur is the pregnancy wt is below 100 pounds?

Back 58

--preterm labor
--low birth wt infants

Front 59

Pregnancy wt above 200 lbs increases incidence in what?

Back 59

--gestational diabetes
--HTN
--neural tube defects
--cesarean
--postpartum infection

Front 60

Woman who are shorter than ____inches may not need to gain as much as taller women

Back 60

62 inches

Front 61

True or False
Younger adolescents need to gain the upper limit for their own growth along with the fetus?

Back 61

true

Front 62

Nutritional needs __________by ________cals to meet the needs of the mother and growing fetus

Back 62

increase
300

Front 63

What is the increase need of complex carbs for?

Back 63

energy/add fiber for fullness and regularity

Front 64

What is the increase in protein needs for? (need 71 grams)

Back 64

support growth of mother and fetus

Front 65

A deficiency in vitamin A may produce what?

Back 65

fetal defects

Front 66

True or False
Vitamin C is needed for cellular formation, healing and immune response

Back 66

true

Front 67

Iron is needed in increased amounts for

Back 67

formation of hemoglobin

Front 68

Increase water intake is needed for the __________and increase in blood volume

Back 68

transport

Front 69

Breastfeeding moms need _______additional cal/day

Back 69

500

Front 70

Folic acid may decrease occurrence of NTD, list food sources of folate

Back 70

---green leafy veggies
--whole grains
--fruits
--liver
--dried peas and beans

Front 71

Non supplemental use of nutrients may produce_______________

Back 71

toxic effects on the fetus

Front 72

What is PICA?

Back 72

ingestion of nonfood substances such as clay, dirt, solid laundry starch

Front 73

A nursing intervention is to monitor and eval of the pattern of wt gain in pregnancy, why do we do this?

Back 73

to identify potential nutritional complications of pregnancy

Front 74

List nursing interventions of absorption of iron

Back 74

--teach moms when to take iron
--give with vit C source like OJ to increase the absorption of iron
--teach that milk or milk products decreases absorption
--never give tea with iron, it decerases absorption

Front 75

List 3 factors that influence nutrition

Back 75

--PICA
--multiparity
--substance use and abuse

Front 76

If a mother chooses the avoidance of milk products list other sources of calcium

Back 76

---salmon
--sardines w. bones
--legumes***
--nuts
--dried fruit
--dark green leafy veggies
--tofu
--bok choy
--broccoli

Front 77

Adolescent mothers will need to gain___________pounds to allow for their growth along with the fetus

Back 77

30-35

Front 78

What are two questions that need to be asked in nutritional assessment?

Back 78

---food preferences
--food prep common to culture

Front 79

Advise smoking cessation or limit cigarette us b/c vasoconstriction does what to blood flow to fetus?

Back 79

decreases

Front 80

What are nursing interventions before 2nd trimester trans-abdominal ultrasound?

Back 80

--tell pt to drink 1-2 quarts of water

Front 81

Why is it important for the bladder to be full before a trans-abdominal ultrasound?

Back 81

this provides a window through which the uterus and its contents can be viewed

Front 82

What is the primary reason for evaluating AFP levels?

Back 82

to determine if the fetus has NTD

Front 83

Why are triple marker screenings done?

Back 83

to predict chromosomal abnormalities/defects
(this is a maternal serum analysis)

Front 84

Maternal diabetes is an indication for fetal diagnostic procedure. Why?

Back 84

---maternal diabetes is a risk factor in pregnancy
--possible impairment of placental perfusion

Front 85

What is the most accurate measurement of gestation age?

Back 85

biparietal diameter via ultrasound

Front 86

Non supplemental use of nutrients may produce_______________

Back 86

toxic effects on the fetus

Front 87

What is PICA?

Back 87

ingestion of nonfood substances such as clay, dirt, solid laundry starch

Front 88

A nursing intervention is to monitor and eval of the pattern of wt gain in pregnancy, why do we do this?

Back 88

to identify potential nutritional complications of pregnancy

Front 89

List nursing interventions of absorption of iron

Back 89

--teach moms when to take iron
--give with vit C source like OJ to increase the absorption of iron
--teach that milk or milk products decreases absorption
--never give tea with iron, it decerases absorption

Front 90

List 3 factors that influence nutrition

Back 90

--PICA
--multiparity
--substance use and abuse

Front 91

Fetal villus tissue may be obtained as early as ________wks

Back 91

10

Front 92

What is the major advantage of chorionic villus sampling over amnio?

Back 92

requries less time to obtain the results (24-48 h) compared to 2-4 wks for amnio

Front 93

List condraindications for transcervical chorionic villus sampling

Back 93

--maternal infection is a risk
--esp if it is an active infection in the cervix, vagina, or pelvic area such as active gential herpes

Front 94

What are most parents concerned about with fetal dx testing?

Back 94

safety of the fetus

Front 95

What are nursing roles in dx testing?

Back 95

--providing the couple with all necessary info about the procedure so the couple can make informed choice
---it is NOT to advice what to do

Front 96

What is an indcaition for third trimester amnio?

Back 96

to determine fetal lung maturity

Front 97

What must a nurse montior after amnio?

Back 97

uterine activity, there is a risk of spontaneous contractions

Front 98

What does a nonstress test assess?

Back 98

fetal well being & eval ability of fetal heart to accelerate r/t movement

Front 99

Reactive is what?

Back 99

at least 2 accelerations with or without movement within 20 min period, 15 bpm above the baseline

Front 100

What is non-reactive?

Back 100

does not demonstrate the required characteristics of a reactive tracing within 40 min

Front 101

What is vibroacoustic stimulation test?

Back 101

tones applied to fetus
stimulus is given up to 3 sec and canbe repeated at 1 min intervals for up to 3 times

Front 102

What does a contraction stress test(CST) record?

Back 102

the response of fetal HR to stress induced by a contraction

Front 103

AFter a contraction the fetal HR should_______

Back 103

increase
--negative is no late deceleration
--positive is late decelerations follow 50% or more contraction

Front 104

What 5 areas does a biophysical profile assess?

Back 104

--nonstress test
--fetal breathing movements
--gross fetal movement
--fetal tone
--amniotic fluid volume

Front 105

What is a normal biophysical score if amniotic fluid volume is adequate?

Back 105

8-10 points

Front 106

What is a modified biophysical profile?

Back 106

--assess fetus only by ultrasound
--omit nonstress test

Front 107

What is PUBS (percutaneous umbilical blood sampling?

Back 107

--aspiration of fetal blood from cord for prenatal dx and tx
--Rh disease
--genetic studies
--dx of blood clotting factors
--severe growth restriction
--acid base status of fetus

Front 108

What is a kick count?

Back 108

maternal assessment of fetal movement
count fetal movements 30 min 3xday
eval if less than 4 movements in 30 min

Front 109

increased vascularization produces softening of the cervix and uterus is called_____________sign

Back 109

Goodell's sign