Maternity Hesi Review

Front 1

What is the rate of uterine growth during pregnancy?

Back 1

1 cm per week after 20 weeks gestation

Front 2

what is lightening?

Back 2

descent of the uterus into the pelvic cavity that occurs late in pregnancy; the fetus is said to have dropped

Front 3

what is Hegar's sign?

Back 3

Hegar's sign is an indication of pregnancy in a woman, specifically the compressibility and softening of the cervical isthmus
It is a "probable" sign of pregnancy

Front 4

what is chadwick's sign?

Back 4

Chadwick's sign is a bluish discoloration of the cervix, (cyanotic cervix) vagina, and labia caused by the hormone estrogen which results in venous congestion.

Front 5

what is Goodell's sign?

Back 5

a softening of the vaginal cervix. another probable sign of pregnancy

Front 6

what is a presumptive sign of pregnancy?

Back 6

the changes felt by the woman that may indicate pregnancy like:
amenorrhea
fatigue
nausea
vomiting
breast changes

Front 7

what is a probably sign of pregnancy?

Back 7

these changes in a woman observed by the examiner that indicate pregnancy
hegars sign, pregnancy test, ballotement

Front 8

what is a positive sign of pregnancy?

Back 8

those signs that are attributed only to the presence of a fetus like:
fetal heart sounds
visualization of the fetus
palpating fetal movements

Front 9

what are braxton hicks contractions?

Back 9

light, usually painless, irregular uterine contractions during pregnancy, gradually increasing in intensity and frequency and becoming more rhythmic during the third trimester.
they begin around the 4th month of pregnancy

Front 10

What is Ballotement?

Back 10

vaginal finger displaces the fetus upward and a tap is felt on the finger as the fetus returns

Front 11

what is quickening?

Back 11

fetal movement perceived by the mother about 14th to 16th week in the multip and later in the primip.
can be confused for peristalsis

Front 12

what is leukorrhea?

Back 12

a normal whitish or grayish discharge from the vagina in a pregnant woman. there is no associated itching.

Front 13

what is an important vaginal change in a pregnant woman?

Back 13

Vaginal pH decreases, which protects against infection , but also makes the woman more prone to yeast infections

Front 14

what is an anemia dx in a pregnant woman?

Back 14

hemoglobin less than 10 and a hematocrit less than 35%

Front 15

what are some circulation changes in the pregnant woman?

Back 15

Increased tendency for blood coagulation
Heart rate increases 10-15 beats/min
BP declines in mid-pregnancy and then increases to first timester levels
BMR increases 25 %

Front 16

what is chloasma?

Back 16

the "mask" of pregnancy.
it is a hyperpigmentation of the cheek; s, nose and forehead

Front 17

what is diastasis recti?

Back 17

it is a separation of the rectus abdominal muscles than can occur in pregnancy.
normally the rectus abdominal muscles are held together by the linea alba

Front 18

what is ptyalism?

Back 18

excessive drooling; occurs in women who are experiencing hyperemesis gravidum, excessive nausea and vomiting far worse than normal morning sickness

Front 19

what is the appropriate amount of weight a woman should gain during her pregnancy?

Back 19

Normal – 24-35 lbs
Underweight – 28-40 lbs
Overweight – 15-25 lbs
Obese – 15 lbs

Front 20

what amount of protein does a pregnant woman require?

Back 20

Increase in protein from 60 to 80 g per day

Front 21

what amount of iron should a pregnant woman consume?

Back 21

Iron from 18 to 24 g per day

Front 22

what amount of folate should a pregnant woman consume?

Back 22

Folate from 400 to 600 mcg per day

Front 23

how many calories should a pregnant woman consume?

Back 23

Increase 300 calories over intake of 1800 to 2200 per day

Front 24

what are come cat X drugs?

Back 24

Accutane, Coumadin, Cancer radiation Therapy, Tegison or Soriatane for psoriasis, streptomycin for tuberculosis, thalidomide for insomnia, diethylstilbestrol (DES) for menstrual disorders and mercury from contaminated food

Front 25

what is fetal variability?

Back 25

Irregular fluctuations of FHR of two cycles or greater per minute
Can be described as long term or short term
Absent or undetected- less than 2 bpm
Minimal 3-5 bpm
Moderate 6-25
Marked greater than 25 bpm

Front 26

what is considered fetal tachycardia?

Back 26

FHR > 160 bpm for greater than 10 minutes

Front 27

what is considered fetal bradycardia?

Back 27

FHR less than 100-110 for 10 minutes or longer

Front 28

what are fetal accelerations?

Back 28

Indicate fetal well being
Rise over BL of FHR 15 bpm for 15 seconds or longer (15 by 15)
In preterm fetus, 10 by 10
Can occur as a result of fetal scalp stimulation

Front 29

what are early decelerations?

Back 29

Related to head compressions as fetal head is compressed during a contraction
Occurs with the start of the contraction and usually ends with the end of the contraction

Front 30

what is a reassuring FHR?

Back 30

a baseline between 110-160 with good accelerations

Front 31

what are the interventions for a nonreassuring FHR?

Back 31

Pitocin off
Position changes, LL or RL
Oxygen 10L via NRFM
IV fluid bolus
Placement of FSE if unable to maintain continuous monitoring
Determine underlying cause and correct, ex. hypotension, maternal temp
Inform CNM or MD

Front 32

what are the components of a post partum assessment BUBBLE-HEB

Back 32

Breasts
Uterus
Bladder- should be able to void by 6-8 hours post delivery
Bowel
Lochia
Episiotomy
Homan's sign
Emotional status
Bonding

Front 33

what are the components of the Apgar score?

Back 33

HR: 0= absent, 1= <100, 2= >100
Respiratory effort: 0=absent, 1=slow irregular, 2= regular/crying
reflex irritability: 0=no response, 1= grimace/frown, 2=good cry/cough
muscle tone: 0=limp, 1= some motion/flexion/resistance, 2= active/spontaneous flexion/good tone
color: 0=cyanotic or pale, 1= body pink/extremity cyanosis, 2= completely pink

Front 34

what is the focus of midwifery?

Back 34

to be with woman through out the pregnancy and assist the family in childbirth.
she can care for any low risk pregnancy

Front 35

what are the 10 ethical principles used in clinical practice?

Back 35

1.respect
2.autonomy
3.beneficence
4.nonmaleficence
5.veracity
6.fidelity
7.justice
8.confidentiality
9.informed consent
10. universality: same principles apply to everyone, everytime

Front 36

what are the 4 elements of informed consent?

Back 36

disclosure of information (teaching)
comprehension
voluntary agreement
competency to make decisions

Front 37

what is a hysterosalpingogram (HSG)?

Back 37

a diagnostic test in which radiopaque dye is instilled into the uterus and fallopian tubes via a catheter inserted through the cervix; used to detect uterine or tubal anomalies
***Ask if the woman is allergic to shellfish!
***Ask when her LMP was- dont want to inturrupt and early pregnancy!!

Front 38

what is estrogen responsible for?

Back 38

development of secondary sex characteristics at puberty, and peaks at the follicular phase in the menstrual cycle.
it also inhibits FSH and LH production

Front 39

what is the corpus luteum?

Back 39

it is the ovum once its released from the ovaried in the fallopian tubes.
it disintigrates if fertilization doesnt take place in 24 hours, or creates progesterone if it becomes fertilized.

Front 40

what changes occur in cervical mucus during ovulation?

Back 40

becomes thinner, more plentiful, and has a more stretchy consistency (spinbarkket)
this is to help the sperm move into the uterus

Front 41

what is a septate uterus?

Back 41

a heart shaped uterus (a dividing membrane down the middle that can be mild or completely separate the uterus into 2 pieces)
if fertilization occurs it makes it harder for this baby to be carried to term

Front 42

what is a bicornate uterus? what problems does this pose to a pregnancy?

Back 42

two banana shaped uteri, side by side, curving away from eachother. they may end at one cervix, or each have their own cervix and own vagina.
the woman may have a normal mesntrual cycle if both horns are fully developed.
***getting pregnant isnt really a problem but carrying the baby to term is an issue

Front 43

if a woman is following a BBT method for tracking fertility, how will she know when she is ovulating?

Back 43

when her temp drops slightly THEN rises 0.5-1.0 F
this temperature spike rises with 24 hours of ovulation.

Front 44

what is mittelschmerz?

Back 44

old term for midcycle pain experienced at the time of ovulation; may last 1-2 days, and may be accompanied by pressure, aching felt into the rectum, or distention

Front 45

what chemical is typically used in spermicide?

Back 45

nonoxynol-9 and oxynol-9

Front 46

what components should you teach when counseling about contraceptives? (BRAIDED)

Back 46

Benefits
Risks
Alternatives
Inquiries (let her ask questions)
Decisions (let her decide or change her mind)
Explanations = how to use the selected method
Documentation

Front 47

what are the goals of family planning?

Back 47

assist with reproductive decision making, enabling the person to prevent pregnancy, limiting the number of children, spacing time between pregnancies, and voluntary interrupting pregnancy as desired.
**has NOTHING to do with fertility treatments, or dx procedures

Front 48

why is informed consent with contraceptives?

Back 48

because of the potentially serious complications associated with so many contraceptive methods

Front 49

what should you teach to a patient that wants to follow the cervical mucus method effects its consistency?

Back 49

douches
semen
blood and discharge from vaginal infections
contraceptive gels, foams, films, or suppositories
antihistamines

Front 50

what should a couple using a diaphragm, a male or female condom, or a cervical cap all avoid?

Back 50

oil based lubricants!! breaks down the material = increases chances of contraceptive failure

Front 51

What are the warning signs and symptoms associated with an IUD? (PAINS)

Back 51

Period late (pregnancy), abnormal spotting and bleeding
Abdominal pain, pain with intercourse
Infection exposure (STD), abnormal vaginal discharge
Not feeling well, fever>100.4, chills
String missing, or shorter or longer than usually felt

Front 52

what are the warning signs and symptoms associated with oral contraceptives? (ACHES)

Back 52

Abdominal pain
Chest pain, cough, and/or shortness breath
Headaches, dizziness, weakness or numbness
Eye problems (blur or change in vision) and speech problems
Severe

Front 53

what are the warning signs and symptoms associated with a diaphragm, cervical cap and the sponge?

Back 53

Toxic shock syndrome:
-elevated temp>101.4F
-diarrhea and vomiting
-weakness and fainting
-muscle aches
-sore throat
-sunburn type rash
difficulty urinating
abdominal or pelvic fullness
foul-smelling vaginal discharge

Front 54

what are some contraindications to a diaphragm?

Back 54

a hx of UTIs
a hx of toxic shock syndrome

Front 55

who is a candidate for an IUD?

Back 55

parous woman in stable monogamous relationships (low risk for STDs) with NO hx of PID, and normal uterine anatomy

Front 56

what should a patient do if she misses a progesterone-only contraception pill (mini pill)?

Back 56

take the pill as soon as remembered, and take the next pill at the regular time
any time a pill is missed the pt should use an ADDITIONAL form of contraception through out the end of the cycle the

Front 57

what should a patient do if she missed a combination oral contraceptive pill?

Back 57

take the pill as soon as remembered and take the next pill at the regular time.
with combination pills NO BACK UP is needed unless:
more than 2 pills consecutively are missed- use additional contarception for a week.

Front 58

what kind of twins run in the family?

Back 58

Dizygotic/fraternal/non identical twins
the pregnancy results from the fertilization of two separate eggs by two separate sperm cells
the zygotes develop separately and do not share placentas or amniotic sacs.

Front 59

what is the optimal time to have intercourse in relationship to ovulation is a couple desires to get pregnant?

Back 59

sex can take place no earlier than 24 hours before ovulation, and no later than 12 hours after to achieve fertilization.

Front 60

what is a morula?

Back 60

what a fertilized egg is called by the time it reaches the uterus and is ready to implant.

Front 61

first 2 weeks after fertilization?

Back 61

cellular multiplication and implantation

Front 62

weeks 2-8

Back 62

rapid cell growth and differentiation:
ectoderm, mesoderm and endoderm form
by the end of the 8th week every organ system and external structure is present!

Front 63

what is the function of the amniotic fluid?

Back 63

cushions the embryo and fetus
controls temp
promotes symmetrical growth of the fetus
prevents fetal adherence to the amnion
allows freedom of movement within the amniotic cavity

Front 64

what is oligohydramnios?

Back 64

a condition of diminished amniotic fluid often related to renal system mlfunction, intrauterine growth restrictions, and post maturity.
it can cause skin and skeletal abnormalities, pulmonary hypoplasia, and cord compression

Front 65

what is wharton's jelly?

Back 65

a gelatinous connective tissue that serves as a protective layer around the umbilical vessels.

Front 66

what hormones are produced during pregnancy and what functions do they serve?

Back 66

progesterone: maintains pregnancy
estirol: stimulates uterine growth and mammary glands
homan chorionic gonadotropin (hCG): siminlar to luteinizing hormone
homan plancental lactogen (hPL): causes decreased insulin sensitivity = diabetogenic effect in the mother = stimulates breast development

Front 67

what is significant in the 4th week of gestation?

Back 67

fetal heart begins to beat

Front 68

what is significant in the 8th week of gestation?

Back 68

all body organs are fully formed

Front 69

what is significant in the 8-12th weeks of gestation?

Back 69

fetal heart tones can be heard by doppler

Front 70

what is significant in the 16th week of gestation?

Back 70

baby's sex can be seen, although thin, the fetus looks like a baby

Front 71

what is significant in the 20th week of gestation?

Back 71

heartbeat can be heard with fetoscope.
mother feels quickening/movements
baby develops a regular schedule of sleeping, sucking, and kicking (!!!)
hands can grasp
baby assumes a favorite position in utero
vernix protects the body and lanugo keeps oil on the skin
head hair, eyebrows and eyelashes are present

Front 72

what is significant in the 24th week gestation?

Back 72

activity is increasing, respiratory movements begin

Front 73

what is significant in the 28th week gestation?

Back 73

eyes begin to open and close, baby can breathe, surficant needed for breathing is formed, baby is 2/3 full size

Front 74

what is significant in the 32th week gestation?

Back 74

baby has fingernails and toenails, SQ fat is being made, baby appears less red and wrinkled