JMU nsg 355 exam 1

37-38 6/7

length of early term

39-40 6/7

length of full term

41-41 6/7

length of late term

42 and beyond

length of post term

20- 36 6/7

length of preterm

changes felt by the woman

what are presumptive signs of pregnancy

-secondary amenorrhea

-breast changes

-n/v

-urinary frequency

-skin changes

examples of presumptive signs of pregnancy (5)

changes observed by an examiner

what are probable signs of pregnancy

-goodell's sign

-chadwick's sign

-hegar's sign

-positive UPT/ hCG

-enlarging of abdomen (12 wks)

-BHC

-placental souffle

-fetal movement (18-20 wks in G1)

examples of probable signs of pregnancy (8)

softening of the cervix (6-8 wks)

what is goodell's sign and when does it occur

blue-ish hue to cervix (6 wks)

what is chadwick's sign and when does it occur

softening of the uterus and distinction between uterus and cervix decrease (4-6 wks)

what is Hegar's sign and when does it occur

signs attributed only to the presence of a fetus

what are positive signs of pregnancy

-fetus on UTS

-FHT

-fetal movements felt by examiner

examples of positive signs of pregnancy

10-12 weeks

when can you hear FHR on a doppler

early US

best way to confirm due date

after 20 wks: +/- 2 cm compared to weeks EGA

fundal height calculations

-urine

-PAP (if needed)

-chlamydia, gonorrhea, syphilis

-CBC

-Rubella Titer

-blood type and Rh

-STD screening

-CF, gene mutation, sickle cell trait

what baseline diagnostic tests are done? (8)

exercise, emotional stress, infection, preeclampsia

what can protein in urine indicate (4)

preeclampsia

what does +1 protein on a dipstick possibly indicate

ketones in urine indicate malnutrition

a pregnant patient comes in and has a urine dipstick done that shows ketones in her urine. Why is this concerning?

-after any episode of vaginal bleeding

-after any blunt force trauma to abdomen

-at 28 wks

-possibly after delivery

when do you administer RhoGAM (4)

-cfDNA

-nuchal translucency w/ maternal blood sample

-Chorionic villi sampling

which fetal tests can be done in the first trimester?

specific chromosomal issues (13,18,21)

what does cfDNA test for

after 9 weeks

when is cfDNA screening done

11-13 weeks

when can nuchal translucency be done

pregnancy-associated plasma protein-A (PAPP-A) and hCG

what blood work is associated with maternal blood sample in NT test

chromosomal abnormality

what does nuchal translucency test for

increase, increase, decrease

(increase/decrease) NT, (increase/decrease hCG) and (increase/decrease) PAPP suggest chromosomal abnormality with a NT test

10-13 weeks

when can chorionic villi sampling be done

18-26 days

when is the neural tube formed in pregnancy

prevention of neural tube defects

what is the role of folate in pregnancy

spina bifida and anencephaly

name 2 neural tube defects

28-40 lbs

appropriate weight gain for underweight (BMI < 18.5)

25-35 lbs

appropriate weight gain for normal weight (BMI 19-24.9)

15-25 lbs

appropriate weight gain for overweight (BMI 25-29.9)

11-20 lbs

appropriate weight gain for obese weight (BMI > 30)

300 kcal/day

how much energy is spent per day in pregnancy

"nodular"

what will breasts feel like in second trimester

milky white discharge

what is leukorrhea

if there is no itching and burning and the smell is musky then it is leukorrhea

how would you teach a patient the difference between leukorrhea and infection

BHC: irregular; taper off with emptying bladder, rest, and hydration

PTL: get closer together, stronger, regular intervals

what is the difference between braxton hicks contractions and pre-term labor

the feeling of the baby moving around in uterus

what is quickening

before 13 weeks

when do most fetal losses occur

-decrease risk of hemorrhoids

-shorten labor

-decrease risk of incontinence

what education should be included about pelvic floor exercises (3)

supine hypotensive syndrome

skin color changes, sweating, nausea, bradycardia, and dizziness are all symptoms of

instruct patient to turn on her side to release compression of descending aorta and vena cava

how would you correct supine hypotensive syndrome

weight of uterus on pelvis

what is femoral venous pressure

edema, varicose veins

characteristics of femoral venous pressure (2)

don't sit for long periods of time

how would you teach a patient to avoid femoral venous pressure

increases; 40-50%

blood pressure (increases/decreases) __-__% during pregnancy

increases; 30-50%; 20-24 weeks

cardiac output (increases/decreases) __-__% with a peak at __-__ weeks

raise arms and slow breathing

how would you instruct a pregnant woman who is SOB

1/5 of total blood supply

at term, how much blood does the uterus and placenta contain

50

GFR increases by ___%

progesterone

what hormone causes a decrease in GI muscle tone and motility

-delayed gastric emptying

-increased risk of reflux

-indigestion

-heartburn

-constipation

-increase risk of gallstones

what are some GI issues a pregnant woman might encounter (6)

-fundal height/ FHR

-US

-glucola screen

-antibody testing (Rh -)

-quad marker/ tetra screen

-amniocentesis

screening/ diagnostic tests done in second trimester

24-28 weeks

when is the glucola screening done