NURS 330-01 Exam 1: Nursing Management During Pregnancy

How can we promote a healthy pregnancy before conception?

Promoting the health of the mother and her partner prior to conception and identifying genetic, biomedical, social, and behavioral risks.

How to calculate estimated due date?

Last menstrual period, minus 3 months, plus 7 days.

What is the standard schedule of prenatal visits?

Every 4 weeks until 28 weeks, every 2 weeks until 36 weeks, and every week until delivery.

What is the most accurate method of determining gestational age?

Ultrasound

What is the age of a high risk pregnancy?

<16 or >35

What is the weight of a high risk pregnancy?

<100lbs or >200 lbs

How many pregnancies is considered high risk?

5 or subsequent

Other factors of high risk pregnancy

Recurrent abortions, previous stillbirth or fetal demise, substance use, physical abuse, Hx of preterm births or anomalies, low SES.

What medical conditions create a high risk pregnancy?

Cardiac, thyroid, renal, epilepsy, or diabetes

Gynecoid pelvis

A true female pelvis. About 40% of women. Less common in men. More favorable for vaginal delivery. Wide, round opening.

Anthropoid pelvis

More common in men. About 25% of women. Second most favorable for vaginal delivery. Long, round opening.

Android pelvis

True male pelvis. About 20% of women. Heart shaped pelvis, common for baby to get stuck or have trouble rotating.

Platypelloid pelvis

Only 3% of population. Difficulty with vaginal delivery. Narrow front to back oval.

What initial labs are important?

Rh factor and blood typing, antibody screen, CBC, renal function panel, rubella titer, HIV screening, hep B surface antigen, RPR (Syphilis), toxoplasmosis

Other lab work

Pap smear, gonorrhea, chlamydia, UA and cultures, fetal cell free DNA

Indirect Coombs

Testing mother for Rh antibodies

Direct Coombs

Testing baby for hemolytic anemia related to Rh incompatibility

What is given to Rh negative mothers to prevent antibody formation against an Rh positive baby?

RhoGAM, given at 26-30 weeks, after delivery, and any other procedure with risk of blood mixing (amniocentesis, chorionic villi sampling, miscarriage)

What is assessed at period prenatal visits?

BP, weight, UA, other labs if needed, fundal height, FHR, fetal movement.

What tests are done at 16-22 weeks?

Ask about fetal movement, anatomy scan, quadruple screening.

What is part of a quadruple screen?

hCG, maternal alpha fetoprotein, estriol, and inhibin A

When is 1 hour Glucose Tolerance Test done?

24-28 weeks. Normal <140, abnormal indicates 3 hour GTT.

High risk tests in third trimester

Additional ultrasounds, non stress test, biophysical profile,