Nursing 166 Quiz Notes

  • Types of Pelvises

    • Gynecoid Pelvis:
    • Considered the most favorable pelvis shape for childbirth.
    • Wide enough for the baby to fit through the birth canal.
    • Related to gynecology due to its suitability for birthing.
    • Android Pelvis:
    • Male-shaped pelvis which has a narrower pelvic brim.
    • Women may still deliver vaginally, but with greater risk of complications requiring cesarean sections.
    • Other Pelvis Types:
    • Various other pelvis shapes exist, but gynecoid is most favorable.

  • Prenatal Visit Schedule:

    • Frequency of visits based on the gestational age:
    • First 28 Weeks: Every 4 weeks.
    • Weeks 28-36: Every 2 weeks.
    • Week 36 and Beyond: Weekly visits.
    • Important Note: Women with previous pregnancy complications may require more frequent visits.

  • Age of Viability:

    • Defined as the gestational week in which a fetus can survive outside the uterus (20 weeks).
    • A fetus born before this week generally will not survive without medical support.
    • Full Term: Babies are considered full term at 37 completed weeks.

  • Lab Work During Pregnancy:

    • Initial lab tests include:
    • Blood type and Rh factor.
    • Complete blood count (CBC) to check for anemia.
    • Torch panel: Tests for infections that can harm the fetus such as rubella, syphilis, hepatitis B, and HIV.
    • Urine culture and STI screen (chlamydia and gonorrhea).
    • The TORCH acronym stands for:
    • Toxoplasmosis
    • Other (Zika, HIV, hepatitis)
    • Rubella
    • Cytomegalovirus
    • Herpes simplex

  • Gestational Diabetes Screening:

    • Blood glucose test performed in the second trimester via a one-hour oral glucose tolerance test.
    • If results indicate high glucose levels (above 130-140 mg/dL), a three-hour glucose test is conducted.
    • Management strategies include dietary changes and insulin if necessary.

  • Third Trimester Testing:

    • Group Beta Strep (GBS) Test:
    • Vaginal swab to check for GBS in the mother.
    • If positive, IV antibiotics are administered during labor to protect the infant.

  • TPALM System for Tracking Pregnancy Outcomes:

    • Gravida (G): Total number of pregnancies (including the current one).
    • Para (P): Number of births after 20 weeks.
    • Multiple births count as one.
    • TPAL Definitions:
    • Term: Infants born at 37 weeks or later.
    • Preterm: Infants born between 20 to 36 weeks.
    • Abortion: Pregnancies ending before 20 weeks (both spontaneous and induced).
    • Living: Number of current living children.

  • Diagnosing Pregnancy:

    • Signs of pregnancy are divided into three categories:
    • Presumptive (e.g., missed period, nausea).
    • Probable (e.g., changes like Chadwick's sign, softening of the cervix).
    • Positive (fetal heartbeat, ultrasound confirmation, felt movement by examiner).

  • Nutritional Needs During Pregnancy:

    • Increase calorie intake: 340 calories in the second trimester, 450 calories in the third trimester.
    • Essential nutrients:
    • Protein: 60 grams per day
    • Calcium: 1200 mg per day
    • Iron: 30 mg per day
    • Folic Acid: 0.4 mg per day before and during pregnancy to prevent neural tube defects.
    • Important to time consumption of iron and calcium appropriately due to absorption interference.

  • Infections During Pregnancy:

    • The TORCH infections are critical to monitor due to potential fetal implications.

  • Bleeding Disorders:

    • Early Pregnancy Issues: e.g., miscarriage, ectopic pregnancies, hydatiform moles.
    • Late Pregnancy Issues: e.g., placenta previa, placental abruption.
    • Placenta Previa: Placenta covers cervix; may result in painless bleeding.
    • Placental Abruption: Premature separation of the placenta leading to severe pain and bleeding.

  • Preeclampsia:

    • Diagnosed with BP ≥ 140/90, protein in urine, and above waist edema.
    • Symptoms may lead to eclampsia (seizures) if not managed properly.
    • Magnesium sulfate may be administered as a treatment to prevent seizures.

  • Eclampsia Management:

    • Monitoring for signs of magnesium toxicity alongside blood pressure management.
    • IV medications are part of the treatment protocol to ensure maternal safety and fetal health.

  • Post-Delivery Care:

    • Instructions for recovery, monitoring for complications such as infections or excessive bleeding.

These notes cover a broad range of topics that will be important for the quiz in Nursing 166, emphasizing the key points of prenatal care, pregnancy outcomes, and complications to expect and manage. Be sure to ask questions for any clarifications!