Nursing 166 Quiz Review Notes

Types of Pelvises

  • Gynecoid Pelvis:

    • Preferred pelvis type for vaginal delivery.
    • Wide enough for the baby to pass through during childbirth.

  • Android Pelvis:

    • Male-shaped pelvis; narrower pelvic brim.
    • May necessitate cesarean birth if the baby cannot fit through.

  • Variability in Pelvic Types:

    • There are four identified pelvis shapes in women.
    • Each can result in vaginal birth but with varying difficulties.
Prenatal Visit Schedule
  • Frequency of Visits:
    • Birth-related check-ups occur every 4 weeks until 28 weeks gestation.
    • After 28 weeks, visits shift to every 2 weeks, then weekly as birth approaches.
    • Important for monitoring high-risk pregnancies, particularly after miscarriages.
Age of Viability and Full-Term Birth
  • Age of Viability:
    • 20 weeks gestation: at this stage, the fetus may survive outside the womb.
  • Full-Term Pregnancy:
    • Defined as 37 completed weeks of gestation.
Prenatal Laboratory Tests
  • Lab Tests at First Visit:
    • Blood type and Rh factor to check for Rh incompatibility.
    • Complete blood count (CBC) to check for anemia or infection.
    • Torch Panel: tests for infections harmful to the fetus:
    • Syphilis: blood test to check for infection.
    • Rubella Titer: ensures immunity against rubella; vaccines should not be given during pregnancy.
    • Hepatitis B: screenings should be performed.
    • HIV Screen: tests for HIV infection.
    • Urine Culture & Vaginal Swab: for chlamydia and gonorrhea; treated with antibiotics if positive.
Second Trimester Tests
  • Blood Glucose Screening:
    • One-hour oral glucose challenge to screen for gestational diabetes.
    • Higher than normal glucose levels lead to a more extensive three-hour test.
    • Management of gestational diabetes may involve diet modification or insulin therapy.
Third Trimester Tests
  • Group Beta Strep Testing:
    • Conducted via vaginal swab after 35 weeks.
    • Positive results mean antibiotic treatment during labor to prevent transmission to the baby.
Understanding Gravida and Para
  • Gravida: Total number of pregnancies a woman has experienced, including the current one.
  • Para: Number of pregnancies that have resulted in live births after 20 weeks, regardless of multiples.
    • Example: A mother with one previous pregnancy (miscarriage before 20 weeks) and current pregnancy is Gravida 2, Para 0.
Definitions of Pregnancy Loss
  • Abortion (medical definition):
    • Termination of pregnancy before the age of viability (20 weeks).
    • Includes both spontaneous (miscarriages) and induced.
Methods of Calculating Estimated Due Date (EDD)
  • Naegle's Rule:
    • Take the first day of the last menstrual period (LMP), subtract three months, then add seven days and adjust the year if necessary.
Diagnosing Pregnancy
  1. Presumptive Signs:
    • Symptoms suggesting pregnancy but not definitive (e.g., amenorrhea, nausea, breast tenderness).
  2. Probable Signs:
    • Signs evaluated by a healthcare professional that might suggest pregnancy but are not definitive.
  3. Positive Signs:
    • Confirmatory signs by a healthcare provider such as fetal heartbeat, fetal movement felt, and ultrasound verification.
Nutritional Requirements During Pregnancy
  • Caloric Intake:
    • 340 calories/day in the second trimester.
    • 450 calories/day in the third trimester.
  • Nutritional Needs:
    • 60 grams of protein daily (high-quality sources).
    • 1200 mg of calcium.
    • 30 mg of iron.
    • 0.4 mg of folic acid (important to take before pregnancy).
TORCH Infections
  • Meaning:
    • Refers to a group of infections that can harm the fetus:
    • T: Toxoplasmosis
    • O: Other (includes Zika, HIV, Hepatitis B)
    • R: Rubella
    • C: Cytomegalovirus
    • H: Herpes Simplex Virus
  • Risks: These infections can lead to severe fetal complications or death.
Bleeding Disorders in Pregnancy
  • Early Pregnancy Issues:
    • Spontaneous abortion (miscarriage) can lead to emotional and physical complications.
    • Types include threatened, complete, or incomplete abortion.
    • Ectopic pregnancy: Fertilized egg implants outside the uterus, generally in the fallopian tube.
  • Late Pregnancy Issues:
    • Placenta Previa: Placenta covers the cervical opening, often leading to bleeding.
    • Abruptio Placentae: Premature separation from the uterine wall, causing pain and darker bleeding.
Preeclampsia
  • Definition:
    • A condition with hypertension and protein in urine often occurring after 20 weeks gestation.
  • Symptoms: Edema, severe headaches, and visual disturbances could indicate worsening preeclampsia.
  • Management: Includes monitoring, lifestyle adjustment, and potential hospitalization.
Eclampsia
  • Severe Condition:
    • Progression of preeclampsia leading to seizures. Must treat urgently with magnesium sulfate and various monitoring measures.