Antepartum 1
What is Nagele's rule?
Bonus if you can tell me what it is.
Expected date of delivery
First day of Last Menstrual period- 3 months+ 7 days
Antepartum Slide 7
Probable signs of pregnancy are_____?
Observed by examiner, but may be attributed to other causes.
Antepartum slide 9
During and after the 2nd trimester what is found moving outside the pelvic cavity?
The fundus
Antepartum slide 25
Uterine distention, oxytocin stimulation, and prostaglandin release are all theories of_______?
Labor Onset
L&D slide 3
What is included in stage 1 of Labor? Bonus tell me what they are.
laten phase(cervix thins and opens), active phase(moderate regular freq of contractions), transition phase(time to push/urge to push)
L&D slide 42
Th effect boost of energy some woman feel that pushes them to make sure life is in order. It is a sign of Labor.
Nesting
Durrham pg 245
Changes in FHR during Contractions is considered _____?
Periodic
Reading and interp. FHR slide 4
What hormone is a at home pregnancy test, testing for?
Bonus tell me what the mom should be Health taught. and if you can tell me what kind of sign it is.
Human Chorionic Gonadotropin (HCG)
First Am urine to get most accurate results. And that they can be inaccurate due to Improper collection, Medications, Hormone-producing tumors.
Probable sign
Antepartum slide 19
Amenorrhea, Nausea/Vommitting, and Fatigue are all _______ signs?
Presumptive
Antepartum slide 10
Sign of pregnancy report by the pt are______?
Presumptive signs
Antepartum slide 9
A soon to be mother's cervix is softening, shortening, and thinning. What is this called?
Effacement
L&D slide 10
What should a newly pregnant woman be health taught in regards to medications?
All Oral, IM, & IV meds affect the fetus.
L&D slide 58
A baby is born with 2200mL of amniotic fluid what is this called what could this lead to?
Polyhydramnios
Fetal GI obstruction/atresia
L&D Slide 78
Tachycardia, Bradycardia, and irregular rhythm are all examples of
Non reassuring FHR
Reading and interp. FHR slide 4
At a mother's last antepartum appointment she was noted with a BP of 148/98 and Proteinuria. What is she at HRF, and what should she be health taught?
HRF Pre-eclampsia
HT monitoring of CNS changes, possible meds, activity restrictions
Antepartum pt 2 slide 36-38
Bleeding, infection, and pain are all_______
warning signs to report to the MD
Antepartum slide 26
A mom is 17 week pregnant when she starts to feel her uterus contract in a tight, intermittent, painless way that has no pattern. What should she be health taught?
These are Braxton-Hick Contractions and are normal in pregnant women past 16 weeks.
Antepartum slide 15
In the transition phase when a mother gets to 10cm of dealation what reflex is inhibited?
Ferguson
What are the 5 P's of labor?
Passenger(fetus), Passageway(mother's physical ability to deliver), Powers(2 types involuntary/voluntary), Position (fetus descend), Psychological(Mother's psyc influence mother).
L&D slide 5
The release of prostaglandins and oxytocin which stimulate contractions is caused by_______?
Uterine muscles being stretched to the threshold point.
L&D slide 4
A FHR of 181 for 12 minutes is considered what?
Fetal Tachycardia.
Reading FHR slide 6/ Durrham pg. 310
The result from increased venous pressure.
Bonus how would you treat it?
Varicosities
support hose, avoid prolonged sitting/standing, avoid crossing legs.
Atepatrum pt 2 slide 15
A baby is born with anomalies and less than 300 mL of amniotic fluid what is this called?
Oligohydramnios.
Antepartum slide 35
A brand new mom has just received a positive sign that she is pregnant. What should she be health taught?
-Exercise
Continue as previous. Do not begin strenuous
exercise. 30min/day. Avoid overheating
-Employment
◦ General practice: cannot forbid. Continue as able,
avoid exposure to environmental hazards.
-Travel (safe in low-risk pregnancy)
◦ Walk, support hose, stop frequently to decrease
risk of thrombophlebitis.
-Smoking
◦ IUGR (smoking and 2nd hand smoke)
◦ Preterm labor, PROM, abruptio placenta, placenta
previa, fetal death
Antepartum slide 46
A woman has entered labor and their cervix is fully dialted, when health teaching a mom about her Voluntary Expulsive efforts which option is the best to tell her?
A. Push until you cant anymore then breath!
B. Push for 6-8 seconds, then exhale. 4 times per contraction.
C. Push as long as you can and hold your breath to keep you diaphragm out of the way, then breath and repeat per contraction.
B. Push for 6-8 seconds, then exhale. 4 times per contraction
Durrham pg 246, 247
A mom was given an epidural, her BP read 94/54 prior to the epidural her BP was 138/86. What is your action?
Notify Anesthesiologist/ Nurse
L&D slide 71
A mother is arrives in labor her RR=21 BP=135/86 O2=98 and she is A&Ox3. She is given Fentanyl during the delivery for Pain. Her vitals after med administration read RR=16 BP=98/62 O2=93 and she is A&Ox3. Is anything wrong and what is intervention if there are any?
Administer O2, Place in Lateral position, Increase Iv fluids.
L&D slide 71
What are the causes of fetal tachycardia?
Maternal: Fever, Infection, Chorioamnionitis, Dehydration, Anxiety, Anemia, Meds, Illicit drugs, Activity, anemia, Cardiac abnormalities, fetal tachyarrythmias.
Durrham pg 310
How many extra calories should pregnant woman be eating to support a baby inutero?
300/day on average or 80,000 total or 300/day 2nd trimester 450/day 3rd trimester
Atepartum pt 2 slide 24
Cravings, Pica, Pagophia are all examples of_____
Nutritional problems for pregnant woman.
Antepartum pt slide 29
What 3 supplements are important for pregnant woman to be on, and for what?
Folic acid for RBC synthesis
Iron for maternal blood supply increase
Sodium major electrolyte
Antepartum pt slides 25-27
During your admission assesment the fetal HR is 148 on average over a 10 minute period. What is this considered and what is you nursing intervention if there are any?
Normal, none.
Tachy=>160
Brady=>110
FHR slide 6
A baby is determined to have an Early Deceleration. What is happening and what is your nursing intervention if there are any?
Head compression, None.
L&D slide 89
A fetus has late deceleration what is happening and what is your nursing intervention if there are any?
Uteroplacental insufficiency
Changer maternal position to lateral, elevate legs, increase IV fluids, D/C Oxytocin, O2
L&D slide 89
List causes of prolonged deceleration in FHR.
Mechanism of profound change in fetal 02, interruption in uteroplacental perfusion, Interruption of umbilical blood flow, Vagal stimulation.
Durrham pg 318
Nursing care of plecenta previa, and abruptio placenta includes
obtain Hx, Last vaginal exam/US results, VS, Lab tests as ordered, Monitoring fetal HR, Assess uterine tone/contractions.
Antepartum pt 2 slide 54
A Mom has been determined to have an Ectopic Pregnancy what treatments are used for these?
Laparotomy, Laproscopy, Methotrexate
Antepartum pt 2 slide 44
A pregnant mom is dx with Hyperemesis gravidum what symptoms is she most likely suffering from?"
A. Low BP, hypovolemia
B. High BP, Proteinuria
C. BH contractions, Low BP
A. Low BP, Hypovolemia
s/s include: continued vomiting (hypovolemia), hemoconcentration, wt loss, tachycardia, low BP, poor skin turgor, dry mucous membranes (dehydration), malnutrition, severe cases –
diminished kidney function, ketosis
Antepartum pt 2 slide 39
Umbilical cord compression, Nuchal/short/prolapsed knot between the pelvis and fetus are examples of_____? What are you interventions if there are any?
Variable Decelerations.
Change maternal position to Lateral, D/C oxytocin, O2, Vaginal exam
L&D slide 90
A mother presents with a Prolapsed cord and vaginal bleeding what is this considered?
Emergency Situation
L&D slide 91
A pregnant lady presents she is having strong contractions that are 210 seconds apart, her cervix is dialated 6 cm which stage of labor is she in?
Active Phase of stage 1
L&D slide 42
A FHR is 102 for 10 mins what is this considered? If its not normal what may be the causes?
Fetal Bradycardia.
Maternal: Supine, Dehydration, hypotension, and acute cardiopulmonary compromise (cardiac arrest, seizures), Rupture of uterus or vasa pervia, placental abruption, Medications, fetal response to hypoxia, umbilical cord occlusion, hypothermia, hypokalemia, fetal head compression, fetal brady arrythmias.
FHR slide 6/Durrham pg 311