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MVCTC Maternity sec
MVCTC Maternity sec 1
| Question | Answer |
|---|---|
| What is Maternity Nursing Care? | Quality Nursing Care expirence for whole family for each patient . |
| The birthing setting where the room is a homelike room, but their postpartum room is in another room, both on Hospital grounds? | {LDR} Labor Delivery recovery Room |
| In collaborative Care who is athorized to deliver in a uncomplicated births of low risk women? | 1. Certified Nurse Midwife 2.) Obstericians and Gynecologists |
| TIMELINES for specific patients diagnosis ? | Clinical Pathways |
| Government Health Influences | Title V Public Health Clinics for mom and newbornTitle XIX Medicaid ie: caresourceWIC food for Women Infant and Children |
| Birth Rate Statistics | # OF live Births per 1000 year |
| Infant Mortality Rate | # OF DEATHS < 1 year old/ 1000 live births |
| Neonatal mortality Rate | # of deaths <28days old/ 1000 live births |
| Family types | Nuclear-RegularBlended- 2+ familiesCommunal-several families live together |
| Legal Liability | Professional negligence to cause injury or death - to prevent remember to do both consent forms and documentation |
| Low Risk Pregnancies | Fetal HR, Activity, VS, urine activity, etc |
| High Risk Pregnancies | Kick Counts 10 kicks in 12 hours or 3 kicks in 1 hour |
| Allows passage of the baby by Stretching | Rugae |
| The muscular layer of the uterus that is functional unit in pregnancy and labor | Myometrium |
| Fallopian tube | 1.)carries the ovum from the ovary to the uterus2.) Site for fertilization3.) passage way for sperm to get to the ovum |
| The ovaries secrete what? | Estrogen and Progesterone |
| Progesterone does what? | Prepares and maintains uterine lining for implantation of zygote/ ovum |
| The pelvis is divided into true and false pelvis by the imaginary line the? | Linea Terminalis |
| Ischial Spines | Represents the shortest diameter of the pelvic cavity(the width) |
| Diagonal Conjugate | distance between the symphysis pubis and the sacral promontory |
| Pelvic type: Gynecoid | normal round female pelvis |
| Ovulation occurs | 14 days before the beginning of the next cycle |
| Ovum is fertile for | approx 24 hours |
| Sperm can survive up to? | 5 days |
| Uterine layer involved in implanation? | Endometrium |
| A decrese in estrogen and progesterone during menstrual cycle is responsible for | Shedding of the endometrium |
| Ovarian follicles matures under influence of | Anterior pituitary horomones FSH and LH |
| What helps maintain the pregnancy:? | Progesterone |
| The milk secreting cells? | acini cells in the alveoli |
| Montgomery's tubercles | small raised areas around the areola they are sebaceous glands. |
| When newborn sucks at breast what horomone releases to stimulate milk Production to fill boobs? | Prolactin (Ant. pituitary) |
| The ejection of milk into the ducts for release through the nipples "the let down" | Oxytocin(contractile)posterior pituitary |
| The Scrotum suspends outside the body for | Allow for cooling that is necessary for Spermatogenesis (FSH helps production) (sperm production) |
| Testosterone functions | 1.) Secondary sex characteristics 2.) formation of sperm 3.) Bones and muscle-thicker and longer 4.) Larynx-enlarged: lower voice 5.)Enhancing production of RBC's |
| Mitosis | Contain the same number of chromosomes as parent - 46 chromosomes- 46 chromosomes |
| Meiosis ( Reproductive cells) | Contain half the number of chromosomes as parent- 46 chromosomes- 23 chromosomes |
| The sex of the baby is xx or xy What is XY and XX? | X Of sperm and X of ovum= female Y of sperms and X of ovum= male |
| In fetal development what weeks is it considered a Fetus? | 9th week of gestation |
| Chorion | the thick outermost layer |
| Amnion | Inner layer- prtects the eymbro |
| Amniotic Fluid an excess that greater than 2 L | Hydramnios- Polyhydramnios |
| Amniotic Fluid less than 30cc | Oligohydramnios |
| Function of the Amniotic Fluid | 1.) Free movement 2.) Cushion |
| Progesterone | Reduces uterine contractions to prevent spontaneous abortion |
| Estrogen | Stimulates uterine growth |
| hCG | Detects in a home pregnancy test within 7-9 days after fertilization |
| Human Placental Horomone | Increases resistance to insulin causing more protein, glucose and minerals to be available for baby |
| The Duncan's Placenta | Maternal Side, Rough, have to watch for hemmorrhage on this side |
| The Schultze's Placenta | Fetal Side, Smooth, you want this side first. |
| 2 arteries | there are 2 arteries so 2 to carry away so they are deoxygented blood and waste away from baby to placenta 2 dirty so away from baby. |
| 1 vein | 1 vein that is oxygenated |
| Ductus Venosus V= vein | (bypass liver) extra help= your have one liver and one vein [connects vein with the inferior vena cava] |
| Foramen Ovale | (Bypass lungs) {extra help}= you have 2 arteries and 2 lung [opening between the R and L atria of the heart bypass' lungs] |
| Ductus Arteriosus | (bypass lung) {extra help} = you have 2 arteries and 2 lungs [Connects the pulomary artery and aorta] |
| Purpose of the Foramen Ovale | to reduce blood flow to the lungs |
| Monozygotic | Identical twins{have to be same sex} splitting of 1 sperm and 1 egg |
| Dizygotic | Faternal Twins { 2 ova and 2 sperm} |
| Gravida | any pregnancy, regardless of duration, includes the present one, |
| Nulligravida | nulli= never, so never been prego |
| multigravida | have been pregnant before |
| primagravida | prima = 1, so first time she's been pregnant |
| para | a woman who has given birth to one or more children who reached 20 weeks dead or alive,para= parent |
| nullipara | women who has not given bith to a baby who's reached 20 weeks,so nulli= never and para=parent |
| Preterm and Post term | Preterm pregnancy that ends at 20 weeks and before 38 weeksPostterm- a pregnancy that goes beyond 42 weeks |
| EDD, EDB, EDC | ALL same thing- EDD estimated date of deliveryEDB estiamted date of birthEDC estimated date of confinement |
| Gestational Age | number of completed weeks of fetal development calculated from the first day of the LMP |
| Fertilization Age | number of completed weeks of fetal develpment calculated from the date of conception approx. 2 weeks shorter than gestational age |
| Nagele's Rule | 1st day of your LNMP + 7 days - 3 months examples LNMP=july 10th2006+ 7days= july17-3 months = april 17, 2007 watch your year! |
| S/S OF Presumptive Pregnancy= may suggest pregnancy | 1.)Amenorrhea 2.) N with or without V 3.) Urinary Urgency 4.)Breast changes 5.)Quickening 6.)Fatigue and Drowsiness |
| s/s of Probable pregnancy= strong indicate pregnancy | 1.) uterine enlargement 2.)pigment changes{linea nigra-abd} areola on breast 3.) + PREGO TEST 4.) Hegar's sign= sofetning of Uterus 5.) Goodell's sign= softening of the Cervic 6.) Chadwick's sign= bluish Discoloration 8.) Braxton Hicks Contactions |
| s/s of Positive pregnancy=confirm pregnancy | Fetal Heartbeat. Ultrasound. active fetal movement palpated by examiner |
| Relaxin | Symphysis pubis more moveable: cervix to soften |
| Cardiovascular system | -Increase Cardiac Output-BP does NOT increase-Increase WBC -Increase HEART rateIncrease clotting factors -Increase maternal blood |
| Due to pressure of enlarged uterus causing decrease venous return what is cause by this ? | Varicosities and Hemorrhoids |
| Supine Hypotension syndrome | due to compression on IVC when lying supine as pregnancy advances |
| Treatment and Signs and Symptoms of Supine Hypotension | S/S dizziness, lightheaded, nausea, pallor, diaporesis , syncope tx= position on left side |
| Increased Relaxin and Progesterone causes? | constipation |
| Chloasma | "mask of pregnancy" pigmentation changes on face |
| Preconception what vitamin do you need? | Folic acid 0.4 mg |
| carries blood with lowest level of 02 | umbilical artery(deoxygenated) |
| what horomone helps maturation of ovarian follicle? | FSH |
| Takes oxygenated blood to the fetal liver and diverts most blood to interior vena cava | Ductus Venous |
| Connects pulmonary artery with aorta | Ductus Arteriosus |
| When is Amnicentesis performed | Done at 16-18 week gestation worry about infection, pregnancy loss an needle injury to fetus |
| What occurs with the Alpha Fetoprotein? | Increase=neural tube- spinal bifidadecrease+chromosomal- Down's |
| nonstress test looks for? | adequate oxygenation/ placenta function |
| normal weight gain | 25-35 pounds |
| when Pregnant how many extra calories? | 300/day |
| during lactation how many extra calories | 500/day---- thats with the 300 already included |
| Slow paced breathing | early stages breathing at half the usual rate |
| Modified Paced Breathing | 2 times normal amount danger for hyperventilation breaths are rapid and shallow |
| Bleeding EARLY in pregnancy | Abortion |
| s/s of spontaneous abortion | Bleeding and cramping |
| Threatened Abortion | -slight to moderate bleeding with or without cramps- Cervix closed- NO tissue passed |
| Inevitable Abortion | Moderate to severe bleeding with modoerate cramps- open cervis- no tissue passed |
| Incomplete abortion | Severe cramps with severe bleeding-cervix open - passage of tissue/part of tissue |
| Complete bleeding | cervix bleeding - cervix closed- loss of placenta |
| Missed abortion | No cramps, cervix closed, brownish discharge, retention of tissue |
| Etopic pregnancy | abnormal implantation of fertilzed ovum outside uterus can lead to hemorrhage or shock |
| Sign and Sympoms of etopic pregnancy | 1.) sudden stabbing abd pain 2.) shoulder pain |
| Treatment of Etopic Pregnancy | Methhotrexate (Folex)- chemo agent used to inhibit cell reproduction, inhibits cell division |
| Hydatidiform mole | takes on apperance of grapelike clusters and fluid filled |
| Hydatidiform mole complete and partial | Complete is all genetic material is paternal no embryopartial is fetus is abnormal: usually aborts |
| s/s of hydatidiform | rapid uterine growth, vaginal bleeding, n/v and high hCG levels |
| Bleeding LATE in pregnancy= Placenta Previa | causes PAINLESS vaginal bleeding after 24 weeks- abnormal implantation of placenta |
| Abruptio Placenta | Premature seperation of placenta from uterine wall PAIN with bleeding |
| RhoGam | give at 28 weeks and then 72 hours after delivery |
| Gestational Hypertension | one of the leading cause of maernal death and perinatal death |
| Preeclampsia | renal involvement leading to protinuria |
| Eclampsia | CNS involvement leading to seizures, chronic HTN AND HELLP |
| Gestational Hypertension Assessment | BP, URINE- protein,edema, weight gain,blood work and fetal well being |
| Gestational Hypertension treatment | Mag Sulfate to prevent seizures if resp rate is < 12 you give calcium gluconate to counteract |
| Pulmonary Embolism | one of the leading cause of maternal death |
| What risk factors can cause a Pulmonary Embolism | Venous Statis, vessel wall injury, use of oral contraceptives, >30 years old, obesity |
| Maternal pushing does what | Taxis the heart and isn't good for a cardiac week patient |
| Anemia s/s | tire easy, suseceptible to infection, increase risk of pregnancy complications |
| Iron deficiency anemia dietary management | Iron supplement/ Vit CGive MEATS AND DARK GREEN LEAFY VEGGIES |
| Folic Acid Deficiency Anemia | increse intake of folic acid to decrease risk of neural tube defects |
| Hyperemesis Gravidarum (early pregnancy) | fetus at risk for Inner uterine growth restriction which will cause a smaller than expected birth weight |
| Hyperemesis Gravidarum diet | Low fat, avoid dairy, small frequent meals EAT CRACKERS BEFORE YOU GET UP IN THE MORNING |
| When is Gestational Diabetes Mellitus checked? | Checked at 24 to 28 weeks gestation |
| S/S of gestational Diabetes | excessive thirst, hunger urination and weakness |
| What was the puropse of the Title V amendment of the Public Health Service Act | establish infant- maternity care centers in public clinics |
| Documentation of assessment made during a home care visit reduces? | reduces legal liability for the nurse and increases the quality of patient care |
| A common therapy performed at home for high risk newborns | Phototherapy |
| What are functions of the uterus? | menstruation, pregnancy, labor and birth |
| Where does fertilization normally occur? | the fallopian tubes |
| Which position best facilitates placental circulation | side lying |
| Where is Testosterone releses? | Testes |
| Where is estrogen releases | The ovary and the placenta |
| Progetsterone is released in the | Overy and corpus luteum and Placenta |
| Which horomones are released in the Ant. Pituitary | LH, FSH, and Prolactin |
| Which horomone is released by the posterior pit | Oxytocin |
| (NCLEX) A pregnant client asks the nurse about the horomone that causes milk production. The nurse tells the client that the primary hormone that stimulates the secretion of milk is? | Prolactin |
| (NCLEX) The LPN tells the adolescents that the normal duration of the menstrual cycle is about? | 28 days |
| (NCLEX) A maternity nursing instructor asks a nursing student to identify the horomones that are produced by the overies? | Estrogen and Progesterone |
| (NCLEX)The nursing instructor ask the student about the Function of Progesterone. Which would be a correct understanding on the function of progesterone? | It maintains the uterine lining for implantation and relaxes all smooth muscle including the uterus |
| (NCLEX) Teaching to a preganant woman the physiological effects and horomone changes that occur in pregnancy. What about the purpose of estrogen? | It stimulates uterine development to provide an environment for the fetus and stimulates the breasts for lactation. |
| (NCLEX) A client asks the nurse about the purpose of the placenta. The nurse plans to respond to the client, knowing that the placenta; | Provides an exchange of nutrients and waste products between the mother and fetus |
| (NCLEX) The structure of the ductus Venosus | Connects the umbilical vein to the inferior vena cava |
| (NCLEX) A nurse is collecting data during an admission assessment on a client who is pregnant with twins. The client also has a 5 year old child. The nurse would document which gravida and para status on this client? | Gravida II, Para I |
| (nclex) The physician has just documented the presence of Goodell's sign. The nurse determines that his sign is indicative of: | A softening of the cervix |
| (nclex) A nursing instructor ask the nursing student to describe the process of quickening. What determines a understanding of this term? | It is the fetal movement that is felt by the mother |
| (NCLEX) The nurse determine that the patient is having Braxton Hicks contrations. What nursing action is appropriate? | Intruct the client that these are common and may occur through out the pregnancy. |
| (NCLEX) A nurse is providing instructions to a pregnant client with genital herpes about the measures that need to be implemented to protect the fetus. The nurse tells the client that: | A cesarean section will be necessary if vaginal lesions are present at the time of labor |
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