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NURS215/216 ExamII
Maternity-Child
| Question | Answer |
|---|---|
| What are the warning signs and what does the nurse/physician instruct her to do about them? | gush of fluid from vagina, vaginal bleeding, abdominal pain, temp >101F, persistent vomiting, visual disturbances, severe headache, edema on hands/face, epigastric pain, dysuria, decreased or absent fetal movement. Call the doctor/practicioner right away. |
| How often should a woman go for a prenatal checkup? What is the recommended schedule? | q 4 weeks until 28 weeks gestation, q 2 weeks until 36 weeks gestation and q week until delivery |
| What is done at each prenatal checkup? | urinalysis, assessment of mom an dbaby- check of growth of baby (fundal height), |
| Why is prenatal care so important? | to carry a healthy baby to term and to help diagnosis any problems or complications as soon as possible |
| What is the MacDonald rule? | a rough determination of fetal age in weeks compared to fundal size. measuring from symphysis pubis to top of fundus. btw 22 wks and 34 wks fundal height=gestational age. |
| Why is the fundal height checked at each visit? | to track the baby's growth |
| What is a biophysical profile? | an ultrasound evaluation of fetal health |
| What parameters are assessed during a biophysical profile? How? | fetal breathing movement, movement of limbs or body, tone (extension or flexion of extremities), amniotic fluid volume, reactive FHR with activity (reactive NST). 2pts for each parameter met. |
| What is a normal biophysical profile score? | normal=7-10, abnormal=<2 |
| Why is a non-stress test ordered? | high risk, report of decreased fetal movement, diagnosis of diabetes or hypertension, multiple gestation, premature rupture of membrane, after an accident (car, fall, etc.), pregnancy past due date, history of complications in third trimester |
| what does it mean if a stress test is negative? | negative is good |
| What is an oxytocin challenge test (OCT)? | oxytocin is used to stimulate uterine contraction either naturally (nipple stim) or artifically (IV/injection) at a desired rate of 3 q 10min with a duration of 40secs to "predict" how the baby will do during delivery |
| What does it mean to have a positive OCT? | repetitive late decelerations or if late decelerations are noted with half or more of the contractions. this would be considered a positive and could indicate fetal distress |
| What is pelvimetry? | measurement of the dimensions and capacity of the pelvis/bony birth canal to determine if it is big enough to have vaginal birth. |
| What measurements are conducive to a normal vaginal birth? | diagonal conjugate=>11.5, obstetric= estimated by subtracting 1.5-2cm from diagonal, pelvic outlet:antero-posterior =9.5-11.5cm and transverse: =8-10cm |
| What diagnostic tests are used to determine biophysical profile? | ultrasound, non-stress test, contractions stress test (OCT) |
| What 5 parameters are assessed in the biophysical profile? | fetal breathing movement, fetal movement of limbs or body, fetal tone (ext and flex of extremities), amniotic fluid volume, reactive FHR with activity (reactive NST result) |
| What is the scoring for a biophysical profile? What is a normal score? | each parameter is 2pts, 0-4 severe, 4-8 moderate, and 7-10 normal |
| What diagnostic test is performed to assess fetal lung maturity? What result would indicate fetal maturity? | L/S ratio (amniocentesis), 2/1 ratio or 72.2 |
| A pregnant woman should increase her caloric intake by ______ calories a day. | 300 |
| A lactating woman should increase her caloric intake by ______ calories a day. | 500 |
| What is the normal monthly pattern of weight gain during pregnancy? What is the average total weight gain? | 3-5lbs 1st trimester, and 12-15lbs in each of the following trimesters (1lb a week) average total weight gain= 25-35lbs |
| What are some possible discomforts experienced early in pregnancy? | nausea/vomiting, breast tenderness, palmar erythema/pruritis, ptyalism (bitter taste), nasal stuffiness |
| What are some possible discomforts experienced late in pregnancy? | heartburn, constipation, hemmorhoids, backache, leg cramps, ankle edema, flatulence |
| How often should a woman go for a prenatal checkup- what is the recommended schedule? | 1st 28wks= once a month, <36=q 2wks, >36 q week |
| What is done at each prenatal checkup? | VS, UA, general assessment mother and fetus |
| What is a bimanual exam? Why is it performed? | internal manual exam performed to determine the size of uterus and pelvis and also check for any abnormalities of the uterus, ovaries, or fallopian tubes. |
| What pelvic measures are desired for a vaginal birth? | diagonal conjugate=/>11.5, obstetric>10cm, pelvic outlet-ant. post=9.5-11.5, transverse=8-10 |
| What pelvic shape is most conducive for a vaginal birth? What is the next best? The worst? | gynecoid(round)-best, anthropoid(oval ant/post)-second best, android(heart-shaped)-bad, platypelloid(oval transverse)-bad |
Created by:
kgrabo99
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