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Antepartum/intrapart
maternal child / Respiratory and Cardiac
| Term | Definition |
|---|---|
| pica | eating none edible substances |
| gravida | pregnant women - any pregnancy regardless of duration |
| para | woman that has borne offspring that reached the age of viability - after 20 weeks |
| fundus | upper portion of the uterus between the fallopian tubes |
| lactation | expressing milk |
| prenatal | occurring or existing before birth, referring to both the care of the woman during pregnancy and the growth and development of the fetus. |
| antepartal | time between conception and onset of labor, usually used to describe the period during which a women is pregnant, same as prenatal |
| Trimesters | one of the three periods of approximately 3 months into which pregnancy is divided. The first trimester includes the time from the first day of the last menstrual period to the end of 12 weeks. The second trimester, closer to 4 months in length than 3, ex |
| TPAL | Term Births Preterm Births Abortions Living children |
| A post-abortion 16-year-old female asks the nurse questions concerning birth control options prior to discharge. Which of the following legal or ethical issues are involved when this nurse answers questions concerning birth control for this client? | Emancipated minor |
| A nurse who uses current research, statistical data, and quality measurements as a guide for nursing care is providing care that is: | Evidence-based. |
| A nurse who keeps her pediatric client's parents informed of treatments and prognosis in an unbiased and supportive manner is delivering care that is: | Family-centered. |
| When the nurse asks a child's parents what they feel caused their child's illness, she is recognizing the importance of the family's: | Cultural values and beliefs. |
| When a nurse follows a comprehensive interdisciplinary care plan for a specific condition that describes the sequence and timing of interventions that should result in expected patient outcomes, she is using guidelines provided by: | When a nurse follows a comprehensive interdisciplinary care plan for a specific condition that describes the sequence and timing of interventions that should result in expected patient outcomes, she is using guidelines provided by: |
| When a nurse explains a procedure, the rationale for the procedure, and any associated risks to her patient, she is protecting the patient's ethical right to: | Autonomy. |
| A nurse gathers data on the number of families with small children that reside in housing units in a community with lead-based paint, which can cause serious health problems for exposed children. The nurse is using statistics in order to: | Determine populations at risk. |
| If an ethical dilemma regarding treatment arises in care of a pregnant woman at 16 weeks' gestation, what factors will be considered in the decision-making process? | The rights of the mother are paramount. |
| The individual ultimately responsible for obtaining an informed consent from the client prior to a cesarean section is the: | Obstetrician. |
| Which of the following factors influence the decrease in maternal mortality in the United States? Select all that apply. | Availability of high-risk maternal-infant care centers Use of a specialized antepartum maternity clinic |
| Which concept related to culture is important for the nurse to consider when planning care for clients? | Clients communicate culture verbally and nonverbally through symbols. |
| A Chinese child is admitted to the hospital. Prior to developing a plan of care for the child, the nurse considers the child's ethnic background, which is correctly identified as: | Chinese. |
| A parent of a 4-year-old diabetic child tells the nurse that the child's illness resulted from disobedience, and that the entire family has been affected. In order to plan educational interventions for this parent, the nurse needs to understand the parent | Magico-religious. |
| A newly admitted child emigrated with her parents from a country with a predominant past-time orientation. As the nurse cares for this 6-year-old, particular attention should be paid to assisting the parents with: | Medication scheduling. |
| As the nurse provides discharge teaching to parents of a Hispanic child, neither parent maintains eye contact. The nurse understands this behavior to convey: | Respect. |
| In planning a child's care, the nurse should develop interventions that address cultural differences considered by families to be major barriers to health care. These barriers can include: | Perception that the health care system is unresponsive to unique needs. |
| The nurse recognizes lack of health coverage as a significant problem for many hospitalized children. Which of the following populations of youngsters suggests the greatest need for collaboration with Social Services to ensure that the families receive ad | Children of immigrant families |
| The nurse assumes that the parents of a Native American child newly diagnosed with asthma will not adhere to a discharge planning regimen. Which of the following factors is influencing the nurse's assumption? | Stereotyping |
| The nurse is performing an initial cultural assessment interview with the family of a newly admitted pediatric surgical client. Which of the following considerations must be included? Select all that apply. | Identify cultural beliefs related to health and illness. Determine who is responsible for making health care decisions. Assess the type of predominant family structure. Identify the roles of family members. |
| The nurse should be cognizant of the reality that nursing diagnostic categories might be culturally biased. Which of the following diagnoses are most likely to be culturally problematic? Select all that apply. | Impaired Communication Noncompliance |
| An adolescent boy asks, "Does the scrotum have a function?" The nurse's best response is: | "The scrotum helps to protect the testes, and provides an ideal environment to create sperm." |
| During a pelvic exam, the nurse practitioner teaches the client about the function of the cervix. The nurse practitioner knows that teaching has been successful when the client states: | "Cervical mucous helps lubricate the vagina." |
| A nurse is teaching a class about the female reproductive system to a group of women aged 45-55. When she asks a participant to name the event that is primarily responsible for the initiation of menopause, she knows the participant has understood when she | The ovaries secrete decreasing amounts of estrogen." |
| The nurse is assessing the pH level of the vaginal environment of a 26-year-old client. Which of the following would be an expected finding for this client? | pH level of 4.6 |
| A nurse is teaching a class for adolescents about the female reproductive system. When the nurse asks the class what the function of the vagina is, she knows that the class has understood when they answer which of the following? Select all that apply. | "It's a passageway for menstrual flow." "It's a passageway for the sperm and the fetus." "It protects against infections from pathogenic organisms." |
| A nurse is teaching a class on the anatomy of the reproductive system. A student states that she has pain during menstruation. The nurse knows that painful menstruations can be due to which of the following ligaments? | Uterosacral ligament |
| A male client is having some problems with infertility, and is waiting for a report on his semen sample. The nurse knows that the problem might not be related to the pH level of the semen based on the following pH lab value: | 7.5 |
| During a discussion about the pelvic bony structure, a client relates that she has been told by her physician that she has a narrow pubic arch, and she wants to know how this might affect childbirth. The nurse's best response is: | "If the arch is too narrow for the head, it could result in the need for forceps or cesarean birth." |
| A nurse is reviewing a client's record, and notices a physician's report of a malformation in one of the fallopian tubes. The nurse knows that the client is most at risk for: | Ectopic pregnancy. |
| Which of the following lists the correct order of the four phases of the menstrual cycle? | Menstrual, proliferative, secretory, ischemic |
| Which of the follow clients would be most likely to choose a Bradley-type labor and birth? | 23-year-old G1P0; married, supportive partner |
| Which of the following statements indicate the need for further teaching as it relates to vitamin recommendations in childbearing? Select all that apply. | My doctor said that I need to take vitamins to stay healthy. I am taking the ones he prescribed, as well as my own multivitamin." "The doctor prescribed vitamins for me, but they make me sick, so I quit taking them." |
| Which of the following statements made by a patient indicate the need for further teaching regarding pregnancy and exercise? Select all that apply. | I feel so tired after my workouts; I need to push myself to remain in shape." "I have gained so much weight during my pregnancy. I am going to start jogging." |
| Which of the following statements indicate that a couple has understood teaching about contraception and conception? Select all that apply. | I am taking off my patch this week. I will buy some condoms to use for the next few months." "I used my last Nuva Ring 2 months ago, and we started using condoms then. I have had two periods, and now am ready to conceive." |
| A married couple is apprehensive about labor and delivery. They report experiencing a loss of control and a reckless regard for their wishes with their previous hospital birth. Which of the following nursing interventions/responses would be most appropria | Assisting this couple with a birth plan Offering information to allow for informed choices |
| A married couple has decided to have their older children present in the delivery room. During labor, the client is verbalizing and writhing in pain. There is bloody show, and her youngest child begins to cry and say, "No! No!" What would be appropriate n | Encourage the support person to take the child from the room. Avoid generalized reassurance. |
| A coworker is teaching prenatal classes. She is covering physiologic changes of pregnancy. Select the changes that are correctly matched with the appropriate times to present them. Select all that apply. | Relief for common discomforts; first trimester Nutrition, rest, and exercise; first trimester |
| Of the following people, who would be the best candidate to provide support to a sibling attending a birth? | The child's close aunt, who has had children before |
| A married woman in your childbirth education class has decided to breastfeed. You enter the classroom and her husband states, "I don't know why she has to do that. None of our other kids like me, because they all were breastfed. They want nothing to do wi | Encourage the husband to discuss his feelings and experiences related to breastfeeding. Explain to the husband why his support and encouragement are vital. |
| A married woman is having a scheduled repeat cesarean delivery. She states that she doesn't know if she can do that again. Upon further questioning, she states that she "labored for 29 hours, then had an emergency C-section." She wasn't able to see her ba | Assess the client's knowledge about C-sections and plan of care. Inform the client that every delivery is different. She likely will not be as fatigued this time without the long labor, and that should help with the pain and recovery time. |
| A 25-year-old client at 18 weeks' gestation has returned to the clinic for her second prenatal visit. Her initial pulse was 60. The nurse can expect her pulse to be __________ bpm at term. | 70-75 |
| A nurse is teaching a prenatal client about cardiovascular changes during pregnancy. The client asks the nurse why she becomes dizzy when getting out of a chair or out of bed. What rationale should the nurse provide as to the cause of this dizziness durin | Increased blood volume in the lower extremities |
| A nurse is assessing a prenatal client's cardiovascular function. When should the nurse expect this client's cardiac output (CO) to begin rising? | 8-10 weeks |
| A nurse is teaching a group of first-trimester prenatal clients about the discomforts of pregnancy. A client asks the nurse, "What causes my nausea and vomiting?" The nurse responds indicating which of the following as contributing factors to first-trimes | Human chorionic gonadotropin Alterations in carbohydrate metabolism |
| A nurse is researching the topic of edema during pregnancy. Which of the following observations contributes to fluid retention? | Increased level of steroid sex hormones |
| A nurse practitioner is taking an initial history of a prenatal client. Which of the following, if detected by the nurse practitioner, would indicate a positive, or diagnostic, sign of pregnancy? | Fetal heartbeat with at Doppler at 11 weeks' gestation |
| The nurse in the prenatal clinic assesses a 26-year-old client at 13 weeks' gestation. Which presumptive (subjective) signs and symptoms of pregnancy should the nurse anticipate? | Excessive fatigue and urinary frequency |
| The nurse is researching the topic of uteroplacental blood flow. Which of the following accurately describes funic souffle? | A soft blowing sound of blood that is at the same rate as the fetal heart rate |
| taking a history from a prenatal client at 7 weeks' gestation. The client states, "I don't know if I want this baby. How will I know if I'll be a good mother?" What is the most appropriate response by the nurse? | "Ambivalence can be a normal reaction to parenthood in the first trimester." |
| The nurse is teaching a parenting class to prospective fathers. The nurse correctly teaches that couvade refers to the: | Development of the physical symptoms of pregnancy in the father of the baby. |
| The nurse is preparing an antenatal client for an initial assessment. What is the first task that the nurse should perform? | Instruct the client to provide a clean urine specimen. |
| The nurse in the prenatal clinic is planning care for a pregnant 15-year-old client. The nurse knows that this adolescent is at risk for which maternal complication? | Pre-eclampsia |
| The nurse has completed the initial assessment on four prenatal clients. Which client is at greatest risk for a spontaneous preterm birth? | A 19-year-old client with twins |
| The nurse is assessing the fundal height of a client at 26 weeks' gestation. The nurse should expect the fundus to be: | The nurse is assessing the fundal height of a client at 26 weeks' gestation. The nurse should expect the fundus to be: |
| A nurse is completing an assessment on a first-trimester antepartal client. Which of the following statements would indicate a psychological risk factor and a need to evaluate further for possible intervention? Select all that apply. | My boyfriend said it better be a boy." |
| An antepartum client tells the nurse her last period was May 18. The nurse uses Nägele's rule to compute the client's expected date of birth, and tells the client that the correct date of birth will be: | February 25 (of the next year) |
| An antepartal client at 29 weeks' gestation is assessed in the prenatal clinic. All assessment data are within normal limits. When should the nurse schedule the client's next appointment? | In 2 weeks |
| A nurse assesses four clients in the prenatal clinic. Which client will present with the most accurate fundal height related to gestational age? | The client who develops hypertension |
| A nurse is assessing a prenatal client at 32 weeks' gestation. The nurse measures the fundal height at 28 cm. The nurse should suspect __________. | IUGR Intrauterine Growth Restriction |
| A client who is 8 weeks pregnant gives the following pregnancy history to the nurse: This is her fourth pregnancy; she had one abortion at 12 weeks, she had a girl born at home at 35 weeks, and she gave birth to a stillborn at 38 weeks. Which of the follo | Gravida 4 para 1111 |
| A client in the prenatal clinic complains of nausea and vomiting. Which intervention should the nurse suggest? | Eat dry crackers or toast before arising in the morning. |
| A second-trimester client in the prenatal clinic complains of ankle edema. Which intervention should the nurse suggest? | Elevate legs when sitting. |
| A prenatal client at 10 weeks' gestation is complaining of urinary frequency. Which self-care strategy should the nurse teach? | Empty the bladder when the urge is felt. |
| A prenatal client in the third trimester of pregnancy is diagnosed with varicosities in the vulva and perineum. Which self-care strategy should the nurse teach? | Elevate legs level with hips while sitting or lying down. |
| A pregnant client complains of severe heartburn. The nurse suggests which of the following relief measures for heartburn? | A pregnant client complains of severe heartburn. The nurse suggests which of the following relief measures for heartburn? |
| The nurse is teaching a group of prenatal clients about care of the breasts during pregnancy. Which self-care measure might be effective for women with inverted nipples? | Breast shields |
| 38 weeks' gestation tells the nurse, "I had white liquid leaking out of my nipples while warm water was running over my breasts in the shower last night." The nurse explains that: | The liquid was colostrum, and that is expected at this point in your pregnancy." |
| teaching a group of prenatal clients about hazards in the workplace during pregnancy. The nurse correctly teaches that pregnant women who have jobs requiring long periods of standing have higher incidences of: | Preterm birth. |
| A nurse is teaching a group of prenatal clients about the importance of exercise during pregnancy. Which client would be the best candidate to continue with her exercise regime? | A client with diagnosis of diabetes |
| The pregnant woman who is over the age of 35 years has risks related to pregnancy outcome. Which statement about increased risk in this age group is true? | Amniocentesis is recommended for all women 35 years and older. |
| hormones of ovaries | estrogen and progesterone |
| progesterone | hormone of pregnancy, inhibits uterine contractions relaxes smooth muscle to cause vasodilation to allow pregnancy to be maintained |
| estrogen | femaleness, breast lodule alveolar growth and duct development |
| prostaglandins | produced by the cells of the endometrium, group E and F |
| PGE | relaxes smooth muscle vasodilator |
| PGF | potent vasoconstricter - increases contractability of arteries and muscles |
| Chronic Obstructive Pulmonary Disease | COPD |
| Chronic Obstructive Lung Disease | COLD |
| Chronic Airflow Limitation | CAL |
| Obstructive Bronchitis,Emphysema, Asthma | Refers to a number of disorders that affect the movement of Air out of the lungs (Expiratory Air Flow Rates) |
| Risk Factors Associated with COPD | Cigarette smoking, Male > Females Alfa 1 Protease inhibitor deficiency Allergies/Sensitivities Familial Tendencies toward COPD Occupational Exposure Chronic Respiratory Infections Age |
| Types of COPD | Chronic Bronchitis About 13.5 million in U.S. Emphysema About 2 million in U.S. |
| Complications from COPD | Major Concerns: Hypoxemia and Acidosis Increased risk of Respiratory Infection Cardiac failure (Cor pulmonale) Cardiac dysrhythmias |
| Pathophysiology in Chronic Bronchitis | Increase in number & size of the mucous secreting glands and bronchial cells Decreased number of cilla Inflammatory changes in bronchial and bronchiolar walls Development of mucous plugs |
| Pathophysiology in Chronic Bronchitis | Cough and sputum production for 3 months/year (Minimum of 2 consecutive years) |
| Assessment of Chronic Bronchitis | Peripheral edema Cyanosis Right Heart failure symptoms Smoker’s hack Coarse crackles/rhonchi Expiratory wheezing Does not appear to be in respiratory distress Pulmonary hypertension Hepatomegaly Clubbing of the fingers |
| Chronic Bronchitis tests | Pulmonary Function Testing ( PFT ) Arterial Blood Gases ( ABGs ) Complete Blood Count |
| Chronic Bronchitis Management | Smoking Cessation. Medications. Oxygen. Theophylline. Mucolytics. Steroids: if other therapy is ineffective Antibiotics Secretion management Nutrition. Postural drainage to remove secretions. Change in occupation if work involves exposure to dust and ch |
| Emphysema part 1 | Dilation of distal airways Increased dead space Thickening of bronchial/bronchiolar walls Narrowing of bronchial lumen Submucosal edema Increased number of mucous secreting glands and cells |
| Emphysema part 2 | Alveolar Septum is destroyed Tissues loose elasticity Air Trapping Changes more pronounced during expiration Decreased pulmonary diffusion surface Decreased ventilation |
| Centrilobular Emphysema | Most Common type Destruction of bronchioles (upper lung region) Inflammation of bronchioles Aveolar Sac Remains Intact |
| Panlobular Emphysema | Tissue distal to terminal bronchioles Destroys Air Spaces of Entire Lower Lung |
| Paraseptal/Panacinar Emphysema | Destroys Aveoli in lower lobes Results in isolated blebs Likely cause of SPONTANEOUS Pneumothorax |
| Clinical Assessment in Emphysema part 1 | Appears short of breath Pink Color Barrel chest Thin Maintains position sitting upright with arms resting in front on the table Prolonged expiration Neck veins may distend on expiration |
| Clinical Assessment in Emphysema part 2 | Pursed lip breathing, Accessory muscle use Unproductive, minimal cough Diminished breath sounds Expiratory wheezing May have crackles Heart sounds diminished/muffled |
| Clinical Assessment in Emphysema in advanced stage. | Memory loss, drowsiness, confusion, lethargy, stupor, coma Carbon dioxide narcosis |
| CO2 Retainer | Body becomes insensitive to high Levels of CO2 Begins to rely on O2 receptors in Aortic Arch and Carotid Body When O2 levels are low lungs are Stimulated to breath If O2 blood levels rise respirations Slow down… O2 levels must Remain low en |
| Pulmonary Function Testing ( PFT ) | Marked decrease in overall function Increased total lung capacity/residual volume |
| Arterial Blood Gases ( ABGs ) | Hypoxemia Compensated state of respiratory acidosis |
| Chest X-Ray | Hyperinflated lung fields |
| prolactin | stimulates glandular production - breast feel nodular, areolas darken, montgomery's tubecles produce secrections |
| melanocyte-stimulating hormone | causes nipples,patches on face, and linea nigra on abd. |
| oxytocin | causes uterine contractions, stimulates let down reflex during breast feeding, stimulates uterus to contract after delivery to control bleeding. |
| thyroid gland is also stimulated to produced what during pregnancy | glucose |
| incresed glucose production during pregnancy causes what | increased 02 consumption, increased bmr, fatigue, anxiety, emotional liability, sweat, heat intolerance. |
| which hormone serves as the basis for pregnancy tests | HCG - human chorionic gonadotropin |
| pregnancy progresses to symphysis pubis at | 12-13 weeks |
| pregnancy progresses to umbilicus at | 19-20 weeks |
| pregnancy progresses to xiphoid process at | 36 weeks |
| contractions of the uterine muscles begine at 16 weeks and usually painless, are called? | braxton hicks are your body’s way of getting ready for actual labor. Initially they may be scary, especially as their intensity increases near the end of the pregnancy and you're not sure if it's the real deal or not. |
| hegar's sign | softening of isthmus |
| goodell's sign | softening of cervix |
| chadwick's sign | blue vaginal mucosa |
| quickening | movement of fetus felt by mother |
| ballottement | movement of fetus in uterus, felt as a tap on examiner's finger |
| lightening | descent of fetal head |
| mucus plug | closes off cervex |
| changes in breast occur due to | estrogen, progesterone, human placental lactogen, and prolactin levels |
| milk is only produced after delivery, why? | estrogen and progesterone drop and prolactin and oxytocin increase |
| striae gravidarum | stretch marks |
| chloasma | areas on face |
| linea nigra | line around stomach |
| what urinary problems are common in early and later stages of pregnancy | urinary frequency, discomfort, nocturia |
| bowel elimination is affected by hormonal changes which cause increased water absorption from the colon and displacement of the intertine by the growing uterus causes what? | constipation, flatulence, and hemorrhoids |
| term pregnancy | 40 weeks + or - 2 |
| post term | placenta starts to age |
| pre term | lungs aren't developed |
| pregnancy blood volume increases | 25-40% |
| hemoglobin before pregnancy | 11.5-16 g/dl |
| hemoglobin during pregnancy | > 11g/dl |
| hematocrit before pregnancy | 35-40% |
| hematocrit during pregnancy | 1st trimester 31-41 2nd 30-39 3rd 28-40 |
| automacicity | ability of a cardiac cell to generate an impulse spontanously and repetitively |
| excitability | ability of a non-pacemaker cell heart cell to respond to an electrical impulse that begins in pacemaker cells to depolarize |
| depolarlization | when normally negative charged cells within the heart muscle develope a positive charge |
| conductivity | ability to send a electrical stimulus from a cell membrane to cell membrane |
| contractability | ability of atrial and ventrial muscle cells to shorten their fiber length in response to electrical stimulation, causing sufficient pressure to push blood forward through the heart - mechnical activity of the heart |
| conduction begins with the ? close to surface of right atrium near its junction with the vena cava. hearts primary pacemaker. | sinoatrial node (SA Node) |
| consists of a transitional cell zone with bundle of his, T cells cause impulses to slow down or be delayed in av node, atria contract and ventricles to fill. | atrioventricular (AV Node) |
| make up bundle of his, bundle branches and terminal purkinje fibers - rapid conduction of electrical impulses through out ventricles | purkinjie cells |
| GPA | Gravida Para Abortions |
| first stage of labor | cervix dilates from 0 to 3-4 cm, |
| 2nd stage of labor | baby is delivered |
| 3rd stage of labor | placenta is delivered |
| fourth stage of labor | recovery |
| SA Node | primary pace maker - fires at 60 - 100 bpm |
| AV Node | Escape pacemaker - fires at 40 -60 bpm |
| Ventericular Node | fires at less than 40 bpm |
| EKG Large boxes | EACH 0.2 sec or 5 equal 1 second |
| EKG Small boxes | EACH 0.04 sec or 5 equal 0.2 or 1 large box |
Created by:
hajet