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Study Guide for Exam 1 OB Nursing Exam
questions with correct answers
What is the sequential process for conception? What are the main 4 steps? Correct Answer-1. Gamete (egg,sperm) formation
- Ovulation (The release of the egg from the ovary)
- Fertilization (Union between the sperm and egg in the FALLOPIAN TUBE)
- Implantation (occurs in the endometrium of the uterus) What is the function of corpus luteum? Correct Answer-The corpus luteum will continue to produce progesterone until the fetus is producing adequate levels to sustain the pregnancy, which usually occurs between 7 and 9 weeks of pregnancy. Progesterone is essential during early pregnancy because:
- it allows the uterus to grow without having contractions
- it supports the growth of the lining of the uterus
- it improves blood flow and oxygen supply When does implantation occur? Correct Answer-6-10 days post or after conception (starts from whole beginning of the sequential process of conception)
What are the developmental stages of fetal development? Correct Answer-1. Pre- embryonic
- Embryo
- Fetus How long does the Pre-embryonic stage last? Correct Answer-conception until day
After the pre-embryonic stage, what is the next stage in fetal development? What day does this start and it lasts until? What is another determinant for determining whether the stage is done or not? Why is this a critical developmental stage? What do you expect to be present in terms of development in the baby at this point? Correct Answer-1. Embryo
- Day 15 until 8 weeks after conception (or until a crown-rump length (CRL) is 3 cm)
- This is a critical stage because cell division occurs here the most and malformation can occur here due to teratogens (drugs, tobacco, etc.).
-Umbilical cord What is the amnion? Correct Answer--embryo draws the amnion around itself, forming a fluid-filled sac What is the function of the amniotic fluid? Correct Answer--maintains stable temp, cushioning, freedom of movement, analysis of chemical and genetic studies provide health info What are the special structures in the fetal circulation? Correct Answer-special structures are ductus arteriosus, ductus venosus and foramen ovale What is the function of ductus arteriosus in fetal circulation? Correct Answer-The ductus arteriosus sends the oxygen poor blood to the organs in the lower half of the fetal body. This also allows for the oxygen poor blood to leave the fetus through the umbilical arteries and get back to the placenta to pick up oxygen. What is the function of ductus venosus in fetal circulation? Correct Answer-The ductus venosus is a shunt that allows oxygenated blood in the umbilical vein to bypass the liver and is essential for normal fetal circulation. [1] Blood becomes oxygenated in the placenta and travels to the right atrium via umbilical veins through the ductus venosus, then to the inferior vena cava. What is the function of foramen ovale in fetal circulation? Correct Answer-The hole between the top two heart chambers (right and left atrium) is called a patent foramen ovale (PFO). This hole allows the oxygen rich blood to go from the right atrium to left atrium and then to the left ventricle and out the aorta. As a result the blood with the most oxygen gets to the brain.
What is multigravida? Correct Answer-woman with history of 2 or more pregnancies What is multipara? Correct Answer-woman who has completed 2 or more pregnancies to viability (multip) What does GTPAL stand for? Correct Answer-1. Gravidity (number of pregnancies including present one)
- Term births (longer than 37 weeks)
- Preterm births (before 37 weeks)
- Abortions or miscarriages
- Living children What does a pregnancy test detect? Correct Answer-beta subunit of HCG (human chorionic gonadotropin) What does presumptive mean? What are common 4 presumptive signs of pregnancy? Correct Answer--it means S/S that are usually noted by the clients -Amenorrhea (an abnormal absence of menstruation.)- often the first sign
How long does it take to feel the fundus at the level of the umbilicus? The fundus will be at what part at term? When does the fundus begin to drop? When do you start measuring with the tape measurer? Correct Answer-1. 12- weeks
- 16 weeks
- 20-22 weeks
- xiphoid process
- 38-40 weeks ("lightening")
- 20-22 weeks What are common physiological changes in women when they are pregnant in terms of their SKIN? Correct Answer--Chloasma (dark skin patches around the face) -Linea nigra (from pubis to the top of the fundus in the midline) -Striae gravidarum - aka "stretch marks", caused by collagen separation in skin - color depends on woman's skin color
-Palmar erythema -Gingival hypertrophy What is the most common physiological changes in women when they are pregnant in terms of their MUSCULOSKELETAL system? Correct Answer--it causes an increase in relaxation of the pelvic joints, resulting in a waddling gait. -Separation of rectus abdominis -Pelvic tilt What are common physiological changes in women when they are pregnant in terms of their Pancreatic System? Correct Answer-Maternal glucose levels will decrease due to the fetal demand, resulting in maternal insulin production to decrease. As pregnancy continues, the pregnancy hormones will decrease insulin sensitivity, causing an increase in blood glucose. This can potentially lead to gestational diabetes (GDM). What are Rubin's Psychological Tasks of the Mother? Correct Answer--Ensuring safe passage through pregnancy labor and birth for both mom and fetus -Seeking acceptance of the child by others -Seeking commitment and acceptance of self as mother ("Binding-in") -Learning to give of oneself on behalf of one's child
- Maintaining consistent behaviors with young children can be reassuring
- Teach them about pregnancy consistently depending on their level of interest, but also give them opportunities to express questions or concerns. What are the nurse's role in family adaptation? Correct Answer-1. Offer opportunities for expectant parents to express their concerns and issues in a safe, non-judgmental environment
- Provide anticipatory guidance on developmental tasks and role development (What are they going to expect?)
- Reassure expectant parents that much of what they are feeling is a normal developmental process, shared by all new parents
- Refer to counseling resources as needed What is last menstrual period? How do you calculate that expected delivery date based on Naegeles' rule? Correct Answer--refers to the first day (onset of bleeding) of your last menstrual period before falling pregnant. -take month and day of LMP, then subtract 3 months and add 7 days. In the first trimester ultra sound, how do you accurately measure the gestational age?
How do you measure CRL? Correct Answer-1. measurement of crown - rump length (CRL)
- the length of the embryo or fetus from the top of its head to bottom of torso. What is the definition of intimate partner violence? What are the negative effects of this in pregnancy? What are the risks of the fetus? Correct Answer-1. the actual or threatened physical, sexual, psychological or emotional abuse by a spouse, boyfriend, girlfriend, date or cohabiting partner (or ex-spouse, etc.)
- Negative effects in pregnancy: depression, suicide, low maternal weight gain, infections, substance abuse
- Risk of fetal injury: low birth weight, preterm birth, fetal demise, placental separation. What are the main 3 things that the California Prenatal Screening Program screen for? Correct Answer-1. trisomy 21 (down syndrome)
- trisomy 18
- Open neural tube defect (ONTD) such as spina bifida and anencephaly What is the normal recommended weight gain for normal BMI in pregnancy? Correct Answer-25-35 pounds
- Severe N/V may need IV hydration and Rx nausea meds What are the 4 factors of labor and birth? Correct Answer-1. Passenger (newborn baby)
- Passageway (where the baby will come out)
- Maternal Position
- Powers What are the five fetal factors? Correct Answer-1. Fetal Head Size
- Fetal Presentation
- Fetal Lie
- Fetal Attitude
- Fetal Station During head first birth, what kind of head shape can occur due to the pressure on head caused by the tight birth canal? Correct Answer-- Oblong (this is due to the slight overlapping of the bones during labor) During labor, there are three different parts of the baby that can enter the pelvic inlet first and leads thru the birth canal. What are the three fetal presentations and what are they and what are the percentages? Correct Answer--Cephalic (96%) -Breech (3%) (feet first) -Shoulder (1%)
What is fetal lie? What kind of fetal lie do you want? What kind of fetal lie you do not want? Correct Answer-1. The relationship of the long axis (spine) of the fetus to the long axis (spine) of the mother
- Longitudinal or vertical
- You do not want transverse of oblique (vaginal birth cannot occur if transverse lie persist) What is fetal attitude? What is a normal fetal attitude? Correct Answer-1. The relationship of the fetal parts to one another. The fetal attitude can be flexion or extension.
- Normal attitude- Back rounded, chin flexed on chest, thighs flexed on abdomen, legs flexed at knees, arms crossed over thorax, umbilical cord lies between arms and legs What is fetal station? What is minus station? What is zero station?
How are "All Fours" position beneficial for giving birth? What is the predominant position in the U.S. for giving birth? What are the benefits? Correct Answer-1. Upright position (walking, sitting, kneeling, squatting) has advantage of assistance of gravity to promote descent, more efficient contractions and improved maternal cardiac output
- "All fours" position (on hands and knees) may relieve backache if fetus is OP (occiput posterior) and may assist in anterior rotation (and in cases of shoulder dystocia)
- Lithotomy position is predominant position in the U.S. for physician-attended births (for doctor's convenience) How many stages are there in Labor? Correct Answer-4 stages What happens in the first stage of labor? This is longer what stages combined? This stage could be longer in? Correct Answer-1. onset of uterine contractions until full effacement and dilation of cervix
- Usually longer than 2nd and 3rd stages combined (can be hard to determine actual time of onset)
- longer in primips (A female during her first pregnancy)
The second stage of labor happens from __________ until ________. What is the average time on this stage? This could as long as ________ hours with epidural anesthesia. What happens in the latent phase? What happens in the active phase? Correct Answer-1. from full cervical dilation of the cervix until birth of fetus
- Average of 20-50 minutes, but may be as long as 3 hrs (with epidural anesthesia)
- Latent phase - complete dilation, but weak contractions and no urge to push (passive fetal descent and rotation)
- Active phase - contractions resume, and woman makes strong bearing-down efforts (pushing) - fetal station advances The third stage of labor happens from __________ until ________. How many contractions does it usually take for the baby to separate from the placenta? How long does this take? What are the risks of longer time? Correct Answer-1. from birth of fetus until delivery of placenta
- Ethnic or cultural differences What are the physiologic expression of pain during intrapartum? How does the pain affect labor? What are the behavioral expression of pain during intrapartum? Correct Answer-1. Physiologic - increased HR, BP, pallor/diaphoresis, N/V; may decrease placental perfusion and uterine activity (prolonging labor).
- Behavioral - increased anxiety, crying, groaning, shivering, hand clenching, and excessive muscular excitability. What are the non-pharmacological measures for pain in labor? Correct Answer- Positioning, massage, paced respirations, hydrotherapy What are side effects of epidural and spinal anesthesia? Correct Answer- Hypotension, fever, urinary retention, limited movement, prolonged labor 2nd stage What are main 5 Emergency Interventions for hypotension/decreased placental perfusion? Correct Answer-1. Position to side-lying
- Increase primary IV rate
- Oxygen by mask, 10L/min
- Elevate legs
- Monitor her constantly
In terms of electronic fetal monitoring (EFM), what is the normal, reassuring pattern? Correct Answer--normal baseline FHR (110-160 bpm), accels with fetal movement, decels with contractions, with return to normal baseline at end of contraction What is the baseline FHR? Correct Answer-It is the average rate during a 10 minute segment In terms of variability, a variation in FHR of 6-25 beats per min is known as which of the following? ~ Absent/Minimal ~ Moderate ~ Marked variability Correct Answer-moderate variability of 6-25 bpm from average baseline is reassuring What is considered Tachycardia in baseline FHR? This is an early sign of what? Correct Answer--baseline FHR > 160, for 10 min or more -sign of early hypoxia What is considered Bradycardia in baseline FHR? What is usually associated with this or causes this? This is a later sign of? Correct Answer-1. baseline FHR < 110 for 10 min or more
