MATERNAL CHILD EXAM STUDY GUIDE COMPLETED 100% APPROVED.2023 VSU.Qualified.Download to sco, Exams of Nursing

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MATERNAL CHILD EXAM STUDY GUIDE COMPLETED 100%

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• Yields positive benefits and should consist of 30 min of moderate exercise (walking or swimming) daily if not medically or obstetrically contraindicated. ■ Avoid the use of hot tubs or saunas. ■ Consume at least 2 to 3 L of water each day from food and beveragesources. o consist of performing external palpations of the maternal uterus through the abdominal wall to determine the following: Number of fetuses Presenting part, fetal lie, and fetal attitude. o Heard over the fetal back - Probable, presumptive, positive signs of pregnancy -Presumptive Signs: (changes felt by the women, signs but not prof) - Probable Signs: (observed by nurse and are more reliable signs) - Positive Signs: - Fundal height measurements and palpate

▪ Fetal Heart Rate: Normal 120 – 160 bpm, fetal

movement by 20 weeks, fetal outline via ultrasound

▪ Uterine enlargement, Hegar’s Sign, Goodwell’s Sign

(softening of the cervix), Braxton Hicks Contractions (painless contractions), Positive pregnancy test, Chadwick’s sign (bluish discoloration of the vaginal wall), outlining of the fetal body ▪ Morning Sickness, Amenorrhea, Change in breast, Fatigue, Lack of Energy, Urinary Frequency and Quickening

- Expectations in the first trimester o _- Leopold maneuvers (locate where to auscultate FHT’s)

• Nutritional needs to reduce the risk of neural tube defects (folic_ _acid)
• Quickening (when to experience)_ _o Weeks 13 to 16
• First trimester and exercise_

• Amniocentesis preparation and procedure (identifying conditions)
• NST preparation and what to expect (nonreactive vs. reactive) o Evaluate fetal heart rate with fetal activity, looking for acceleration occur with fetal movements, interpretation o REACTIVE: 2 or more FHR accelerations of at least 15 bpm with a duration of at least 15 seconds in a 20-minute interval o NONREACTIVE: Reactive criteria not met within 30 minutes o “NNN” NON_REACTIVE, NON_STRESS TEST IS NOT GOOD!!
• Signs preceding labor o Backache, Weight Loss, Lightening (fetal head has dropped), Contractions, Increased Vagal Discharge, Energy Burst, GI changes, Cervical Ripening (cervix becomes soft, partially effaced), Assessment of the amniotic fluids.
• Black cohosh o Can be used to terminate a pregnancy, and can be taken to induce labor and should not be taken by women in the first or second trimesters. Causes GI discomfort, headache.
• Nutritional intake during pregnancy o The patient should have a diet journal with. 340 calories per day in second trimester, 462 calories per day increased in third trimester. o Folic Acid foods: beef, red meats, dried peas, cereals and breads. o Iron Supplements: Best absorbed between meals and with Vitamin C (MILK AND CAFFEINE INTERFERE). o Calcium: 1,000 mg/day o Fluid: 8 to 10 glasses of water per day. o Limit coffee to 200 mg of coffee per day o With the use of ultrasound, a sterile needle is inserted through the abdominal wall into the amniotic sac. Small amount of fluid is withdrawn. Fetal cell and amniotic fluid is separated (chemical, DNA and Chromosomal) o The fundal height first day after birth should be 1 cm below the umbilicus, should be midline and firm immediately after delivery (decreases about 1 com per day)

o PKU: foods that are high in protein should be avoided.

• Urinary frequency during pregnancy (what to expect) o The extra blood flow increases the urine and the weight of the fetus.
• Serum alpha fetoprotein indications (Who should get it, etc.) o Part of the triple test, during 14 th^ to 22 nd^ week of pregnancy. o FOR WOMEN WHO: have family history of birth defects, 35 or older, medications during pregnancy and diabetes. o Looking for possible genetic disorder, high levels show a neural tube defect such as spina bifida or anencephaly. o Low levels can indicate that there is a trisomy 21 or 18 defect.

GTPAL

Evaluates the Respiratory function of the placenta Records FHR, compress arteries to placenta Negative: 3 good contractions lasting 40 seconds to 10 minutes’ interval with n Positive: Persistent late decelerations with more than 50% of the contractions Contraction stress test results

• Ambivalent feelings about pregnancy o Feels sad, worries about money, lose control of feelings, wouldn’t/t want to have children again
• Nagele’s rule o From the first day of last menstrual period add one year, subtracting three months and adding seven days to that date.
• Calcium intake during pregnancy o 1,000 mg/day
• Conception, implantation o Once the embryo reaches the blastocyst stage, approximately five to six days after fertilization, it hatches out of its zona pellucida and begins the process of implantation in the uterus o Gravida, Term, Preterm, Abort and Living Child
• Causes of heartburn during pregnancy o Heartburn may occur during the second and third trimesters due to the stomach being displaced by the enlarging uterus and a slowing of gastrointestinal tract motility and digestion brought about by increased progesterone levels. The client should eat small frequent meals, not allow the stomach to get too empty or too full, sit up for 30 min after meals, and check with her provider prior to using any over-the-counter antacids.
• Weight gain norms
• Fetal development (when can you hear the heartbeat?); milestones o At 6 weeks, 110 times a minute with four hollow chambers
• Where to listen to FHT’s in first trimester o Single Pregnancy: 11.3 to 15.9 about 1 to 2 kg during first trimester and 0.4 kg after for the last two trimesters. o Underweight Women: Gain 28 to 40 lb o Overweight Women: 15 to 25 pounds

o Missed: the embryo dies in utero but is not passed o Complete: Complete expulsion of product of conception o Incomplete: if there is partial expulsion of product of conception (the fetus) with retention of some parts (placenta)

• Abortion types (missed, incomplete, complete, inevitable, etc.)PG. 40 o Listening the midline between the symphysis pubis and the umbilicus.

o Inevitable: If the cervix becomes dilated, the bleeding increases and there is pain. o Threatened: Vaginal bleeding before 24 weeks gestation when there is a viable fetus without cervical dilation and pain

• Vaginal secretions during pregnancy o Lochia Rubra: Dark Red will last 3 – 4 days after delivery, blood and fetal membranes o Lochia Serosa: Pinkish Brown will last 4 – 10 days, less red blood cells and more white cells o Lochia Alba: Whitish Yellow will last 10 – 28 days and is white fluid
• Skin changes during pregnancy (linea nigra, chloasma, striae gravidarum) o Linea Nigra: Dark Line of pigmentation from umbilicus to the pubic area o Chloasma: an increase in pigmentation on the face o Strie Gravidarum: Stretch marks
• Nutritional requirements during lactation (Zinc) o Protein increased, vitamins A, E, C
• Physiologic changes during pregnancy (lordosis) o
• Immunizations during pregnancy (influenza) o HEP A and HEP B, Influenza, Tdap, Tentanus, Meninococcal and Pneumoccocal both if indicated (no live)
• Order of changes (amenorrhea, goodell’s sign, quickening, lightening); what comes first etc. o
• PKU while pregnancy (foods to avoid) o
• Rhogam injections (Rh incompatibility complications, ex. Hydrops)
• Exercise during pregnancy
• BPP (What is being evaluated?)

• Kegel exercises
• Smoking during pregnancy (risks for newborn)
• True labor vs. False labor
• Signs of labor
• Pattern-paced breathing (hyperventilation)
• Crowning (which station?)
• Supine hypotension
• Cord prolapse (what to do)
• Decelerations and interventions
• Station
• Fetal position in relation to where to find FHT’s
• Backache in labor in relation to OP

• How to assist a client who has to push when she is not dilated completely (panting)
• Therapeutic communication
• Complications of epidural (hypotension and interventions)
• Priority interventions after amniotomy
• Tetany (notify physician)
• Amniotic fluid infection (temp, odor etc.)
• Medication administration in the active phase of labor
• Vertex (when to document this)
• Importance of emptying bladder every 2 hours during labor
• FHT requirements prior to spinal anesthesia
• Priority nursing interventions for rapid labor
• Contraction patterns during labor
• AVA
• TOLAC/VBAC likelihood and when you cannot
• Methergine uses o Used to stop bleeding, increase the strength of contractions
• Gate control theory of pain
• L/S ratio findings and indications
• When to discontinue oxytocin
• Culture beliefs and pregnancy
• Foods to avoid with heartburn