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NU3 21 Exam 1 With
Complete Solution
Germinal stage - ANSWER conception through week 2
embryonic stage - ANSWER 3 to 8 weeks; highest risk for teratogen involvement
fetal stage - ANSWER 9 to 42 weeks
toxoplasmosis, rubella, cytomegalovirus, herpes, HIV, syphilis - ANSWER blood tests included in a TORCHES panel
ectoderm - ANSWER epidermis, glands, nails, hair, CNS, peripheral nervous system, tooth enamel
mesoderm - ANSWER bones and teeth, muscles, dermis, connective tissue, cardiovascular system, spleen, urogenital system
endoderm - ANSWER epithelium for resp and digestive tracts, glandular cells, roof of yolk sac
amnion - ANSWER inner cell membrane of amniotic sac
chorion - ANSWER outer cell membrane of amniotic sac that contains chorionic villi on surface; covering on fetal side of placenta
oligohydramnios - ANSWER less than 300mL of amniotic fluid; can cause renal abnormalities
polyhdramnios - ANSWER greater than 2 L of amniotic fluid; can cause GI and
other organ malformations
amniocentesis - ANSWER needle puncture of amniotic sac that provides L/S ratio, karyotype, and gender
yolk sac - ANSWER aids in transferring maternal nutrients and oxygen, serves as support for fetus until placenta can produce enough
HcG, human placental lactogen, progesterone - ANSWER hormones produced by the placenta
lecithin/sphingomyelin ratio - ANSWER Test for fetal lung maturity; a ratio of 2:1 indicates maturity
48 hours - ANSWER standard length of stay for mother/baby after vaginal delivery
96 hours - ANSWER standard length of stay for mother/baby after c-section
12 weeks unpaid - ANSWER length of time given off by FMLA in 1993
21 - ANSWER how US ranks in terms of infant mortality rate
congential abnormalities, LBW, SIDS, resp distress - ANSWER leading causes of infant mortality in the US
infection, hypertension, hemorrhage, sepsis, amniotic fluid embolism, abortion complications - ANSWER major direct causes of maternal mortality
improve access to skilled birth attendants, post abortion care, improved family planning, better adolescent education - ANSWER major ways to reduce maternal mortality
Association of Women's Health, Obstetric, and Neonatal Nurses - ANSWER AWHONN, publishes standards of practice and education for perinatal nurses
chorionic villus sampling - ANSWER test that removes tissue specimen from fetal potion of the placenta to perform genetic testing; performed at 10 to 12 weeks for high-risk moms that are more than likely making the decision to terminate based on results
percutaneous umbilical sampling - ANSWER insertion of needle directly into a fetal umbilical vessel under US guidance
maternal serum alpha fetoprotein - ANSWER done at 16-18 weeks; test of maternal blood that screens for NTD, ID's who needs to follow up
quad screen - ANSWER alpha-fetoprotein, estriol, inhibin, HcG; done around 16 weeks
estriol - ANSWER one of three main estrogens, secreted in significant amounts in pregnancy; normal levels indicate normal placenta/fetal adrenal cortex function; decreased levels indicate compromised fetal-placental unit
inhibin - ANSWER protein complex produced by the placenta
Coombs test - ANSWER used to screen for Rh incompatibility
nonstress test - ANSWER Client presses a button whenever they feel fetal movement which allows nurse to assess FHR in relationship to the fetal movement
nonreactive nonstress test is not good - ANSWER rule of thumb to remember how to interpret NSTs
contraction stress test - ANSWER FHR in response to contractions which decreases placental blood flow
37 to 42 weeks - ANSWER term birth range
26 weeks - ANSWER fetal viability point, generally
Nagele's Rule - ANSWER first day of LMP, subtract 3 months, add seven days, add 1 year
Phase 1 - ANSWER phase of mother adaptation where the mother accepts her pregnancy
phase 2 - ANSWER phase of mother adaptation where the mother accepts the fetus as a separate entity from herself
phase 3 - ANSWER phase of mother adaptation where the mother realistically prepares for the birth and her role as a parent (childbirth class, working through birth anxiety)
Couvade syndrome - ANSWER somatic symptoms experienced by the father during pregnancy simulating those of the pregnant mother
announcement phase - ANSWER first phase of father's adaptation; may last hours to weeks, where the father accepts the biologic fact of pregnancy
moratorium phase - ANSWER second phase of father's adaptation; where the father adjusts to the reality of the pregnancy
focusing phase - ANSWER third phase of father's adaptation; where the father is actively involved with pregnancy and relationship with the child
indicates
Down syndrome - ANSWER what low levels of maternal alpha fetoprotein indicates
Triple Marker test (MSAFP, estriol, HcG) - ANSWER how 60% of Downs infants are identified antenatally
spontaneous abortion, infection, hematoma, fetal death, limb reduction - ANSWER risks of CVS
Rhogam - ANSWER medication given to limit the immune response of an Rh negative mother with an Rh positive fetus
dx blood dyscrasias, CBCs (infection risk), Coomb's test, blood gases, karyotyping, blood transfusions - ANSWER purposes of percutaneous umbilicus blood sampling (cordocentesis)
fetal infection, bradycardia, ROM, preterm labor - ANSWER risks associated with cordocentesis (PUBS)
education, RhoGam, assess for premature labor - ANSWER nursing
interventions associated with amniocentesis
vibroacoustic stimulation test - ANSWER use of vibration and sound stimulation in adjunction with NST
nipple stimulation, pictocin - ANSWER ways to stimulate contractions for a CST
late decelartions - ANSWER indicative of a positive CST; indicates placental insufficiency or fetal hypoxia
12 hours - ANSWER fetal alarm signal; how long can fetal movements cease before it's concerning?
hygiene, UTIs, Kegels, dental care, physical activity, posture, rest, sleeping, bras, travel - ANSWER components of self care during pregnancy that nurses need to educate about
no live vaccines - ANSWER rule of thumb when giving immunizations to a pregnant woman
teenaged or over 35 - ANSWER age extremes for OB patients
preterm births - ANSWER 20 to 36 6/7 weeks
abortions - ANSWER less than 19 to 6/7 weeks
para - ANSWER number of pregnancies carried to 20 weeks regardless of outcome
amenorrhea, NV, frequent urination, breast changes, quickening, skin changes - ANSWER presumptive signs of pregnancy
Hegars sign - ANSWER softening of the lower uterine segment found upon palpation
Goodell's sign - ANSWER a softening of the cervix
Chadwick's sign - ANSWER violet color to the vagina, cervix, and vulva
ballotment - ANSWER the fetus floats away when palpated and then returns back to examiner's finger
visualization of fetus, fetal movement, fetal heart beat - ANSWER positive
signs of pregnancy
Hegar's sign, Goodell's sign, Chadwick's sign, ballottment - ANSWER probable signs of pregnancy
lightening - ANSWER uterus/baby drops more into the pelvis
Braxton Hicks - ANSWER practice contractions
contractions, supine position, low maternal BP - ANSWER causes of decreased blood flow to the uterus
20 weeks - ANSWER when nullipara women will generally feel most movement
16 weeks - ANSWER when multipara women will generally feel most movement
Nagele's rule - ANSWER 1st day of last period + 7 days - 3 months
1500 mL - ANSWER blood volume increase in pregnancy
300 mg - ANSWER maximum daily caffeine intake for pregnant women
Stevia - ANSWER only artificial sweetener that has not yet been approved by the FDA for pregnant women
30 mg starting at 12 weeks gestation - ANSWER iron supplementation recommendation
not routinely recommended - ANSWER fat soluble vitamin supplementation
vitamin B6 - ANSWER vitamin that may help reduce maternal nausea and vomiting
vitamin c - ANSWER vitamin that may cause a deficiency in an infant if taken in excess by the mother during pregnancy
pica - ANSWER consuming nonfood substances
need for more weight gain and balanced nutrition (mother is competing with fetus for resources to grow) - ANSWER special nutritional considerations for adolescent mothers
deli meat, raw meat, fish with mercury (tuna, mackerel), raw shellfish, raw egg, soft cheese, unpasteurized milk, pate, caffeine, ETOH, unwashed veggies
- ANSWER foods to avoid during pregnancy
800 to 1200 mL - ANSWER amount of amniotic fluid present in term pregnancy
amniotic band syndrome - ANSWER group of abnormalities associated with the entrapment of fetal parts in the amnion, often resulting in fetal amputations or clefting
renal impairments - ANSWER associated with oligohydroamnios
GI malformations - ANSWER associated with polyhydroamnios
Wharton's jelly - ANSWER gelatinous substance within the umbilical cord used for protection and insulation; contains stem cells
ductus arteriosus - ANSWER a blood vessel in a fetus that bypasses pulmonary circulation by connecting the pulmonary artery directly to the ascending aorta
