Maternal Newborn Ati

Front 1

calendar method of contraception

Back 1

• The start of the fertile period is figured by subtracting 18 days from the shortest cycle
• the of the fertile period is established by subtracting 11 days from the longest cycle
• short cycle, 26-18 = 8th day
• long cycle, 30-11 = 19th day
• fertile period is 8 through 19

Front 2

basal body temperature method of contraception

Back 2

• Temperature can drop slightly at the time of ovulation
• Measure oral temperature prior to getting out of bed each morning

Front 3

Symptom-based method of contraception

(cervical mucus)

Back 3

• Following ovulation cervical mucus becomes thing and flexible under the influence of estrogen and progesterone to allow sperm viability and motility.
• Spinnbarkeit sign= the ability for the mucus to stretch between the fingers
• Begin examining mucus from the last day of the menstrual cycle, obtained from introitus

Front 4

A nurse in a health clinic is reviewing contraceptive use with a group of adolescent clients. Which of the following statements made by the client needs clarification?

1. "A water soluble lubricant should be used with condoms"
2. "Spermicide is used once when using a diaphragm"
3. " Oral contraceptives can improve acne"
4. "A contraceptive patch is worn for a week"

Back 4

2. " Spermicide is used once when using a diaphragm"

(With each act of coitus, the client should apply a spermicide)

Front 5

A nurse is reviewing instructions with a client who has been prescribed oral contraceptives about danger signs. The nurse evaluates that the client understands the teaching regarding side effects when she states the need to report which of the following?

1. Reduced menstrual flow or amenorrhea
2. Weight gain or breast tenderness
3. Chest pain or SOB
4. Mild hypertension or HA

Back 5

3. Chest pain or SOB

(Can indicate a pulmonary embolus or myocardial infarction)

Front 6

Which of the following statements made by a client requesting info regarding an IUD indicates a need for additional teaching?

1. "An IUD may increase my risk for an ectopic pregnancy"
2. " I will wait until I have a child before I can have an IUD"
3. " I might have irregular bleeding after I get an IUD"
4. "A change in the string length of my IUD is expected"

Back 6

4. " A change in the string length of my IUD is expected"

(should be reported to provider, can indicate expulsion)

Front 7

A nurse in a clinic is reinforcing teaching with a client about her new prescription for medroxyprogesterone (Depo-Provera). Which of the following should be included in the teaching?

1. " Weight loss can occur"
2. " You are protected against STI's"
3. " You should be taking calcium also"
4. "You should avoid taking antibiotics when using this contraceptive"

Back 7

3. "You should be taking calcium also"

(Clients should take calcium and vitamin D to prevent loss of bone density, which can occur when taking Depo-Provera)

Front 8

Which of the following should the nurse include when reinforcing teaching with a client about the potential disadvantages of the minipill? (Select all that apply)

1. Amenorrhea
2. Irregular vaginal bleeding
3. Increased appetite
4. Decreased libido
5. Ovarian cysts

Back 8

2. Irregular vaginal bleeding

3. Increased appetite

4. Decreased libido

5. Ovarian cysts

Front 9

Presumptive signs of pregnancy

Back 9

• Amenorrhea
• Fatigue
• N&V
• Urinary frequency
• Breast changes- darkened areolae, enlarged Montgomerys glands
• Quickening

Front 10

Probable signs of pregnancy

Back 10

• Abdominal enlargement
• Hegar's Sign- softening and compressibility of lower uterus
• Chadwicks Sign- deepened violet-bluish color of cervix and vaginal mucosa(chad is violent)
• Goodells Sign-softening of the cervical tip (good and soft)
• Ballotement- rebound of engaged fetus
• Braxton Hicks contractions
• Positive pregnancy test
• Fetal outline felt by examiner

Front 11

Positive signs of pregnancy

Back 11

• Fetal heart sounds
• Visualization of fetus by ultrasound
• Fetal movement felt by experienced examiner

Front 12

Naegeles Rule

Back 12

Take the first day of the woman's last menstrual cycle, subtract 3 months, and then add 7 days and adjusting the year if necessary

Front 13

Nulligravida

Back 13

A woman who has never been pregnant

Front 14

Primigravida

Back 14

A woman in her first pregnancy

Front 15

Multigravida

Back 15

A woman who has had 2 or more pregnancies

Front 16

Nullipara

Back 16

No pregnancy beyond the stage of viability

Front 17

Primipara

Back 17

has completed one pregnancy to stage of viability

Front 18

Multipara

Back 18

has completed two or more pregnancies to stage of viability

Front 19

GTPAL

Back 19

• Gravidity
• Term births (38 weeks or more)
• Preterm births (from viability up to 37 weeks)
• Abortions/ miscarriages (prior to viability)
• Living children

Front 20

G3 T1 P0 A1 L1. How should the nurse interpret the information? (select all that apply)

1. A client has delivered one newborn at term
2. Client has experienced no preterm labor
3. Client has been through active labor
4. Client has had two prior prgnancies
5. Client has one living child

Back 20

1. T1 indicates the client has delivered one newborn at term

4. G3 indicates the client has had two prior pregnancies and is currently pregnant

5. L1 indicates the client has one living child

Front 21

A nurse is reviewing the health record of a client who is pregnant. The provider indicated the client exhibits probable signs of pregnancy. Which of the following would be included? (select all that apply)

1. Montgomery's glands
2. Goodell's sign
3. Ballottement
4. Chadwick's sign
5. Quickening

Back 21

2. Goodell's sign

3. Ballottement

4. Chadwick's sign

Front 22

A nurse in a prenatal clinic is caring for a client who is pregnant and experiencing episodes of maternal hypotension. The client asks the nurse what causes these episodes. Which of the following is an appropriate response by the nurse?

1. "This is due to an increase in blood volume"
2. "This is due to pressure from the uterus on the diaphragm"
3. "This is due to the weight of the uterus on the vena cava"
4. "This is due to increased cardiac output"

Back 22

3. Maternal hypotension occurs when the client is lying in the supine position, and the weight of the gravid uterus places pressure on the vena cava, decreasing venous blood flow to the heart

Front 23

Danger Signs of Pregnancy

Back 23

• Gush of fluid prior to 37 weeks
• Vaginal bleeding
• Abdominal pain
• Changes in fetal activity
• Persistent vomiting
• Severe HA
• Elevated temperature
• Dysuria
• Blurred vision
• Edema of face and hands
• Epigastric pain

Front 24

A nurse is reinforcing teaching with a group of women who are pregnant about measure to relieve backache during pregnancy. The nurse should instruct the women on which of the following?(select all that apply)

1. Avoid any lifting
2. Perform Kegel exercises twice a day
3. Perform the pelvic rock exercise every day
4. Use proper body mechanics
5. Avoid constrictive clothing

Back 24

3. The pelvic rock or tilt exercise stretches the muscles of the lower back and helps relieve lower-back pain.

4. The use of proper body mechanics prevents back injury due to the incorrect use of muscles when lifting.

Front 25

A client who is at 8 weeks of gestation tells the nurse that she isnt sure she is happy about being pregnant. Which of the following is an appropriate response by the nurse to the clients statement?

1. "I will inform the provider that you are having these feelings."
2. "It is normal to have these feelings during the first few months of pregnancy"
3. "You should be happy that you are going to bring new life into the world"
4. "I am going to make an appointment with the counselor for you to discuss these thoughts"

Back 25

2. Feelings of ambivalence about pregnancy are normal during the first trimester

Front 26

A nurse is caring for a client who is pregnant and reviewing signs of complications the client should promptly report to the provider. Which of the following complications should the nurse include?

1. Vaginal bleeding
2. Swelling of the ankles
3. Heartburn after eating
4. Lightheadedness when lying on the back

Back 26

1. Vaginal bleeding indicates a potential complication of the placenta, such as placenta previa, and should be reported immediately

Front 27

A client who is at 7 weeks of gestation is experiencing nausea and vomiting in the morning. The nurse in the prenatal clinic reinforces teaching that should include which of the following instructions?

1. Eat crackers or plain toast before getting out of bed
2. Awaken during the night to eat a snack
3. Skip breakfast, and eat lunch after nausea has subsided
4. Eat a large evening meal

Back 27

1.Nausea and vomiting during the first trimester can be relieved by eating crackers or plain toast 30-60 min. prior to rising in the morning

Front 28

A nurse is reinforcing teaching with a group of clients who are pregnant about behaviors to avoid during pregnancy. Which of the following statements by a client indicates a need for further instruction?

1. " I can have a glass of wine with dinner"
2. " Smoking is a cause of low birth weight in babies"
3. "Signs of infection should be reported to my doctor"
4. "I should not take over-the-counter meds without checking with my obstetrician

Back 28

1. Alcohol should not be consumed during pregnancy due to the risk of birth defects

Front 29

When can the fetal heart be heard by Doppler?

Back 29

10 to 12 weeks of gestation

Front 30

When can the fetal heart be heard by ultrasound?

Back 30

16 to 20 weeks of gestation

Front 31

one-hour glucose tolerance test

Back 31

• fasting not necessary
• oral ingestion or iv administration of concentrated glucose
• venous sample taken 1 hour later

Front 32

three-hour glucose tolerance test

Back 32

• fasting overnight
• oral ingestion or iv administration of concentrated glucose
• venous sample taken 1, 2 and 3 hours later

Front 33

TORCH

Back 33

• group of infections capable of crossing the placenta and affecting fetal development
• Toxoplasmosis
• Other infections
• Rubella
• Cytomegalovirus
• Herpes virus

Front 34

Caloric intake during 2nd & 3rd trimesters

Back 34

• 340 calories/day
• 452 calories/day

Front 35

Caloric intake during breastfeeding

Back 35

330 calories/day

Front 36

Biophysical Profile definition?

Back 36

Uses a real time ultrasound to visualize physical and physiological characteristics of the fetus and observe for fetal biophysical responses to stimuli

Front 37

5 variables measured in Biophysical Profile

Back 37

1. Reactive FHR
2. Fetal breathing movements(1 episode>30sec. in 30 min.)
3. Gross body movements(3 body/limb extensions with return to flexion in 30min.)
4. Fetal tone(1 episode of extension with return to flexion)
5. Qualitative amniotic fluid volume(1 pocket of fluid that measure 2cm in 2 perpendicular planes)