Exam 1 (Module 1)

What series of events occur in the Active Phase of labor?

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What is the mucus plug & its function?

-A thick mucus secreted from endocervical glands that acts as a barrier between vagina & fetus to protect from bacteria of the vagina. -Falls out in 9th month of pregnancy.

When would a mother be administerd RhoGam?

-At the initial prenatal visit if mother is tested as Rh positive. -At 26-28 wks regardless if positive or not as a preventative measure -If neonate is positive after birth the mother will receive RhoGam for 72 hours postpartum.

What gastrointestinal changes occur during pregnancy?

-Bloating, flatulence, constipation, lack of appetitie, heartburn, & increased risk of gallstones & cholestasis due to delayed gastric emptying. -Abdominal distention, cramping, flatulence, round ligament spasm, pelvic heavienss, & diastasis recti due to intestinal displacement from enlarged uterus. -Hemmorhoids due to increased venous pressure. -Nausea & vomiting due to increased hCG levels. -Alterations in taste & smell, pica may occur but isn't normal. -Gingivitis due to increased estrogen. -Bleeding & swollen gums due to increased vascularity. -Ptyalism (excessive salivation).

What changes occur to the vagina during pregnancy?

-Chadwick's sign (violet discoloration). -Goodell's sign (softening of vaginal muscle w/ leukorrheal discharge). -Acidic pH causes yeast infections. -Enlarges & thickens. -Surrounding ligaments in pelvis soften.

How do the breasts change during pregnancy?

-Engorgment - s&s include fullness, firm, tender, tingling sensations, warm to the touch, & prominent veins. -Areola darker. -Nipples more prominent. -Striae. -Colostrum may leak from nipples. -Montgomery follicles hypertrophy. -Increased ductal growth.

What are the positive signs of pregnancy?

-FHR detected by doppler at 12 wks. -Observation & palpation of fetal movement by examiner (20 wks). -Visualization of embryo via ultrasound (5 wks).

What are three things the nurse can do at a prenatal visit to help the patient become more attached to the fetus?

-Have her hear the fetal heartbeat. -Have the mother see the fetus move on ultrasound. -Have the mother feel the fetus kick.

Intrapartum Group B Strep (GBS) prophylaxis is indicated when?

-History of infant w/ GBS. -A positive GBS screening at anytime of current pregnancy, especially a positive GBS screening in late gestation. -ROM >18 hrs. -Temperature >100.4

What changes occur to the uterus during pregnancy?

-Hypertrophies & thickens. -Braxton-Hicks contractions (intermittent contractions that will go away with interventions, false labor). -Hegar's sign (softening of lower uterine segment). -Cessation of menstrual cycle & ovulation. -Increased vascularity.

What changes occur to cervix during pregnancy?

-Hypertrophy, shortens, more elastic. -Mucus plug secretion. -Chadwick's sign (violet discoloration). -Goodell's sign (softening). -During labor effacement, dilation, & closing.

What cardiovascular changes occur during pregnancy?

-Increase heart rate by 15-20 bpm. -Hypotension. -Supine hypotension. -Anemia due to increased RBC by 30%. -Hypervolemia due to increased blood volume by 45%. -Decreased blood flow to extremeites (edema, varicosities, etc.). -Increased venous pressure (hemorrhoids). -Increased cardiac output by 40%. -Increases stroke volume by 25-30%.

You are about to measure the fundus of a patient at a routine prenatal visit. Starting with introducing yourself to the patient, list the steps of the procedure in order.

-Introduce yourself to the patient -Explain the procedure -Obtain consent. -Ask the patient to void before beginning. -Provide patient privacy. -Lower the foot & head of bed so patient is flat. -Monitor for supine hypotension. -Remove the patient's peripads to assess lochia at same time. -Palpate the abdomen to locate the fundus. -Using a soft centimeter tape, measure from the symphysis pubis to the fundus. -Document.

What are the functions of the placenta?

-Nutrient & gas exchange. -Barrier to protect harmful substances in maternal blood from reaching fetal blood w/ some exceptions (e.g. drugs). -Production of key pregnancy hormones (e.g. estrogen, progesterone, hCG, hPL, & hCS.

What would you include in a teaching for a patient at a routine prenatal visit with new onset of varicose veins?

-Preventing edema prevents varicosities. ---wear comfortable nonrestrictive clothing. ---use a maternity girdle. ---avoid prolonged standing or sitting. ---dorsiflex feet every now & again. ---elevate legs. ---position on side lying down. -Put on compression stockings before rising each morning. -Lie w/ feet & hips elevated. -Avoid crossing legs when sitting. -Elevate feet when sitting. -Move around while standing to improve circulation.

What are the expected psychological adaptations of pregnant women?

-She desires for & accepts her pregnancy. -She identifies w/ her motherhood role. -Her mother is supportive & happy for her. -Her spouse is supportive & ready for his role in fatherhood. -She takes steps to prepare for labor. -She feels staff is treating her well. -She feels she has supportive friends. -She values herself, her assertiveness, & her decisions.

What respiratory changes occur with pregnancy?

-Slight hyperventilation. -Slight respiratory alkalosis. -Dyspnea -A shift from abdominal to thoracic breathing due to enlarging uterus pressing on diaphragm. -Nasal congestion due to increased estrogen. -Epistaxis (nosebleed). -Increased inspiratory volume. -Decreased expiratory volume. -Increased oxygen consumption by 15-20%. -Increased tidal volume by 35-50%.

A patient complains of nocturia & is worried that something is wrong with the pregnancy. What is the nurse's action?

-Teach her that nocturia is expected due to hormonal changes & enlarged uterus pushing on bladder. -Encourage her to empty bladder frequently. -Stress the importance of maintaining fluid intake, only restricting before bedtime. -Encourage her to wear peripads as needed. (Duraham p. 90).

A patient in her third trimester is complaining of achy, cramping, or sometimes sharp pain on both sides of the lower abdomen at a routine prenatal visit. What action should you take?

-Teach patient that round ligament spasm is normal during the late second & third trimesters due to increased relaxin & pressure of enlarged uterus. -Teach patient to lie on her side & flex knees up to abdomen. -Teach patient to bend towards the pain. -Teach patient to do pelvic tilt/pelvic rock exercises. -Teach patient to use warm compresses or warm baths. -Teach patient to use an exaggerated sim's position with pillows for support. -Teach patien to use a maternity belt. (Durham p. 92)

A patient in her third trimester (week 27) feels uncomfortable menstrual-like cramps. She is worried that she is going into labor. What should the nurse do for the patient?

-Teach that Braxton-Hicks contractions are uterine contractions that are uncomfortable but not painful and they do not cause cervical changes therefore are not indicative of labor. They will go away with hydration, position change, massage, or a warm shower. If they do not go away, report!

A woman has amnorrhea, breast tenderness, nausea & vomiting, & a positive urine pregnancy test. She wants a blood pregnancy test to confirm she is pregnant. What action do you take?

-Teach that all of those listed & a blood pregnancy are not positive signs of pregnancy. -To be positively determined pregnant the FHR must be auscultated w/ doppler (10 wks), the embryo must be visualized w/ ultrasound (4 wks), or an examiner must feel fetal movement.

During a routine prenatal visit, a patient complains of constipation. What action should you take?

-Teach that constipation is normal throughout pregnancy due to decreased gastric emptying or slowed peristalsis. -Teach to increase fluid intake to 3000mL per day. -Teach to engage in at least 150 mins of exercise per week (e.g. brisk walk). -Teach to increase fiber consumption through fruits, vegetables, & whole grains. -Teach to maintain regular bowel happens & to go as soon as has the urge. -Teach good posture & body mechanics. (Durham p. 91)

At a routine prenatal visit the patient complains of nasal congestion & nosebleeds. She says she heard that nosebleeds are common during pregnancy & isn't too concerned about it. What action do you take?

-Teach that epistaxis is common throughout pregnancy due to increased hormonal levels. -Teach to use a cool air humidifier to help w/ nosebleeds. -Teach to use saline sprays instead of other nasal sprays. (durham p. 90)

During a routine prenatal visit, a patient complains of embarrassing flatulence. What action should you take?

-Teach that flatulence is normal throughout pregnancy due to slowed digestive processes. -Teach regular bowel movements. -Teach to engage in 150 mins per week of exercise (e.g. brisk walk). -Teach to avoid gas producing foods (e.g. beans, asparagus, brocoli, cabbabe, milk, soft drinks). -Teach to chew food slowly & thoroughly. -Teach to use knee-chest position during periods of discomfort.

A patient is complaining of painful hemmorhoids during a routine prenatal visit. What action should you take?

-Teach that hemorrhoids are normal during pregnancy due to increased venous pressure. -Teach that constipation can cause & to avoid by increasing exercise such as a 20 minute brisk walk per day, increase fluid intake, & increase intake of fiber (vegetables, fruits, & whole grains). -Teach to avoid straining during bowel movements. -Teach to elevate hips & lower extremeties several times a day. -Teach to use ice packs, warm baths, sitz baths, or witch hazel compresses to aleviate. -Teach to reinsert a hemorrhoid into rectum during kegel exercises. (durham p. 91)

At a routine prenatal visit a patient is worried about her skin because dark sploches have developed on her cheeks & nose. What action should you take?

-Teach that melasma is a type of hyperpigmentation due to increased estrogen levels & it is very normal during pregnancy. -Teach that treatment is not needed, this will go away a few months after birth. -Teach that sun exposure exacerbates.

A patient at her routine prenatal visit complains of nausea, vomting, & excessive salivation. What action should you take?

-Teach that nausea & vomiting is normal during the first & sometimes second trimester due to increased hCG levels. -Teach that ptyalism (excessive salivation) occurs due to nausea & vomiting & is normal. -Teach to eat small frequent meals. -Teach to eat as soon as hungry. -Teach to drink after meals not during. -Teach to eat at a slow pace. -Teach to eat crackers or dry toast before rising or whenever nauseous. -Teach to drink cold, clear, carbonated beverages when nauseous. -Teach to brush teeth after eating. -Teach to eat ginger-flavored lollipops. -Teach to use an accupressure wrist band. -Teach to take vitamins at bedtime w/ a snack, not in the morning. -Teach to take B6 or ginger supplements. -Administer oral or rectal medications if needed. -Teach to use gum & hard candy for increased salivation. (Durham p. 91)

You have a patient at a routine prenatal visit in her first trimester stating she feels faint often & even passed out one time. What actions do you take?

-Teach that syncope is common during the first trimester of pregnancy. -Determine the cause (e.g. anemia will show via low h&h values, supine hypotension will show when patient lays supine, etc.). -Teach how to avoid -->change positions slowly. -->do not lay on back, lay on side -->include iron rich foods in diet & take supplements

Upon a uterine assessment on a third trimester patient at a routine prenatal visit, you notice she has diastasis recti. What action should you take?

-Teach the patient that a separation of abdominal muscles is normal during the third trimester due to the enlarging uterus pushing those muscles. -Teach patient to gentle abdominal strengthening exercises such as tiny abdominal crunches but no crunches. -Teach patient to cross arms over abdomen for splinting when coughing or sneezing. -Teach patient to roll to the side when getting up. -Teach patient to lift torso up with arms when sitting. (Durham p. 92)

A patient at a routine prenatal visit complains of heart burn. What action should you take?

-Teach the patient that heart burn is common in the third trimester. -Teach to eat small, frequent meals. -Teach to maintain good posture. -Teach to maintain fluid intake. -Teach to avoid fluids during mealtime. -Teach to avoid fatty or fried foods. -Teach to remain upright for 30 mins after eating. -Teach to eat at least 3 hrs before bedtime.

At a routine prenatal visit you notice that a patient in her third trimester is holding her lower back & is waddling, and she didn't do that at the last visit. What action should you take?

-Teach the patient that her experience is normal due to relaxation of ligaments & the pelvis dropping. -Teach the patient to maintain good posture. -Teach the patient to use proper body mechanics (e.g. stoop using knees, bend for lifting). -Teach to do pelvic rock/pelvic tilt exercises. -Teach to wear supportive shoes w/ low heels. -Teach to apply warmth or ice. -Teach to use a maternity girdle. -Teach to use massage. -Teach to use relaxation techniques. -Teach to sleep on a firm mattress w/ pillows for support. (Durham p. 92)

A patient is experiencing frequent UTIs during her pregnancy. What actions should you take?

-Teach to wipe front to back -Teach to elminate frequently -Teach to maintain adequate fluid intake. -Change peripads often if applicable. -Teach to wash hands before & after urination. -Administer antibiotic. -Teach to complete entire course of antibiotics. -Teach s&s to report if gets another one (frequency, dysuria, urgency, pus or blood in urine). -Teach to urinate before & after intercourse. (Durham p. 68).

What changes occur with the bladder during pregnancy?

-Urinary incontinence due to progesterone smooth muscle relaxation. -Frequency & nocturia due to bladder displacement. -Decreased bladder tone & capacity, & increased risk of UTI due to dilated renal pelvis & ureters. -Glucosuria & proteinuria. -Hyperemia (excess blood in bladder & ureteral vessels).

What are the functions of amniotic fluid?

-cushions fetus from sudden movements. -allows for symmetrical musculoskeletal development. -maintains body temperature. -prevents the fetus form attaching to membranes in the womb. -allows the fetus to freely move.

What series of events occur during latent phase?

-phase duration 6 hrs multip, 6-12 hr premip. -cervical dilation from 0 to 4 cm. -cervical effacement -no change in ROM -contractions mild, cramp-like -contractions q5 to q15min -contractions last 10-45 secs -station primip -2 to 0, multip 0 -bloody show minimal -patient feels happy, excited, anxious, curious, relieved, quiet, talkative, w/ thoughts centered on self & experience. -support person needed Headache possible.

At an intial prenatal visit you are trying to determine a patient's EDD. Her LMP lasted from 03/02/20 to 03/11/20. What is her EDD?

01/09/21

What are the steps in the Leopold's Maneuver & the purpose of each?

1. Fundal Grip --Facing the superior of the patient & using both hands palpate fundus. This determines what part of the fetus is in the fundus. 2. Umbilical Grip --Facing the superior of the patient & using both hands palpate the sides of the abdomen with firm pressure to determine the location of the fetal spine & back. 3. Pawlick Gruip --Facing the superior of the patient & using only one hand in a U shape , palpate just above the symphysis pubis to determine the presentation of the fetus. *Think shape of cat tongue 4. Pelvic Grip --Facing the posterior of the patient & using two hands & firm pressure palpate the sides of the abdomen towards the symphysis pubis to locate the fetal brow & determine the cephalic prominence.

How much amniotic fluid does momma have at full term?

1000mL or 1L.

What is the normal baseline range for FHR?

110 - 160 bpm

You have a patient that was in a car accident. She is pregnant & unconcious. You have palpated her fundus to determine gestational age. The fundus is just above the symphysis pubis. What is the gestational age?

12-14 weeks

The umbilical cord has three vessels, which are? Why does the nurse need to know this?

2 arteries & 1 vein. The nurse must assess the umbilical cord upon delivery to confirm this. If this is not the case, may indicate several conditions.

You have a patient that was in a car accident. She is pregnant & unconcious. You have palpated her fundus to determine gestational age. The fundus is at the naval area. What is the gestational age?

20-22 weeks

When is fetal viability?

24-28 weeks.

You have a patient that was in a car accident. She is pregnant & unconcious. You have palpated her fundus to determine gestational age. The fundus is just below the breast plate. What is the gestational age?

36-38 weeks

How many weeks of gestation are there in a typical pregnancy?

40 weeks

Define vernix caseosa?

A thick, cheesy, white, & protective substance that covers the fetus for the purpose of protecting its skin from getting pruney due to sitting in amniotic fluid.

Define colostrum?

A yellow secretion from nipples rich in antibodies (not breast milk).

Kegel exercises are recommended for which of the following? A) Prevention of uterine prolapse. B) Prevention of hemorrhoids. C) Urinary incontinence. D) Urinary frequency.

All of the above. Rationale: -Uterine prolapse is when the pelvic floor muscles & ligaments stretch & weaken causing the uterus to slip down into the vagina. Kegel exercises help to prevent. -Hemorrhoids can be prevented w/ kegel exercises which increase blood supply to that area. -Kegel exercises strengthen the pelvic floor which helps the elasticity issue or urinary incontinence. -Kegel exercises strenthen bladder muscles which help control bladder elmination. (Durham p. 568)

At a patient's routine prenatal visit in her thrid trimester she explains to the nurse that she has ambivalent feelings about her pregnancy. She feels ashamed. What action do you take?

Ambivalence is normal during the first trimester. If these feelings persist past the first trimester, assess for unresolved conflict, reason, & intensity.

Define Antepartum, Intrapartum, & Postpartum?

Antepartum - before birth (while pregnant) Intrapartum - during birth (labor) Postpartum - period following birth

A patient complains of colostrum leaking from nipples. What can the nurse do for her?

Apply soft pads to nipples.

Full term neonates have decreased vernix caseosa, found where?

Armpits & genitals

You overhear another nurse instruct a patient to restrict fluids to <2000 mL per day due to her experiencing frequency. What action should you take? A) Tell a coworker about the mistake the nurse made. B) Tell the patient the correct information. C) Do nothing, the information was correct.

B) The patient should never restrict fluids due to frequency, urgency, or nocturia. Appropriate interventions include emptying bladder frequently, wearing peripads, etc. (Durham p. 90)

Full term neonates have decreased lanugo, found where?

Back, shoulders, arms, & forehead.

You are assessing a patient's uterus & therefore fetus during a routine prenatal visit via the Leopold's Maneuver. She is in her 38th week of pregnancy. What fetal position, lie, & presentation is best? Which is the worst?

Best: LOA, Longitudinal, Cephalic Worst:

When can the nurse expect to detect FHR w/ a doppler?

By week 12 of fetal development

The fetal heart beat is detected by a regular fetoscope at what gestational age?

By week 20 of fetal development

*When is vernix caseosa expected to disappear?

By week 40 of gestation the vernix is mostly gone. There is some in baby's armpits & genitals.

The results of a vaginal & rectal screening for Group B Strep (GBS) is positive in her third trimester. So what?

Can cause neonate sickness, morbidity, or even death.

What defects are associated to polyhydraminos?

Chromosomal, gastrointestinal, cardiovascular, & renal tube disorders.

What defects are associated to oligohydraminos?

Decreased placental function & congenital renal issues.

Define polyhydraminos?

Excessive amniotic fluid (1500-2000mL). *poly = multiple, too much

Which of the following are positive signs of pregnancy? A)Blood pregnancy test B)Fetal movement felt by mother C)Braxton-Hicks contractions D)Ballotement E)Chadwick's sign F)None of the above G)All of the above

F) None of the above

What are the stages & phases of labor & delivery?

First Stage (Labor) --Latent --Active --Transition Second Stage (Delivery of Baby) --Expulsive Third Stage (Delivery of Placenta) --Placental Fourth Stage (Recovery) --Immediate Postpartum

At an initial prenatal visit for a pregnant mother you must educate her about nutrition in the first trimester. What & how much of daily foods should she be consuming.

First trimester nutrition Fruits 2 cups daily --->pick canteloup, honey dew melon, bananas, oranges, mangoes, apricots, grapefruit, & prunes. Dairy 3 cups daily --->pick low fat, fat free, vitamin A, D, & calcium fortified. Vegetables 2.5 cups daily -->pick green leafy veggies, winter squash, beans, peas, lentils, carrots, sweet potatoes, pumpkin, tomatoes, tomato sauces, & red sweet peppers. Protein 5.5 oz daily -->pick lean meats, salmon, trout, herring, polloci, sardines, oysters, mussels, crab, beans, peas, nuts, & seeds. Whole Grains 6oz daily -->pick fortified cereals with whole grains, iron, & folic acid.

How is EDD determined via Naegele's Rule?

Formula: (first day of LMP) - (3 months) + (7 days) + (1 year) = EDD

A patient is in her 32nd gestational week at a prenatal visit. You need to educate her that her future frequency of visits is about to change. To what?

From 36 weeks to birth, the prenatal visits are twice weekly.

At an initial prenatal visit you are tyring to determine GTPAL. She has currently 2 boys aged 6 & 9 plus she is pregnant with twin boys. She has had 1 stillbirth.

G - 4 (gravida) T - 2 (term) P - 1 (preterm) A - 0 (abortions) L - 2 (living)

What integumentary changes occur during pregnancy?

Hyperpigmentation: -Linear nigra (dark line down abdomen). -Melasma (mask of pregnancy, dark areas) -Red/purple striae. -Increased pigmentation of nipples, areola, moles, & scars. Edema Facial flushing Hot flashes, perspiration, altered sense of hot & cold.

How often are prenatal visits?

In the first & second trimester every 4 weeks. In third trimester every 2 weeks until week 36 then twice weekly until birth.

At a routine prenatal visit for a patient you obtain her lab results. Her hemoglobin & hematocrit is 9 & 29%. What action do you take?

Iron deficiency anemia is defined as hemoglobin <11 & hematocrit <33% in pregnant women. -Teach that anemia is common in pregnancy due to increased fetal need for iron. -Teach to eat foods high in iron (e.g. lean meats, beans, lentils, baked potatoes, dark green leafy vegetables, fortified breakfast cereals, & whole grains). -Teach to take iron supplements.

You are about to measure a patient's fundus at a routine prenatal visit. Knowing that she is in her 19th week of gestation, where do you expect the fundus to be located?

Just below the navel

Define multip & primip?

Multip Primip - someone pregnant for the first time.

How do you determine gestational age?

Neagele's Rule: (first date of LMP) - (3 mths) + (7 days) + (1 year)

What is gestational age?

Number of weeks pregnant calculated from first day of LMP (not date from actual conception). (durham 76)

You have a patient that was in a car accident. She is pregnant & unconcious. How do you determine the gestational age?

Palpate for location of fundus.

What are the periods of fetal development?

Preembryonic period - first 2 weeks of conception Embryonic period - day 15 to week 8 Fetal period - week 9 to birth

What is PROM?

Premature rupture of membrane (amniotic).

If a neonate has an abundant amount of vernix caseosa or lanugo, what does this indicate?

Preterm

Why is the placenta assessed upon delivery of it?

Retained Placental Tissue is a complication that causes uterine atony & more where placental tissue is still in the uterus. The placenta must be assessed for any missing tissue.

What is ROM?

Rupture of membrane - typically occurs during Active Phase of labor (e.g. water breaks, amniotic sac breaks).

What is the daily nutrition requirement for a woman in her second or third trimester?

Second & third trimester nutrition Fruits 2 cups daily -->choose canteloupe, honey dew, oranges, mangoes, bananas, apricots, grapefruit, & prunes. Dairy 3 cups daily -->choose vitamin a, d, & calcium fortified Vegetables 3 cups daily --choose leafy green vegetables, peas, lentils, carrots, pumpkin, sweet potatoes, winter squash, tomatoe, tomato sauce, & red sweet peppers. Protein 6.5 oz daily -->choose lean meats, salmon, trout, herring, pollock, sardines, mussels, oysters, & crab. Whole Grains 8 oz daily -->choose cereals & such fortified with iron & folic acid.

How do you assess fetal lie, position, & presentation?

Several ways include Leopold's Maneuver, ultrasound, & SVE.

A patient is in her 24th gestational week at a routine prenatal visit. You need to educate the patient that the frequency of her visits is about to change. Why & to what?

She is entering her third trimester, which means her visits must be every 3 weeks now instead of every 4 weeks until she reaches 36 weeks of gestation then her visits will be twice weekly.

Define Hegar's sign?

Softening of lower uteirne segment to prepare for passage of baby through birth canal.

Define Goodell's sign?

Softening of vaginal muscle & cervix to prepare for passage of baby through birth canal with a leukorrheal discharge that is white, thick, & acidic.

You have a patient that was in a car accident. She is pregnant & unconcious. You have palpated her fundus to determine gestational age. The fundus is between the naval & the breast plate. With this informaiton, do you believe the fetus reached the age of viability?

The age of viability is 24-28 weeks. When the fundus is midway between the naval & breast plate the gestational age is 28-30 weeks. So yes with this information I would believe so, but an ultrasound can confirm for sure I believe.

Define parity?

The number of total births whether living or still births after 20 weeks gestation. *Think par as in partial or half way

Define gravida?

The number of total pregnancies regardless of outcome. *Think Gr as in Grand total

A pregnant woman who has no history & no family history of hyperglycemia has excess glucose in her urine. Why?

The renals like to increase secretion of glucose during pregnancy which is normal (p. 60 durham).

A pregnant woman has proteinuria with no other symptoms of preeclampsia. Why?

The renals like to increase secretion of protein during pregnancy which is normal (p. 60 durham).

During what trimester is the diagnostic results for Group B Strep (GBS) obtained during a routine prenatal visit?

Third trimester

Define oligohydraminos?

Too little amniotic fluid (<500mL).

What phase of labor should the ROM be initiated if did not occur already?

Transition phase.

Define Chadwick's sign?

Violet discoloration of vaginal mucosa & cervix due to increased vascularity.

You are assessing a patient at a routine prenatal visit. She is in her first trimester. What are her vitals expected to be?

WNL

You are assessing a patient at a routine prenatal visit. She is in her second trimester. What are her vitals expected to be?

WNL except slight decrease in BP

When do spontaneous movments begin in fetal development?

Week 12 of fetal development

When does colostrum begin to develop?

Week 12 of fetal development.

Lanuago hair develops at what gestational age?

Week 16

Hair develops on the fetal head at what gestational age?

Week 24

The ability for the fetus to hear develops at what gestational age?

Week 24

Vernix caseosa covers the entire body at what gestational age?

Week 24

*At what gestational age is the fetus expected to use the lungs to breathe if born prematurely?

Week 28

What week does the heart first begin to form?

Week 3 of fetal development

What week of fetal development does the brain & spinal cord first begin to form?

Week 3 of fetal development

*What fetal week does lanugo disappear?

Week 36

What week of fetal development does the heart start beating?

Week 4 of fetal development

What week of fetal development do limbs begin to form?

Week 5 of fetal development

What weeks are in the first trimester?

Weeks 1-12

How do you obtain a FHR?

You can obtain a FHR either by a fetoscope, an ultrasound transducer (goes on abdomen, noninvasive, aka doppler), or via spiral electrode (wire inserted into birth canal to reach fetal scalp, invasive).