Nur 221 Final Exam Review

Topics: Pregnancy, Childbirth, Obstetrics Pages: 7 (1488 words) Published: October 8, 2012
NUR 221 Final Review

• Physiological changes of pregnancy of each body system including fundal height and vs • Postpartum changes (progressive,- return of menstruation and lactation retrogressive,- involution of the uterus, 6 weeks involution,- return of the uterus to it’s pre-pregnant stage, contraction, lochia- rubra-1-3 days, mod-heavy, red w/ clots, serosa-4-10 days, mod-scant, pink, alba-11-21 days, scant, whitish/tan) • Postpartum checks ( B-breasts U-uterus/fundus B-bleeding B-blues/bowels L-lochia E-episiotomy H-headache E-emotions R, REEDA) • Types of episiotomies (advantages, disadvantages)

• Hormone levels
• Breastfeeding (hormones, care, nutrition during)
• Taking in,- first 24 hours, dependent, needy, discuss delivery cont. taking hold,- days 2-6, teachable, independent, self-care letting go- day 6+, ok separation and relinquishing care to others • Postpartum blues- 1st 10 days vs. depression

• Maternal attachment/bonding- enface (and sensitive period- first hour after birth, best time to breast feed, baby alert, bonding occurs) • G & P (TPAL) # pregnancies, # pregnancies to term, (Term, Preterm, Abortion, Living) • Contraception (types, who should get what kind, teaching) – oral pills-not over 35, no smokers, no hx of thrombo, diaphragm-refit +/- 10lbs, in 30 min bf/ 6 hrs aft, aft pregnancy • Menstruation (menopause,- cease PMS,- breast tenderness, edema, depression, avoid caffeine, dysmenorrhea,- painful • Impotence, infertility, diagnostic tests – lack of conception after one year of unprotected intercourse, basal body temp, ovulation tests, semen analysis, post-coital tests, • 4 P's of labor (attitude, lie presentation, position, engagement, station) • Mechanism of labor (DFIEEE)

• Signs of labor, true vs. false
• Stages of labor (contraction patterns, interventions, danger signs) • Early vs. late vs. variable decels (cause and action needed) • Nagele's rule- +7 days/-3 months
• Analgesia vs. anesthesia (effects on mom and baby)
• Labor induction (AROM, prostaglandins, pitocin)
• C/S (pre-op, post-op, indications) VBAC, TOLAC
• Stages of fetal development- 4th wk-heart beat, 8th wk-heart 4 chambers, 12th wk-secretes urine, nails, 16th wk-lanugo, liver/pancreas dev, 20th wk-vernix, head hair, 1st quickening, fundus @ umbilicus, 24th wk-surfactant, 32nd wk-brown fat, 38th wk-lanugo goes away, lose vernix, 40th wk-considered term • Positive,- objective, by MD/NP, x-ray, fetal heart tones, ultra sound, probable,- objective, abd enlargement, Hegar’s sign, Goodell’s sign, Braxton-Hicks contractions, ballottement, positive pregnancy test presumptive signs of pregnancy- subjective, menstrual supp, n/v, vaginal changes (Chadwick’s), quickening, breast/skin changes, fatigue • Adolescent pregnancy differences

• Nutrition & vitamins needed
• Diagnostic tests (NST, CST, ultrasound, amniocentesis , AFP, PUBS, FFN, CVS) • Anemia (iron def, sickle cell, megaloblastic)- effect on mom and baby • Gestational diabetes, heart disease, hypertension, rubella, candidiasis, HSV, STDs, glomerulonephritis, AIDS, PVD, Rh incompatibility, TORCH (effect on mom/baby) • PIH - s/s, mild/severe/eclampsia (interventions, nursing dx) • Causes of bleeding (SAB, ectopic pregnancy, incompetent cervix, placenta previa, abruptio placenta (causes, s/s, interventions) • Hydatiform mole (interventions, tx)

• Types of abortion
• DIC (s/s, interventions)
• Preterm labor (causes, tx)
• Hypertonic/hypotonic contractions, prolonged/precipitous labor, ruptured uterus (causes, risks, tx, interventions) • Causes of fetal distress - malpresentation, abnormalities, characteristics, interventions • Prolapsed cord, hydramnios, oligohydramnios - causes, interventions • Hemorrhage - causes, interventions, early vs. late, s/s

• Postpartum infection - mastitis, endometritis, episiotomy • Thrombophlebitis (3 kinds)
• Pulmonary embolism/amniotic fluid embolism (s/s, tx, interventions) • Meds - oxytocin,...
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