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N164 Exam 2 Questions With 100% Verified
Answers
Smoking Education - answer✔Smoking should be avoided by pregnant woman cause can lead to
preterm labor and LBW infants, higher risk of SIDS; mother can use nicotine patches to curb
withdrawal effects of nicotine
Alcohol + other teratogens Education - answer✔Alcohol should be avoided, can cause fetal
alcohol syndrome and lifelong developmental issues
Illicit drugs should be avoided because they can be teratogenic and can cause neonatal abstinence
syndrome after birth
Caffeine should be avoided because can cause spontaneous abortion and/or preterm labor
CBC Values during Pregnancy - answer✔Hgb:
-baseline 12-16
-1st trimester: 11.5-14
-2nd trimester: 10-15
-3rd trimester: 9.5-15
Hct:
-baseline: 35-44
-1st trimester: 31-41
-2nd trimester: 30-39
-3rd trimester: 28-40
WBC
-baseline: 4-10
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-1st-3rd trimester: 6-16
Plt:
-baseline: 150-400
-1st trimester: 170-390
-2nd trimester: 150-400
-3rd trimester: 145-400
When might CBCs be ordered? - answer✔For women w/ hx of infection, anemia, gestational
HTN, or other disorders
Breast enlargement and tenderness - answer✔Increased progesterone and estrogen levels lead to
fullness and tingling sensations
Premenstrual changes, chronic cystic mastitis, hyperestrogenism (related to oral contraceptives)
Breast Changes - answer✔-Increase in size and sensitivity
-Skin pigmentation of the areola darkens as pregnancy advances and due to increased estrogen
production
-Nipples become more erect and sensitive, colostrum may be seen in third trimester
-Montgomery glands (small bumps on nipples) become more prominent and may produce a
small amount of breast milk or natural, oily substance that cleans and lubricates the nipple and
areola
Breast Changes that affect breastfeeding - answer✔-Scars on breast can indicate previous breast
reduction surgery, which can affect milk production
-Breast implants can hinder successful breastfeeding
-Asymmetry of breasts or tubular-shaped breasts suggest a lack of glandular tissue and potential
problems with adequate milk production
-Flat or inverted nipples can affect the baby's ability to latch onto the breast
Danger Signs to Watch for in 2nd and 3rd Trimesters - answer✔-Persistent, severe vomiting (flu,
food poisoning)
-Sudden discharge of fluid from vagina before 37 weeks (premature rupture of membranes)
-Vaginal bleeding, severe abdominal pain (abruption, placenta previa)
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-Chills, fever, burning on urination, diarrhea (urinary tract infection, pyelonephritis)
-Severe backache or flank pain (urinary tract infection, pyelonephritis)
-Change in fetal movements, absence of fetal movements, any unusual change in fetal movement
pattern (risk for intrauterine demise, low amniotic fluid)
-Uterine contractions, pressure, cramping before 37 weeks (preterm labor, dehydration)
-Visual disturbances: blurring vision, double vision, or spots before eyes (high blood pressure,
preeclampsia)
-Swelling of face or fingers and over sacrum (high blood pressure, preeclampsia)
-Headaches: severe, frequent, or continuous (high blood pressure, preeclampsia)
-Muscular irritability or convulsions (high blood pressure, eclampsia)
-Epigastric or abdominal pain (perceived as heartburn) (preeclampsia, HELLP syndrome
[hemolysis of red blood cells, elevated liver enzymes, low platelet count])
-Glycosuria, positive glucose tolerance test (gestational diabetes)
How to Palpate Fundus - answer✔Position woman with knees flexed and head flat. Just below
umbilicus, cup hand and press it firmly against the woman's abdomen. At same time, stabilize
uterus at symphysis with opposite hand.
If fundus is firm (and bladder is empty), with uterus in midline, measure its position relative to
umbilicus. Measure how many fingerbreadths or cm fit between the umbilicus and top of fundus.
If fundus is not firm, massage it gently to contract and expel any clots before measuring the
distance from umbilicus.
Assessing Uterine Contractions Via Palpation - answer✔Mild: Slightly tense fundus that is easy
to indent with the fingertips (feels like pressing a finger to the tip of the nose)
Moderate: Firm fundus that is difficult to indent with the fingertips (feels like pressing a finger to
the chin)
Strong: Rigid board-like fundus that is almost impossible to indent with the fingertips (feels like
pressing a finger to the forehead)
Positive signs of pregnancy - answer✔-Visualization of a fetus by real-time ultrasound
examination (5-6 weeks)
-Fetal heart tones detected by ultrasound (6 weeks)
-Visualization of a fetus by radiographic study (16 weeks)
-Fetal heart tones detected by a -Doppler ultrasound stethoscope (8-17 weeks)
