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Maternity HESI Study GuideAnatomy and Physiology of Reproduction
The menstrual phase varies in length in most women
Between ovulation and the beginning of the next menstrual cycle, there are usually
exactly 14 days. In other words, ovulations occurs 14 days before the next menstrual
period
Sperm live approximately 3 days (48 to 72 hours), and eggs live about 24 hours. A couple
must avoid unprotected intercourse for several days before the anticipated ovulation and
for 3 days after ovulation to prevent pregnancy
Antepartum Nursing Care
Look for signs of maternal-fetal bonding during pregnancy; for example, talking to fetus
in utero, massaging abdomen, and nicknaming fetus are all healthy psychosocial
activities
For many women, battering (emotional or physical abuse) begins during pregnancy.
Women should be assessed for abuse in private, away from the male partner, by a nurse
who is familiar with local resources and knows how to determine the safety of the client.
Practice determining gravidity and parity. A woman who is 6 weeks pregnant has the
following maternal history: She has a healthy 2-year old daughter; She has had a
miscarriage at 10 weeks; She had an elective abortion at 6 weeks, 5 years earlier; With
, this pregnancy, she is a gravida 4, para 1 (only one delivery after 20 weeks’ gestation.
GTPAL is 4-1-0-2-1.
Practice calculating EDB. If the first day of a woman’s last normal menstrual period was
October 17, what is her EDB, using the Nagle Rule? July 24. Count back 3 months and
add 7 days (always give February 28 days.)
At approximately 28 to 32 weeks’ gestation, the maximum placenta volume increase of
25% to 40% occurs, resulting in normal hemodilution of pregnancy and Hct values of
32% to 42%. High Hct values may look good, but in reality they represent pregnancy-
induced HTN and a depleted vascular space.
Hgb and Hct data can be used to evaluate nutritional status. Example: A 22-year-old
primigravida at 12 weeks’ gestation has an Hgb of 9.6 g/dL and an Hct of 31%. She has
gained 3 pounds during the first trimester. A weight gain of 2 to 4 pounds during the first
trimester is recommended, and this client is anemic. Supplemental iron and a diet higher
in iron are needed.
Foods high in iron: Fish and red meats, cereals and yellow vegetables, green leafy
vegetables and citrus fruits, egg yolks and dry fruits
As pregnancy advances, the uterus presses on abdominal vessels (vena cava and aorta).
Teach the woman that a left side-lying position relieves supine hypotension and increases
perfusion to uterus, placenta and fetus.
Fetal well-being is determined by assessing fundal height, fetal heart tones and rate, fetal
movement, and uterine activity (contractions). Changes in fetal heart rate are the first and
most important indicators of compromised blood flow to the fetus, and these changes
require action! Remember, the normal fetal heart rate is 110-160 bpm.
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