NUR2513 Maternal-Child Nursing – Examination Blue Print – Exam 1 Fall 2023

NUR2513 Maternal-Child Nursing – Examination Blue Print – Exam 1 Fall 2023 Psychosocial adaption to pregnancy - 1st trimester- Accept the pregnancy 2nd trimester- Accept the baby 3rd trimester- Prepare for parenthood fetal development - Fertilization takes place in the outer third of the Fallopian tube Placenta - -organ that transfers nutrients the fetus -2 sides (shiny shultzy-fetal side, dirty duncan-martenal side) umbilical cord - -a tube containing the blood vessels connecting the fetus and placenta (the supply line) -AVA (2 arteries--deoxygenated blood--and 1 vein--oxygenated blood. fetal circulation - through the 3 shunts and other fetal structures fetal shunts - ductus venosus, foramen ovale, ductus arteriosus Signs of pregnancy - Presumption-subjective(nausea,breast tenderness, quickening) Probable-objectives (chadwicks,braxton hicks, positive pregnancy test) Positive signs-(objectives , audible fetal heart rate ,fetal movement felt through palpation, ultrasound nutrition in pregnancy - -Recommended intake of folic acid is 0.4mg -increase diet by 300cals -Eat foods that are nutrient-dense (protein vs sugary foods) -AVOID mercury heavy fish (shark, mackerel, swordfish) & uncooked fish like sushi, undercooked beef, Deli meats, soft cheeses like blue cheese and feta, anything w/ raw eggs, wash fruits and veggies Cardiac adaptations in pregnancy - Blood volume increases by ~45% -increases provides for: exchange of nutrients, oxygen, and waste products within the placenta Needs of expanded maternal tissue Reserve for blood loss at birth -Pulse rate increases by 10-15bpm -bp lowers in early pregnancy due to decreased peripheral vascular resistance from progesterone effect -may hear heart murmur due to increase blood volume Prenatal advice/self-care - prenatal lab tests - First Trimester = CBC (blood count), HIV, Hepatitis B, Syphilis, Rubella, Blood type & antibody screen, Urinalysis, PAP test & cultures Second trimester= Ultrasound/anatomy scan, 20-22 weeks Diabetes (glucose) testing, hemoglobin & hematocrit, blood type & antibody screen, syphilis, ^ 24-28 weeks Optional testing MS-AFP or quad screen, 15-22 weeks (testing to screen for genetic disorders, e.g. Down syndrome, or neural tube defects, e.g. spina bifida) Third trimester= Group-B Streptococcus (GBS) approximately 35-37 weeks prenatal weight gain - -Normal weight gain 25-35 pounds -First trimester 3-4 pounds. 1 pound / week after Nonstress test - -A method for evaluating fetal status during the antepartum period by observing the response of the fetal heart rate to fetal movement. -Client presses a button whenever they feel fetal movement which allows nurse to assess FHR in relationship to the fetal movement MSAFP - Maternal alpha serum protein test performed around 16-20wks for screening purposes; elevated levels may indicate neural tube defect (NFT) (conduct ultrasound to diagnose)