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NUR2005 Exam Latest Update
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NUR2005 Exam Latest UpdateMain physiological changes that occur during pregnancy and postpartum - Answer
Nausea and vomiting (digestive system)
Frequency of micturition (passing urine), especially at night (renal/reproductive system)
Quickening- signs of fetal movements felt as 'gentle flutter or butterflies'
Fatigue and insomnia
Common signs and symptoms of labour - Answer Contractions and cervix dilation, lower
back pain, water breaks, urge to vomit, loose bowl motions.
Three stages of labour and how to care/support women during birth - Answer 1) Dilation:
women first has contractions and starts to dilate until she reaches 10cm
2) Birth: begins pushing, gives brith to baby
3) Afterbirth delivery: the women expels the placenta
4) Afterbirth care: the aftercare also postpartum period
What happens to blood during pregnancy? - Answer Increase plasma and RBC volume,
as well as anemia
What happens to respiratory system during pregnancy? - Answer Increased respiratory
centre stimulation --> Increase in RR, Increase tidal volume and decrease residual
volume
What happens to cardiovascular system during pregnancy? - Answer Increase HR,
decrease arterial pressure, increase cardiac output, decrease peripheral vascular
resistance
What happens to the genital system during pregnancy? - Answer Decrease vaginal pH,
increase glycogen in vaginal epithelium
Oxytocin theory - Answer A hypothesis regarding the cause of labor - the hormone
causes the uterus to contract, some people believe that a rise in these levels may be
responsible for initiating labor
Prostaglandins theory - Answer Research finding vary as to whether the concentration
of prostaglandins increase in amniotic fluid and maternal bloodstream before labour but
certainly are high during and after labour.
Prostaglandins may be used to induce labour, particularly to ripen the cervix in
preparation for induction of labour with Oxytocics.
Fetal steroids theory - Answer Fetal adrenal glands secrete corticosteroids that trigger
,labour
Corticosteroids release the precursor to Prostaglandins- Oestrogen and Progesterone-
levels of both hormones regulate concentrations of Oxytocin receptors in the uterus
Animal studies show a decrease in Progesterone levels with the onset of labour,
however, this has not been demonstrated in humans
Emotional changes to occur during pregnancy - Answer Women may become:
bored, poor memory, negative thoughts, impatient, sensitive, may struggle with body
image, have presence of sleep disorders and sexual function/well being disorders
Maternal postnatal check includes: - Answer Access blood loss (amount, colour, clots
and odour)
Palpating uterine height, position and tone
Check perineum/caesarean wound and document observations
Common Postpartum changes: - Answer Endometritis - inflammation/infection of uterine
lining
Perineal injury/trauma
Pelvic floor dysfunction/incontinence
Caesarean section wound infection
Mastitis: inflammation of breast can lead to infection
Postnatal mental health: baby blues, depression and psychosis
Degrees of perineal injury/trauma - Answer Perineal injury/trauma includes:
- first-degree tear = injury to perineal skin and/or vaginal mucosa, can heal on their own
- second-degree = injury to perineum muscles, but not anal sphincter (requires suturing)
- third-degree = injury to perineum involving anal sphincter complex (External (EAS) and
Internal (IAS)) (requires suturing in operating room/anaesthetic)
- fourth-degree = injury to perineum involving anal sphincter complex and anorectal
mucosa (requires suturing in operating room/anaesthetic)
Assessment of newborn - Answer Involves APGAR score:
Appearance - skin colour
Pulse - heart rate
Grimace - reflexes
, Activity - muscle tone
Respiration - breathing rate and effort
Initial management for healthy newborns - Answer Access the babies response to brith
Attach name bands x2 and check with mother
Perform APGAR assessment at 1 min and 5 min
Mum and baby stay together and encourage breast feeding (especially if baby
mouthing/rooting reflex)
Documentation
Newborn measurements - Answer Weight
Length
Head Circumference
blinking reflex - Answer stimulation = flash of light/puff of air
infants response = close both eyes
Babinski reflex - Answer stimulation = sole of foot stroked
infants response = fans out toes, twist foot in
Grasping reflex (palmar reflex) - Answer stimulation = palms touched
infants response = grasps tightly
Moro reflex (startle reflex) - Answer stimulation = sudden stimulation (i.e. loud
noise/being dropped)
infants response = startles, arches back, throws head back, flings out arms and legs,
and then rapidly closes them to centre of body
Rooting reflex - Answer stimulation = cheeked stroked or side of mouth touched
infants response = turns head, opens mouth, begins suckling
stepping reflex - Answer stimulation = infant held above surface and feet lowered to
touch surface
infants response = moves feet as if to walk
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