N164 Maternity Final Exam Questions And Accurate Answers
GTPAL vs GP
Gravidity/Term birth/ Preterm/Abortions and miscarriages/ Living Children
GTPAL: #pregnancies/ #pregnancies ending in term births at 37 weeks+/ #pregnancies
that ended in preterm births ie 20 weeks 0 days to 36 weeks 6 days/ #pregnancies that
ended in miscarriage-spontaneous abortion or elective termination-therapeutic
abortion-before 20 weeks/ #children currently living
G/P: the # of pregnancies the woman has head (including the present one)/ the # of
pregnancies that have reached 20 weeks or more
- if full acronym is GTPAL, then P includes T + P (ignore A & L)
How to calculate gestational age
count backwards from the EDD (assume EDD is exactly week 40)
Past
How to calculate EDD
Naegele's rule: take LMP, subtract 3 months and add seven days + 1 year
Cervical exam (dilation, effacement)
Dilation: thinning of cervix (up to 10 cm)
Effacement: shortening and thinning of cervix (up to 100%
,Station:
Cervical exam: what is station?
the relationship of the presenting fetal part to an imaginary line drawn b/w maternal
ischial spines + a measure of degree of descent of presenting part through the birth
canal
above spines is & below spines is + +0= engagement- aligned with R & L maternal ischial
spines
+2 = pushing starts
+3 = baby is crowning
+4 to +5= birth is imminent
Presumptive signs of pregnancy
subjective and reported by the woman
amenorrhea, fatigue, breast changes, N/V, quickening (could be flatulence), uterine
enlargement
only the presence of a fetus can explain these findings
fetal heart sounds, visualization of the fetus, fetal outline and movement movement
palpated by an experienced examiner; US visualization
Physiologic adaptation of pregnancy - CV
- Blood volume increases 45% to 50% to meet needs of woman and fetus
,- Physiologic anemia is caused by hemodilution (ratio 75% plasma: 25% RBCs
- Increase in clotting factors to protect against blood that will be lost during birth (but in
2nd and 3rd trimesters may increase risk of thrombophlebitis)
Physiologic adaptation of pregnancy- Resp
- Mild hyperventilation with decreased PaCO2 and increased PaO2-- state of respiratory
alkalosis
- diaphragm elevates and is displaced by 4cm= more room for the baby, may cause SOB
- inc. estrogen relaxes rib cage and inc. vascularization in upper respiratory tract
- BMR inc 10-20% due to utero-placental-fetal demand for O2
Physiologic adaptation of pregnancy- Renal
bladder irritability, nocturia, urinary frequency; may experience proteinuria
- by term gestation, there is an increase in total body water of 6.5-8.5 L
- selective reabsorption to maintain Na and H2O balance; esp Na to help expand fluid
volume
- physiologic/dependent edema: req no tx; as pregnancy progresses, capacity of
kidneys to excrete water is less efficient
Physiologic adaptation of pregnancy- Integ
- chloasma: mask of pregnancy
- linea nigra: vertical line replaces linea alba
- striae gravidarum: stretch marks
, - angiomatas: vascular spiders caused by inc. estrogen
- palmar erythema: redness in palms
- pruritis gravidarum: mild itching, usually over abd
Physiologic adaptation of pregnancy- MS
- dec. abd muscle tone
stretch during 3rd trimester-- may lead to diastasis recti abdominis (abd muscles
separate)
-center of gravity shifts
Lordosis (inc. lumbosacral curve) + exaggerated anterior flexion to compensate--> leads
to aching, numbness, and weakness of UEs
Waddling gait
Relaxin and progesterone loosen ligaments of pubic symphysis and sacroiliac joints
Physiologic adaptation of pregnancy- Neuro
hypothalamic-pituitary neurohormonal changes:
nerve compression/ vascular stasis= sensory changes in legs
lordosis= pain bc nerve compression
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller Braxton. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $9.99. You're not tied to anything after your purchase.