MATERNAL NEWBORN NURSING

1. MATERNAL NEWBORN NURSING REVIEW OF REPRODUCTIVE A&P, FETAL CONCEPTION AND DEVELOPMENT ANTEPARTUM TERMINOLOGY ANTEPARTUM ASSESSMENT PHYSIOLOGICAL CHANGES IN PREGNANCY PSYCHO-SOCIAL CHANGES IN PREGNANCY MATERNAL NUTRITION ASSESSMENT OF FETAL WELL BEING

2. MODULE 1 PART 1 REVIEW OF REPRODUCTIVE ANATOMY AND PHYSIOLOGY

3. REVIEW REPRODUCTIVE A&P, FETAL CONCEPTION & DEVELOPMENT THIS WILL NOT BE COVERED IN THIS LECTURE—BE PREPARED TO ANSWER REVIEW QUESTIONS IN CLASS THE QUIZ IN CLASS 1 WILL FOCUS ON CHANGES IN PREGNANCY AND TERMINOLOGY

4. Review of Reproductive A&P External Genitals Internal Reproductive Organs Vagina Uterus Uterine corpus Cervix Uterine ligaments Fallopian Tubes Ovaries

8. REVIEW OF REPRODUCTIVE A&P UTERINE LIGAMENTS ROUND LIGAMENTS OVARIAN LIGAMENTS CARDINAL LIGAMENTS INFUNDIBULOPELVIC LIGAMENT UTEROSACRAL LIGAMENT

13. MODULE 1 PART 2 REVIEW OF REPRODUCTIVE A & P

14. PELVIC STRUCTURE Innominate bones ILIUM ILIAC CREST ISCHIUM ISCHIAL TUBEROSITY ISCHIAL SPINES PUBIS SYMPHYSIS PUBIS Sacrum SACRAL PROMOTORY, SACROILIAC JOINTS Coccyx

15. REVIEW OF REPRODUCTIVE A&P PELVIC DIVISION TRUE PELVIS INLET PELVIC CAVITY OUTLET

19. REVIEW OF REPRODUCTIVE A&P PELVIC DIAPHRAGM LEVATOR ANI COCCYGEAL MUSCLES DEEP FASCIA PELVIC FLOOR MUSCLES LEVATOR ANI ILLIOCOCCYGEUS PUBOCOCCYGEUS, COCCYGEUS PUBORECTALIS, PUBORECTALIS PUBOVAGINALIS

21. REVIEW OF REPRODUCTIVE A&P BREASTS NIPPLE AREOLA TUBERCLES OF MONTGOMERY LACTIFEROUS DUCTS ADIPOSE, GLANDULAR, FIBROUS TISSUE COOPER’S LIGAMENTS

23. MODULE 1 PART 3 CONCEPTION

24. MATURATION OF OVARIAN FOLLICLE OVULATION CORPUS LUTEUM NEUROHUMORAL RESPONSE HYPOTHALMUS RELEASES GONADATROPIN-RELEASING HORMONE TO PITUITARY FROM RESPONES FROM CNS ANTERIOR PITUITARY THEN SECRETES FSH AND LH

25. FEMALE REPRODUCTIVE CYCLE OVARIAN CYCLE FOLLICULAR PHASE LUTEAL PHASE FEMALE HORMONES ESTROGEN PROGESTERONE PROSTAGLANDINS UTERINE CYCLE (MENSTRUAL)

28. REVIEW OF CONCEPTION AND FETAL DEVELOPMENT CELLULAR DIVISION MITOSIS MEIOSIS OOGENESIS SPERMATOGENESIS PRE-FERTILIZATION CAPACIATION ACROSOMAL REACTION FERTILIZATION

29. PREEMBRYONIC STAGE CELLULAR MULTIPLICATION CLEAVAGE MORULA BLASTOCYST TROPHOBLAST IMPLANTATION CHANGES IN ENDOMETRIUM DECIDUA CAPSULARIS DECIDUA BASALIS DICIDUA VERA

34. MODULE 1 PART 4 REVIEW OF CONCEPTION AND FETAL DEVELOPMENT

35. CELLULAR DIFFERENTIATION THREE PRIMARY GERM LAYERS ECTODERM MESODERM ENDODERM EMBRYONIC MEMBRANES AMNION CHORION AMNIOTIC SAC

36. REVIEW FETAL DEVELOPMENT AMNIOTIC FLUID UMBILICAL CORD PLACENTA

37. REVIEW OF FETAL DEVELOPMENT EMBRYONIC AND FETAL DEVELOPMENT EMBRYONIC STAGE—DAY 15 T0 8TH WEEK FETAL STAGE—8TH WEEK TO BIRTH

44.

45. MODULE 1 PART 5 REVIEW QUESTIONS

46. REVIEW QUESTIONS WHAT IS THE SIGNIFICANCE OF THE ENDOMETRIAL (MUCOSAL) LAYER OF THE UTERUS? THE UTERUS IS MADE UP OF WHAT TYPE OF MUSCLE? ESTROGEN IS SECRETED BY THE_______? PROGESTERONE IS SECRETED BY THE_______? WHAT IS THE FUNCTION OF LSH AND FH? DESCRIBE MEIOSIS.

47. REVIEW QUESTIONS WHERE DOES FERTILIZATION OCCUR? THE BLASTOCYST DEVELOPS INTO THE ______. THE TROPHOBLAST DEVELOPS INTO THE ____. THE PLACENTA DEVELOPS FROM THE ______. WHICH SYSTEMS/STRUCTURES DEVELOP FROM THE MESODERM LAYER?

48. NAME THREE FACTORS THAT AFFECT FETAL DEVELOPMENT. WHAT IS THE ROLE OF THE BROAD AND ROUND LIGAMENTS? WHAT IS THE UPPER PORTION OF THE UTERUS CALLED? WHATS CHANGES OCCUR IN THE FUNCTION OF THE OVARIES AT ABOUT THE 12- 14TH WEEK OF PREGNANCY?

49. MODULE 1 PART 6A PHYSIOLOGICAL CHANGES IN PREGNANCY

50. PHYSIOLOGICAL CHANGES IN PREGNANCY

51. REPRODUCTIVE SYSTEM PLACENTA AMNION CHORION UMBILICAL CORD AMNIOTIC FLUID

52. REPRODUCTIVE SYSTEM PLACENTAL FUNCTION METABOLIC TRANSPORT ENDOCRINE

53. REPRODUCTIVE SYSTEM OVARIES STOP PRODUCING OVA. CORPUS LUTEUM IS ACTIVE 10-12 WEEKS INTO PREGNANCY TO PRODUCE ESTROGEN AND PROGESTERONE. THEN WHAT HAPPENS? BREASTS INCREASED VASCULARITY AND SIZE HYPERTROPHY OF MAMMARY AVEOLI BECOME MORE NODULAR; NIPPLES ENLARGE PIGMENTATION OF AREOLA; COLUSTRUM

54. REPRODUCTIVE SYSTEM UTERUS INCREASE IN SIZE, WEIGHT, AND VOLUME CAPACITY FIBROUS TISSUE INCREASES INCREASE IN BLOOD FLOW CERVIX GOODALL’S SIGN, CHADWICK’S SIGN DEVELOPMENT OF MUCOS PLUG

55. REPRODUCTIVE SYSTEM VAGINA MUCOSA THICKENS INCREASE IN SECRETIONS LOOSENING OF CONNECTIVE TISSUE—WHY?

56. RESPIRATORY SYSTEM O2 CONSUMPTION INCREASES SUBCOSTAL ANGLE AND A/P DIAMETER INCREASE BREATHING CHANGES FROM ABDOMINAL TO THORACIC NASAL STUFFINESS AND EPITAXIS INCREASED VACULARITY DIAPHRAGM ELEVATES

57. CARDIOVASCULAR SYSTEM BLOOD VOLUME INCREASES 40%-50% PHYSIOLOGIC ANEMIA—WHY? DECREASE IN SYSTEMIC AND PULMONARY RESISTANCE IN THIRD TRIMESTER INCREASE IN CARDIAC OUTPUT, PULSE INCREASE (10-15 BPM)

58. MUSCULOSKELETAL SYSTEM PELVIC JOINTS RELAX CENTER OF GRAVITY CHANGES SEPARATION OF RECTUS ABDOMINUS METABOLISM EXTRA WATER, FAT, AND PROTEIN STORED FATS ARE MORE COMPLETELY ABSORBED BMR INCREASE (CAN BE UP TO 25%)

60. MODULE 1 PART 6B PHYSIOLOGICAL CHANGES IN PREGNANCY

61. GASTRONTESTINAL SMOOTH MUSCLE RELAXATION—RELATED TO PROGESTERONE INFLUENCE WHAT CHANGES WOULD YOU EXPECT TO SEE RELATED TO RELAXATION OF SMOOTH MUSCLE IN THE GI TRACT?

62. RENAL PRESSURE ON BLADDER CAUSES FREQUENCY—IN WHICH TRIMESTER AND WHY? DILATATION OF KIDNEYS, URETERS ELONGATE INCREASED GFR, CREATININE CLEARANCE AND RENAL PLASMA FLOW—WHY? GLYCOSURIA MAY OCCUR

63. INTEGUMENTARY HYPERPIGMENTATION STRIAE CHLOASMA (MELASMA) VASCULAR SPIDER NEVI DECREASED HAIR GROWTH HYPERACTIVE SWEAT AND SEBACEOUS GLANDS

64. ENDOCRINE SYSTEM THYROID—T4 AND BMR INCREASE (25% BY TERM), TSH DECREASES THYROID—GLAND ENLARGES, INCREASED IODINE METABOLISM, INCREASED VASCULARITY PITUITARY—FSH AND LH SUPPRESSED, SECRETION OF PROLACTIN, OXYTOCIN, AND VASOPRESSION PANCREAS—INSULIN PRODUCTION INCREASE TO COMPENSATE FOR PLACENTAL HORMONE INSULIN ANTAGONISTS

65. ENDOCRINE SYSTEM CONCENTRATION OF PARATHYROID HORMONE INCREASES—WHY IS THIS SIGNIFICANT? INCREASED ALDOSTERONE ADRENALS—LITTLE CHANGE

66. ENDOCRINE SYSTEM ESTROGEN LIST FIVE ACTION OF ESTROGEN DURING PREGNANCY ESTROGEN IS PRIMARILY EXCRETED BY THE ______ DURING PREGNANCY

67. ENDOCRINE SYSTEM hCG--(HUMAN CHORIOGONADATROPIC HORMONE)--STIMULATES PROGERTERONE AND ESTROGEN TO MAINTAIN PREGNANCY hPL—(HUMAN PLACENTAL LACTOGEN)—DECREASES MATERNAL METABOLISM FOR GLUCOSE (INSULIN ANTAGONIST) PROSTGLANDINS

68. ENDOCRINE SYSTEM PROGESTERONE LIST FIVE ACTIONS OF PROGESTERONE DURING PREGNANCY

69. ENDOCRINE SYSTEM RELAXIN DECREASES UTERINE CONTRACTILITY SOFTENS CERVIX SOFTENS JOINTS REMODELS COLLAGEN

70. MODULE 1 PART 7 PSYCHOLOGICAL CHANGES IN PREGNANCY

71. MOTHER’S RESPONSE TO PREGNANCY AMBIVALENCE ACCEPTANCE INTROVERSION MOOD SWINGS FEAR CHANGES IN BODY IMAGE ANTEPARTUM DEPRESSION?

72. FATHER’S RESPONSE TO PREGNANCY CONFUSED BY PARTNER’S MOOD SWINGS FEELS LEFT OUT RESENTS ATTENTION GIVEN YO THE WOMAN RESENTS CHANGES IN THEIR RELATIONSHIP NEEDS TO RESOLVE CONFLICTS ABOUT FATHERING

73. MODULE 1 PART 8 ANTEPARTUM TERMINOLOGY

74. GESTATION ANTEPARTUM INTRAPARTUM POSTPARTUM PRETERM LABOR POSTTERM LABOR 

75. GRAVIDA NULLIGRAVIDA PRIMIGRAVIDA MULTIGRAVIDA

76. PARA NULLIPARA PRIMIPARA MULTIPARA

77. TPAL T--NUMBER OF TERM PREGNANCIES P--NUMBER OF BIRTHS AFTER 20 WEEKS A—NUMBER OF ABORTIONS L—NUMBER OF LIVING CHILDREN

79. G/TPAL EXERCISES G T P A L G3 1 2 0 1 G2 0 3 1 3 G5 2 1 3 3 G2 0 5 0 3

80. MODULE 1 PART 9AANTEPARTUM PHYSICAL AND PSYCHO-SOCIAL ASSESSMENT

81. ANTEPARTUM PHYSICAL AND PSYCHOSOCIAL ASSESSMENT

82. CULTURAL BELIEFS AND PRACTICE ASSESSMENT IN ANTEPARTUM PERIOD HOME REMEDIES NUTRITION ALTERNATIVE HEALTH CARE PROVIDERS FAMILY SUPPORT EXERCISE SPIRITUALITY

83. CULTURAL CONSIDERATIONS/ASSESSMENT IN ANTEPARTUM PERIOD VIEW OF PREGNANCY SELF CARE PRACTICES PAIN CHILDBIRTH PRACTICES CARE OF THE NEWBORN POST PARTUM

85. SIGNS OF PREGNANCY SUBJECTIVE (PRESUMPTIVE) OBJECTIVE (PROBABLE) DIAGNOSTIC (POSITIVE)

86. DUE DATE EDD, EDC, EDB NAEGLE’S RULE—SUBTRACT 3 MONTHS FROM FIRST DAY OF LAST MENSTRUAL PERIOD AND ADD 7 DAYS EXAMPLE: LMP OCT. 12—EDB---JULY 19

87. CLIENT PROFILE CURRENT PREGNANCY PAST PREGNANCY CURRENT MEDICAL/SUGICAL HISTORY GYN HISTORY FAMILY MEDICAL HISTORY RELIGIOUS, SPIRITUAL, CULTURAL HISTORY OCCUPATIONAL HISTORY PERSONAL INFORMATION—(PSYCHOSOCIAL)

88. ANTEPARTUM RISK FACTORS FACTORS RELATED TO: ECONOMICS ENVIRONMENT CURRENT HEALTH STATUS/PRACTICES AGE NUTRITION CHILDBIRTH HISTORY SOCIAL ISSUES PYSCHOLOGICAL STATUS

89. PSYCHO-SOCIAL ANTEPARTUM ASSESSMENT CULTURE PSYCHOLOGIC STATUS EDUCATIONAL NEEDS SUPPORT SYSTEMS FUNCTIONING OF FAMILY ECONOMIC STATUS ENVIRONMENT

90. CRITICAL THINKING IN WHAT SYSTEMS/AREAS WOULD YOU EXPECT TO SEE DEVIATIONSAND/OR ALTERATIONS FROM EXPECTED FINDINGS IN THE PHYSICAL ASSESSMENT? WHAT DEVIATIONS/ALTERATIONS MIGHT YOU OBSERVE?

91. MODULE 1 PART 9B ANTEPARTUM PHYSICAL AND PSYCHOSOCIAL ASSESSMENT

92. ANTEPARTUM PHYSICAL ASSESSMENT VS UTERUS SKIN EXTERNAL GENITALS MOUTH, EARS, NECK CERVIX, VAGINA CHEST AND LUNGS ANUS AND RECTUM BREASTS LAB EVALUATION HEART ABDOMEN EXTREMITIES REFLEXES SPINE

93. MATERNAL NUTRITION AVERAGE WEIGHT GAIN PATTERN OF WEIGHT GAIN NUTRITIONAL REQUIREMENTS CALORIES PROTEIN

94. MATERNAL NUTRITION FAT CARBS VITAMINS MINERALS CULTURAL CONSIDERATIONS

95. MATERNAL NUTRITION VEGETARIANISM LACTOSE DEFICIENCY EATING DISORDERS PICA ADOLESCENT WHAT TEACHING WOULD YOU DO FOR THESE ALTERATIONS/ CHANGES IN NUTRITION?

98. LAB EVALUATIONS INITIAL ANTEPARTUM VISIT SCREENING TESTS CBC ABO AND Rh TYPING WBC WITH DIFFERENTIAL FIRST TRIMESTER ANEUPLOIDY STD SCREENING, HIV GLUCOSE RUBELLA TITER HEPATITS B SICKLE CELL PAP SMEAR

99. ANTEPARTUM ASSESSMENTFETAL DEVELOPMENT FUNDAL HEIGHT QUICKENING FETAL HEART RATE ULTRASOUND

103. MODULE 1 PART 10 ASSESSMENT OF FETAL WELL BEING

104. FETAL ACTIVITY ULTRASOUND TRANSABDOMINAL TRANSVAGINAL NUCAL TRANSLUCENCY TESTING (NTT) DOPPLER BLOOD FLOW STUDIES

105. AMNIOCENTESIS (AMNIOTIC FLUID ANALYSIS) EVALUATION OF FETAL HEALTH EVALUATION OF LUNG MATURITY CHORIONIC VILLI SAMPLING (CVS) WHAT IS THE ADVANTAGE OF THE CVS?

106. TERATOGENESIS MEDICATIONS MATERNAL: NUTRITION VIRUS ALCOHOL RADIATION COCAINE TOBACCO HYPERTHERMIA CAFFEINE MARIJUANA

107. MODULE 1 PART 11 DANGERS/DISCOMFORTS IN PREGNANCY

108. DANGER SIGNS OF PREGNANCY VAGINAL BLEEDING LEAKAGE OF FLUID FROM VAGINA ABDOMINAL PAIN TEMP > 101 DIZZINESS, BLURRING OF VISION SEVERE HEADACHE EDEMA OF HANDS, FACE, FEET

109. DANGER SIGNS OF PREGNANCY PERSISTENT VOMITING MUSCULAR IRRITABILITY EPIGASTRIC PAIN OLIGURIA DYSURIA ABSENCE OF FETAL MOVEMENT

110. DISCOMFORTS OF PREGNANCY FIRST TRIMESTER NAUSEA AND VOMITING URINARY FREQUENCY FATIGUE BREAST TENDERNESS

111. DISCOMFORTS OF PREGNANCY INCREASED VAGINAL DISCHARGE NASAL STUFFINESS & EPITAXIS PTYALISM

112. DISCOMFORTS OF PREGNANCY SECOND & THIRD TRIMESTER HEARTBURN ANKLE EDEMA VARICOSE VEINS HEMORRHOIDS

113. DISCOMFORTS OF PREGNANCY CONSTIPATION BACKACHE LEG CRAMPS FAINTNESS

114. DISCOMFORTS OF PREGNANCY DYSPNEA FLATULENCE CARPAL TUNNEL SYNDROME DIFFICULTY SLEEPING ROUND LIGAMENT PAIN

115. DISCOMFORTS OF PREGNANCY DETERMINE WHICH SYSTEM IS RESPONSIBLE FOR EACH OF THE DISCOMFORTS OF PREGNANCY. EXPLAIN HOW THE PHYSIOLOGICAL CHANGES THAT OCCUR IN EACH SYSTEM DURING PREGNANCY CAN BE RESPONSIBLE FOR THE DISCOMFORTS.

116. SUBSEQUENT LAB EVALUATION HEMOGLOBIN QUAD MARKER (15-20 WEEKS) INDIRECT COOMBS 50 G 1 HOUR GLUCOSE SCREEN URINALYSIS—GYCOSURIA, PROTEINURIA GROUP B STREP SCREENING (35-37 WEEKS)

117. SELF CARE PROMOTION BATHING EMPLOYMENT TRAVEL ACTIVITY, REST FETAL ACTIVITY MONITORING BREAST CARE CLOTHING BATHING

118. SELF CARE PROMOTION DENTAL CARE IMMUNIZATIONS SEXUAL ACTIVITY COMPLEMENTARY & ALTERNATIVE THERAPIES ABSTINENCE FROM ALCOHOL, TOBACCO, DRUGS PSYCHO-SOCIALSUPPORT