OB NORMAL

MATERNAL • CHILD HEALTH NURSING

•

FATIGUE
=↓RBl= Anemia / Iron deficiency Anemia )

During Pregnancy Fetus deposits Fein their liver : from their Iron
'
-
-
-

Newborn : Breast milk No Iron content

/
↳ __

↳
Iron deposits are consumed for Gmos .

6m05 Solid food / Iron )

PRESUMPTIVE / SUBJECTIVE) - Riviera :# itood :/ east Allergy - ↑ie

Folic Acid ✗ Neural tube Detect

-

M Morning sickness
• -

Nausea / Vomiting URINARY FREQUENCY

-
•

1st -
Hlb / from placenta )=↑AUDiné Stomach
↳ normal

2nd -

Progesterone / Hormone oé pregnancy -

compression o Bladder
i. 1st 1- 11.2.37 -

Normal 1st -1,2 ,3mos=tUF

2nd
'

-21-14,56 ) ABN-H.mu/elplacentaisEnlarged ) 4.5.6 XUF Upward ang fetus Nocompression

- -_ - -_
-

Hyper Emesis Graiiidarum

-
-

3rd t.8.9.tv/---Fetaldescend- lightening

-

Mbti * 2nd tri -

- 1- VF ;ABN

Crackers / skyflakes ) ☆ =H mole -

-
-

enlarge placenta continuous compression :(HUF

:

Dysuria Abnormal IUTD

↳
out -0 Bed *
before getting :

Rich in sodium Bicarb / Alkaline ) Neutralizes e- Gastric ↑ chance during pregnancy

Activity
→ -
-

After kaininlahat Water is allowed to prevent Aspiration Bleeding

-

-_

1st : Abortion 's Ectopic 3rd Abruptio Placenta

-

2nd : H mole
Placenta Prellia
-

. . "* .

temporary loss oé Menstrual cycle teitbyé Mother / subjective )

-

↳ BF -

Gmos .
-

Fetal Movement
lactation Amenorrhea Gmos : Exclusive Breastfeeding 2nd trimester : Moro reflex ;
upper Body Hearing
-
-
- -

-
↓ Hormone / HP ) : ✗ ovulation -

noeggcells Primi 5th Mon hindispelifiediitosagot

say
-
-
-

f g)
-

After lemos
-
-

switch to other
contraceptive Multi -

4th Mon Breech

→
Non BF 2- 3m05 menses return 3rd trimester lower :
Body legs :
-

5M :viz
-
-
-

◦
,

↳
itoangpiliinsa Board Examitmagkahillllalay 4) Fetal Movement ( Positive sign )
-

7th Mon :/ ikotpa

2- 3m10s
ang Examiner : palpation immanent
-

CAUSE 0 Amenorrhea :↑ Estrogen • ↑ Progesterone =

masmataas
Uterine Relaxation
↓ Promotes 1-9mosikeq.to/ta1tAbortionPR0BABlESlbNl0BJElTNE1
↳ :

Mild Contraction -

Braxton Hick contraction

OXYTOCIN ↳
severe contraction Discoloration
-

SIDE NOTE :b / Omid CHADWICK 'S SIGN

:↑Egg cell production softening
-
•
-

Multiple Pregnancy Bluish discoloration olerllix

-

caused by ↑ Estrogen ↑ Blood supply to e- cervix

- -
-

•
BREAST ENLARGEMENT CERVIX -

Internal
↳ ↑
Estrogen -

Inspect via VAGINAL SPECULUM -

inspection
•
Pink -

non -

pregnant
Bluish : Pregnant
"
?⃝
 •
GOODELL 'S SIGN TRUE LABOR

softening ié CERVIX Oxytocin Pain Intensifies

-
-
-

Palpate : Internal Examination ↑ Pain when

walking Regular contraction
-
- -

↳ i.
Handllvashing walking ↑ Pain Painful
-

i. blokes / Sterile ) -

lhandonly -

lower Back

3. Dominant Hand
4. lubricant : water soluble •
BALLOTIUENT
KY Jelly Bouncing iéietusupon Palpation
- -

5. Insert lfingers : Pointing & Middle finger Floating

-

↳ thumb is closed paraditamaanang Clitoris lanbeasignovterine cancer

-

•
HEGAR 'S SIGN
↳
softening oéuteruslloiirersegmentl POSITIVE SIGN / CONFIRMATORY )
organ for implantation / Nidation
↳

Upper segment Oé Uterus : Posterior More common / BE)

-

1. HUH .

↳
kumakapal -1^02=1^13 / oodsupplytoélygote transabdominal
-

Pag / Oliver :
Placenta Preiia -

Anterior -

Normal ; less common

-

Dorsal Recumbent -

supine
thinner ;t Pressure pababang Upper segment paramadeliiler Full Bladder I Give water) -11=4 glasses 1191955250mn
- -

Endometrium Implantation oplaoenta pushes uterus upward

q30mins-2hrprep.myometrium-paghanggandn.to
UTERUS :
-

;Makapit : Placenta Acoreta clear Visualization

-

Perimetrium →
transvaginal UTI
-

Ectopic Pregnancy Outside e- Uterus : Fallopian empty bladder / Voiding /

-

ABN lithotomy
-
-

salpingectomy / Remove e- Site )

Fallopian tube : 2. IHFHT

-

Ampulla ↳
Leopold 's Maneuver
→
siteoiertilizationlt.gg/-spermVnion--1ygote ) -

identity éteta / Back -

Cephalic : Below Abdomen

→
common site 0 Ectopic Pregnancy
-

Breech : Above
-

Isthmus •

Doppler UR -3 months

Interstitial Most fatal site it:p

fetoscope 4m05 KYJEHY transmits sound
-
- • -
-

Narrowest Part : Prone to Rupture / Hemorrhage ) •

stethoscope -

5- gmos .

Fibrae Widest -

,
Finger like ↳ Use Bill

catcheste-tggc.eu from e- Ovary NORMFHT :/ 20

-

1606pm
-

7160
Bituba / ligation Tachycardia / Fetal Distress )
-

Isthmus is ligated
-

Early sign
1120
Bradycardia / Fetal Distress )
-

•
POSITIVE PREGNANCY TEST late sign : More Dangerous
-

:( HE

Presence oltlbinllrine UTI confirmatory

-
-

↳ It) :
Hmole Blood Hbb Assessment

4) FETAL MOVEMENT
not confirmatory
Indconfirmatory DX 3.
-

Examiner
-

•
BRAXTON HICKS CONTRACTION / False labor ) NORM -10-12 tmlhour
↳
Estrogen : Mild contraction 112 Hyperactive / Assess paggising )
-_

False labor ↳
fetal distress / early )=↓0z=↓0iiné Brain causing
↳
Painless contraction →
Irregular contraction :
unanticipated restlessness

Promote Pain / Relieved 110

lower Abdomen walking Hyperactive
→ •
•
- ↳ -

Abn : Fetal Distress / late ) ; Priority

?⃝
?⃝
 TRANS / EN ORGANS ③ Dark Yellow
-

↳
↑ Bilirubin / Waste Product )
↳ ✗ RBC / Hemolysis)
"
""
1. AMNIOTIC FLUID / FETAL URINE Amnio
"
RH incompatibility
f.

④ Red
◦

FUNCTIONS : ↳
Bleeding -
A. Placenta -

Dark Red

Protection / cushion ) -

placenta Previn -

Bright Red

thermoregulation / Heat ; Hypothalamus is Immature Rupture 3trimeste.ir

-
-

④ Musculoskeletal development
-

Space : Allows Fetal Movement / Physical Activity )

•
VOLUME
④ Nutrition ↳ UTZ
↳
Intestine o-e-ietus-tstfec.es MECONIUM / IN / in24hrs ) Normal -800 -1200mL
-

⇐•
IMPERFORATE DANUS sterile •
71200mL

Potyhydramnios
↳
↳
724° Meconium IN /
no
00pem.mg
HIRSHPRVNG 'S DSE 1.) GDM / Malrosomia )
↳
724° Meconium IN / ↑ Urine Volume
no Opening
-

MECONIUM INTESTINE 2.) Fetus

↳
nollitklbood Bacteria ) -61 problem
sterile
-

↳
Cleft lip
•
COLOR ! -

dimagsuokng A. Fluid

Rupture 01301N / spontaneous)

↳
continuous angurine-turine.IN
-

Clear straw colored / Pale yellow/ Amber ) 1800mL

•
•

kakulayngurine Oligohydramnios
- -

◦
Amniotic fluid -

Alkaline 1) Fetus / Renal )

Urine Acid ;UTl= Alkaline ↳
Polycystic kidney
-
◦

NITRAZINETEST Amniotic fluid

Dimakaihiperonaiinomang
◦ -

test for Amniotic fluid

kayanauubos Amniotic Fluid
-

•
BLUE -

Alkaline : Amniotic Fluid :c) Rupture 0131N

•
YELLOW Acid ; Urine ; -413131N -

AMNIOCENTESIS
-

fetal lung maturity

ABNORMAL COLOR -

iii. Immature -

Give Bethametasone / Dexamethasone / PHIIM / 111

days )
BLACK ↳ 42 72hrs12 -3
-2 :| Mature
-
-

Fetal Death before delivery oé Baby

-

IUFD ; pungent smell

-

Necrosis o-skinlcellsimixes.IN/Amniotiofluid
-

Skin is Macerated
2. UMBILICAL CORD
Deathlsmosi Abortion OTHER NAME : FUND
> 5m05 Stillbirth
Passageway :02 / Nutrition
→
.

BLOOD VESSELS :

② GREEN •
31311 :L Arteries ;1Vein / AVA )
-

Meconium stained / Nagpoopsaloob )

-
↳ monitor e- size / Diameter
-

Post Term -

Baby ;cs Delivery ◦

small -

U .

Artery
Aspiration ( suction ) large Akin
- • -

cephalic presentation Oxygenated

↳
Carriero Blood
g
-

Normal in Breech
Opposite Adult circulation
↓
0
- -

Meconium
No prob : Diniyamakakainang
*
IAIN
Congenital Heart Detects
-

:
?⃝
?⃝
?⃝
•

LENGTH :
↳ UTZ
FETAL CIRCULATION
-

NORMAL : 50 -60cm ;AVE : -55cm -02 from e- Mother Placenta 'll .Hein- liver / immature )
-

•
> 60cm
Inferior Ductus Bypass

[
.

lordloilllordloop / Nuchal cord fetal Vena lava

↳
1- 0:30 venous

Maha bang cord blood

%=jµmen↑¥uno×Y
.

umikotangiordsaleeg
-

blood

DR will palpate then clamp then Cuttounloil -1USD retained

t.inbet.ra.ua
-

n-eaa.r.in " " '

.

CORD PROLAPSE -

Moreoitor Brain
Extremities
Development
Unang IUMADAS SAKUMA 30%00×9 Ozislonsumed cozlunoxy )
-

Becomes
-

mood
Banal naangNDS-Macompressandbord-o.lv 02 Acrooyanosis
- -

IS Delivery
-

Foramen ovale Closes -

@
Mbt :
trendelenburg / knee Chest
-
-

prevent further prolapse

↳

cover w/ moist pack 3. PLACENTA

-

Caused by PROM IUNBIION

-

i. Protection from Infection

-

2nd trimester

During labor Ambulate to promote fetal descend Not Absolute : Rubella Fully Mature Placenta
-

*
_
-

2. Nutrition
1.
Floating fetus PROM : Umbilical cord angunanglalabas
-_

1
Engaged Fetus :/ stloltmbulate
3.
Oxygenation
4. Endocrine Function
i.
Engagement
2.
Descent lllvalking )
↳ Produce Hormones
•
Hlb
•
1606m •
HPL
-

causes GDM

Abruptio Placenta Nahihilapababa Estrogen

→
↑
-

] -

Amenorrhea
dark red Bleeding
↳
progesterone ,
•

•
3rd Tri downward MSH / Melanocytes Hormone )
Stimulating
-

_
◦

↳ ↑ Melanin
•

SPECIAL ELEMENT i. Chloasma -

Face , Neck ,
Armpit
i. Wharton 's Jelly i. Linea Nigra Dark vertical line
-

prevention oobstruotion 3. striae Grallidarum stretchmarks

-

CORD INFECTION SHAPE

•
•

lord stump Pancake / round atlatl / PIE shaped

→ -

Dry
-

_
7- todays

wet > todays •

SPECIAL ELEMENT
-

Omphalitisllnfx ) -

cotyledons / 20-25 )
lllltntibiotics Naiman sallterusllt
-120
Bleeding
-

-_

Retained Placental
=
Fragments
CREPE 'S PROPHYLAXIS ↳ sx :D / C- Dilation Ilurettage
Erythromycin 725 Normal
-
-

Opthdlmiatveonatorum lnfx 745 :H mole /

Grapelike vesicles)
-
-
-
.

CORD CARE

Airoirying
-

sterile water
 7111-605111
ECLAMPSIA
S
•

SEIZURE

cognitive affectation toé

Baby dlt Cerebral Hypoxia
-

i. ACETKACIDTEST -

c. sielivery

XNSD stress Vasoconstriction :P'BP Placenta

OB Abruptio
↳
bag essential
-

__
-
-
-

Determine Presence i Protein iné Urine Gestational DM

=

Nakakapitmasyadoyungplacentasavterus :L
"

pressure lit
-

PROTEINURIA / ABN ) caused HPL Abruptio Placenta Hemorrhage

--

by
-

↳ PIH / Pregnancy Induced HTN )

PROCEDURE TREATMENT / MANAGEMENT

f- urini.yzo-e-chestiubeft.IE/tRtHEATT%1earH
• 113 Acetic Acid •

PRE-ECLAMPSIA
11-2 )
→
mins
cloudylt) •
Proteinuria HPN / Vasoconstriction )
-
-
-

Anti -

HPN / Vasodilator)

PREGNANCY INDUCED HPN ↳

DOG
-

Hydrdlazinel SEVERE PRE-ECLAMPSIA )

caused by Placenta : HCG / Blood ) MILD PRE-ECLAMPSIA Dietltxeroise

-
- -

-
HCG __
vasoconstriction -1>
TBP
-

15=1,2 ,3=HPN:H -

molelenlargedplancenta
__
THCG ) •
ECLAMPSIA
21=4 ,⑤6=HPN :P / H ↳
DOCIMGSOY
-

↳ 201ms : usual start OPIH ↳ Anti seizure / Anticonvulsant

-

safe for fetus

.

'
*
Assess RR.HR ,IUObef Drug Administration
Manifestations
.

•
1st :
HPN
•
Proteinuria caused by damaged
-

oglomerulioausingé large
-

MgsO4 TOXICITY

molecules / Protein )toé Blood lstsx -

ti
Deep tendon Reflex / Absent

Albumin controls oncotiot

Resp i. depression
-

fluids deposits
,
-

inéoells Plasma
•
Edema
-

Cardiac depression

ABN : Upper Body / Facial Urine output 130mL / hr

-

↳
Generalized Edema / Anasarca ) ↳
ticiroulation from kidney
Normal : lower Extremities / Mg deposits in e- Blood : titanium level
legs
-

Growing stomach compresses e- B. Vine ANTIDOTE :( a Gluconate

legs
-

Elevate é legs
PN :2T:5THmos 2. BENEDICT 'S TEST
OBBAG : BLUE
-

BP :
120180 Aske Normal BP
AFTER PREGNANCY
-
-
•

miso its before

! Pregnancy GLYCOSURIA ABN
-
-

Normal Bppieturns
-
- -

90160
P E
Heat + 1- 8- logttslllropper)
CRITERIA :
YYmmmltff-g.pl/tMi1dPreed-
ampsia
Blue : -5mL
+
11 2min51-

☐ Midstream clean
catch Urine

CLASSIFICATION / LEVELS RESULTS : ADULT NORMAL BLOOD SUGAR

•
MILD PRE-ECLAMPSIA BLUE :c) -701110mg / dl
-

120180-140190 specific
→

GREEN
•
-

→
t1&t2 Proteinuria ↳ tl NORMAL BLOOD SUGAR / BABY )
YELLOW -_
1-2
=
40 -60mg / dl
SEVERE PRE-ECLAMPSIA ORANGE -1-3 collect specimen
'
•
- -

140190-1601100 RED -_
1-4 i. GORNEROÉ Heel
-

✗ seizure
↳✗ Center :P Nerve Ending
:| Pain
"
-

1-321-4
?⃝
 -

GESTATIONAL DM 12nA Trimester : 614051241ms )

-

Placenta :HPll Human Placental lactogen )

↳
Antagonist cilnsulinl Blocks ) OCCURENCE : .MB Rha
-

FB :
Rhlt)

Mother :
Hyperglycemia
-

/)
"" 9m05.NO
1-
mixing Blood

2Mt
0
Polyuria twine
-

zp -

-
Polydipsia
Polyphagia iappetite
-

-
itnirst

Delivery
labor / Delivery : Placental separation
↳
Open wound
ltntry Point 01:B)
:(Rh -111s / Rht) •
Winner
-

Newborn : Macroom:O -

↳ loser
i. Monitor Blood sugar
itrigger Immune system
i.
Hypoglycemia After Delivery ↳ RH
Antibody Destroys éRBb0é
__
2nd CHILD
↳ No sugar source

MEDICATION :

2nd SCENARIO ! NO PROBLEM

XOHA : teratogenic
-

DOC : Insulin ↳
MIRHT ) ;FlRh )
need for Insulin
RHt=t9mos=NoRxn
IT NOGDM .NO
'

- -

2T -

tilnsulin
Baby LABOR -_ First
Barrier bet
! '

3T insulin Placenta / Delivery / W/ open wound Entry )

- -

__
- -

µp,&µ,

MBT ;FB
-

ORGANOGENESIS ↳ winner .NO/tnH' body

'

protein
-

1st trimester / 2nd Month / burhs) FATHER :

RhH=TRHH chance ié Baby

3. COOMB 'S TEST
↳ Bloodiest :RH INCOMPATIBILITY TREATMENT
-
•

Pihobam
DIRECT COOMB 'S TEST Newborn :
'

↳
preventive .pro/entProduotionoRhAntibody
•

INDIRECT COOMB 'S TEST : Mother Mother : 1st Dose :# Mon / Ioovvkslpih -7
"
Done during Pregnancy
• -
→
.

RESULTS : 2nd Dose : 48 -72hm after Delivery

(t) -

Blood ✓ RH Antibody ↳ 2nd -

3rd Day
f)
'

Blood XRH Antibody -24hr : womb 's test / Confirmatory )

=/ tfetalis Affected Given every pregnancy
-

Hemolysis -_
jaundice
-
-

ix. Exchange transfusion curative

t.gl#1:tCt:VRhA-- ✗
-

12h06am
# 2: -

Ct :X RHA
-

✓ 13h06am
RHINCROMPATIBILITYIERYTHROBLATOSISFETAIIS
1*1 chance
during
"

PREGNANCY
-

Affects e- RBC :
Hemolysis : FETUS

.IN?BABY-LASTbHllD1stlH1lD:safe
ONSET
'

; Delivered before Production i Antibody

ITYPESO BLOOD RHTYPE

i.
MATERNAL BLOOD -11-1,1-1 Western
-
•

↳ common in PH / ASIAN
2. FETAL BLOOD
 STAGESOLABOR 'D 74 SECOND STAGE OIABOB
2. .

↳
expulsion stage passenger :

ONSET : Full Cervical Dilation

1. FIRST STAGES i.ABOR ENDING .DE/iveryoFetus
'

Dilation
stage : passageway
-

ONSET .
MECHANISM OIABOR / CARDINAL MOVEMENT
↳
True labor contraction / TINUPPER segment) i.
Engagement
•
TRUE LABOR PAINS / oxytocin ) -
Ischia / spine
lower Back / lumbosaoral Pain Encourage walking
-

l Pain
"

Intensities / Fetal Descend ) 2. Descent

during walking
-
-

contraction / Anticipated ) 3. Flexion

Regular
-

ii. requenoyo contraction 4. Internal Rotation

5. Extension
-

I Durationo contraction / strong )

6. External Rotation
"
1 Interval / Dikitdikitang contraction)
-

Confirmatory sign 0Th 7.

Expulsion
-

Dilation -

Effacement DO 's • DON'T DURING LABOR / EINO

-

Passage 0 Bloody show •

Fundo / Push :X
↳ I
pressure Rupture __
oé Uterus

•
Duration : start totndolcontraotion
•

Artificial Rupture -0 Membranes

"t 2ND
start 0 e- next contraction ✗ it lnfectiontoé Baby
Ending to
Interval :
-

Frequency : start ooneiontraotiontoeistartlpurationlin.gg Episiotomy

•
•
.

R.lt/973-EpisiorhapyliN/ proper training

0 Another
-

• Frequency •

)
.

CERVIX : •

Food Intake
NON PREGNANT
-
-

✓ Early stage ; soft diet Energy

-

OPEN
•

Water Intake

PREGNANT
-

✓ :tDHN caused by pushing or Insensible fluid loss

-

CLOSE
•

Insertion ollllinelltdmission ) :
-

Mucus plug : operculum

-

✗ ii. normal / Early stage / Ambulation

Delivery ; Passage 0 Bloody show ABN :/ oogauie for BT
⇐• -

Oxytocin
•

•
ENDING : Full Cervical Dilation 110cm ) -

X -

Impolite ; Deltoid
Gradual
Nlethergine Administration XITHPN
-

• -

i. latent •

suction e- Baby
1- 3cm :/ E CM / HR
-

X : Normal :
Hypoxia
-

d. Active PRIMI :lom1hr -

Vimeo Stained .

1- tom MUTI : 1.5cm / hr

Milking e- Lord towards é Placenta
-

3. Transitional -

X ; cause Jaundice
-

8- 10cm •

stimulate try
↳
pushing -

✗ i. Aspiration
CROWNING •

complete Bath @ Birth

Pant blow
-

X : Maintain éllernixlaseosallteat)
-

Relaxation 0 Perineal Muscle .it/ laceration

After 240
-

✗
Pushing Silver Nitrate Administration
-

I contraction tlaoeration
; Erythromycin llredes Prophylaxis ) ; Inner
-_
to outer
-

Avoid canthus
Opthalmialveonatorum
-
Bradt Andrew Ritgen 's Maneuver Rooming In
-

-
-

Deliver é Placenta -

prevention olaoeration -

Within ÉROOMO Mother

UPIDOINN support e- perineum -24ms

-
-

brede 's Maneuver 3. THIRD STAGE 0111-13012

compress Abdomen to promote urination placental stage
-
-

onset
'

NEWBORN CARE
.DE/iveryoBabyENDlN6:DeliverPlacenta
yo-
↳ Gradual

1. IMMEDIATE DRYING oé BABY SIGNS 0 PLACENTA SEPARATION

Thermoregulation catkin 's sign

-

i.

Abdomen Globular Abdomen

-

1st
↳
pag-gumataw-massage.EU/-erus- contraction Prevent
Bleeding sign
-

>
.

Dry e- Baby for 30seoslMax )

-

lengthening oécord
2.
Head to toe
↳ : Brandt Andrews Maneuver
largest Part :
largest Heat loss

Dry to
prevent ups down
-
-

Eyes Nose Mouth Face

• -
-
-

↳ Sudden
Wipe secretion clear
:

airway 3.
gusho Blood

Reddit Blood
-

2.SK/NTOSK.lNGONTACl-UnangYaKap •
SCHULTZ
•

DUNCAN

Thermoregulation : Prevent Hypothermia clean ; shiny Dirty : Maternal Part

- -
-

Heat / Mother ) :tTemp 138.1% ) Normal Inner : cotyledons

-

Fetal part :
-
-
-

conduction -

umbrella
-

Retained Placental Fragments

transfer olteattoé Baby Intact cotyledons
-

Put e- Babyiné Mother 's CHEST

-

Prone Position : Promote FOURTH STAGE OIABOR

Breastfeeding 4.
-

boveri Head : Bonnet Recovery stage / Postpartum

-
-

Body :Dry& Clean Blanket

-

i. lochia
3. PROPER TIME TOGUTTHEGORD CSINSD / Abortion
-

I -3min after delivery Present bastanabuntis

- -

Clamp (2)
•
Rubra / REDI
1st
lomfromébase / Disposable clamp ) Bleeding ;1 -3 days
-

• -

•
2nd -

Jcmfromé Baselforoep )
•
serosa / Pink )
less
Bleeding ,4 todays
'

3cm from e- 1st clamp

- -
-

Cutting e- cord Near e- 1st clamp Alba / White )

-

- •

old concept : Middle :X tinted ion 11-14 day

- - -
-

Dry :t todays
-

Mouret __
lntxiomphalitis 2.
Breastfeeding
-

IGA 1-66 -

Placenta
4. NON SEPARATION OF MOTHER HAND
-
-

E. 051 / Milkcode )

Bonding promote breastfeeding

-
-

Exclusive
Breastfeeding Breastfeeding :6Mos
-
-

90min :/
pahavvakkay Extended Breastfeeding .ly/okBeyondl4y1o )
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Mother
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 * NLE * NCLEX * CGFNS * HAAD * PROMETRICS * DHA * MIDWIFERY * LET * RAD TECH * CRIMINOLOGY * DENTISTRY * PHARMACY *

PRE-TEST
OBSTETRICS NURSING
MAY 2022 PHILIPPINE NURSE LICENSURE EXAMINATION REVIEW
NAME:
7. Which of the following is correct regarding the
measurement of the fundic height?
1. During uterine contractions, either spontaneous or
induced, maximum decrease in the uterine blood flow A. It is measured along the abdominal wall from the
is: middle of the symphysis pubis to the top of the
A. At the peak of uterine contractions fundus
B. Before the start of uterine contractions B. It is measured along the abdominal wall from the
C. At the end of uterine contractions top of the symphysis pubis to the xyphoid
D. At the start of uterine contractions C. It is measured along the abdominal wall
2. Which of the following statement related to the from the top of the symphysis pubis to the top
urinary system in the fetus is correct? of the fundus
A. Fetal kidneys start to produce urine at 20 weeks D. It is measured along the abdominal wall from the
AOG middle of the symphysis pubis to the xyphoid
B. Failure to produce urine may affect the 8. If the baby is in cephalic presentation, what structure
musculoskeletal development of the fetus occupies the fundus?
C. Mesonephros are the functionally immature kidneys A. Small parts
D. Kidneys are essential for the survival of the fetus B. Head
3. The nurse is providing instructions to a pregnant C. Breech
client who is scheduled for an amniocentesis. Which D. Shoulder
of the following is FALSE? 9. Which of the following is decreased during
A. It is done at 15-20 weeks AOG pregnancy?
B. It can assess fetal lung maturity A. Inspiratory capacity
C. Strict bed rest is required after the B. Tidal volume
procedure.
C. Residual volume
D. One of the complication is choriomanionitis
4. A healthy 25-year-old woman who previously has D. Vital capacity
experienced spontaneous, cyclical, predictable 10. Patient in active labor with ruptured bag of waters,
menses consulted today because of missed period of sutures between the frontal and parietal bones can be
12 weeks. Which of the following choices can be used palpated. These sutures are called:
to confirm the pregnancy? A. Temporal
A. Palpable round pelvic mass B. Coronal
B. Internal examination C. Frontal
C. Clinical pelvimetry D. Sagittal
D. Audible fetal heart tones 11. At birth, the orifice of the ductus venosus retract and
5. Which of the following drugs has been associated narrow, resulting in functional closure of the vascular
with cranial neural crest defects when more than shunt. In utero, which of the following statements are
10,000 IU per day is consumed in the first trimester? correct about the ductus venosus?
A. Retinol A. The viability of the fetus does not rely on these
B. Warfarin vascular shunts because of placental circulation.
B. It connects the umbilical artery to the inferior
C. Phenytoin
vena cava
D. Nitrofurantoin C. If there is impedance or absence of flow
6. A 30-year-old primigravid was seen for prenatalcare. through these shunts, it may correlate with
Her LMP was last July 11, 2020. Compute for the EDC aneuploidies, cardiac defects, and/or other
based on her LMP. postpartum disease states.
A. May 04, 2021 D. Postpartum, the ductus venosus remains open for
B. April 04, 2021 3 months due to increased cardiac pressures and
C. April 18, 2021 decreased circulating prostaglandins.
D. May 18, 2021 12. A pregnant client comes to the clinic for ultrasound.
She is currently at 16 weeks AOG. Which of the
following ultrasound findings is most probable?
 A. Phenotypic sex already present
B. Fetal lung already developed
C. Fetal testes are descended into the scrotal sac
D. Surfactant production already beginning
13. Which of the following Nonstress Test results denotes
fetal viability?
A. 2 accelerations of FHR that peak at 15 bpm,
each lasting 20 seconds within 20 minutes
of observation
B. No increase in FHR
C. Silent oscillary pattern
D. None of the above
14. Which of these statements is true of the ovarian
cycle?
A. The corpus luteum is maintained by high frequency
and low amplitude LH
B. Decrease in FSH is needed for final oocyte
maturation and follicular rupture
C. Both proteolytic enzymes and inhibitors are
involved in the LH surge
D. The dramatic increase in estrogen is crucial for the
next ovarian cycle
15. Which of the following fetal delivery is considered an
abortus?
A. 2 days old newborn
B 25 weeks old fetus
C. 600 grams fetus
D. 20 cm long fetus
 POST TEST
OB
1. The nurse is assessing the fundal height of a client at 26 weeks’ gestation. The nurse should
-

expect the fundus to be:

Fundio Height 1cm )=A06in INKS
A. Level with the umbilicus. 20th INK -

B. Halfway between the symphysis and umbilicus.

C. Slightly below ensiform cartilage.
0
D. At 26 cm.

2. What statement by a woman who is 28 weeks pregnant would indicate that she understands the
pattern of normal prenatal visits? I -7m lmos
0
-
-

A. “My next visit will be in 1 month.” 8m : 2x a month / LINKS

B. “I will be back at 34 weeks for my next visit.” 9m : of week
C. “I need to come for prenatal check-ups every week.”
D. “My next visit will be in 2 weeks.”
-

3. A nurse is planning to teach a 14-year-old pregnant adolescent at 38 weeks’ gestation. Which .

topic would be most helpful at this time in the pregnancy? I

A. Nutrition for the third trimester full term : labor

0B. Signs of true labor

C. Abdominal exercises for postpartum
D. Infant bathing

4. The nurse is assessing the weight of a client who is having a normal pregnancy. The nurse
would expect the client to have gained _____ pounds by 20 weeks’ gestation.
123450
A. 8.5 – 10 lbs. Wt gain 25-35 pounds
.
:
1 1 14 4=11 lbs

① B. 10.5 – 12 lbs. 1st -1lb / mon ; } pounds

-

C. 12.5 – 15 lbs. 2nd -1lb / INK

; 12 pounds Greatest vvgt gain
- -

D. 15 – 17 lbs. 3rd 0.8 -0.9lb / Wk ;t Amniotic Fluid # Weight gain

:

5. Another client at 30 weeks’ gestation is admitted to the birthing unit with vaginal bleeding.
What is the first action the nurse should take? t ,

31T¥;]
:A. Administer
X oxygen. ↳ Assessment
Dependent
B. Prepare✗equipment for examination. NOLE -

C. Assess family coping skills. Psychologie

-

① D. Take vital signs. Physiologic / Physical

-

Independent Intervention
-

6. A nurse is assessing a client with rupture of membranes. A pelvic exam reveals the cervix to be -

4 cm dilated, and the presenting part is ballottable. Based on this data, the client is most at
Itching
-

risk for:
A. Placenta previa.
 B. Amniotic infection.
C. Abruptio placentae.
0
D. Prolapsed cord.

7. Information gained using Leopold’s maneuver reveals that the fetus is in a cephalic position.
Where should the nurse place the Doppler to hear the fetal heart tones?
-

o
-
A. The lower quadrant of the maternal abdomen
-

B. The level of the maternal umbilicus

C. The upper quadrant of the maternal abdomen
D. Above the apex of the fetal heart
as 4
8. A male infant was born 60 seconds ago. Now his heart rate is 132 bpm; he gives several vigorous
cries; he has strong flexion at his hips and elbows, with his knees elevated off the mattress;

0
A. 9
!
and his coloring shows acrocyanosis.

B. 7
C. 5
D. 3
Normal
f. Contract ;
9. Three hours postpartum, a primiparous client’s fundus is firm and midline. On perineal
-

inspection, the nurse observes a small, constant trickle of blood. Which of the following
conditions should the nurse suspect? 311 : Abnormal Relax : Bleeding
✗
A. retained placental tissue : Full Bladder Uterine Atony -

B. uterine inversion
✗
C. bladder distention
✗
-

Nasa Midline

C)
D. perineal lacerations outside oé Uterus
-

10. While making a home visit to a postpartum client on0

day 11, the nurse would anticipate that
the client’s lochia would be which of the following colors?
A. dark red I -3 -

B. pink 4-10
-

C. brown
① D. white 11-14 =

↳ Alba

11. During a home visit on the fourth postpartum day, a primiparous client tells the nurse that she
has been experiencing breast engorgement. To relieve engorgement, the nurse teaches the
client that before nursing her baby; the client should do which of the following?
A. apply an ice cube✗ to the nipples Engorgement
B. rub her nipples gently with lanolin cream I -3 postpartum
-

①
C. express a small amount of breast milk ✗ Good snake
-

D. offer the neonate a small amount of formula Milk stasis Pain

-

Engorgement
-_ -

Reduce Milk
1. continue Breastfeeding
2. Express Breast milk
3.
Breast-feeding Warm -4min
-

Non -

Breastfeeding
-

cold
12. A nurse is assessing the lochia in
a 24-hour-postpartum client, and expresses blood clots with
fundal massage. The client’s fundus is firm but elevated, and deviated to the right. What
↳ a-
would be the most appropriate nursing action?
HBN : Full Bladder
A. Assess the activity pattern. normal
B. Change the perineal pad.
0
C. Assess the voiding pattern.
D. Administer analgesics.

13. The clitoris is the seat of sexual excitement in the female. Its significance is valuable for
-

obstetrics is that it:

G-
A. guides catheterization. landmark
-

B. serves as the sexual organ of stimulation.

C. guides internal examination.
D. protects vestibular parts.

14. The pregnant mothers ask about external organs of reproduction and are collectively called:
0
A. Vulva
B. Perineum
C. Vagina
D. External organs

15. The mothers are excited to know the onset of labor and delivery. In which the exact cause of
labor is unknown. However, some of the theories were explain to them which include:
1. decreased estrogen level tiwntraction
2. uterine stretch
✗ progesterone level Relax
3. increased -

4. oxytocin theory
A. 1, 2 and 4
B. 1, 3 and 4
0
C. 2 and 4
D. 2, 3 and 4

16. The supervisor evaluates client Cory for signs of true labor, which include:

i.
1. uterine discomfort starting from the back radiating to the abdomen
2. cervical effacement and dilatation
3. uterine contractions increasing in interval and decreasing in duration
4. rupture of the bag of waters and passage of vaginal bleeding
A. 1 and 2
B. 1 and 4
C. 2 and 3
D. 2 and 4
17. A Head Nurse assigned in a OB ward gave a scenario while teaching trainees regarding signs
of immediate labor during emergency such as strong typhoon. She ask the0
trainees specific
signs for labor and delivery that they need to immediately attend to?
A. Contractions are progressive and strong
B. Cervical dilatation has begun
C. The cervix is effacing
0
D. The membranes have ruptured Risktorlnfx
-

18. Nurse Delia is assessing the characteristics of active labor contractions of a multiparous
woman, just admitted in a labor unit. Delia would assess the frequency between which of the
following?
A. acme of one contraction to the beginning of the next contraction
B. beginning of one contraction to the end of the next contraction
C. end of one contraction to the end of the next contraction
0
D. beginning of one contraction to the beginning of the next contraction
19. A client 39 weeks pregnant has been admitted in the Labor room in the first stage of labor.
Which of the following clinical manifestations would be considered abnormal and should be
reported to the Physician immediately? 1:30 secs
A. Expulsion of a blood tinged mucous plug " ✓ A : 60sec
2min -120 secs
0
B. Continuous contraction of 2 minutes duration 1- : qosecg
longer contraction
-

C. Feeling of pressure on perineum causing her to bear down Normal

-

D. Expulsion of clear fluid from the vagina -

20. The MCN nurse is preparing the mother for a Leopold’s Maneuver the nurse plans to perform
Leopold’s Maneuver (LM) to Mrs. Fe. What would be the- priority nursing actions that can

T
be included in the nursing care plan before the Leopold’s maneuver? Palpation
-

A. Locate the site of FHT auscultation before performing the procedure Empty Bladder
-

B. Have the client drink 8 oz. of water one hour before the exam
C. Warm the sonogram gel before the procedure
D. Have the client empty her bladder before beginning the exam

21. As the nurse performs Leopold’s maneuver0

€÷
one, she palpates a hard, round ballottable mass.
Which of the following is an appropriate interpretation of the findings?
A. The fetus is in cephalic presentation Fundus
0
B. The fetus is in breech presentation
C. The presenting part is engaged
✗
✗
D. The fetal back is on the left abdominal wall

22. The Physician advised pregnant mother to ambulate around labor room and to be re-assessed
after 45 minutes. Which assessment distinguishes between true and false labor?
A. confirmation of spontaneous rupture of membranes
0
B. signs and symptoms of increasing discomfort pain -

C. evidence of cervical dilation

 D. presence of copious bloody vaginal discharge
aged Dapat
23. A G2P1 woman in labor (parturient) asked if she can still walk around in the labor room-DR-
nursery area. Which of the following is the most important criterion to consider before
allowing her to ambulate? Fetal station
0A. station
¥
B. status of the bag of waters
C. permission by the physician
t
} Is .

D. cervical effacement He
-

-
3

24. Katerina is to receive Ergonovine maleate (Methergine) by mouth during the first to third
postpartum days. Before administering Methergine, it is most important to check her:
A. lochia
B. deep tendon reflexes

:
C. blood pressure
D. uterine tone
25. Jo a post partum mother wants to breast feed her baby. As part of your nursing care to prevent
sore nipple soreness during breastfeeding, you would determine that the client needs further -

instruction when she states which of the following?

A. “I should position the baby the same way for each feeding.” Isang Breast Lang ;D apat Alternate
-

Breast
B. “I should make sure the baby grasps the entire areola and nipple.”
i.
C. “I should air dry my breast and nipples for 10-15 minutes after the feeding.”
D. “I shouldn’t use a hand breast pump if my nipples get sore.”

26. A G3 P4 client who is breastfeeding complains of severe cramps or after pains 30 hours after
cesarean delivery. The nurse explains that these are caused by which of the following?
A. flatulence accumulation after a cesarean delivery Breastfeeding
B. healing of the abdominal incision after cesarean delivery Release 0 Oxytocin
=

C. side effects of the medications administered after delivery contraction

=

0
D. release of oxytocin during the breastfeeding session Normal -

←
27. Primigravida Nora is seen crying in the postpartum ward. As a MCN nurse what would be your
priority assessment for a postpartum mother experiencing depression?
A. comfort measures to foster feelings of general well-being • Risk for

0
B. privacy and reassurance that crying is therapeutic and normal
C. to see and make tactile contact with her baby
D. to talk about her labor experience
(
•
-
suicide
close

Verbalize feelings
monitoring

Situation: As a MCN nurse in the community it is expected that you will conduct a post-partum
visit after delivery. The following findings were noted during the visit: her 0 left calf is swollen,
warm to touch, reddened and painful. Temperature is 37.9C.
ME / Dvt Thrombophlebitis
:
inflammation & Clot formation piivede ma
=
- -

28. You would advise her for immediate check and instructed her① not to:
dislodge Palm -

-
.

Embolism
 A. decrease leg movement ✓
B. apply warmth to the leg ✓ Vasodilation
C. elevate the leg ✓ Promote Venous Return
-

0
D. gently massage the painful area of the leg

-
29. Mrs. Fe G2, P2, just undergone post Cesarean Section and is diagnosed with Thrombophlebitis.
The Physician started treatment on her condition. The client’s response to treatment will be
evaluated regularly assessing the client for: ↳ Anti
coagulant
-

A. dysuria, frequency, urgency Heparin

-

B. red, swollen, painful calf SISXODVT I Bleeding

-
-

0
C. hematuria, ecchymosis, and epistaxis
D. sudden chest pains and dyspnea

30. While an Obstetric nurse is assessing the mother’s perineum on her third postpartum day after
having a vaginal delivery. She notes a large ecchymotic area located to the left of the
mother’s perineum. Which one of the following interventions should the OB nurse initiates
-

at this time? ↳ Internal

Bleeding :stOPé Bleeding
A. Have the client expose the area to air
0
B. Apply ice to the perineum
C. Encourage the client to take warm sitz baths.
D. Inform the physician STAT

31. In the immediate care of the newborn, which nursing action is implemented first to ensure

÷
newborn safety?
A. Identify a newborn using a foot tag identical with that of the mother
B. Clear the mouth and the nose of mucus
C. Inject vitamin K to prevent bleeding
D. Dry the baby

32. Nurse Josie is evaluating a return demonstration on a client performing breast self-examination.
Which of the following techniques require further teaching from the Registered Nurse?
A. Client compresses the nipple with the thumb and finger. Determine Discharge
-

0B. Client uses palm of hand to palpate breast tissue.

C. Client palpates tissue from the axilla to the sternum.
D. Client inspects breast by lifting arms over her head jtjingerpads
33. The nurse has requested the client to return tomorrow for an ultrasound. Which of the following
instructions is most appropriate prior to the ultrasound?
A. Do not eat prior to the ultrasound.
①C. Drink 1 quart of water 2 hours before the ultrasound. lquart
-

B. Empty your bladder right before the ultrasound.

D. Do not drink fluids prior to the ultrasound.
34. Nurse Sarah is trying to determine the estimated date of delivery for a client whose last
menstrual period began on May 6 and ended on May 11. The estimated date of delivery using
Naegele’s rule is which of the following dates in February?
A. 6 Naegele s
'

B. 11 -

z tt t 1
C. 13
0
D. 18

35. A pregnant client states she had a boy at 40 weeks’ gestation and a girl at 38 weeks’ gestation.
Nurse Sarah documents this as:
0
A. G3P2/T2A0 :P, -
Para
B. G2P2/T2A0 -

Age 0 Viability
C. G2P1/T1A0 1¥ 5 most 20 INKS
=

Gravid a
D. G3P1/T1A0 # 0
-

pregnancy