Contraceptive Methods and Ovulation

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Questions and Answers

What is the primary function of the placenta during pregnancy?

To regulate the maternal immune response.

To provide a barrier against all contaminants.

To secrete hormones that inhibit fetal development.

To facilitate transport of nutrients and oxygen to the fetus. (correct)

Which symptom should be monitored as a potential complication of combined oral contraceptives?

Chest pain (correct)

Nausea

Weight gain

Increased appetite

What is the purpose of using spermicide with a diaphragm?

To serve as a lubricant.

To increase contraceptive effectiveness. (correct)

To prevent toxic shock syndrome.

To block ovulation.

According to Nagele's rule, how do you calculate the estimated delivery date?

Subtract 3 months and add 7 days to the last menstrual period. Signup and view all the answers

What is a critical instruction before performing an amniocentesis?

Empty the bladder before the procedure. Signup and view all the answers

Which hormone is essential for maintaining the endometrial lining during pregnancy?

Progesterone Signup and view all the answers

What is a major consideration for clients using a diaphragm for contraception?

It is not recommended for those with a history of certain medical conditions. Signup and view all the answers

What does the Lecithin/sphingomyelin (L/S) ratio indicate in terms of fetal health?

It indicates the fetal lungs' maturity. Signup and view all the answers

What indicates a reactive nonstress test (NST)?

FHR accelerates at least 15 beats above baseline, for at least 15 seconds Signup and view all the answers

What is recommended for a mother if the baby hasn't moved during an NST?

Offer the mother a drink or snack and encourage movement Signup and view all the answers

Which sign indicates probable pregnancy during a pelvic examination?

Hegar’s sign Signup and view all the answers

What additional caloric intake is recommended for women during pregnancy?

300 calories per day Signup and view all the answers

Which type of drug should be avoided during pregnancy unless prescribed?

Herbal supplements Signup and view all the answers

What is a nonpharmacological pain relief method during labor?

Reflexology Signup and view all the answers

What dietary change is advised during pregnancy to manage edema?

Limit dietary sodium Signup and view all the answers

What is considered the normal heart rate for a newborn?

100 to 160 beats per minute Signup and view all the answers

When does fetal movement, referred to as quickening, typically begin?

16-20 weeks Signup and view all the answers

What signifies the engagement of the fetus during labor?

When the presenting part passes the pelvic inlet at the level of ischial spines Signup and view all the answers

What is a potential effect of late decelerations during labor?

Placental insufficiency Signup and view all the answers

What is recommended for hydration during pregnancy before exercise?

2 cups of water Signup and view all the answers

Which reflex is NOT typical of newborns?

Adult walking reflex Signup and view all the answers

What is a primary goal for pain management during labor?

To preserve the mother's physical energy Signup and view all the answers

Why are premature infants at higher risk for heat loss?

Lack of fat insulation Signup and view all the answers

What happens if a diaphragm is left in place for more than 24 hours?

It can cause toxic shock syndrome. Signup and view all the answers

Which hormone is secreted by the placenta to assist in regulating maternal metabolic levels for the fetus?

Human placental lactogen Signup and view all the answers

Which complication should not be a concern for clients taking combined oral contraceptives?

Weight gain Signup and view all the answers

What is the primary purpose of amniocentesis?

To obtain amniotic fluid for examination. Signup and view all the answers

What should be done immediately before the amniocentesis procedure?

Empty the mother's bladder. Signup and view all the answers

How is ovulation estimated based on the menstrual cycle?

It occurs about 14 days before the next cycle begins. Signup and view all the answers

Which of the following best describes Nagele's Rule for calculating the estimated delivery date?

Subtract 3 months and add 7 days to the first day of the last menstrual cycle. Signup and view all the answers

What is a key characteristic of cervical mucus during the fertile period?

Thin, slippery, and stretchable. Signup and view all the answers

What is indicated by the presence of Chadwick’s sign during a pelvic examination?

Deepened violet-bluish color of cervix and vaginal mucosa Signup and view all the answers

Which maternal behavior is NOT recommended if the baby is not moving during a nonstress test?

Wait quietly for movement Signup and view all the answers

How many calories should a pregnant woman with a normal BMI aim to consume daily?

2,200 calories Signup and view all the answers

What is an appropriate intervention for late decelerations during labor?

Notify the provider Signup and view all the answers

Which sign is associated with early labor and indicates that labor is approaching?

Ripening of the cervix Signup and view all the answers

What is the primary purpose of Leopold maneuvers during pregnancy?

Determine fetal lie, presentation, and position Signup and view all the answers

What does an increase in cardiac output during pregnancy indicate?

Increased metabolic demands of the fetus Signup and view all the answers

Which of the following is a characteristic of nonpharmacological pain relief methods during labor?

They are based on stimulating nerve endings Signup and view all the answers

Which of the following foods should be avoided during pregnancy due to potential health risks?

Raw fish and undercooked meats Signup and view all the answers

What physiological change in the mother indicates the presence of edematous lower extremities during pregnancy?

Impaired blood return Signup and view all the answers

Which process is essential for maintaining fetal well-being during pregnancy?

Tissue perfusion to the placenta Signup and view all the answers

What dietary component is advised to be increased to help prevent dehydration during pregnancy?

Fluid intake Signup and view all the answers

What is indicated when the presenting part of the fetus has passed the pelvic inlet?

Engagement Signup and view all the answers

Study Notes

Diaphragm

Dome-shaped barrier placed over the cervix to prevent sperm passage
Should remain in place for 6 hours after intercourse; left in for 24 hours may cause toxic shock syndrome
Spermicide increases effectiveness
Replaced every two years
Refits needed after 15-20 pound weight fluctuation, childbirth or abdominal surgery
Not recommended for clients with a history of toxic shock, cystocele, UTIs, or uterine prolapse

Combined Oral Contraceptives

Hormonal contraception containing estrogen and progestin, suppressing ovulation, and thickening cervical mucus to block semen
Prevents implantation
Monitor for complications (chest pain, shortness of breath, leg pain, headache, vision changes, hypertension)
Not recommended for clients with thromboembolic disorders, smokers, or hypertension

Ovulation

Determining fertile days by tracking menstrual cycle to estimate ovulation time, which occurs approximately 14 days before the next menstrual period
Cervical mucus is thin, slippery, and stretchable during the fertile period

Placenta Function

Transports nutrients and oxygen to the fetus.
Filters waste, and acts as a barrier to certain toxins and substances like insulin.
Attached to the baby by the umbilical cord (2 arteries, 1 vein)
Secretes hormones:
- hCG: Detected in maternal blood/urine as early as the first missed period, shortly after implantation
- Progesterone: Maintains endometrial lining of uterus during pregnancy
- Estrogen: Contributes to mammary gland development for lactation
- Human placental lactogen: Regulates maternal glucose, protein, and fat levels for fetal use
- Oxytocin & prostaglandin: Secreted later in pregnancy to facilitate labor

Nagele's Rule

Calculating estimated delivery date
Using the first day of the last menstrual cycle, subtract three months, add seven days, and potentially add a year

Amniocentesis

Aspiration of amniotic fluid from the pregnant uterus for examination
Empty bladder before procedure
RhoGAM administration if mother is Rh-negative
Lecithin/Sphingomyelin (L/S) ratio (2:1) primary for fetal lung maturity

Nonstress Test (NST)

Noninvasive method to assess fetal well-being
Measures fetal heart rate response to fetal movement
Reactive NST: FHR accelerates at least 15 bpm above baseline for at least 15 seconds, occurring two or more times in 20 minutes
If baby hasn’t moved, offer mom a drink/snack and activity

Reproductive System Changes

Amenorrhea and breast tenderness are initial presumptive signs
Probable signs include cervical changes:
- Hegar's sign – softening and compressibility of lower uterus
- Chadwick's sign – deepened violet-bluish color of cervix and vaginal mucosa
- Goodell's sign – softening of cervical tip
Fetal movement (quickening) begins around 16-20 weeks

Cardiovascular Changes

Cardiac output increases 25-50%
Blood volume increases 25-30%
Impaired blood return from lower extremities can lead to edema
Management includes increased rest, leg elevation, limited sodium, and increased fluid intake (12 cups of water daily)

Prenatal Care

Exercise During Pregnancy

Recommended 3x per week, 30 minutes each session
Warm-up (5 minutes), active phase (20 minutes), cool-down (5 minutes)
Consume protein and complex carbohydrates 15 minutes before exercise
Stay hydrated before and after exercise

Teratogenic Drugs

Most drugs cross the placenta
Avoid any unprescribed drug or supplement during pregnancy
Risk-benefit analysis for any drug use during pregnancy

Preliminary Signs of Labor

Lightening (fetal descent into pelvis) occurs approximately 10-14 days before labor
Cervical ripening (internal sign); indicates imminent labor
Cervical ripening due to prostaglandin release
Medication (Cervidil, Cytotec) or manual ripening possible

Nutrition During Pregnancy

Average recommended daily calories for childbearing age are 2,200, increase by 300 daily during pregnancy
Should gain 25-35 pounds throughout the pregnancy
BMI 25-29.5 target: 15-25 pounds
Foods to avoid: raw fish, predatory fish, undercooked meat, lunch meats, hot dogs, soft cheeses, caffeine, and alcohol

Stages of Labor

Engagement: Presenting part (fetal head) passes the pelvic inlet at the level of the ischial spines (station 0)
Station: Relationship of presenting part to ischial spines
Crowning around +4 station

Leopold Maneuvers

Systematic method to determine fetal lie, presentation, position, engagement
Have client empty bladder

Pain Relief During Labor

Nonpharmacological:
- Reflexology
- Effleurage (light stroking of abdomen)
- Sacral counterpressure
Pharmacological:
- Intravenous narcotics (latent labor)
- Epidural anesthesia (active labor); preferable for certain medical conditions like heart disease, pulmonary disease, diabetes, gestational hypertension
- Local anesthesia (third stage labor, lacerations)

Psychological Adaptation (During Pregnancy)

Heat Loss in Newborns

Conduction, convection, radiation, evaporation cause heat loss in newborns
Premature or low birth weight infants at increased risk due to lack of body fat
Cannot shiver to generate heat

Infant Cardiac and Respiratory Adaptations

Normal heart rate: 100-160 bpm
Normal respiratory rate: 30-60 breaths/minute
Functional murmurs reflect closing foramen ovale and/or ductus arteriosus

Infant Reflexes

Moro: Extension and abduction of arms following head drop
Babinski: Fanning of toes after stroking sole of foot
Rooting: Turning toward stroked cheek

Fontanel and Head Assessment

Fontanels should be soft and flat; depression = dehydration; bulging = increased intracranial pressure
Anterior fontanel closes 12-18 months
Posterior fontanel closes 8 weeks
Cephalohematoma: Blood collection between periosteum and skull
Caput succedaneum: Scalp swelling due to pressure during labor
Molding: Temporary shape change

Hypoglycemia in Newborns

Few symptoms; assessed with heel capillary blood sample
Transitional hypoglycemia usually resolves within 48 hours
Serum glucose <40 mg/dL (symptomatic); <45 mg/dL (asymptomatic) -Symptoms: jitteriness, lethargy, seizures

Breastfeeding

Optimal nutrition source for newborns, promotes bonding
Recommended for first 6 months
Feed every 2-3 hours, monitor weight gain, urination, and rest
Colostrum (days 1-3), Mature milk (days 4-10)
Maternal benefits: uterine involution, potential cancer protection, faster weight loss, convenience
Infant benefits: Lactoferrin, lysozyme, interferon, reduced obesity risk

Diabetes Mellitus in Pregnancy

Gestational diabetes: Impaired glucose tolerance during pregnancy
Management: Diet control, oral glycemic agents (glyburide/metformin), insulin (as needed)
Exercise improves glucose regulation
Carbohydrate intake limited to 50% calories
Fetal risks: Hypoglycemia, macrosomia, electrolyte imbalance, birth trauma, congenital anomalies
Maternal risks: Infections, hydramnios, ketoacidosis, glucose irregularities

Heart Disease in Pregnancy

Varying effects depending on disease
Rest periods (2-3 30 minute rest periods), left lateral recumbent position, elevated bedhead to prevent supine hypotension and stress

RhoGAM

Used for Rh incompatibility
Administrated at 28 weeks and within 72 hours of delivery (if Rh-positive baby)
Give RhoGAM anytime fetal and maternal blood may mix

Preterm Labor

Labor before 37 weeks
Potential significant infant health risks
Terbutaline (beta-adrenergic agonist) tocolytic to relax uterine muscles; risk of tachycardia (hold dose for HR >120)

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Description

This quiz covers essential information about various contraceptive methods, including diaphragms and combined oral contraceptives, along with ovulation tracking. It highlights usage guidelines, effectiveness, and contraindications for these methods. Test your knowledge of reproductive health and contraception!