Worksheet on Pregnancy, Fetal Development , Labor & Delivery

Competency Appraisal I -MCN

Name:________________________________
Adviser:_______________________________

Signs and Symptoms of Pregnancy

I Presumptive Cause/ Physiologic basis Nursing Action/s in the Care

of clients
1) amenorrhea
2) nausea & vomiting
3) urinary frequency
4) breast changes &
tenderness
5) excessive fatigue
6) uterine enlargement
7) quickening

II Probable changes Cause/ Physiologic basis Nursing Implication/s

1) changes in pelvic organs
-Goodell sign
-Hegar sign
-Piskacek sign
2) (+) HCG
3)Uterine souffle
4) Skin pigmentation
5) Ultrasound
III Positive (diagnostic) When appreciated & how Nursing Implication/s
changes appreciated
1) Fetal heart beat
2) Fetal movements
3) Ultrasound (presence of
fetus)

Fetal Circulation Fetal Circulation Structures

A. Umbilical Artery
Placenta

B. Umbilical Vein

1.
C. Left Ventricle
Ductus Venosus

D. Foramen Ovale

2.
E. Hepatic Vein

IVC

RA
3.

LA

4.

Aorta

5.

Placenta

Embryonic and Fetal Development

Age of Gestation (AOG) Developmental Milestones

4 weeks of gestation
8 weeks of gestation
12 weeks of gestation
16 weeks of gestation
20 weeks of gestation
24 weeks of gestation
28 weeks of gestation
32 weeks of gestation
36 weeks of gestation
40 weeks of gestation -fetus begins to kick actively and forcefully, causing maternal discomfort
-Vernix caseosa is fully formed
-Soles of feet demonstrate creases covering at least 2/3 of the surface
-Conversion of fetal hemoglobin to adult hemoglobin begins
-Testes descend fully into the scrotal sac

Labor & Delivery

Theories of Labor Physiologic basis

Progesterone
Deprivation

Uterine Stretch

Oxytocin

Prostaglandin

Aging Placenta

Factors Affecting NORMAL ABNORMALITIES

Labor
Passageway Pelvic types
Pelvic inlet and outlet
 diameters

Passenger Presentation
Attitude
Lie
Position
Power Contraction
Station
Placental Factors
Psychological

Comparison of False and True Labor

True Labor MANIFESTATIONS False Labor

CONTRACTION
DISCOMFORT
CERVIX
SHOW
EFFECT OF SEDATIVE

STAGES OF LABOR Clinical Manifestations Nursing Responsibilities

1ST STAGE: STAGE OF
DILATATION
 First true
contractions to
complete cervical
dilatation
1) Latent Stage
2) Active Stage
3) Transition Stage
2ND STAGE: STAGE OF
EXPULSION
 Complete dilatation
to delivery of fetus
3RD STAGE: PLACENTAL
STAGE
 Delivery of infant to
delivery of the
placenta
4TH STAGE: STAGE OF
IMMEDIATE RECOVERY
 1st hour following
delivery of the
placenta

Mechanisms of Labor (Description)