102-Antepartum Flashcards

1
Q

HR with pregnancy

A

Increases 15-20 bpm

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2
Q

WBC with pregnancy

A

Increase to about 15,000 sometimes (normal 5-10,000) due to hormones, stress, exercise

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3
Q

Hyper coagulation

A

Fibrinogen increases by 50% with pregnancy to decrease risk for PP hemorrhage but increase DVT risk

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4
Q

Ptyalism

A

Increased saliva

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5
Q

Optimal positivism for urinary function and circulation

A

Left lateral recumbent

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6
Q

Chloasma

A

Hyper pigmentation on darker skinned pregnant women

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7
Q

Linea nigra

A

Darkened (hyper pigmentation) through umbilicus

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8
Q

Striae gravidarum

A

Stretch marks

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9
Q

Presumptive diagnosis

A

Woman perceives own pregnancy (subjective)

Nausea/vomiting, amenorrhea, fatigue, urinary freq, breast changes, quickening

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10
Q

Probable diagnosis

A

Provider perceived (objective)

Chadwick’s sign, goodells sign, uterine and abdominal growths skin hyper pigmentation, positive pregnancy tests

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11
Q

Positive diagnosis

A

Objective but ONLY attributed to fetus

FH auscultation (fetus HR), fetal movement and palpation noted by provider, ultrasound visitation

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12
Q

Fetal heart rate can be felt when? (Positive diagnosis)

A

4-8 weeks

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13
Q

Chadwick’s sign

A

Bluish color of vaginal mucosa (probable sign of pregnancy)

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14
Q

Goodells sign

A

Softening of cervix (probably sign of pregnancy)

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15
Q

Nageles rule

A

How to calculate estimated due date:

Last noted monthly period (LNMP) - 3 months + 1 week

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16
Q

1st trimester

A

First day LMP-12 weeks

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17
Q

2nd trimester

A

13-27 weeks

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18
Q

3rd trimester

A

28-40 weeks

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19
Q

Term gestation

A

37-42 weeks

Most babies born either 3 weeks before or 2 weeks after due date

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20
Q

Gravida

A

times pregnant

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21
Q

Para

A

pre term births

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22
Q

T

A

term births

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23
Q

A

A

abortions (including miscarriages under 20 weeks)

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24
Q

L

A

living children

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25
Q

GTPAL

A

Way to identify patients gravida and para (jargon)

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26
Q

Nullgravida

A

Never pregnant before

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27
Q

Primigravida

A

First time ever pregnant

28
Q

Multigravida

A

Pregnant 2+ times

29
Q

Why is folic acid important before and during pregnancy

A

Prevents neural tube defect

30
Q

Prenatal visits conception-28 weeks

A

Every 4 weeks

31
Q

Prenatal visits 29-36 weeks

A

Every 2 weeks

32
Q

Prenatal visits 37 weeks- birth

A

Every week

33
Q

Normal pregnancy weight gain

A

25-35 lbs

34
Q

Transnational ultrasound

A

Used in 1st trimester to confirm pregnancy and calculate age (probe into vagina)

35
Q

Transabdominal ultrasound

A

2 & 3 trimesters

Anatomical survey of fetus, further evaluation

36
Q

When is maternal blood drawn

A

15-20 weeks gestation

37
Q

Quad screen

A

At 15-20 weeks gestation this screens for Down syndrome (low AFP) and neural tube defects (high AFP)

38
Q

Kick counts

A

Daily fetal movement count after 28 weeks

4 movements in one hour or 10 in 2 hours

39
Q

Nonstress test

A

Assess fetal well being, FH accelerates in respect to movement= adequate oxygenation

40
Q

Vibroacoustic stim test

A

Confirm non-reactive NST (nonstress test)

41
Q

What is the biophysical profile

A

Assessment of 5 parameters for fetal well being (NST and US)

42
Q

What are the 5 parameters for fetal well being in the biophysical profile

A
  1. NST
  2. Fetal breathing movements
  3. Gross body movements
  4. Fetal tone
  5. Amniotic fluid (fluid around baby)
43
Q

Iron deficiency hgb/hct ranges

A

Hgb

44
Q

Gestational trophoblastic disease

A

Aka hydatiform mole

Benign proliferating growth placenta trophoblasts; nonviable pregnancy

45
Q

Gestational trophoblastic disease assessments

A

Vaginal bleeding, hyperemesis due to EXCESSIVE HCG levels

**can develop into cancer

46
Q

How to prevent antibodies in Rh- women

A

Rhogam injections at 28 weeks or abdominal trauma/procedures

47
Q

What does practitioner do for incompetent cervix?

A

Cerclage placement

-pursued string suture to reinforce cervix

48
Q

Nursing care after cerclage placement for incompetent cervix

A

Monitor: uterine activity, vaginal bleeding/leaking fluid, infection, and administer tocolytics

49
Q

What does it mean when a mom is sensitized

A

Develops antibodies against Rh

50
Q

Placenta previa

A

Placenta implanted in low segment of uterus over cervix- requires c-section, 20 weeks found usually and usually migrates to correct spot as uterus grows

51
Q

Clinical mani placenta previa

A

Painless, BRIGHT RED uterine bleeding

Mom at risk for: hemorrhage and hypovolemic shock

Fetus at risk for: anemia, hypoxia, death

52
Q

Main nursing actions for placenta previa

A

Insert large bore IV cath to anticipate blood transfusion, corticosteroids as ordered for fetal lung maturation, monitor CBC (h/h), clotting

53
Q

Abruptio placenta

A

Partial or total separation of placenta after 20 weeks and before delivery (3 trimester); leading cause of maternal and fetal death

54
Q

Clinical manifestations abruptio placenta

A

DARK RED bleeding, severe abdominal pain, contractions, uterine tenderness

55
Q

Nursing actions for abruptio placenta

A

Mom must deliver, palpate uterus (tenderness, distention), hypotension-tachycardia-administer O2 (hypovolemic shock), CBC &clotting

56
Q

Main clinical mani of preeclampsia

A

BP, edema, quiet environment, bed rest in recumbent position, anticonvulsant (mag sulfate), anti hypertensive

57
Q

HELLP syndrome

A

Complication of severe preeclampsia

H- hemolysis (anemia/jaundice)
E- elevated L- liver enzyme (epigastric pain, nausea/vomiting)
L- low P- platelets (abnormal bleeding and clotting)

58
Q

Syncope

A

fainting

59
Q

Polyhydroamnios

A

Increased amniotic fluid

60
Q

Oligohydramnios

A

Decreased amniotic fluid

61
Q

Newborn macrosomia

A

Large birth weight- common morbidity of GDM (gestational diabetes mellitus)

62
Q

Infections that complicate pregnancy

A

TORCH

T- toxoplasmosis (cat litter)
O- other (hep B) 
R- rubella
C- cytomegalovirus
H- herpes simplex 

(* can all cross placenta and have teratogenic to fetus)

63
Q

Group B streptococcus (GBS)

A

A symptomatic bacteria colonizing rectum vagina cervix and urethra.

35-37 weeks gestation

Penicillin

64
Q

Chorionic villus sampling (CVS)

A

Tests placental tissue for fetal abnormalities (cyst. fibrosis, down);
10-12 weeks
Low risk for fetal loss/bleeding from procedure

65
Q

Amniocentesis

A

Diagnose genetic disorders, lung maturity, hemolytic disease fetus, intrauterine infection

Needle through abdomen to get amniotic fluid

2/3 trimester

Less favorable than CVS (expensive, risk, later term)