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OB > 12. Prenatal > Flashcards

12. Prenatal Flashcards

1
Q

Three categories of pregnancy signs

A

Presumptive
Probable
Positive

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2
Q

Define “Presumptive” signs of pregnancy

A

Subjective changes felt by the woman – not diagnostic (least reliable)

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3
Q

Define “Probable” signs of pregnancy

A

Signs, symptoms and/or changes that can be observed by an examiner. – Not diagnostic (but more reliable)

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4
Q

Define “Positive” signs of pregnancy

A

Signs that cannot be attributed to anything but pregnancy– Diagnostic.

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5
Q

Presumptive signs and symptoms (6)

A
  • Amenorrhea
  • Fatigue
  • Nausea and vomiting
  • Breast changes
  • Urinary Frequency
  • Quickening
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6
Q

Breast changes with pregnancy (Presumptive - 3)

A

o Tingling
o Heaviness
o Tenderness

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7
Q

Four characteristics of “Quickening”

A

o The feeling of fetal movement
o Often described as a “fluttering”
o Difficult to distinguish between fetal movements and peristalsis
o Occurs at 16-20 weeks

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8
Q

Probable Signs and Symptoms (8)

don’t memorize

A
  • Pregnancy Tests
  • Chadwick’s Sign
  • Goodell’s Sign
  • Hegar’s Sign
  • Ballottment
  • Enlarged abdomen (uterine)
  • Braxton Hicks Contractions
  • Pigment changes – vagina, cervix
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9
Q

Pregnancy Tests – Accuracy

A

o 95-98% accurate. It is possible (but not likely) to have a false positive
o After a terminated pregnancy, your hCG levels remain elevated for a short time. (False +)

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10
Q

Chadwick’s Sign

A

o Blue-purple discloration of the cervix

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11
Q

Goodell’s Sign

A

o Softening of the cervix

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12
Q

Hegar’s Sign (including when)

A

o Softening and compressibility of the lower uterine segment (isthmus) after 6 weeks gestation

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13
Q

Ballottment

A

o Palpate fetal body part and it “bounces back” to examiner’s hand when cervix is tapped (16-18 weeks)

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14
Q

Positive signs of pregnancy (3)

A
  • FHT (Fetal Heart Tones)
  • Visualization of fetus – Ultrasound
  • Palpating fetal movements – Felt by the examiner
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15
Q

Serum Pregnancy Tests:
• Test for ______
• Type
• ___ days after conception

A
  • Beta hCG
  • Quantitative
  • (+) by 6-11 days after conception
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16
Q

Urine Pregnancy Tests:
• Test for ______
• Type
• ___ days after conception

A
  • hCG
  • Qualitative
  • (+) by 17-25 days after conception
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17
Q

Other possible causes of Amenorrhea (5)

A
  • Emotional stress
  • Strenuous physical exercise • • Endocrine problems
  • Chronic disease
  • Early menopause
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18
Q

Other possible causes of Nausea and Vomiting (3)

A
  • GI virus
  • Food poisoning
  • Emotional stress
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19
Q

Other possible causes of Fatigue (3)

A
  • Illness
  • Stress
  • Sudden changes in lifestyle
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20
Q

Other possible causes of Urinary Frequency

A

• UTIs

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21
Q

Other possible causes of Breast and Skin changes (2)

A
  • Premenstrual changes

* Use of oral contraceptives

22
Q

Other possible causes of Vaginal / Cervical Color changes (2)

A
  • Infection

* Hormonal imbalance

23
Q

Other possible causes of Quickening (3)

A
  • Abdominal gas
  • Peristalsis
  • Pseudocyesis
24
Q

Other possible causes of Abdominal enlargement

A

• Abdominal or uterine tumors

25
Q

Other possible causes of Cervical Softening (2)

A
  • Infection

* Hormonal imbalance

26
Q

Other possible causes of Ballottment

A

• Uterine or cervical polyps

27
Q

Other possible causes of Braxton Hicks contractions

A

• Leiomyomas

28
Q

Other possible causes of Palpation of fetal outline

A

• Leiomyomas (large ones may feel like fetal head, small soft ones may feel like other parts of fetus

29
Q

Other possible causes of positive pregnancy tests (4)

A 
THINGS THAT PRODUCE hCG:
•	Certain medications
•	Premature menopause
•	Blood in urine
•	Malignant tumors
30
Q

Other possible causes of auscultation of fetal heart sounds

A

None. This is a positive sign.

31
Q

Other possible causes of Fetal movements.

A

None. This is a positive sign.

32
Q

Other possible causes of visualization of embryo or fetus.

A

None. This is a positive sign.

33
Q

Pseudocyesis (def)

A

False pregnancy

34
Q

Leiomyomas (def)

A

Soft uterine fibroids

35
Q

How to document gravidy and parity

A 
Gravidy
Parity
•	Term
•	Preterm
•	Abortions
•	Living
36
Q

Gravidy (def)

A

Number of pregnancies, regardless of outcome

37
Q

Parity (def) - when documenting G/P

A

Number of times a woman gives birth beyond 20 weeks

38
Q

Term (def)- when documenting G/P

A

Number of births after 37 weeks

39
Q

Preterm (def)- when documenting G/P

A

Number of births before 37 weeks

40
Q

Abortions (def) - when documenting G/P

  • Def
  • Two types
A

Pregnancies ending before 20 weeks
• SAB = Spontaneous
• VTOP = Voluntary

41
Q

Living (def) - when documenting G/P

A

Children currently living

42
Q

Components of the physical exam on 1st prenatal visit (5)

A
  • Blood pressure
  • Height and weight
  • Urine dip (glucose, protein)
  • Head to toe exam
  • Pelvic exam
43
Q

Nägele’s Rule (def)

A

Used to determine “due date” based on a woman with a “normal” cycle of approximately 28 days

44
Q

Other ways of saying “due date” (medical - 3)

A
  • Estimated date of birth (EDB)
  • Estimated date of delivery (EDD)
  • Estimated date of confinement (EDC)
45
Q

How to calculate EDD using Nägele’s Rule

A
  • First day of LMP
    • 7 days
    • 3 months
  • SUBTRACT A YEAR
46
Q

Frequency of prenatal visits (three breakdowns)

A
  • Before 28 weeks: Q 4 weeks
  • 28 – 36 weeks: Q 2 weeks
  • Week 36- Birth: Q 1 week
  • Can be more frequent if there are complications, questions or concerns
47
Q

What is included in prenatal follow-up visits (7 things - don’t memorize)

A
  • BP, Height and weight
  • Urine dip stick
  • Abdominal exam
  • Patient ed: Danger sxs to report to provider immediately
  • Patient ed: Sxs of pre-term labor
  • Complaints
  • 3rd trimester: Discuss preparation and readiness for birth
48
Q

What is included in a prenatal abdominal exam? (4)

A
  • Fundal height
  • Fetal heart tone
  • Leopold’s Maneuvers
  • Fetal movement
49
Q

10 sxs to report to provider immediately during pregnancy

don’t memorize necessarily

A
  • Vaginal bleeding
  • Alteration in fetal movements
  • Rupture of membranes
  • Visual disturbances
  • Swelling of face or hands
  • Severe headache
  • Epigastric pain
  • Fever or chills
  • Contractions that increase in frequency or duration prior to 37 weeks
  • Persistant vomiting
50
Q

Four steps to Leopold’s Maneuver

A

1) Determine what fetal part is in the fundus
2) Determine location of small parts (feet, hands)
3) Determine what fetal part is presenting
4) Is there engagement?

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