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Exam 4 (Spring) > 1st Trimester > Flashcards

1st Trimester Flashcards

1
Q

1st Trimester

A

0-12 weeks

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2
Q

Presumptive signs of pregnancy

A
  • Amenorrhea
  • N/V (“morning sickenss”) (most common)
  • Unexplained fatigue
  • Skin changes
  • Sensation of movement in abdomen 16-20wks(quickening)
  • Frequent urination (enlarged uterus, increased circulating volume)
  • Breast tenderness and changes
  • Ptyalism (excess salivation
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3
Q

Probable signs of pregnancy

A
    • pregnacy test (hCG, by blood or urine)
  • Softening of cervix at 6-8 wks (Goodell’s sign)
  • Bluish coloration of cervix, vagina, and vulva at 6-8 wks (Chadwick’s sign)
  • Enlarged abdomen
  • Braxton-Hicks
  • Passive movement of fetus furing an exam (ballottement)
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4
Q

Hegar’s sign

A

Softening of lower uterine segment

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5
Q

Goodell’s sign

A

Softening of cervix at 6-8 wks

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6
Q

Chadwicks sign

A

Bluish coloration of cervix, vagina, and vulva at 6-8 wks

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7
Q

McDonald’s sign

A

Flexion of body uterus against cervix

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8
Q

Braxton Hicks

A

Irregular, painless uterine contractions that begin in the 2nd trimester

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9
Q

Ballottement

A

Fetal part is displaced by light tap of the examining finger on the cervix and then rebound quickly (occurs about 20-28 weeks)

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10
Q

hCG

A

hormone produced by the chorionic cvilli of placenta

Used to test for pregnancy

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11
Q

Radioimmunoassay (RIA)

A

Type of pregnancy test

Reliable at 1 wk after ovulation

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12
Q

Positive signs

A
  • Fetal heart sounds heard by doptone or doppler
  • Fetus visible on ultrasound or visualization
  • Fetal movements felt by caregiver
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13
Q

When can a fetal outline be identified?

A

After the 24th week

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14
Q

Abdominal striae

A
  • Stretch marks

- Breakdown and atrophy of underlying connective tissue

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15
Q

What is abdominal striae due to?

A

The stretching and increased estrogen that causes a rise in adrenal gland activity

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16
Q

Fetal ultrasound

A
  • Can be done by the 4th -5th wk of pregnancy if problems
  • Noninvasive
  • Routinely done at 8-12 wks
  • Never done just to determine sex
17
Q

Doppler of FHR

A

110-160 bpm for 2 mins

18
Q

What are the components of an initial exam?

A 
Medical History
Dates
Pelvic exam
Blood test
Testing for fetal abnormalities
Counseling
19
Q

Medical history during an initial exam

A

Medical conditions, including allergies
Menstrual cycle, use of contraceptives, past pregnancies, STDs
Prescription or OTC meds
Family history of congential abnormalities or genetic diseases
Sensitive issues, (abortion, past drug use)

20
Q

Naegele’s rule for determining EDB

A

1st day of LMP minus 3 month plus 7 days and 1 year

21
Q

EDB example using Naegele’s rule if LMP was 4/15/08

A

1/22/09

22
Q

What does a pelvic exam inlcude?

A 
Normal anatomy throughout
External genitalia- lesions
Vagina- infection, lesions
Cervix- pap, can help to confirm pregnancy
Ovaries- pain, enlargement
Uterus- size
23
Q

How many shapes are there for a bony pelvis?

A 
4:
Gynecoid
Android
Anthropoid
Platypelloid
24
Q

Blood tests during 1st trimester

A 
Blood type, including Rh
Syphilis
MMR
Hep B
HIV
Varicella
Toxoplasmosis
25
Q

Urine tests during 1st trimester

A

Urinalysis (glucose, protein, signs of infectoin)

Culture and sensitivity- bladder/kidney infection

26
Q

Screening tests during 1st trimester

A

Chorionic villus sampling
Amnocentesis
Ultrasound
Blood tests- alpha fetoprotein

27
Q

Fetal alpha protein

A

Protein made by immature liver cells
Spills into the amniotic fluid
May indicate neural tube defect

28
Q

Why CVS (chorionic villus sampling) or amnio?

A
  • Abnormal results from a prenatal screening test
  • Chromosomal abnormality in a previous pregnancy
  • Age 35+
  • Family hx of a specific genetic disorder, patient or partner is a known carrier of a genetic disorder
  • IDs Down syndrom and other disorders (tay-sachs, CF)
  • Neural tube defect (amnio only)
  • Lung maturity (late amnio)
29
Q

CVS/Amnio risks

A
  • Miscarriage (CVS has 1/100 risk)
  • Cramping & Vag bleeding
  • Rh sensitization (CVS may cause baby’s blood cells to enter maternal bloodstream; if Rh-, give Rh immunoglobulin (rhogam) after test)
  • Infection
  • Needle stick, leaking fluid (amnio)
30
Q

Counseling for 1st trimester: Lifestyle issues

A 
Nutrition
Prenatal vitamins
Exercise
Work environment
Tobacco use
Substance use (ETOH, drugs, meds)
Personal issues
31
Q

Counseling for 1st trimester: Body changes

A 
Tender breasts
Bouts of N/V
Unusual fatigue
Increased urination
Dizziness
32
Q

Physiology of changes in pregnancy

A 
Increase in candida albicans
Mom breathes more deeply
Nasal stuffiness
Changes in voice
Epistaxis
Mom's HR increases 10-15 bpm
Increase incidence in DVTs
Ptyalism
Pyrosis
Pruritus
Waddling gait
33
Q

Sycope during pregancy

A

Blood volume increaes
Vascular changes (dilation) allow for the extra blood
Pooling in the vascular system

Exam 4 (Spring) (12 decks)

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