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Exam 4 (Spring) > 2nd and 3rd Trimester > Flashcards

2nd and 3rd Trimester Flashcards

1
Q

2nd trimester

A

13-28 weeks

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2
Q

3rd trimester

A

29-40 weeks

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3
Q

Body changes as you move into 2nd and 3rd trimester

A 
Larger breasts and belly 
Braxton Hicks contractions 
Skin changes 
Nasal and gum problems 
Dizziness
Leg cramps 
Heartburn and constipation 
SOB 
Vaginal d/c 
Bladder and kidney infections
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4
Q

Venacaval syndrome

A

Pressure on the vena cava due to enlarging uterus that interferes with returning blood flow

Corrected by woman lying on side

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5
Q

What does venacaval syndrome cause?

A

Decreased BP
Dizziness
Pallor
Clamminess

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6
Q

Calorie requirement for 2nd and 3rd trimester:

A

2300-2400 cals/day
300 calories above pre-pregnancy

Gain 1 lb/week

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7
Q

Subsequent routine prenatal exam

A 
VS
Weight gain
Uterine size & fetal position 
Urinalysis 
CBC and other blood work 
Fetal heartbeat and movement 
Psychological status 
Complaints
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8
Q

Fetal Well Being Tests

A 
Kick counts
Ultrasound 
Amniocentesis 
CVS
Non-stress test 
Contraction stress test
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9
Q

Start monitoring kick counts when?

A

28 weeks and after

Should have 3 movements/hour

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10
Q

AFP screening tool

A

15-22 weeks gestation

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11
Q

Elevated AFP levels indicate:

A 
Open NTD 
Congenital nephrosis/anomalies 
Multiple gestation 
Maternal diabetes 
Rh incompatibility
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12
Q

Low AFP levels indicate:

A

Down’s Syndrome (Trisomy 21)

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13
Q

Amniocentesis (when and what is it?)

A

15-18 weeks

Transabdominal removal of a sample of amniotic fluid

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14
Q

Non-Stress Test (NST)

A

Shows if the baby is not receiving enough oxygen because of placenta or umbilical problems

Detects fetal heart rate acceleration in response to fetal movement to determine adequacy of fetal oxygenation and autonomic function

External fetal monitoring for 20 - 40 mins

Interpretation 2 movements/20 minutes

  • Reactive - FHR accelerations (repeat q wk)
  • Non-reactive - insufficient HR accels x 40 min (repeat in 12-24 hrs or refer for wk up)
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15
Q

Reason for Non-Stress Test (NST)

A

If mother reports baby not moving as frequently as usual
Mom is overdue
Any reason to suspect the placenta is not functioning properly
High risks

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16
Q

Why is a Contraction Stress Test (CST) done?

A

To see if the baby will stay healthy during the reduced O2 levels that normally occur during contractions during labor

If the placenta is healthy and can support the baby

17
Q

When is a CST done?

A

34 weeks+

When results from a non-stress test or a biophysical profile are not in normal range

18
Q

Normal (-) CST results:

A

Baby’s heart rate does not slow and stay low after contraction

If 3 contractions occur in10 minutes lasting > 45 seconds with no decelerations, baby can tolerate labor

19
Q

Abnormal (+) CST results:

A

Late decelerations that stay low after the contraction

Contractions that last longer than 90 seconds and occur every few minutes are present

20
Q

How to prepare a patient for a CST:

A

NPO 4-8 hours before
Empty bladder
No smoking for 2 hours prior
Consent

Test may take 2 hours
Observed until contractions go away

21
Q

Risks of CST

A

Labor may start earlier than expected
Prolonged contractions - may cause issue for baby
Contractions usually stop when oxytocin is stopped

If contractions don’t stop, then Dr. may recommend delivery

22
Q

Contraction Stress Test (CST)

A

Placental insufficiency
Induce contraction with nipple stimulation or Pitocin
3 contractions of 40 second duration in 10 minutes

23
Q

Indications for NST and CST

A 
Maternal diabetes 
Chronic HTN 
IUGR 
Sickle cell disease 
Maternal cyanotic heart disease 
Post-maturity
History of stillbirth 
Decreased fetal movement
24
Q

Biophysical Profile

A 
Fetal breathing and movements 
Gross body movements 
Fetal tone 
Reactive FHR 
Amniotic fluid volume
25
Q

3 signs of labor

A

Bloody show
Contractions
Rupture of amniotic sac membranes

26
Q

Early amniotic fluid contents:

A

Water

Electrolytes

27
Q

Late amniotic fluid contents:

A 
Lipids
Proteins
Carbs
Phospholipids 
Urea
28
Q

pH of amniotic fluid

A

7.0-7.5

29
Q

Does the baby breath in and out in the amniotic fluid?

A

Yes

Breathes in the fluid bathing the lungs

Exam 4 (Spring) (12 decks)

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