4570 Exam 1 Flashcards
What nutrient deficiency is r/t neural tube defects?
Folic Acid Deficiency
What 2 immunizations are recommended during pregnancy?
Flu and TDaP. (and covid)
Which vaccines shouldn’t be given during pregnancy?
Live virus vaccines (MMR, HPV, Varicella.
How many pounds should a pregnant woman gain in the first trimester?
5 lbs total in the first trimester.
How many pounds should a pregnant woman gain per week after the first trimester?
1lb per week.
What causes supine hypotension in pregnancy?
Vena Cava Syndrome (Uterus compresses vena cava when lying supine)
What routine labs are done @ 24 to 28 weeks?
Repeat RPR/VDRL, CBC, antibody screen (if rH -), and 1hr glucose screen for diabetes.
What lab is done @ 36 weeks?
Group B strep (GBS) swab.
What is the schedule for prenatal visits?
-Q4 wks until 28wks
-Q2 wks until 36 weeks
-Weekly until birth
1st trimester danger signs
Bleeding, pain, vomiting w/ weight loss, fever, rash, infx, and dysuria.
Danger signs for preterm labor
Cramps, low backache, thigh pain, water leaking, gush of fluid, and increased mucus discharge.
Danger signs for preeclampsia
Headache, visual changes, generalized edema and sudden weight gain.
Danger signs for placental issues
Bleeding and pain
Danger sign for fetal issues
Decreased fetal movement.
FDA Pregnancy classes for medications
A = Proven safe.
B = No known problems but not fully studied.
C = Possible problems but not fully studied.
D = Known dangers but benefit may outweigh risk.
X = Never safe for use/ may just induce labor.
What is lanugo?
Fine, soft, un-pigmented hair.
What is striae gravidarum?
Pregnancy stretch marks
What is chloasma?
Blotchy brown areas on the face.
What is linea negra?
Dark line on belly
What risk factors may lead to the need for a nutritional referral?
- Adolescence
- High BMI
- Low BMI
- Special diets
- Food sensitivities
- Cultural or personal preferences
- Pica
- Closely spaced pregnancies
- Multiple fetuses
What is a positive sign of a pregnancy?
Direct evidence of a fetus.
What cardiovascular changes are expected during pregnancy?
- Cardiac output increases 30-50%
- Pulse increases 10-15bpm above baseline
- Murmurs are common
- Slight increase in heart size
- Blood volume increases 40-45%
What hematologic changes are expected during pregnancy?
- Increased clotting factors –> Increased risk for thrombus
- Increased production of RBCs
- Low H&H
- Hemodilution
- Physiologic anemia
- Lowered BUN and Uric acid r/t increased flow through kidneys
What is the cycle of violence?
Honeymoon phase –> Tension Building –> Abusive Incident –> Repeat
Why is magnesium sulfate used?
Seizure prevention
Side effects of magnesium sulfate?
Feeling warm, flushing, diaphoresis, burning @ IV site, warmth in perineum.
Signs of magnesium sulfate toxicity
Decreased/ absent DTRs, cardiac arrest, decreased respirations, lethargy, double vision/ slurred speech, maternal hypotension and bradycardia.
How is magnesium sulfate toxicity treated?
Calcium Gluconate
What indicates that someone has hyperemesis gravidarum vs regular pregnancy sickness?
Excessive vomiting resulting in weight loss, electrolyte and fluid imbalances, and nutritional deficits.
How is hyperemesis gravidarum treated?
- Pt will be NPO
- IVF
- Antiemetics
- Supplements to correct electrolyte imbalance
What are examples of iron-rich foods?
Meat, dried fruits, beans, and leafy greens
What is the deadliest complication of pregnancy?
Heart disease
What is normal HR for a newborn?
110 to 160 bpm and irregular.
What are three tests that can be used for genetic anomalies
- Maternal Serum Alphafetal Protein (msAFP)
- Chorionic Villi Sampling (CVS)
- Amniocentesis
Which genetic testing can be done earliest?
CVS (10 weeks)
What is it called when there is a lack of amniotic fluid?
Oligohydramnios
What is it called when there is excessive amniotic fluid?
Polyhydramnios
What can cause polyhydramnios?
Poorly controlled diabetes and fetal congenital abnormalities
What can cause oligohydramnios?
Not making fluid or loss of fluid.
What is considered a bad BPP result?
Less than 4/10.
What is considered a bad NST result?
Less than 2 accelerations in 20 min
What is considered a bad CST result?
Late decelerations present w/ more than half of contractions.
What is usual fundal height at 20 and 24 weeks?
of week +/- 2
What are priority systems to assess in a newborn?
Respiratory and circulatory (heart and lungs), followed by reflexes.
What is considered low birth weight (LBW)?
Less than 2500g (5.5lb)
True or false: Women tend to wake up from anesthesia quicker than men
True
True or false: Men experience more side effects than women
False. Women experience more side effects.
True or false: Black women are more likely to give birth to LBW and premature babies
True
What are 4 main functions of the placenta?
- Transfer oxygen & nutrients to the fetus.
- Remove waste products and CO2 away from fetus, into maternal blood.
- Make hormones (HCG).
- Transfer antibodies from mother to fetus.
What 2 ways can someone detect ovulation?
Temperature changes and mucus changes.
True or false: A drop in BBT predicts ovulation
True
True or false: BBT spikes up 2 degrees after ovulation
False. BBT only rises 1/2 a degree after ovulation.
When is the fetus most vulnerable to birth anomalies?
Embryonic stage (15 days to 8 weeks)
The nurse interviewing a pregnant client on her first prenatal visit notes the following pregnancy history: vaginal birth of twins at 33 weeks gestation, both healthy, miscarriage at 8 weeks gestation, cesarean birth of a breech baby at 38 weeks gestation, healthy, and vaginal birth at 36 weeks, also healthy . How would the nurse describe the pregnancy history using GTPAL?
5-1-2-1-4
The nurse is setting up an appointment for a pregnant client at low risk who is currently 34 weeks gestation. When should the next routine appointment be scheduled?
In two weeks
Which client is at highest risk for nutritional problems during her pregnancy?
A. 31 year old at 22 weeks gestation, pregnant with twins, pre-pregnant weight 95 pounds, current weight 111 pounds.
B. 18 year old at 10 weeks gestation whose pre-pregnant weight was 112 pounds, current weight is 117 pounds.
C. 25 year old at 25 weeks gestation, history of morning sickness which resolved at 14 weeks, pre-pregnant weight 120 pounds, current weight 140 pounds.
D. 22 year at 36 weeks gestation, pre-pregnant weight of 220 pounds, current weight is 235 pounds.
A
What suggests UTI in pregnant patient?
Normal UTI symptoms basically
Molar Pregnancy Characteristics
2nd trimester, dark brown discharge, assisted reproductive meds. Acts like cancer, can turn into cancer. No presence of fetal heart tones ever. Uterus larger than what would be expected
Placenta previa characteristics
3rd trimester
Risk factors: Previous c-section, AMA, multiparity, tobacco use, living, hx of D&C. Nothing inserted through vagina because it can cause hemorrhage. C-section only
Ectopic characteristics
Pain wherever the pregnancy has developed.
Methotrexate to stop growth. Abnormal bleeding if ruptured.
How much folic acid before pregnancy?
400mcg
