Antenatal

Question 1

How long the typical menstrual cycle?

Answer 1

28 days

need to assess length

Question 2

Which hormone stimulates maturation of the egg?

Answer 2

follicle stimulating hormone (FSH)

Question 3

Which hormone triggers the release of the egg/ovulation?

Answer 3

luteinizing hormone (LH)

Question 4

Which hormone allows implantation?

Answer 4

progesterone

Question 5

What marks the beginning of pregnancy?

Answer 5

union of a single egg and sperm (conception)

Question 6

sperm can live in the tract for __ to __ days

Answer 6

2 to 4

Question 7

Hormones produced by the placenta (4)

Answer 7

1) Human Chorionic Gonadotropin (hCG)
2) Human Placental Lactogen (hPL)
3) Progesterone
4) Estrogen

Question 8

Human Chorionic Gonadotropin (hCG)

Answer 8

stimulates ongoing production of progesterone

Question 9

Human Placental Lactogen (hPL)

Answer 9

stimulates breast growth and exerts lactogenic properties

Question 10

Progesterone

Answer 10

maintains the endometrium around the fetus

increases the alveoli in the breast

keeps the uterus in a quiescent state

Question 11

Estrogen

Answer 11

stimulates duct formation in the breast

increases the weight of the uterus

increases certain uterine receptors important to birth

Question 12

Length of pregnancy in weeks

Answer 12

40 weeks

Question 13

Pregnancies are computed from the 1st day of the __________

Answer 13

last menstrual period (LMP)

conception occurs approximately 2 weeks after the first day of the LMP

Question 14

Nagele’s Rule

Answer 14

for computing estimated due date (EDD)

assumes normal cycle*

First day of LMP – 3 months back + 7 days + 1 year
OR
First day of LMP + 7 days + 9 months

Question 15

How to determine EDD if period cycle isn’t normal

Answer 15

dating ultrasound around 8 - 12 weeks

Question 16

Types of Signs and Symptoms of Pregnancy (3)

Answer 16

1) Presumptive
2) Probable
3) Positive

Question 17

Presumptive Signs and Symptoms of Pregnancy

Answer 17

subjective changes reported by the patient

e.g. amenorrhea, tender breasts, nausea, fatigue, polyuria

could also be things like diabetes, stomach bug

Question 18

Probable Signs and Symptoms of Pregnancy

Answer 18

objective changes by an examiner

Chadwick’s sign, Goodell’s sign, Hegar’s sign, positive pregnancy test

Question 19

Positive Signs and Symptoms of Pregnancy

Answer 19

objective signs assessed by an examiner that can be attributed ONLY to the presence of the fetus

ultrasound, Dopplers - heart tones of fetus

Question 20

Chadwick’s Sign

Answer 20

bluish or purplish discoloration of the vulva, vaginal tissue, or cervix

caused by increased blood flow

Question 21

Goodell’s Sign

Answer 21

softening of the cervix

Question 22

Hegar’s Sign

Answer 22

uterus becomes globular in shape, softens, and flexes easily over the cervix

Question 23

Primigravida

Answer 23

client who is pregnant for 1st time

Question 24

Multigravida

Answer 24

client who has had 2 or more pregnancies

Question 25

Nulligravida

Answer 25

client who has never been pregnant

Question 26

Gravida

Answer 26

TOTAL # of pregnancies prior PLUS present pregnancies regardless of gestational age, type, time or method of termination/outcome pregnancy with twins/multiples is counted as 1 pregnancy

Question 27

Term

Answer 27

Total # of previous pregnancies WITH BIRTH occurring at greater than or equal to 37 completed weeks

Question 28

Preterm

Answer 28

Total # of previous pregnancies WITH BIRTH occurring between 20 + 0 and 36+7 completed weeks

Question 29

Abortus

Answer 29

Total # of spontaneous or therapeutic abortions occurring prior to 20+0 weeks spontaneous abortions include miscarriage, ectopic pregnancy, missed abortion, and molar pregnancy

Question 30

Living Children

Answer 30

Total # of children the patient/client has given birth to that are presently living Providers can include each child’s name in the free text

Question 31

39 year old; one miscarriage, one birth at 23 weeks non live, 4 abortus prior to 20 weeks, 3 children at home, one set of twins born at 36 weeks; one singleton born at 41 weeks GTPAL format

Answer 31

G: 8 T: 1 P: 2 A: 5 L: 3

Question 32

T-ACE acronym meaning

Answer 32

for illicit drug use T: Tolerance - how much to feel effect A: Annoyance - being told to cut down C: Cut down - feeling like they need to cut down E: Eye opener - first thing in the morning

Question 33

Concerning Findings in Pregnancy (many)

Answer 33

edema in face unilateral edema in legs (DVT) hyper-reflexive deep tendon reflexes (preeclampsia) sudden vision changes (preeclampsia)

Question 34

Expected findings during pregnancy (many)

Answer 34

weight gain dyspnea peripheral edema constipation hypotension vaginal bleeding bleeding gums mammary souffle (heart murmur sound over breasts)

Question 35

What is fundal height used to estimate?

Answer 35

fetal growth

Question 36

Fundal height is measured from the _______ to the _______

Answer 36

symphysis pubic bone top of the uterus (fundus)

Question 37

At approximately how many weeks of gestation does the fundal height in cm correlate with the gestational age in weeks?

Answer 37

20 weeks

Question 38

A pregnant individual at 30 weeks gestation has a fundal height of 26 cm. What is the most appropriate next step? a) reassure the patient this is normal b) schedule an ultrasound to assess fetal growth c) perform a non-stress test immediately d) measure blood pressure

Answer 38

b) schedule an ultrasound to assess fetal growth

Question 39

First trimester length

Answer 39

0 to 12 weeks

Question 40

Second trimester length

Answer 40

13 to 27 weeks

Question 41

Third trimester length

Answer 41

28 weeks to birth

Question 42

Leopold's Maneuvers

Answer 42

used to assess fetal lie, presentation, attitude, position, and engagement

Question 43

During which trimester are Leopold's Maneuvers used?

Answer 43

3rd trimester

Question 44

Fetal HR should be between ___ and ___ bpm

Answer 44

110 - 160 bpm count for 1 full minute*

Question 45

How to differentiate between fetal and maternal HR?

Answer 45

palpate the mother's pulse while you listen

Question 46

BP changes by trimester

Answer 46

1st -pre-pregnancy values -diastolic may decrease due to decreased SVR 2nd -diastolic drops 10 - 15mmHg lower than pre-pregnancy -especially with position changes, get up slowly 3rd -rises to prepregnancy levels

Question 47

HR changes by trimester

Answer 47

1st -15 - 20 bpm higher 2nd / 3rd -15 - 20 bpm higher -functional systolic murmur

Question 48

How to frame questions related to abuse

Answer 48

“I ask everyone these questions because of my concern for all women.”