Antenatal Physiology and Care

Question 1

Prolactin is released from?

Answer 1

pituitary gland

Question 2

Oxytocin is released from?

Answer 2

pituitary gland

Question 3

Presumptive signs of pregnancy?

Answer 3

subjective signs: amenorrhea, breast tenderness, N/V, fatigue, frequency and quickening

Question 4

What is the medical term for the woman’s perception 1st fetal movement?

Answer 4

• quickening
• 1st preg: 18-20 wks
• > 1 preg: 16-18 wks

Question 5

Probable signs of pregnancy?

Answer 5

abd enlargement, chadwick sign, hegars sign, goodalls sign, pos pregnancy test

Question 6

Positive signs of pregnancy?

Answer 6

auscultation of fetal heart sounds, US, fetal movement upon palpation

Question 7

What is fetal souffle?

Answer 7

blowing sound heard in sync with heart sounds

Question 8

Bluish disoloration of cervix and vag from increased blood loss?

Answer 8

Chadwick sign

Question 9

What is the Hegars sign?

Answer 9

softening of the uterus

Question 10

What is goodalls sign?

Answer 10

softening of vaginal portion of the cervix

Question 11

What is Nagele’s Rule?

Answer 11

• used to determine EDD and has 2 methods using last date of last menstruation
• Apr-Dec: sub 3 months, add 7 days, add 1 yr
• Jan-Mar: add 9 months, add 7 days

Question 12

Using Nagele’s Rule, which calculation is used if the LMP was Jan-Mar?

Answer 12

add 9 months, add 7 days

Question 13

Using Nagele’s Rule, which calculation is used if the LMP was Apr-Dec?

Answer 13

sub 3 months, add 7 days, add 1 yr

Question 14

What is the timeframe for the 1st semester?

Answer 14

1-13 wks

Question 15

What is the timeframe for the 2nd semester?

Answer 15

13-28 wks

Question 16

What is the timeframe for the 3rd semester?

Answer 16

28-40 wks

Question 17

Tradition Prenatal Visit Scheduling?

Answer 17

• once a month until 28 wks
• q 2 wks until 36
• Wkly after 36 wks until delivery
• Total visits: 13 –14

Question 18

Centering Pregnancy Prenatal Visit Scheduling (group care)?

Answer 18

• First visit w/in 1st trimester
• 16-28 wks: every 4 wks
• 29-40 wks: every 2 wks
• Total visits: 10

Question 19

Fundal Height:

1) 12 weeks
2) 16 wks
3) 20 wks
4) > 20 wks
5) > 24 wks

Answer 19

1) top of symphysis pubis
2) midpoint to umbilicus
3) at umbilicus or 20 cm
4) see increase of 1 cm/wk
5) gestation in wks = cm (+/- 2 cm)

Question 20

How do you measure fundal height?

Answer 20

start at the symphysis pubis and measure up to top of the uterus or fundus

Question 21

Follow-Up/Repeat Labs during pregnancy?

Answer 21

• Diabetes Screen (26 -28 weeks)
• Hgb/Hct (28weeks)
• Rh Antibody screen (28weeks)
• Group B Strep (GBS) (36 weeks)
• Gonorrhea / Chlamydia (36 weeks)

Question 22

When can you use the below to auscultate the fetal heartbeat?

1) Fetoscope
2) Doppler

Answer 22

1) 20 wks

2) 12 wks

Question 23

When is the gestational sac visible on an US?

Answer 23

at 5wks

Question 24

When is fetal heart activity visible on an US?

Answer 24

6-7 wks

Question 25

How do you measure gestational age: 1) during 1st trimester 2) after 12 wks

Answer 25

1) crown to rump length | 2) biparietal diameter

Question 26

Discomforts Of Pregnancy: 1st Trimester

Answer 26

``` N/V Fatigue Urinary Frequency Breast fullness and tenderness Increased vaginal discharge Food cravings and aversions Increased intestinal gas Constipation Mood Swings ```

Question 27

When does most nausea resolve in pregnancy?

Answer 27

around 16th wk

Question 28

Hyperemesis Gravidarum s/s

Answer 28

constant N/V, weight loss, ketonuria

Question 29

Tx of Hyperemesis Gravidarum?

Answer 29

TPN, IV hydration and tx N/V

Question 30

Discomforts of Pregnancy: 2nd Trimester

Answer 30

``` Nose Bleeds Bleeding gums Constipation Headaches Braxton-Hicks contractions Round ligament pain Backache Skin changes Varicosities Leg Cramps ```

Question 31

A woman presents at 20 wks with a burning/painful sensation on her sides with movement, what do you suspect?

Answer 31

round ligament pain

Question 32

Discomforts of Pregnancy: Third Trimester

Answer 32

Mood swings Insomnia Dyspnea - improves after baby “drops” in primips Lightening/pelvic discomforts Prelabor uterine activity Persistent or worsening round ligament pain

Question 33

Pregnant women should avoid these when exercising?

Answer 33

- Supine or inverted positions - Prolonged overheating - Exercising to the point of exhaustion - Exercises that might result in loss of balance or abdominal injury

Question 34

Danger Signs: General Pregnancy

Answer 34

- Vaginal bleeding or watery discharge - Painful urination - Abdominal pain - Persistent Vomiting - Chills or fever - Dizziness (sudden or extreme) - Visual disturbances - Rupture of membranes (leaking of fluid) - Decrease or cessation in fetal activity

Question 35

Which categories of drug(s) are safe for use in pregnancy?

Answer 35

- A & B are safe | - C can be used but need to weight risk vs gains

Question 36

OTC drugs safe for use during pregnancy?

Answer 36

- Antacids for heartburn (Maalox, Mylanta, Tums) - Cough or cold: An expectorant (Mucinex, Robitussin, Vicks 44 Cough Relief), Cough drops, Vicks VapoRub - Headache: Acetaminophen - Allergies: An antihistamine (Chlor-Trimeton allergy tablets, Claritin, Tavist ND, Triaminic Allerchews, Benadryl)

Question 37

Vaccinations safe during pregnancy?

Answer 37

- Killed viruses: Hepatitis B (recombinant), tetanus, diphtheria, rabies, flu vaccine - Flu vaccination administration is a very important prenatal health promotion activity

Question 38

Vaccinations not safe to give during pregnancy?

Answer 38

Live or attenuated: rubeola, rubella, chicken pox, mumps