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Antenatal Testing Flashcards

1
Q

When would a patient start feeling fetal movement?

A

between 16-18 weeks

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2
Q

What are the criteria for fetal kick counts?

A

5 movements in 1 hours or 10 in 2 hours

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3
Q

True or False: Is fetal movement a reliable predictor of fetal well-being?

A

True: but the absence of fetal movement does not always be predictive of adverse fetal outcomes.

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4
Q

What are the criteria for a reactive Non-Stress Test?

A

Greater than 32 weeks: two accelerations that are 15x15’s in 20 minutes.
Less than 32 weeks: two accelerations that are 10x10’s in 20 minutes.

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5
Q

What are the five components of a Biophysical Profile?

A
  1. fetal breathing movements
  2. gross body movements
  3. fetal tone
  4. amniotic fluid volume
  5. fetal heart rate reactivity
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6
Q

Fetal Gross Movements

A

Normal: at least three rolling movements of the extremities or trunk in 30 minutes
Abnormal: to or fewer episodes of movement

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7
Q

Fetal Tone

A

Normal: extension of the extremities with a return to flexion or the opening or closing of the hand.
Abnormal: either slow extension with return to partial flexion or the absent of movement

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8
Q

Fetal Breathing

A

Normal: this is the continuous movement of the chest of the abdominal well lasting at least 30 seconds, with breath-to-breath intervals shorter than 6 seconds.
Abnormal: absent fetal breathing movements or no episodes >30 seconds in 30 minutes

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9
Q

Amniotic Fluid volume index

A

Normal: at least one pocket of fluid measuring 2 cm or more in the vertical axis
Abnormal: either no fluid or a pocket <2 cm in two perpendicular planes

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10
Q

How much folic acid should women of childbearing age take?

A

400 mcg

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11
Q

When does testing for Gestational Diabetes take place?

A

24-28 weeks

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12
Q

What test is low with Downs Syndrome and/or other chromosomal abnomalities?

A

Alpha-fetoprotein (AFP)

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13
Q

What is nuchal translucency?

A

This test is to assess the amount of fluid behind the neck of the fetus.

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14
Q

What abnormality includes an increased nuchal translucency?

A

Downs Syndrome

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15
Q

What does a fetal fibronectin evaluate for? What is the significance of a negative and a positive result?

A

This can evaluate women in possible preterm labor.
Negative: not in preterm labor
Positive: not a sure sign of preterm labor.

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16
Q

What is the highest indication for a preterm delivery?

A

Previous Preterm Delivery

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17
Q

What is Antiphospholipid Antibody Syndrome?

A

This is when the blood is thicker than normal and this makes it more prone to clot.

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18
Q

What signs will you see in newborns with maternal exposure to lead?

A

Neuro issues and low IQ.

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19
Q

What is the most common method of evaluation in the 1st trimester?

A

Crown-rump length- this can determine the GA within one week.

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20
Q

What is the normal Amniotic Fluid level?

A

5-25 at term

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21
Q

What are the two parts of the Amniotic sac called?

A

Amnion: inner part of the bag, closest to the fetus
Chorion: outer part of the bag, closest to the uterus

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22
Q

What is a condition that can occur when the amnion part of the bag breaks?

A

Amniotic band syndrome- this can cause amputations or death

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23
Q

What is the range for Oligohydramnios?

A

Borderline: 5-8
True: <5

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24
Q

What maternal diagnosis is common with oligo?

A

Hypertension

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25
What are two fetal concerns with Oligo?
Growth Restriction (think this is a placental problem. Less flow in, less flow out) and decreased surfactant (increased breathing issues)
26
What is the range for polyhydramnios?
>25
27
What are three diagnoses related to Poly?
1. Diabetes 2. TE fistulas 3. Anomalies
28
What are the two major things that a nurse should watch for when you rupture a Poly patient?
Placental abruption and cord prolapse.
29
What are the main purposes for an Amniocentesis?
1. Culture amniotic fluid 2. Genetic studies 3. CNS anomalies 4. Ventral wall defects 5. Lung Maturity
30
When is an Amniocentesis normally done (if needed)?
14-20 weeks
31
What are the three main risks of Amniocentesis?
1. Bleeding 2. Infection 3. Rupture of membranes
32
What is the L/S ratio?
This ratio is to determine fetal lung maturity. L and S are types of surfactants
33
What are 5 things that can lead to a false positive in the L/S ratio?
1. Diabetes 2. Contaminated amniotic fluid (meconium) 3. Severe fetal anemia (Erythroblastosis fetalis) 4. Placental/ fetal disorders 5. Bloody amniocentesis
34
Where should the L/S ratio be for good lung maturity?
>2:1
35
What is the purpose of the PUBS (percutaneous umbilical cord sampling)?
This is to obtain fetal blood to determine fetal anemia
36
When should a PUBS procedure take place?
after 18 weeks
37
What should the nurse look for with a PUBS procedure?
Preterm labor
38
In what conditions would you see an ELEVATED AFP (Alpha Fetal Protein)?
neural tube defects, anencephaly
39
in what conditions would you see a DECREASED AFP?
Down's Syndrome (Trisomy 21) and Edwards Syndrome (Trisomy 18)
40
In which trisomy will you see an INCREASE in Inhibin A?
21: Down's Syndrome
40
What is included in a Quad Screening?
AFP, hCG, Estriol, and Inhibin A
40
In which trisomy will you see a DECREASE in Inhibin A?
18: Edward's Syndrome
41
Which test is preferred for trisomy diagnosis: Quad screen or AFP?
Quad
42
How long is an NST "good for"?
24 hours
43
How long is an BPP "good for"?
7 days
44
In which scenarios are contraction stress tests contraindicated?
Placenta previa, classical incision, and vasa previa
45
Which is the most concerning in a BPP?
Lack of tone- this means long-term perfusion issues
46
What shape is the Anterior fontanelle?
Diamond shape
47
What shape is the Posterior fontanelle?
Triangle shape
48
What is the definition of attitude of the fetus?
This is the relationship of the fetal parts to each other. This is either flexion (head is tucked- this is normal) or extension (Military- head is straight up and down, Brow, or Face)
49
What is the definition of lie of the fetus?
This is compared to the long axis of the mother Transverse, longitudinal (breech or vertex), or oblique (unstable)
50
What are the cardinal movements of labor?
1. Engagement 2. Descent 3. Flexion 4. Internal rotation 5. Extension 6. Restitution (external rotation) 7. Expulsion
51
Where is oxytocin released from?
Posterior Pituitary
52
A decrease in which hormone allows estrogen to cause the uterine muscles to contract?
Progesterone
53
How many stages are there in the labor process?
4 1. First stage 0-10 cm 2. Pushing and delivery 3. Delivery of the placenta 4. From placenta delivery and the 1st hour postpartum
54
How many phases are there in the labor process?
3 phases- all in the 1st STAGE of labor 1. Latent: 0-6 cm 2. Active 6-8 cm 3. Transition 8-10 cm
55
How many maneuvers are a part of Leopold's maneuvers?
1. Palpate uterine fundus 2. Deep palpation of the maternal abdomen on both sides- this is to find the fetal back 3. Above symphysis pubis- is the presenting part engaged 4. Use the tips of the fingers for engagement details
56
What is the normal cervical length in pregnancy?
3.5-5 cm
57
If a women gets Zika virus, how long should she wait to get pregnant?
2 months
58
If a male gets Zika virus, how long should he wait to have unprotected sex?
6 months

RNC OB (21 decks)

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