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RNC OB > Antenatal Testing > Flashcards

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
Q

What are two fetal concerns with Oligo?

A

Growth Restriction (think this is a placental problem. Less flow in, less flow out) and decreased surfactant (increased breathing issues)

26
Q

What is the range for polyhydramnios?

A

> 25

27
Q

What are three diagnoses related to Poly?

A
  1. Diabetes
  2. TE fistulas
  3. Anomalies
28
Q

What are the two major things that a nurse should watch for when you rupture a Poly patient?

A

Placental abruption and cord prolapse.

29
Q

What are the main purposes for an Amniocentesis?

A
  1. Culture amniotic fluid
  2. Genetic studies
  3. CNS anomalies
  4. Ventral wall defects
  5. Lung Maturity
30
Q

When is an Amniocentesis normally done (if needed)?

A

14-20 weeks

31
Q

What are the three main risks of Amniocentesis?

A
  1. Bleeding
  2. Infection
  3. Rupture of membranes
32
Q

What is the L/S ratio?

A

This ratio is to determine fetal lung maturity.
L and S are types of surfactants

33
Q

What are 5 things that can lead to a false positive in the L/S ratio?

A
  1. Diabetes
  2. Contaminated amniotic fluid (meconium)
  3. Severe fetal anemia (Erythroblastosis fetalis)
  4. Placental/ fetal disorders
  5. Bloody amniocentesis
34
Q

Where should the L/S ratio be for good lung maturity?

A

> 2:1

35
Q

What is the purpose of the PUBS (percutaneous umbilical cord sampling)?

A

This is to obtain fetal blood to determine fetal anemia

36
Q

When should a PUBS procedure take place?

A

after 18 weeks

37
Q

What should the nurse look for with a PUBS procedure?

A

Preterm labor

38
Q

In what conditions would you see an ELEVATED AFP (Alpha Fetal Protein)?

A

neural tube defects, anencephaly

39
Q

in what conditions would you see a DECREASED AFP?

A

Down’s Syndrome (Trisomy 21) and Edwards Syndrome (Trisomy 18)

40
Q

In which trisomy will you see an INCREASE in Inhibin A?

A

21: Down’s Syndrome

40
Q

What is included in a Quad Screening?

A

AFP, hCG, Estriol, and Inhibin A

40
Q

In which trisomy will you see a DECREASE in Inhibin A?

A

18: Edward’s Syndrome

41
Q

Which test is preferred for trisomy diagnosis: Quad screen or AFP?

A

Quad

42
Q

How long is an NST “good for”?

A

24 hours

43
Q

How long is an BPP “good for”?

A

7 days

44
Q

In which scenarios are contraction stress tests contraindicated?

A

Placenta previa, classical incision, and vasa previa

45
Q

Which is the most concerning in a BPP?

A

Lack of tone- this means long-term perfusion issues

46
Q

What shape is the Anterior fontanelle?

A

Diamond shape

47
Q

What shape is the Posterior fontanelle?

A

Triangle shape

48
Q

What is the definition of attitude of the fetus?

A

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
Q

What is the definition of lie of the fetus?

A

This is compared to the long axis of the mother
Transverse, longitudinal (breech or vertex), or oblique (unstable)

50
Q

What are the cardinal movements of labor?

A
  1. Engagement
  2. Descent
  3. Flexion
  4. Internal rotation
  5. Extension
  6. Restitution (external rotation)
  7. Expulsion
51
Q

Where is oxytocin released from?

A

Posterior Pituitary

52
Q

A decrease in which hormone allows estrogen to cause the uterine muscles to contract?

A

Progesterone

53
Q

How many stages are there in the labor process?

A

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
Q

How many phases are there in the labor process?

A

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
Q

How many maneuvers are a part of Leopold’s maneuvers?

A
  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
Q

What is the normal cervical length in pregnancy?

A

3.5-5 cm

57
Q

If a women gets Zika virus, how long should she wait to get pregnant?

A

2 months

58
Q

If a male gets Zika virus, how long should he wait to have unprotected sex?

A

6 months

RNC OB (21 decks)

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