Antenatal testing, antepartum care, High-risk antepartum nursing care Flashcards by Simon L

What is the most common used screening test throughout pregnancy?

Ultrasound

How well did you know this?

Not at all

Perfectly

what is nuchal translucency?

ultrasound screening test for measuring the amount of fluid behind the fetal neck

How well did you know this?

Not at all

Perfectly

which type of ultrasound allows for visualization of complex facial movements and features?

3-dimensional and 4-dimenstional ultrasound

How well did you know this?

Not at all

Perfectly

What type imaging would be a diagnostic evaluation of tissue and organs?

MRI

How well did you know this?

Not at all

Perfectly

Which test assess placenta perfusion?

(rate and volume of blood flow through placenta and umbilical cords)

umbilical artery doppler flow

How well did you know this?

Not at all

Perfectly

Which diagnostic tests involves aspiration (biopsy) of placental tissue for chromosomal, metabolic, or DNA testing.

Chorionic villus sampling

How well did you know this?

Not at all

Perfectly

which diagnostic test involves a needle to obtain a sample of amniotic fluid for genetic testing, fetal lung maturity*, hemolytic disease of the fetus, intrauterine infection, treatment for polyhydramnios?

Amniocentesis

How well did you know this?

Not at all

Perfectly

Which diagnostic test involves removal of fetal blood from the umbilical cord to test for metabolic and hemolytic disorders, fetal infection, fetal karyotyping.

Fetal Blood Sampling/Percutaneous Umbilical Blood Sampling (PUBS)

How well did you know this?

Not at all

Perfectly

Which test allows for earliest detection of fetal sex?

Cell-Free DNA testing

(maternal assay)

How well did you know this?

Not at all

Perfectly

What test extracts DNA (maternal & fetal) from a maternal blood sample and screened for the increased chance of specific chromosome problems, such as Down syndrome, trisomy 13 and trisomy 18.

Cell-free DNA testing

How well did you know this?

Not at all

Perfectly

Does increased or decreased Alpha-Fetoprotein (AFP) levels detect the following?

NTD, anencephaly, omphalocele, gastroschisis, Trisomy 21 (Down Syndrome)

Increased AFP = NTD, anencephaly, omphalocele, gastroschisis
Decreased AFP = Trisomy 21 (Down Syndrome)

How well did you know this?

Not at all

Perfectly

What are the risks of examining Alpha-Fetoprotein (AFP)?

Without accurate dating, may lead to false positive rates.

How well did you know this?

Not at all

Perfectly

What does nonstress test (NST) monitor?

Fetal heart rate

How well did you know this?

Not at all

Perfectly

Which type of antenatal fetal surveillance is described?

Uses auditory stimulation to assess fetal well-being with EFM when NST is nonreactive.

Vibroacoustic stimulation (VAS)

How well did you know this?

Not at all

Perfectly

Which type of antenatal fetal surveillance is described?

Assesses the ability of the fetus to maintain a normal FHR in response to uterine contractions.

Contraction stress test

How well did you know this?

Not at all

Perfectly

Which type of antenatal fetal surveillance is described?

Measures the volume of amniotic fluid with ultrasound to assess fetal well-being and placental function.

Amniotic fluid index (AFI)

How well did you know this?

Not at all

Perfectly

What is the average range Amniotic fluid index?

8 cm to 24 cm

How well did you know this?

Not at all

Perfectly

What (5) indicators are assessed in a biophysical profile?

Fetal movement
Fetal tone
Fetal breathing movement
Amniotic Fluid
Nonstress Test

How well did you know this?

Not at all

Perfectly

What is a passing biophysical profile score?

8/10

How well did you know this?

Not at all

Perfectly

A modified biophysical profile consists of what indicators?

Amniotic Fluid
Nonstress test

How well did you know this?

Not at all

Perfectly

Which hormone causes many physiological changes in the maternal mother during preganancy?

Progesterone and Estrogen

How well did you know this?

Not at all

Perfectly

What happens to the pH of the vagina during pregnancy?

What increased/decreased risk is there due to change?

pH decreases (becomes more acidic)

Acidic environment ↓ risk of bacteria

but ↑ risk yeast infections (Candida albicans)

How well did you know this?

Not at all

Perfectly

What is colostrum?

yellow secretion (breastmilk) rich in antibodies

How well did you know this?

Not at all

Perfectly

What vital sign changes occur during pregnancy?

Blood pressure ↓
Heart Rate ↑

How well did you know this?

Not at all

Perfectly

When would the **Chorionic villus sampling** exam be performed?

Preformed during first or second trimester ideally at **10–13 weeks’ gestation** (**First Trimester**)

When is **Amniocentesis** typically performed?

Between **14-20 weeks** | (during the second trimester)

When is a **Fetal Blood Sampling/Percutaneous Umbilical Blood Sampling (PUBS)** performed?

Performed after **18 weeks** | (typically during 2nd Trimester)

When is **pregnancy** confirmed and **gestational age _estimated_** with an ultrasound?

First Trimester (0-13 weeks)

If a patient is in their **first trimester of pregnancy** and they want a diagnostic test to tell them if there are any chromosomal abnormalities, which test would you recommend?

**Chorionic villus sampling**

If a patient is in their **Second trimester of pregnancy** and they want a diagnostic test to tell them if there are any chromosomal abnormalities, which test would you recommend?

**Amniocentesis**

What are some **presumptive** signs (6) of pregnancy? (*think symptoms*)

1. **P**eriod absent (amenorrhea) 2. **R**eally tired (fatigue) 3. **E**nlarged breast 4. **S**ore breast 5. **U**rination ↑ 6. **M**ovement perceived (Quickening) 7. **E**mesis & nausea

What are some **probable** signs (5) of pregnancy?

1. **Bimanual pelvic examination** (*color change, softening of cervix, vagina and uterine segment*) 2. **Uterine** and **abdominal** **growth** 3. **Skin hyperpigmentation** (*face, linea nigra, nipples and areola*) 4. **Ballottement** (*late sign 16-18 weeks*) 5. **Positive pregnancy tests**

What are the **positive** signs (3) of pregnancy?

1. **Sonographic visualization** of fetus 2. **Auscultation of fetal heart** (10-12 weeks) w/ **doppler**. 3. **Observation and palpitation of fetal movement** (after 20 weeks)

How many weeks is the first trimester?

Last menstrual period = 0 to 14 weeks

How many weeks is the **second** trimester?

15 to 28 weeks

How many weeks is the **third** trimester?

29-40 weeks

What is considered early term?

37 to 38 weeks

What is Naegele's rule? What is the formula? What two factors does it depend on?

Calculates **estimated date of delivery** (EDD) Last menstrual period (**-**) 3 months (**+**) 7 days **Regular** menstrual cycle and **length** of person's **menstrual cycle**.

Define Gravida and Para

Gravida = **Total # of times pregnant** (*includes miscarriages and terminations*) Para = **# of births**

Define GTPAL

* G = # times pregnant * T = # of term births * P = # of **pre**-term births * A = # of abortions (*spontaneous or elected*) * L = # of living children

What supplements are recommended before getting pregnant?

* **Folic acid** (*↓ risk of neural tube defects*) * **Calcium**, **Magnesium** and **Vitamin D** (*bone health*) * **Iron** (*blood supply)*

What do Multiple Marker screen for?

**Calculates _risk_** of trisomy anomalies and neural tube defects.

What additional information does a **Quad** screen for in Multiple Marker Screening?

Inhibin-A

When is **Group B Streptococcus (GBS)** screened for?

**35 to 37 weeks** (Third Trimester)

What is defined as pre-term delivery?

any delivery **before 37** weeks

What is **Nulligravida**?

A person who has **never been pregnant** or **given birth**.

What is **Primigravida**?

A person who is pregnant for the first time.

What does an **ultrasound** tell you?

1. **Dating** (*gestational aging*) 2. **Nuchal translucency** 3. **Guides procedures that req. ultrasound** (*chorionic villus sampling, amniocenteses* 4. **Biophysical assessment** (*fetal movements, tone breathing, & AFI*)

Which prenatal supplements ↓ risk of neural tube defects? When is the greatest benefit received when taking the supplement?

Folic Acid 1 month before conceiving and through the 1st trimester

What is the purpose of Leopold’s maneuvers? Which trimester is it used in?

Palpation of the abdomen to _identify the position of the fetus_ in utero 2nd and 3rd trimester

When does screening for gestational diabetes occur?

2nd trimester b/w weeks 24 to 28.

What is the purpose of the vibroacoustic simulation?

Vibroacoustic stimulation is a tool that is used to stimulate a baby who might not have a reactive non-stress test.

Oligohydramnios is when AFI what?

AFI \< 5 cm

**Polyhydramnios** is when AFI what?

AFI \> 24 cm.

Which tests are **diagnostic** for **_chromosomal_** abnormalities?

1. Chorionic villus sampling, 2. amniocentesis 3. Fetal Blood Sample/PUBS

What weeks are included for “A” in GTPAL?

**Weeks 1 to 19**

What is the average weight gain in a normal BMI pregnancy?

25 to 35lbs

What are the parameters for **reactive** NST for **fetus \> 32k weeks**.

FHR increases by 15 beats above baseline for 15 seconds 2 or more times in 20 minutes.

What are **abnormal** findings on an **umbilical artery doppler flow**?

1. Systolic/Diastolic above 95 percentile for gestational age 2. Ratio above 3.0 3. End-diastolic blood flow is **absent** or **reversed**. (see image B and C)

What does a triple marker screen for?

1. Alpha Fetal Protein 2. Human chorionic gonadotropin 3. Estriol

What is the normal parameter for **fetal movement counts**?

* Ten distinct movements within 2 hours * Four movements within 1 hour

What is the **normal** parameter for a **contraction stress test**?

_Negative when there are no decelerations_ in a 10-minute strip with 3 contractions in more than 40 seconds. Baby is tolerating the contractions