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Obstetrics > Antenatal testing, antepartum care, High-risk antepartum nursing care > Flashcards

Antenatal testing, antepartum care, High-risk antepartum nursing care Flashcards

1
Q

What is the most common used screening test throughout pregnancy?

A

Ultrasound

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2
Q

what is nuchal translucency?

A

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

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3
Q

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

A

3-dimensional and 4-dimenstional ultrasound

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4
Q

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

A

MRI

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5
Q

Which test assess placenta perfusion?

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

A

umbilical artery doppler flow

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6
Q

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

A

Chorionic villus sampling

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7
Q

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?

A

Amniocentesis

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8
Q

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

A

Fetal Blood Sampling/Percutaneous Umbilical Blood Sampling (PUBS)

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9
Q

Which test allows for earliest detection of fetal sex?

A

Cell-Free DNA testing

(maternal assay)

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10
Q

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.

A

Cell-free DNA testing

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11
Q

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

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

A
  • Increased AFP = NTD, anencephaly, omphalocele, gastroschisis
  • Decreased AFP = Trisomy 21 (Down Syndrome)
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12
Q

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

A

Without accurate dating, may lead to false positive rates.

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13
Q

What does nonstress test (NST) monitor?

A

Fetal heart rate

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14
Q

Which type of antenatal fetal surveillance is described?

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

A

Vibroacoustic stimulation (VAS)

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15
Q

Which type of antenatal fetal surveillance is described?

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

A

Contraction stress test

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16
Q

Which type of antenatal fetal surveillance is described?

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

A

Amniotic fluid index (AFI)

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17
Q

What is the average range Amniotic fluid index?

A

8 cm to 24 cm

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18
Q

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

A
  1. Fetal movement
  2. Fetal tone
  3. Fetal breathing movement
  4. Amniotic Fluid
  5. Nonstress Test
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19
Q

What is a passing biophysical profile score?

A

8/10

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20
Q

A modified biophysical profile consists of what indicators?

A
  1. Amniotic Fluid
  2. Nonstress test
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21
Q

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

A

Progesterone and Estrogen

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22
Q

What happens to the pH of the vagina during pregnancy?

What increased/decreased risk is there due to change?

A

pH decreases (becomes more acidic)

Acidic environment ↓ risk of bacteria

but ↑ risk yeast infections (Candida albicans)

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23
Q

What is colostrum?

A

yellow secretion (breastmilk) rich in antibodies

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24
Q

What vital sign changes occur during pregnancy?

A
  • Blood pressure ↓
  • Heart Rate ↑
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25
Q

When would the Chorionic villus sampling exam be performed?

A

Preformed during first or second trimester

ideally at 10–13 weeks’ gestation (First Trimester)

26
Q

When is Amniocentesis typically performed?

A

Between 14-20 weeks

(during the second trimester)

27
Q

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

A

Performed after 18 weeks

(typically during 2nd Trimester)

28
Q

When is pregnancy confirmed and gestational age estimated with an ultrasound?

A

First Trimester (0-13 weeks)

29
Q

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?

A

Chorionic villus sampling

30
Q

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?

A

Amniocentesis

31
Q

What are some presumptive signs (6) of pregnancy?

(think symptoms)

A
  1. Period absent (amenorrhea)
  2. Really tired (fatigue)
  3. Enlarged breast
  4. Sore breast
  5. Urination ↑
  6. Movement perceived (Quickening)
  7. Emesis & nausea
32
Q

What are some probable signs (5) of pregnancy?

A
  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
33
Q

What are the positive signs (3) of pregnancy?

A
  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)
34
Q

How many weeks is the first trimester?

A

Last menstrual period = 0 to 14 weeks

35
Q

How many weeks is the second trimester?

A

15 to 28 weeks

36
Q

How many weeks is the third trimester?

A

29-40 weeks

37
Q

What is considered early term?

A

37 to 38 weeks

38
Q

What is Naegele’s rule?

What is the formula?

What two factors does it depend on?

A

Calculates estimated date of delivery (EDD)

Last menstrual period (-) 3 months (+) 7 days

Regular menstrual cycle and length of person’s menstrual cycle.

39
Q

Define Gravida and Para

A

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

Para = # of births

40
Q

Define GTPAL

A
  • G = # times pregnant
  • T = # of term births
  • P = # of pre-term births
  • A = # of abortions (spontaneous or elected)
  • L = # of living children
41
Q

What supplements are recommended before getting pregnant?

A
  • Folic acid (↓ risk of neural tube defects)
  • Calcium, Magnesium and Vitamin D (bone health)
  • Iron (blood supply)
42
Q

What do Multiple Marker screen for?

A

Calculates risk of trisomy anomalies and neural tube defects.

43
Q

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

A

Inhibin-A

44
Q

When is Group B Streptococcus (GBS) screened for?

A

35 to 37 weeks (Third Trimester)

45
Q

What is defined as pre-term delivery?

A

any delivery before 37 weeks

46
Q

What is Nulligravida?

A

A person who has never been pregnant or given birth.

47
Q

What is Primigravida?

A

A person who is pregnant for the first time.

48
Q

What does an ultrasound tell you?

A
  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)
49
Q

Which prenatal supplements ↓ risk of neural tube defects?

When is the greatest benefit received when taking the supplement?

A

Folic Acid

1 month before conceiving and through the 1st trimester

50
Q

What is the purpose of Leopold’s maneuvers?

Which trimester is it used in?

A

Palpation of the abdomen to identify the position of the fetus in utero

2nd and 3rd trimester

51
Q

When does screening for gestational diabetes occur?

A

2nd trimester b/w weeks 24 to 28.

52
Q

What is the purpose of the vibroacoustic simulation?

A

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

53
Q

Oligohydramnios is when AFI what?

A

AFI < 5 cm

54
Q

Polyhydramnios is when AFI what?

A

AFI > 24 cm.

55
Q

Which tests are diagnostic for chromosomal abnormalities?

A
  1. Chorionic villus sampling,
  2. amniocentesis
  3. Fetal Blood Sample/PUBS
56
Q

What weeks are included for “A” in GTPAL?

A

Weeks 1 to 19

57
Q

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

A

25 to 35lbs

58
Q

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

A

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

59
Q

What are abnormal findings on an umbilical artery doppler flow?

A
  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)
60
Q

What does a triple marker screen for?

A
  1. Alpha Fetal Protein
  2. Human chorionic gonadotropin
  3. Estriol
61
Q

What is the normal parameter for fetal movement counts?

A
  • Ten distinct movements within 2 hours
  • Four movements within 1 hour
62
Q

What is the normal parameter for a contraction stress test?

A

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

Obstetrics (9 decks)

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