Antepartal Care Flashcards
maternal blood begins to collect in the intervillous space of the uterine endometrium
12th day of pregnancy
O2 and other nutrients (glucose, amino acids, fatty acids, minerals, vitamins and water OSMOSES from maternal blood through CHORIONIC VILLI into the VILLI CAPILLARIES. From there, nutrients are transported to embryo
3rd week
uteroplacental blood flow
50 ml/minute in 10 weeks
Braxton Hicks contractions – _____ week – maintains ___________
12th; pressure
Functions of the Placenta:
- Oxygen
- Nutrition
- Excretion
- Regulate Hormones
compression on the vena cava when the client is in the supine position
Vena Cava Syndrome
leads to very low maternal blood pressure and low uterine contraction
Vena Cava Syndrome
reduced placental circulation
Vena Cava Syndrome
keep the patient in the ____________ position
LEFT lateral
- fetal side
- smooth and shiny
Schultz
- attached to the maternal side
- dirty, rough and dull
- cotyledon
Duncan
Normal Amniotic Fluid:
800 ml – 1200 ml
Polyhydramnios:
> 2000 ml
Oligohydramnios:
< 500 ml
UMBILICAL CORD
- ___cm and ____ thick – TERM
53 ; 2 cm
a loose loop of cord around the neck
Nuchal cord
is a complication that occurs when the umbilical cord wraps around the fetus’ neck
Nuchal cord
Can interrupt normal blood, nutrient and oxygen exchange, resulting in the baby sustaining serious injuries such as HIE (hypoxicischemic encephalopathy) and cerebral palsy
Nuchal cord
- gelatinous
- monopolysaccharides
- cord’s body and prevents pressure
WHARTON’S JELLY
associated with maternal HPN
Hypocoiling
associated with FETAL RESPIRATORY DISTRESS
Hypercoiling
Hypocoiling is associated with
maternal HPN
Hypercoiling associated with
FETAL RESPIRATORY DISTRESS
3 weeks LMP
5 – 50 mIU/ml
4 weeks LMP
5 – 426 mIU/ml
5 weeks LMP
18 – 7,340 mIU/ml
6 weeks LMP
1,080 – 56,500 mIU/ml
7 -8 weeks LMP
7,650 – 229,000 mIU/ml
9 – 12 weeks LMP
25,700 – 288,000 mIU/ml
13 – 16 weeks LMP
13,300 – 254,000 mIU/ml
17 – 24 weeks LMP
4,060 - 165,400 mIU/ml
25 – 40 weeks LMP
3,640 – 117, 000 mIU/ml
Non-pregnant
55 – 200 ng/ml
presence of gram-negative bacteria
nitrites
detects the presence of nitrate-reducing bacteria (ie, gram-negative bacteria)
Nitrites (Nitrite test)
is a condition in which you have high levels of white blood cells (leukocytes) or pus in your urine (pee)
Pyuria
Blood Serum Tests
- CBC
- serology test for syphilis
- blood type and Rh
- MSAFP (Maternal Serum Alpha-Fetoprotein)
- Hepatitis B and C
- Rubella Varicella
- HIVA
- PAPP-A (Pregnancy Associated Plasma Protein A)
Purified protein derivative
Tuberculosis Screening (Mantoux Test)
the tool used to measure the sound waves from the embryo/fetus
Ultrasound
Ultrasound is __ weeks initial diagnose
6
Ultrasound can confirm the _________________________ (of fetus)
presence, size and location
Ultrasound establish the fetus’ ________________________________________
health, sex, presentation, position
before the ultrasound examination, ensure the client is ______________________ at the time of the procedure.
full bladder
A combination of UTZ and non-stress test done during 26-28 weeks of gestation
Antepartum: Biophysical Profile
A combination of UTZ and non-stress test done during _________________________
26-28 weeks of gestation
Stress test - to be done at
32 weeks
AMNIOCENTESISCOLOR
Clear, Pale Yellow
98% predictive of fetal lung activity
LECITHIN/SPHINGOMYELIN RATIO: 2:1
predictors of fetal lung maturity
Phosphatidyl glycerol and Desaturated Phosphatidylcholine
determines abnormal RBC breakdown or may have only a very mild anemia by checking the optical density of amniotic fluid
BILIRUBIN determination
helps predict the likelihood of premature delivery within the next 7-14 days
Fetal Fibronectin
Fetal Fibronectin helps predict the likelihood of premature delivery within the next ____________
7-14 days
Inborn Errors of Metabolism
Down Syndrome
Cystic Fibrosis
Tay Sachs Disease
The test checks the baby’s risk for having certain genetic problems and birth defects.
Alpha-Fetoprotein
Alpha-Fetoprotein is usually done between _________________ of pregnancy
15 and 20 weeks
is a protein that a developing baby makes
Alpha-Fetoprotein
Complications of Amniocentesis
cramping
bleeding or leaking of amniotic fluid from the needle puncture site or vagina
infection
miscarriage
preterm labor
Checks for fetal heart’s acceleration
NON-STRESS TEST
NON-STRESS TEST is done at
26-28 weeks
Checks for fetal heart deceleration
STRESS TEST
STRESS TEST is done _______________ – near delivery
32 weeks
Chorionic Villus Sampling at
9-14 weeks
Amniocentesis at
14-16 weeks
TERATOGENS
- Radiation
- Syphilis and Toxoplasmosis
- Lead and Mercury
- Rubella
- Live Vaccines
- Herbal Supplements
- Drugs
- Alcohol and Tobacco
leads to serious fetal defects or death
Radiation
causes abnormalities in organs
Syphilis and Toxoplasmosis
causes nerve damage
Lead and Mercury
hearing impairment, cognitive and motor difficulty, cataracts, cardiac problem (PDA and pulmonary stenosis), IUGR, thrombocytopenia, purpura, facial defects – cleft lip/palate
Rubella
causes severe vasoconstriction, compromised placental flow
Cocaine
Vitamin B deficiency, neurological damage
Alcohol and Tobacco
stillbirth, low birthweights
Tobacco
Adequate and wellcontrolled studies in pregnant women have failed to demonstrate a risk to the fetus in the first trimester of pregnancy.
Category A
Category A Drug Examples
Doxylamine
Folic acid
Levothyroxine
Animal reproduction studies have failed to demonstrate a risk to the fetus, and there are no adequate and wellcontrolled studies in pregnant women, or animal reproduction studies have shown adverse effects, but wellcontrolled studies in pregnant women have shown no adverse effects to the fetus
Category B
Category B Drug Examples
Amoxicillin
Loratadine
Ondansetron
Animal reproduction studies have shown an adverse effect on the fetus or there are no animal reproduction studies and no wellcontrolled studies in humans.
Category C
Category C Drug Examples
Fluconazole
Metoprolol
Sertraline
Positive evidence of fetal risk but benefits may outweigh risks.
Category D
Category D Drug Examples
Lisinopril
Lithium
Phenytoin
Positive evidence of fetal risk, and risks clearly outweigh any possible benefit.
Category X
Category X Drug Examples
Methotrexate
Simvastatin
Warfarin
increase sweating and increase of vaginal discharges - shower is recommended than tub baths
Bathing
colostrum secretion begins
16 weeks
alters pH of the vagina
Douching
Shoes – moderate low heel to
minimize pelvic tilt
Avoid tight jeans because it
compresses lower extremities circulation
HEALTH PROMOTION
- Bathing
- Dental Care
- Breast Care
- Perineal Care
- Clothing
- Sexual Activity
- Exercise
- Sleep
- Nutrition