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NURS 3800 > Antepartal Period > Flashcards

Antepartal Period Flashcards

0
Q

How many weeks are each trimester

A

13 weeks

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1
Q

How long is the antepartal period

A

9 calendar months , 40 weeks average

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2
Q

What are signs called that the mother can perceive? What is an example

A

Presumptive signs. Absence of mensturation is most obvious sign

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3
Q

Rebound of unengaged fetus

A

Ballottement

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4
Q

Signs of pregnancy that can be detected by a physical exam by a health care professional. What is an example

A

Probable signs.

Hegar’s sign, Goodells sign, Chadwick’s sign

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5
Q

Softening and compressibility of lower uterus

A

Hegar’s sign

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6
Q

Softening of the cervical tip

A

Goodell’s sign

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7
Q

Bluish-purple coloration of vaginal mucosa and cervix

A

Chadwick’s sign

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8
Q

What kind of signs are pregnancy test?

A

Probable sign

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9
Q

What are some positive signs of pregnancy

A

Visualizing fetus by ultrasound, palpating fir fetal movements, and hearing fetal heartbeat

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10
Q

Spontaneous, irregular, painless contractions. They are false contractions and usually relieved by walking

A

Braxton Hicks Contractions

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11
Q

Lower portion of the uterus

A

Isthmus

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12
Q

Excessive salivation

A

Ptyalism

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13
Q

Promotion of the health and well being of a woman and her partner before pregnancy

A

Preconception care

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14
Q

The state of being pregnant

A

Gravid

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15
Q

A pregnant woman

A

Gravida

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16
Q

The number of deliveries at 20 week or greater the woman has, regardless whether the newborn was born alive or dead.

A

Para

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17
Q

A thin brownish black pigmented line running from the umbilicus to the symphysis pubis

A

Linea nigra

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18
Q

When can hCG production start? When can it be detected?

A

Can start as early as the day of implantation and can be detected as early as 7-10 days after conception

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19
Q

What can higher levels of hCG indicate?

A

Multifetal pregnancy, ectopic pregnancy, or a genetic abnormality

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20
Q

What can lower levels of hCG indicate?

A

Miscarriage

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21
Q

What you use to look for presence of hCG

A

Urine or serum test

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22
Q

What is Nägele’s rule

A

Take the first day of woman’s last menstural cycle, subtract 3 months, and then add 7 days and 1 year, adjusting the year as necessary

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23
Q

How do you measure fundal height? What does fundal height tell you?

A

Measure in centimeters from the symphysis pubis to the top of the uterine fundus (between 18 and 32weeks of gestation). This approximates the gestational age

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24
Q

Number of pregnancies

A

Gravidity

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25
Q

A woman who has never been pregnant

A

Nulligravida

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26
Q

A woman in her first pregnancy

A

Primigravida

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27
Q

A woman who has had two or more pregnancies

A

Multigravida

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28
Q

No pregnancy beyond stage of viability

A

Nullipara

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29
Q

Has completed one pregnancy to stage of viability

A

Primipara

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30
Q

Has completed two or more pregnancies to stage of viability

A

Multipara

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31
Q

Stretch marks most notably found on the abdomen and thighs

A

Striae gravidarum

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32
Q

What are reproductive changes that occur in pregnant woman

A

Uterus increases in size and changes shape and position. Ovulation and menses cease during pregnancy.

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33
Q

Cardiovascular changes in pregnant woman

A

Cardiac output and blood volume increase (45-50% at term) to meet the greater metabolic needs. Heart rate increases during pregnancy.

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34
Q

Respiratory changes in pregnant woman

A

Maternal oxygen needs increase. During the last trimester, the size of the chest may enlarge, allowing for lung expansion , as the uterus pushes upward. Respiratory rate increases and total lung capacity decreases

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35
Q

What happens to pelvic joints during pregnancy

A

They relax

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36
Q

What can cause nausea and vomiting during pregnancy?

A

Hormonal changes and increase in pressure within the abdominal cavity as pregnant clients stomach and intestines are is displaced within the abdomen

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37
Q

Why may constipation occur during pregnancy

A

Increased transit time of food trough the gastrointestinal tract and thus increased water absorption

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38
Q

What kind of organ does placenta become? What does it produce?

A

Becomes an endocrine organ that produces large amounts of hCG, progesterone, estrogen, human placental lactogen, and prostaglandins

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39
Q

What does blood pressure do during the second trimester of pregnancy

A

Decreases 5-10 mm Hg for both diastolic and systolic

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40
Q

When should blood pressure return to baseline range after how long

A

Approximately 20 weeks gestation

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41
Q

When does pulse increase during pregnancy

A

Increases 15-20 around 20 weeks gestation and remains elevated throughout remainder of pregnancy

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42
Q

What changes occur with breasts

A

Increase in size and areolas darken

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43
Q

Pigmentation increases on the face

A

Chloasma

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44
Q

What may cause episodes of maternal hypotension

A

Due to the weight of the uterus on the vena cava, this decreases venous blood flow to the heart

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45
Q

When should urine pregnancy test be done

A

First voided morning specimen to provide most accurate results

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46
Q

When can the FHR be heard on Doppler?

A

10-12 weeks gestation

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47
Q

When can FHR be heard with an ultrasound stethoscope?

A

16-20 weeks gestation

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48
Q

Where do you listen to hear FHR

A

At midline, right above the symphysis pubis, by holding stethoscope firmly on the abdomen

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49
Q

When can you measure fundal height

A

After 12 weeks gestation

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50
Q

When can you begin assessing for fetal movement

A

Between 16-20 weeks gestation

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51
Q

What does CBC with differential, Hbg, and Hct detect

A

Detects infection and anemia

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52
Q

How much water should pregnant woman consume

A

2-3 L of water each day from food and beverage source

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53
Q

I’m third trimester how should you instruct mother to count fetal movement/kick counts

A

2-3 times a day for 60 minutes each time. Fetal movements of less than 3 per hour or movements that cease entirely for 12 hours indicate a need for further evaluation

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54
Q

Ptylism

A

Increased or excessive saliva

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55
Q

Least reliable signs of pregnancy

A

Presumptive signs

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56
Q

Why should pregnant women not use saunas

A

Expose women to bacteria and increase risk of fetal tachycardia and raise the maternal temperature

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57
Q

Hormone that inhibits the formation of urine via vasoconstriction

A

Vasopressin

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58
Q

Pregnant women may experience discomfort resulting from variocosities of the rectum that are called _____.

A

Hemorrhoids

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59
Q

What is a oral anticoagulant that is used for the blood clotting and it is a known teratogen?

A

Warfarin

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60
Q

The pituitary gland is also called the _____.

A

Hypophysis

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61
Q

Emptying time of the gallbladder is ______.

A

Prolonged

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62
Q

The pregnant woman may experience ______ is dependent areas

A

Edema

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63
Q

The compulsive ingestion of no food substances is referred to as _______.

A

Pica

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64
Q

__________ is a hormone that contributes to the development of constipation during pregnancy

A

Progesterone

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65
Q

Hormone released by the posterior pituitary gland and is responsible for contractions

A

Oxytocin

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66
Q

What is the complaint that may be caused by a decrease in unconscious swallowing during nausea

A

Ptyalism

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67
Q

Goodells sign is described as _______ of the cervix

A

Softening

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68
Q

What is increased vaginal secretions that occur during pregnancy called

A

Leukorrhea

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69
Q

What position do you use for pelvic exam

A

Lithotomy

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70
Q

A pregnant women who withdraws and becomes increasingly preoccupied with herself and her fetus is experiencing what?

A

Introversion

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71
Q

What hormone is called the “hormone of pregnancy”

A

Progesterone

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72
Q

This hormone is believed to be a contributor in nausea and vomiting

A

TSH

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73
Q

What is a vaccine that is contraindicated during pregnancy

A

Rubella

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74
Q

Leukorrhea helps decrease most infections but what type of infection does it increase?

A

Fungal infections

75
Q

What is quickening?

A

When mother feels baby kicking. 16-20 weeks

76
Q

Glycoproteins produced initially by the yolk sac and the fetal gut, and later predominately by the fetal liver

A

Alpha-fetoprotein

77
Q

Involves transabdominal puncture of the amniotic sac to obtain a sample of amniotic fluid for analysis

A

Amniocentesis

78
Q

What is a procedure obtaining a sample of the chorionic villi for prenatal evaluation of chromosomal disorders, enzyme deficiencies, and fetal gender determination and to sex linked disorders

A

Chronic villus sampling (CVS)

79
Q

What uses a real-time ultrasound to allow assessment of various parameters of fetal well-being

A

Biophysical profile (BPP)

80
Q

A birth without pain reliving medications

A

Natural birth

81
Q

What are 6 presumptive signs of pregnancy

A

Amenorrhea, N/V, exercise fatigue, urinary frequency, changes in breasts, quickening

82
Q

What should you tell a woman who is complaining of nausea?

A

Keep dry crackers by bed and eat before getting up, watch spicy foods, eat small amounts, and get up slowly

83
Q

Is there a increase or decrease vascularization with cervical changes

A

Increase vascularization

84
Q

What is McDonalds sign?

A

Ease flexing of uterus. It is moving cervix easily and then there is easily flexion of uterus

85
Q

What is Von Braun-Fernwald’s sign

A

clinical sign in which there is an irregular softening and enlargement of the uterine fundus during early pregnancy.

86
Q

What are 4 probable signs of pregnancy

A

Cervical changes with increased vascularization, enlargement of abdomen, Braxton-Hicks Contractions , positive pregnancy test

87
Q

What are 3 positive signs of pregnancy

A

Fetal heartbeat, Leopolds Maneuvers where fetal movement is palpated by caregiver, Ultrasound

88
Q

What does a positive pregnancy test detect?

A

hCG

89
Q

What does a cervix look like in a healthy woman? What about when she gets pregnant?

A

In healthy woman cervix looks nice and pink and during pregnancy it turns a bluish, purple

90
Q

When can you visualize fetal parts/movement with ultrasound? When can you see gestational sac?

A

Fetal parts/movement @ 8 weeks

Gestational sac @ 4-5 weeks

91
Q

What does enlargement of uterus deal primarily with early? What about after that?

A

Early it deals with myometrial hyperplasia (cells developed) and then hypertrophy ( cells getting bigger)

92
Q

Does the isthmus hypertrophy?

A

No!

93
Q

What are two concerns with enlarged uterus

A

Vena cava syndrome and supine hypotension

94
Q

When the uterus pushes against the diaphragm what can this cause

A

Shortness of breath

95
Q

What is lightening? What happens?

A

Uterus grows out and then sinks down into pelvic area. Breathes faster and frequency of urination.

96
Q

What four things happen with the stretching and growth of the uterus

A
  1. Increased circulatory requirements (80-90% blood flow to placenta)
  2. Diameter of main uterine article doubles
  3. Increase size and number of blood and lymphatic vessels
  4. Uterus in pelvic cavity for first 3 months
97
Q

Spontaneous, irregular, intermittent contractions; begins early in pregnancy then, throughout pregnancy

A

Braxton-Hicks Contractions

98
Q

What is a mucous plug

A

Thick, tenacious mucus that seals the endocervical canal

99
Q

When is the mucus plug expelled

A

When cervical dilation begins

100
Q

What is white, cheesy patches in mouth of newborn

A

Thrush

101
Q

What does estrogen influence with vagina

A

Hypertrophy and vascularization

102
Q

How early can colostrum be expressed

A

Early as 12 weeks , it’s the first secretion

103
Q

What is a medication that is given to Rh negative woman at 28 weeks gestation and within 72 hours of delivery

A

Rhogam

104
Q

Stretch marks that may occur with growth and connective tissue changes

A

Striae

105
Q

How does corpus luteum develop

A

From a ruptured follicle

Corpus luteum- ova becomes fertilized by sperm and creates

106
Q

Corpus luteum is maintained with ______. If egg is fertilized to produce _______ regress approx 6-7 weeks and _______ takes over to produce progesterone

A

Corpus luteum is maintained with hCG. If egg is fertilized to produce progesterone regress approx 6-7 weeks and placenta takes over to produce progesterone

107
Q

What do progesterone and estrogen influence with mouth

A

Gingivitis and soft, hyperemic gum tissue=bleeding

108
Q

Reflux of acidic secretions

A

Pyrosis (heartburn)

109
Q

How much increased blood volume is there by 30 weeks?

A

Over 50% pre-pregnancy level

110
Q

There is a increased plasma and erythrocytes so what does the woman need?

A

Iron

111
Q

Cardiac output increases ____-_____% over pregnancy levels and peaks around _____ weeks

A

Increases 30-50% and peaks around 32 weeks

112
Q

Does the pulse increase or decrease?

A

Increases. 10-15 BPM by 14-20 wks

113
Q

What does blood pressure do during pregnancy?

A

Decreases. It is lowest at mid pregnancy and then increases to pregnant level until term

114
Q

What can you tell a woman to do who has dependent edema and varicose vein formation?

A

Support hose, put feet up often, check diet for amount of sodium she is having

115
Q

Reduced blood pressure that can occur in women who lie down on their back which causes the uterus to compress the vena cava

A

Supine hypotensive syndrome

116
Q

What does increased fibrin and plasma fibrinogen cause during pregnancy

A

Hypercoagulable state

117
Q

What is physiological anemia of pregnancy? Why does it occur?

A

Blood volume increases and the woman’s RBC increases a little but not as much and blood volume which makes it look like woman has anemia. Usually you don’t have to treat, but you encourage her to take a prenatal vitamin

118
Q

Breathing changes from abdominal to ________

A

Thoracic (diaphragmatic) - deep;faster

119
Q

Tidal volume / volume of inhaled air increases which causes what? What actions should you take?

A

Hyperventilation. Sit her down and slow her breathing down

120
Q

Estrogen induced edema and vascular congestion of nasal mucosa puts woman at risk for? Nursing implications?

A

Epitaxis (nosebleeds)

Lean forward, pressure on nose, ice pack

121
Q

Melasma of chloasma on forehead and cheeks. What is this called?

A

Mask of pregnancy

122
Q

What is skin pigmentation affected by?

A

Estrogen, progesterone, and melanocyte-stimulating hormones

123
Q

What are vulvular changes

A

It looks darker

124
Q

What is vascular spider nevi

A

Veins that look broken down on dependent areas or abdomen

125
Q

What are the changes in the musculoskeletal system influenced by

A

Relaxin, progesterone, fetal growth, and maternal weight

126
Q

What does relaxation of pelvic joints cause

A

Waddling

127
Q

What can softening and stretching of ligaments in pelvis cause?

A

Round ligament pain. Pain in the lower abdomen and legs. Get woman off her feet, use support hose

128
Q

What postural changes occur?

A

Increased swayback

Center of gravity changes ( increased lordosis)

129
Q

What is diastasis recti

A

Abdominal muscle separating, can happen late in pregnancy and post partum

130
Q

What are important teaching points for woman with diastasis recti

A

Need to tone after, post partal exercises, help her learn to push if happens before baby is born

131
Q

What is the process of an accurate fundal height measurement

A

Use non stretch tape and measure distance from top of pubic bone to top of uterus (aka fundus)

132
Q

Usually if you get a fundal height measurement of 20 cm you can assume the gestational age is 20 weeks. When would this not apply

A

After 36 weeks due to lightening

For twins, too much fluid, or tumors

133
Q

Facilitates lactogenesis

A

Prolactin

134
Q

Stimulates cell hormone

A

GH

135
Q

Stimulates uterine contractions; milk ejection

A

Oxytocin

136
Q

FSH and LH are inhibited by ____

A

hCG

137
Q

TSH is ______ in the 1st trimester

A

Reduced

138
Q

Stimulating hormone that increases pigmentation

A

Melanocyte

139
Q

Inhibits urine production and increases BP

A

ADH (vasopressin)

140
Q

How does pancreas work to produce insulin?

A

Works on supply-demand mode. Maternal insulin does not cross the placenta

141
Q

The realization of a pregnancy can lead to fluctuating responses, possibly at the opposite ends of the spectrum

A

Ambivalence

142
Q

Focusing on ones self, this is common during the early part of pregnancy

A

Introversion

143
Q

Emotional lability is characteristic throughout most pregnancies

A

Mood swings

144
Q

What food should women avoid in pregnancy?

A

Fish with moderate to high mercury level
Foods that risk getting listeriosis
Cold hot dogs or lunch meat
Soft cheeses

145
Q

How much folic acid is needed during pregnancy

A

800 mcg/day

146
Q

How much ferrous iron is needed during pregnancy

A

30 mg/day

147
Q

How many more calories do woman need during pregnancy

A

300

148
Q

What is normal weight gain during pregnancy

A

25-35 pounds

149
Q

What could lack of folic acid lead to

A

Neural tube defects

150
Q

An ultrasound is the most common

A

Diagnostic test

151
Q

What can an ultrasound detect

A

Confirm pregnancy
Assess for congenital abnormalities
Assess fetal size and growth
Assess for placental location

152
Q

There are five different measurements for fetal growth, what are they

A 
Crown-rump length
Biparietal diameter (BPD) 
Femur length
Abdominal measurement 
Head/abdominal ratio
153
Q

BPD is the most common measurement for fetal growth, what is this

A

The diameter of the head between the two parietal eminences

154
Q

What makes up the 5 fetal biophysical variables

A 
Fetal movement 
Fetal tone
Fetal breathing 
Amniotic fluid volume 
NST normal
155
Q

What is the normal fetal heart rate measurment

A

110-160

156
Q

Nuchal translucency screening is what

A

An ultrasound to assess for nuchal translucency (looking at chromosomes) due to subcutaneous fluid accumulation behind fetal neck

157
Q

When does the pregnant women usually think she feels quickening

A

16-20 weeks

158
Q

What are the two things that are considered feeling quickening

A

10 movements per hour

Left lateral position, after a meal, 4 movements in an hour

159
Q

How should a women count her movements she feels per hour

A

At same time
Count until you feel 10
Record them

160
Q

What is a non stress test

A

Indirect measurement of uteroplacental function by trained personnel

161
Q

Amniocentesis

A

Transabdominal puncture of amniotic sac for amniotic fluid after ultrasound

162
Q

If amniocentesis is done between 11-14 weeks what are they looking for

A

Abdominal and fluid leakage

Detect generic abnormality

163
Q

Amniocentesis done between 15-20 weeks

A

Most common time

Chromosomal and biochemical determination

164
Q

Amniocentesis during 3rd trimester

A

Assess lung maturity

165
Q

Chronic villus sampling

A

Obtain sample of chronic villus for PN elevation disorders

Chromosomal, enzyme or sex linked, fetal gender

166
Q

Percutaneous umbilical blood sampling (PUBS)

A

Allows rapid chromosomal analysis test

167
Q

When would you do a PUBS

A 
Coagulation study
Blood typing
CBC
Blood disorders
Women at risk for genetic abnormalities
168
Q

Risks with PUBS

A 
Bleeding puncture site 
Cord laceration 
Hematomas
Thromboembolism
Infection
Labor
169
Q

What intervals should a pregnant women be seen

A

Every 4 weeks up to 28 weeks
Every 2 weeks from 29-36 weeks
Every week from 37 weeks to birth

170
Q

Is exercise or working allowed during pregnancy

A

Yes, both are fine. The mother should not do more than she can handle

171
Q

What can a women do to lessen the chance of nausea upon awakening

A

Eat dry crackers before getting out of bed and get up slowly

172
Q

When it comes to washing the breast, what teaching points should you give a mother

A

Wash with warm water and do not use soap. Soap will dry out the nipple

173
Q

What is increased thyroid hormone critical for?

A

Fetal brain and neurological growth

174
Q

What changes happen with thyroid

A

Increased size and activity

175
Q

What does a Doppler flow study show

A

Movement of red blood cells in vessels

176
Q

What is alpha-fetoprotein analysis

A

Glycoprotein-form yolk sac and fetal gut; later fetal liver

177
Q

What are biomarker screening tests for all pregnant women with AFP at different weeks for

A

10-14 weeks- amino fluid
12-14 weeks- maternal serum
16-18 weeks- optimal time to assess

178
Q

What could AFP readings be influenced by

A

Number of fetuses
Gestational age
Low maternal weight
Race

179
Q

Elevated levels of AFP usually are linked to

A

Neural tube defects

180
Q

What are we worried about if we see nuchal translucency on an ultrasound

A

Trisomy 21,18,31
Skeletal issues
Cardiac issues
Neurological issues

181
Q

What do we want to see when performing a non stress test

A

At least 2 fetal movements with increased fetal heart rate 15 bpm greater than normal for at least 15 seconds over a20 minutes period

182
Q

Contraction stress test

A

Not preformed often

Mother given small dose of oxytocin

183
Q

What do we want to see with a contraction stress test

A

Uterine contractions in 10 minutes without fetal heart rate decelerations

NEGATIVE TEST IS GOOD

184
Q

Lecithin/ sphingomyelin deals with lung maturity. What must the ratio be with these to have mature lungs

A

2:1

2 lecithin to 1 sphingomyelin

185
Q

Source of amniotic fluid

A

Fetal urine

NURS 3800 (19 decks)

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