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antepartum 1 Flashcards

1
Q

barriers to care

A

financial, cultural, gender, sexual orientation

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2
Q

EDB wheel

A

need LMP to be accurate
basically if you cant do math?

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3
Q

uterine size

A

start at 16 -20 weeks

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4
Q

auscultation

A

ultrasonic doppler device = 12 weeks
fetoscope = 20 weeks

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5
Q

preparing for parenthood

A

choose provider, birth setting, type of labor, sibling prep, prenatal classes, adolescent parenting classes, prep for C/S, prep for vaginal, prep for vaginal after C/S

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6
Q

danger s of pregnancy

A

absence of fetal movement, gush of fluid from vagina <37 wk, vaginal bleed, abd pain, fever, persistent v, dysuria, dizzy, blurred vision, spots before eyes, persistent HA, edema, muscular irritability or convulsions, epigastric pain, oliguria

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7
Q

fundal height

A

mcdonalds
20 - 34 wk +/- wk

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8
Q

IPV

A

intimate partner violence
increases with pregnancy
interview alone

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9
Q

GTPAL

A

gravida: total # and current
term >37 wk
preterm 20 - 36^6 wk
abortion (spontaneous <20wk)
living

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10
Q

+ diagnosis

A

fetal HR, fetal movement, visualize fetus

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11
Q

probable

A

change in pelvic organs (signs)
abd enlarge, braxton hicks, abd striae, uterine souffle, change in skin pigmentation, + test, palpate fetal outline

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12
Q

presumptive

A

amenorrhea, n/v, fatigue, urinary freq, breast change, quickening

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13
Q

endocrine changes

A

thyroid enlarge, [] of PTH increases, prolactin and oxytocin = lactation, vasopressin, increase aldosterone

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14
Q

metabolic changes

A

extra waste, fat, and P stored, fats stored more completely

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15
Q

supine hypotensive syndrome

A

lay flat, uterus will depress venacava, dropping BP, always sit up

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16
Q

mothers response to pregnancy

A

ambivalence (right time, intended, role change), acceptance, introversion, mood swings, fear, changes in body image

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17
Q

rubins tasks of pregnancy

A

ensuring safe passage
seek acceptance by others
seek commitment and acceptance of self
learn to give oneself on behalf of child

18
Q

father’s response to pregnancy

A

confused by mood changes, feels left out, resents attention and change in their relationship, resolve conflicts about fathering, couvade

19
Q

family response to pregnancy

A

siblings: rivalry, fear of changing parent relationships, may need reassurance
grandparents: closer relationship with expectant couple, clarify role of helping grandparent

20
Q

prenatal hx

A

current and past pregnancies, gyno hx, current and past med hx, substance use, fam med hx, religious, spiritual, cultural, occupational hx, partner hx, social hx and pref

21
Q

factors related to father’s health

A

fam hx, significant health problems, blood type and Rh, occupation, best learning method, attitude

22
Q

psychosocial factors

A

hx of abuse, hx of emotional problems (depression and anx, postpartum depression), support, overuse or underuse of healthcare system, acceptance of pregnancy (intended or not), pans for care of child after birth, feeding pref

23
Q

cultural/religious factors

A

influence expectations of childbearing experience
beliefs or practices that maintain spiritual wellbeing or influence care (blood, diet)
ASK!!

24
Q

major prenatal screening tests

A

pap smear, CBC, hgb, rubella titer, ABO and Rh typing, hep B screen, STI, sickle cell (african or latino descent), CF, HIV, drugs, fetal chromosome anomaly, urine (protein, glucose), urine culture at 12 -16 wk, GBS

25
Q

MSAFP

A

quad screen
high AFP = spina bifida, anencepathaly, multiple gestation, DM
low AFP = down syndrome, edwards syndrome

26
Q

NIPT

A

cell free fetal DNA

27
Q

cognitive changes

A

decreased attention, concentration, and memories

28
Q

eye changes

A

decreased intraocular P, cornea thick

29
Q

MS changes

A

pelvic joints relax, center of gravity changes (lordosis), separation of rectus abdominus
weight gain: normal = 25 - 35; over = 15 - 25; obese = 11 - 20; under = 28 - 40

30
Q

skin changes

A

hyperpigmentation, striae, facial chloasma, vascular spider nevi, decreased hair growth, hyperactive sweat and sebaceous glands
linea nigra

31
Q

urinary changes

A

dilation of kidneys and ureters + pressure on bladder by ureters = increased residual volume and urine stasis
increased risk for infection, increased risk for preterm labor

32
Q

GI changes

A

n/v
softening and bleeding of gums
increase in saliva (pytalism)
c - progesterone
heartburn (pyrosis)
gallstones
hemorrhoids

33
Q

cardiac changes

A

uterus can compress vena cava when laying down flat (later trimesters)
blood volume 40-50%, phys anemia (increase volume, rbc same, pseudoanemia), decreased systemic and pulmonary vascular resistance, increased CO, hypercoag

34
Q

respiratory changes

A

O2 consumptions increases, subcostal angle and AP diameter increase, breathing abd -> thoracic, nasal stuffiness and epistaxis

35
Q

breast changes

A

glandular hyperplasia AND hypertrophy
areolae darken
superficial veins prominent
striae may develop
colostrum is secreted

36
Q

vaginal changes

A

mucosa thicken
increase in secretions, loosening of connective tissue

37
Q

ovary changes

A

stop producing ova
secrete progesterone until week 7 to maintain endometrium (placenta takes over)

38
Q

mucous plug

A

thick piece of mucous that blocks opening of cervix during pregnancy

39
Q

uterine/cervical changes

A
  1. softening of cervix = goodells
  2. softening of uterus = hegar
  3. bluish discoloration of cervix = chadwick
40
Q

uterine changes

A

enlargement - hypertrophy
fibrous tissue increases
increase in blood flow
braxton hicks contractions

ob - 332 (15 decks)

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