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maternity and newborn health > antepartum > Flashcards

antepartum Flashcards

1
Q

What is conception?

A

fertilization (joining of sperm and ovum)

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2
Q

Where does fertilization occur?

A

fallopian tube

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3
Q

What is a fertilized ovum called?

A

zygote

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4
Q

What is a blastocyst?

A

Zygote that repeatedly as it moves down the fallopian tube towards the uterus

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5
Q

What is the preembryonic period?

A

First 2 weeks after conception

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6
Q

What are stages of development after conception?

A

fertilized ovum (zygote), blastocyst, embryo, fetus

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7
Q

What vitamin is important for pregnant women and those attempting pregnancy?

A

folic acid

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8
Q

What is folic acid?

A

water-soluble B-complex vitamin

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9
Q

What is folate for?

A

red blood cell production

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10
Q

What is the minimum amount of folic acid needed per day for pregnant women and those attempting pregnancy?

A

400 mcg/day

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11
Q

Why is it necessary to increase folic acid before and during pregnancy?

A

to decrease risk of neural tube defects (eg spina bifida, anecephaly)

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12
Q

What are ways to increase folic acid?

A

dietary sources of folic acid and supplementation (contains 400-800mcg)

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13
Q

What are best dietary sources of folic acid?

A

leafy green vegetables (asparagus, broccoli, spinach, green peas)

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14
Q

What are appropriate food choices to increase folic acid?

A

cooked beans, rice, spaghetti, fortified cereals, peanut butter, enriched breads

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15
Q

Where is amniotic fluid produced?

A

fetal kidney

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16
Q

What are 2 major purposes of amniotic fluid?

A

prevent cord compression and promote lung development

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17
Q

What is oligohydramnios?

A

condition characterized by low amniotic fluid volume

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18
Q

What causes oligohydramnios?

A

fetal kidney anomalies (renal agenesis or urine flow obstruction) or fluid leaking through the vagina (undiagnosed ruptured membranes)

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19
Q

What is the risk with a 41 weeks gestation?

A

fluid volume declines

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20
Q

What are signs of oligohydramnios?

A

small uterine size for gestational age or fetal outline that is easily palpated through maternal abdomen

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21
Q

Which test confirms diagnosis of oligohydramnios?

A

ultrasound

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22
Q

What are major complications of oligohydramnios?

A

1) pulmonary hypopolasia 2) umbilical cord compression

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23
Q

What causes pulmonary hypoplasia?

A

lack of alveolar distention by aspirated amniotic fluid

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24
Q

What are interventions for the complications of oligohydramnios?

A

1) Additional neonatal personnel should attend birth. 2) continuous fetal monitoring of variable decelerations

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25
Q

Why should more personnel be present during oligohydramnios intervention?

A

possible resuscitation or evaluation of newborn

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26
Q

What is induction of labor?

A

deliberate initiation of uterine contractions that stimulates labor

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27
Q

What increases operative vaginal birth (use of forceps or vacuum)?

A

prolonged second-stage labor or fetal distress

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28
Q

What is polyhydramnios?

A

excessive amniotic fluid volume

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29
Q

When is polyhydramnios a risk?

A

postpartum hemorrhage

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30
Q

Why is polyhydramnios a risk factor?

A

overdistension of the uterus

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31
Q

What is the type of drug needed for polyhydramnios?

A

uterotonic durgs

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32
Q

What is pyrosis?

A

Heartburn

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33
Q

Why is pyrosis common during pregnancy?

A

increase of progesterone hormone and uterine enlargement displaces the stomach

34
Q

How does progesterone cause heartburn?

A

Relaxes smooth muscle, resulting in esophageal sphincter relaxation. Gastric contents are regurgitated, usually causing burning sensation behind sternum

35
Q

What can reduce heartburn during pregnancy?

A

lifestyle changes (keep HOB elevated, sit upright, eat small frequent meals, avoid tight-fitting clothing, eliminate dietary triggers (fried/fatty foods, caffeine, citrus, chocolate, spicy foods, tomatoes, carbonated drinks, peppermint)

36
Q

What is a liver disorder exclusive to pregnancy?

A

Intrahepatic cholestasis of pregnancy

37
Q

What are the manifestations of intrahepatic cholestasis?

A

Intense, generalized itching but no rash

38
Q

Where do the manifestations of intrahepatic cholestasis occur?

A

hands and feet

39
Q

What is the risk of intrahepatic cholestasis?

A

intrauterine fetal demise

40
Q

What is the assessment of intrauterine fetal demise?

A

loss of fetal movement, absent fetal heart tones, diseeminated intravasular coagulation, bleeding, low hemoglobin and hematocrit levels

41
Q

What is a immediate intervention of intrahepatic cholestasis?

A

assessment by the HCP

42
Q

What are interventions for intrahepatic cholestasis of pregnancy?

A

laboratory testing (elevated bile acids), fetal surveillance (biophysical profile, nonstress test), medication (ursodeoxycholic acid), and labor induction around 37 weeks gestation

43
Q

What is the nonstress test?

A

evaluates fetal heart rate and response to fetal movement, placental function and oxygenation, fetal well-being

44
Q

What is a biophysical profile?

A

Noninvasive assessment of the fetus

45
Q

What does the biophysical profile include?

A

fetal breathing movements, fetal movements, fetal tone, amniotic fluid index, fetal heart rate patterns, nonstress test

46
Q

What does normal fetal biophysical activities indicate?

A

fetal central nervous system is functional and not hypoxemic

47
Q

What are physiological maternal skin changes?

A

chloasma (mask of pregnancy)

48
Q

What is chloasma?

A

a brownish hyperpigmentation over the bridge of the nose and cheeks

49
Q

What causes chloasma?

A

increase in malanocyte-stimulating hormone due to increase levels of estrogen and progesterone

50
Q

When does chloasma appear?

A

second trimester

51
Q

What are the interventions with chloasma?

A

Benign and fades in postpartum

52
Q

What is condylomata acuminata?

A

sexually transmitted disease caused by human papillomavirus

53
Q

What are the manifestations of condylomata acuminata?

A

fleshy, nontender bumps on genital/anal areas

54
Q

What is the treatment for condylomata acuminata?

A

trichloroacetic acid, or removal of warts in pregnancy

55
Q

What is a dermatological complication in pregnancy?

A

pruritic urticarial papules and plaques of pregnancy (PUPPP)

56
Q

What are the manifestations of pruritic urticarial papules of pregnancy?

A

pruritic, raised lesions within abdominal striae, spare the umbilicus. not harmful but can cause discomfort

57
Q

Where can pruritic urticarial papules and plaques of pregnancy spread?

A

on the thighs, arms, legs, back

58
Q

What is an ectopic pregnancy?

A

occurs when a fertilized egg implants and begins to grow outside the uterine cavity

59
Q

Where does the fertilized egg implant most frequently in ecotopic pregnancy?

A

fallopian tubes

60
Q

What is commonly reported with ectopic pregnancies?

A

positive pregnancy test, vaginal spotting/bleeding, and/or abdominal pain

61
Q

What is the risk with ectopic pregnancy?

A

continued growth of the fertilized egg, untreated, leading to rupture

62
Q

What is the result ectopic rupture?

A

hemorrhage (intra-abdominal bleeding) and hemodynamic compromise.

63
Q

What are the manifestations of ectopic rupture?

A

referred shoulder pain (sign of diaphragm irritation)

64
Q

What is the priority intervention with ectopic rupture?

A

emergency surgery and hemodynamic support (IV fluids, blood transfusion)

65
Q

What are pregnancy signs?

A

Presumptive, probable, positive

66
Q

What are presumptive signs?

A

subjective signs of pregnancy, self-reported by client

67
Q

What is included in presumptive signs?

A

amenorrhea, N/V, urinary frequency, breast tenderness, quickening, excessive fatigue

68
Q

What is most important to ask when presented with possible sign/symptoms of early pregnancy?

A

assess date of last menstrual period

69
Q

What are the normal lab values during third trimester?

A

Hemoglobin >11 g/dL, Hematocrit >33%, RBCs 500,000-625,000 /mm3, WBCs 5,000-15,000/mm3, platelets 150,000-400,000/mm3

70
Q

What is a physiological cardiovascular change during pregnancy?

A

physiological anemia (total blood volume increases by 40-45%)

71
Q

Why does total blood volume increase in pregnancy?

A

To meet the increased oxygen demand and nutritional needs of the growing fetus and maternal tissues

72
Q

What causes physiological anemia during pregnancy?

A

plasma volume increase exceeds the increase in production of red blood cells

73
Q

What values are lower in physiologic anemia of pregnancy?

A

low hemoglobin (>11 g/dL) and hematocrit (>33%)

74
Q

What is also increased during pregnancy?

A

white blood cell count (up to 15,000/mm3)

75
Q

BMI (kg/m2)

A

<18.5 (underweight);

18.5-24.9 (appropriate weight); 25-29.9 (overweight); >30 (obese)

76
Q

What is the weight gain during the first trimester?

A

1.1-4.4 lb (0.5-2.0kg)

77
Q

What is the weight gain during second & third trimester?

A

~1 lb/wk (0.5kg/wk) for underweight and appropriate weight; ~0.6 lb/wk (0.3 kg/wk) for overweight; and ~0.5 lb/wk (0.2 kg/wk) for obese

78
Q

What is the total weight gain for underweight clients in pregnancy?

A

28-40 lb

79
Q

What is the total weight gain for appropriate weight clients in pregnancy?

A

25-35 lb

80
Q

What is the total weight gain for overweight clients in pregnancy?

A

15-25 lb

81
Q

What is the total weight gain for overweight clients in pregnancy?

A

11-20 lb

maternity and newborn health (1 decks)

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