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OB > Antepartum > Flashcards

Antepartum Flashcards

1
Q

End of Week 1

A

Blastocyst implants in endometrium

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2
Q

End of Week 4

A

weighs 400mg

  • at greatest vulnerability to teratogens
  • Blood vessels and heart form
  • Neural tube is forming
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3
Q

End of Week 8

A

FHR 110-160
Iron and glycogen get stored in the liver (and for 5mos after)
-End of the embyronic period

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4
Q

End of Week 12

A

FHR can be hears w/ doppler

  • sex is apparent
  • movements occur
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5
Q

End of Week 16

A

Amniotic fluid is adequate for an amniocentesis

-Face looks human

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6
Q

End of Week 20

A

Quickening can now be felt

  • Fetus is viable or at 500g+
  • Meconium accumulates in the colon
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7
Q

End of week 24

A

weight is 600g

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8
Q

End of week 28

A

Surfactant forming on alveolar surfaces - lungs are developed but not mature

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9
Q

End of week 32

A

Bones are fully developed

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10
Q

End of week 36

A

LS ratio is 2:1 so lungs are mature

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11
Q

End of Week 40

A

weight of about 7lbs

-full term!

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12
Q

TORCH: Toxoplasmosis

A

Maternal - flu like aches, lymphadenopathy, spontaneous abortion
Fetal - LBW, congenital toxoplasmosis

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13
Q

TORCH: Rubella

A

Maternal - rash, fever, malaise, spontaneous abortion during 1st trimester
Fetal - deafness, IUGR, microcephaly

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14
Q

TORCH: Cytomegalovirus

A

Maternal - cervical discharge, flu-like symptoms

Fetal: death, hemolytic anemia, jaundice, microcephaly, hydrocephaly

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15
Q

TORCH: Herpes

A

Maternal - lesions, pain, papules, ulcers, fever, malaise, dysuria, dyspareunia
Fetal - crosses placenta and can also be giver o baby at birth

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16
Q

Common risks in childbearing years

A
  • STDs
  • IPV
  • nutrition issues (obesity v eating disorders
  • TORCH
  • Cancer (hormonal)
  • Economis issues
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17
Q

Risk factors affecting Fetus

A
  • Alcohol
  • Tobacco
  • Caffeine
  • Drugs
  • Prescription drugs
  • nutrient deficiencies
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18
Q

Sentinel events in OB setting

A
  • APGAR less than 7
  • Preterm labor and preterm birth
  • Giving more than 3 or 4 units of blood to mom
  • Placental abruption
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19
Q

Tocolytics for preterm labor

A

Magnesium Sulfate
Terbutaline
Nifedipine
Indomethacin

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20
Q

Glucocorticoid - assist premature infant to grow

A

Betamethasone

Dexamethasone

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21
Q

Care for Preeclapmsia

A
  • Assess BP often
  • Give magnesium sulfate + watch I&Os (125ml/hr)
  • Decrease stimulation
  • Assess DTRs
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22
Q

HELLP Syndrome

A

Hemolysis
Elevated Liver Enzymes
Low Platelet count
-can be caused from Preeclampsia

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23
Q

DIC

A

Blood cannot clot and patient can bleed out from everywhere

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24
Q

1st Trimester

A

wk0 - 13

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25
Q

2nd trimester

A

wk14 - 26

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26
Q

3rd Trimester

A

wk27 - 40

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27
Q

Warning signs during 1st Trimester

A

severe vomiting

  • Chills, fever
  • dysuria
  • diarrhea
  • Abd cramping
  • Vaginal bleeding
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28
Q

Warning signs 2nd & 3rd trimesters

A
  • Persistent, severe vomiting
  • Sudden discharge of fluid from vagina < 37wks
  • Vaginal bleeding
  • Severe backache/flank pain
  • Change in fetal movements
  • Contractions; pressure; cramping < 37 wks.
  • Visual disturbances
  • Face/fingers/sacrum swelling
  • Headaches
  • Muscular a or convulsions
  • Epigastric/Abd pain
  • Glycosuria, + GTT reaction
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29
Q

Prenatal Visit Schedule

A

wk16 - 28: every 4 weeks
wk29 - 36: every 2 weeks
wk36 - term: every week
Post: 2x week

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30
Q

Emergency Situations

A
  • uterine contractions q10 minutes or less for an hour or more
  • vaginal bleeding
  • fluid leaking from vagina
  • odorous vaginal discharge
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31
Q

Ultrasound

A

L1: fetal viability, presentation, age, placental location, structures, AFV
L2: fetal presentation, FHT
L3: anatomically or physiologically abnormal fetus

32
Q

Types of Ultrasound

A

Abdominal: gel is placed on abd, bladder must be full
Transvaginal: lithotomy position, determines cervical length

33
Q

Non-Stress Test (NST)

A

Reactive: normal FHR with 2 accelerations
Nonreactive: additional testing needed
*Vibroacoustic stimulation

34
Q

Contraction Stress Test (CST) or Oxytocin Contraction Test (OCT)

A

-FHR baseline –> you want a NEGATIVE TEST
Contractions started by nipple stimulation of pitocin
Negative: no late decelerations
Positive: late decelerations

35
Q

Biophysical Profile

A

-Fetal breathing movements
-Gross body movement
-Fetal tone
-Qualitative amniotic Fluid volume
-Reactive non-stress test
Normal score 10:10

36
Q

Amniocentesis

A
  • *after 14 weeks + informed consent
  • LS ratio
  • Alpha-fetoprotein (NTDs)
  • Desquamated fetal cells (genetic testing)
37
Q

Complications of Amniocentesis

A
  • infx
  • injury to fetus
  • leaking AF
  • pregnancy loss
  • maternal hemorrhage
  • Rh isoimmunization
  • Amniotic Fluid Embolism
  • Fetal death
38
Q

Nursing: Amniocentesis

A
  • Mother empties bladder
  • Monitor fetus before and for 1hr after
  • watch for vaginal bleeding, leaking AF, cramping or fever
  • EDUCATE
  • Give expectations for mild discomfort
39
Q

Chorionic Villus Sampling

A
  • *10-13 weeks + informed consent
  • genetic defects
  • sample of blood and tissue taken from chorionic villi
40
Q

PUBS test

A

kleihauer-betke test –> tests for fetal or maternal bleeding

41
Q

Maternal Serum Alpha-Fetoprotein (MSAFP)

A

***15-20wks

elevated levels associated w/ open neural tubes

42
Q

Coombs test

A

Screens for Rh incompatibility and detects fetal hemolytic anemia

43
Q

Recommended weight gain: underweight

A

28-40lbs

44
Q

Recommended weight gain: Normal

A

25-35lbs

45
Q

Recommended weight gain: Overweight

A

15-25lbs

46
Q

Recommended weight gain: Obese

A

11-20lbs

47
Q

Recommended amount of Folic Acid for pregnancy

A

400mcg daily

48
Q

Foods w/ folic acid in them

A

fortified cereals, dark green leafy veggies, oranges, broccoli, asparagus, artichokes, liver

49
Q

Ductus Arteriosis

A

Bypasses lungs - blood flows from pulmonary arteries to the aorta

50
Q

Ductus Venosus

A

bypasses liver from umbilical vein to the inferior vena cava

51
Q

Foramen ovale

A

blood passes thru right atrium through the FO to the left atrium

52
Q

Components of Biophysical Profile

A 
Breathing movements
Amniotic Fluid Volume
Fetal Tone
Heart rate reactivity
Body movements
53
Q

Good score for BPP

A

10:10 or 2 rating for each section

54
Q

Diagnosis for Chlamydia

A

Culture or immunoassay in 1st trimester

55
Q

Treatment for Chlamydia

A

Azithromycin

56
Q

Effects of Chlamydia

A

PROM, PTL, ectopic pregnancy

57
Q

Diagnosis of Gonorrhea

A

Gram stain culture

58
Q

Treatment of Gonorrhea

A

Ceftriaxone

59
Q

Effects of Gonorrhea

A

amnionitis, PTL

60
Q

Diagnosis of Syphilis

A

VDRL or RPR serologies

61
Q

Treatment of Syphilis

A

Penicillin + treat by 18th week

62
Q

Effects of Syphilis

A

spontaneous abortion, PTL, congenital syphilis

63
Q

Diagnosis of Herpes

A

examination and culture of lesions/ulcers

64
Q

Treatment of Herpes

A

Acyclovir + cryotherapy

65
Q

Effects of Herpes

A

can cross the placenta

66
Q

Management: Toxoplasmosis

A

Blood test for titer; no cat litter; avoid uncooked meat; elective abortion if titer is too high

67
Q

Management: Varicella

A

Immune globulin for exposed pregnant women

68
Q

Management: Rubella

A

Rubella titer 1:8 means immune

69
Q

Management: Cytomegalovirus

A

Therapeutic abortion if primary infection is prior to 20wks

70
Q

Precipitous Labor

A

Labor that lasts 3 hours or less from onset of contractions to birth of the baby

71
Q

Nursing interventions post ROM

A
  • take temperature often
  • count and weigh pads that mom uses
  • check moms abdomen for tenderness at least q2 hours
72
Q

Signs of Placenta previa

A

Painless bright red bleeding after 20 weeks

73
Q

Signs of Placental abruption

A

Severe Abdominal pain, with or without bleeding

74
Q

ACHES

A 
A - abdominal pain
C - Chest pain/SOB
H - headaches/vascular accident/increased BP
E - eye problems
S - severe leg pain
75
Q

BRAIDED

A

B: benefits
R: risks
A: alternatives

75
Q

BRAIDED

A 
B: benefits
R: risks
A: alternatives
I: inquiries
D: decisions
E: explanations
D: documentation
76
Q

Acid - Base balance

A

Respiratory Alkalosis compensated by metabolic acidosis

OB (1 decks)

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