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Nurs 368 > Antepartum > Flashcards

Antepartum Flashcards

1
Q

Goal of prenatal care

A

Ensure a healthy baby and minimize maternal risk

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2
Q

How much more likely is a baby to have a low birthweight if the mother does not receive prenatal care?

A

3x more likely

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3
Q

How much more likely is a baby to die if the mother does not receive prenatal care?

A

5x more likely

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4
Q

When is the ideal time for the first prenatal visit?

A

6-10 weeks

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5
Q

How often should a pregnant woman be visiting the ob doctor throughout pregnancy?

A

Every 4 weeks up until 28 weeks, every 2 weeks between 28 and 36 weeks, and every week from 36-40 weeks

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6
Q

Which prenatal visit will be the most comprehensive?

A

1st

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7
Q

What information should be gathered for a woman’s prenatal history?

A

LMP, EDD, GA, G/P, G-TPAL, GYN history, STD history, medical/surgical history, genetic history, occupation, medications, if contraceptives were used, allergies, significant FOB health history, social profile

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8
Q

What tests are run when bloodwork is done during the 1st prenatal visit?

A

Blood type, rubella titer, syphilis, hep b, HIV, CBC baseline, serum glucose

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9
Q

Which immunizations are recommended during pregnancy?

A

Influenza, tdap(2nd or 3rd trimester), hep A and b, covid-19

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10
Q

What is included in the physical examination at the first prenatal visit?

A

Vital signs, height/weight, head to toe assessment, pelvic and breast exam, ultrasound

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11
Q

Which test is performed at every prenatal visit?

A

Urinalysis

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12
Q

What is examined in the pelvic exam?

A

Vulva and cervix

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13
Q

Is ultrasound dating or LMP dating for EDD more accurate?

A

Ultrasound

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14
Q

why is folic acid important in pregnancy?

A

Prevents neural tube defects

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15
Q

What is prescribed to decrease likelihood of preeclampsia in at risk women?

A

Low dose aspirin

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16
Q

At 32 weeks pregnant, how often should prenatal visits be scheduled?

A

Every 2 weeks

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17
Q

When is a late preterm baby born?

A

34 weeks to 36 6/7 weeks

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18
Q

What is considered early term?

A

37 - 38 6/7 weeks

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19
Q

What is considered full term?

A

39- 40 6/7 weeks

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20
Q

What is considered late term?

A

41-41 6/7 weeks

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21
Q

What is considered post term?

A

> 42 weeks

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22
Q

Are twins/triplets considered as multiple para in the G/P system?

A

No

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23
Q

What does G/TPAL stand for?

A

Gravida/term, preterm, abortion, living

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24
Q

what type of history is gathered for prenatal visits after the first visit?

A

Interval history

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25
Q

What things are assessed at prenatal visits following the first visit?

A

Vital signs, height, edema, fundal weight, FHR, fetal movement

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26
Q

Why is it important to take vital signs at every prenatal visit?

A

To assess for preeclampsia

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27
Q

Why is a fever of 101°f a concern in pregnancy?

A

Infection

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28
Q

Why is sudden severe of continuous pain or cramping in the lower abdomen a concern in pregnancy?

A

Ectopic pregnancy, preterm labor, placental abruption, non-pregnancy causes such as: UTI or appendicitis

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29
Q

why can bleeding or spotting from the vagina be a cause of concern for a pregnant woman?

A

Could be a spontaneous abortion, abruption, placenta previa, friable cervix, labor

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30
Q

What can severe headaches or visual disturbances be a sign of?

A

Pre-eclampsia

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31
Q

What can sudden, severe swelling of hands, feet, face, or generalized edema be a sign of?

A

Pre-eclampsia

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32
Q

Why is persistent vomiting a concern?

A

Can cause a risk of dehydration

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33
Q

4 or more uterine contractions per hour before 37 weeks can be a sign of____?

A

Preterm labor

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34
Q

A continuous leaking of small amounts of fluid from the vagina or a gush or water from the vagina may be a sign of _____?

A

PROM

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35
Q

What are 6 common discomforts of the first trimester?

A

Nausea/vomiting, urinary frequency increases, fatigue, breast tenderness, increased vaginal discharge, nasal stuffiness and nosebleed

36
Q

Common discomforts of pregnancy in the second and third trimesters

A

Heartburn, ankle/mild edema, faintness, dyspnea, carpaI tunneI syndrome, varicose veins, hemorrhoids, constipation, leg cramps, round ligament pain, backache-sciatica, SI joint, flatulence

37
Q

Fundal height at 10 weeks

A

An orange

38
Q

Fundal height at 12 weeks

A

A grapefruit

39
Q

Fundal height at 16 weeks

A

Midway between symphysis pubis and umbilicus

40
Q

Fundal height measurement at 22-34 weeks

A

Measurement in centimeters roughly corresponds with weeks’ gestation

41
Q

Fundal height measurement at 38 weeks

A

@Xiphoid process

42
Q

Normal FHR range

A

110-160 bpm

43
Q

When can you hear the fetal heart rate on the ultrasound?

A

6-7 weeks

44
Q

When can the fetal heart rate be heard on the Doppler?

A

10-12 weeks

45
Q

When can a fetal heartbeat be heard with a fetoscope?

A

17-20 weeks

46
Q

When will mothers be able to feel the fetus moving?

A

~ 16 weeks

47
Q

How many fetal movements should be felt in 1 hour/2 hours?

A

4/10

48
Q

When can a noninvasive prenatal test be done to determine genetic abnormalities?

A

10 weeks (results in 5 days)

49
Q

When can an ultrascreen for chromosomal abnormalities be performed?

A

11 1/7 weeks to 13 6/7 weeks

50
Q

What can maternal serum alpha-fetoprotein indicate if it is too high/low at 15-20 weeks?

A

Chromosomal trisomies/NTDs

51
Q

When is the diabetes screen for gestational diabetes performed?

A

24-28 weeks (at the end of 2nd trimester)

52
Q

When would a 3 hour glucose tolerance test be performed?

A

If 1 hour glucose test is ≥ 140

53
Q

What lab screenings are done in the 2nd trimester?

A

Diabetes screen, hemoglobin/hematocrit, antibody screening for Rh neg patients, rhophylac (RhoGAM) administration

54
Q

What is one of the most important lab screening to be done in the third trimester?

A

Group B streptococcus culture

55
Q

Barriers to prenatal care

A

Financial, systemic, attitudinal, may not realize She’s pregnant

56
Q

Types of prenatal tests

A

Nonstress test (nst), contraction stress test (CST), biophysical profile (bpp), ultrasound, Doppler ultrasound blood how assessment, chorionic villus sampling (CVS), fetal movement counts, alpha-fetoprotein screening, multiple marker screening

57
Q

What is considered a geriatric pregnancy?

A

≥ 35 yo

58
Q

What age is considered a young mom?

A

<16

59
Q

Can you confirm abnormalities with screening tests?

A

No. Only diagnostic tests can confirm abnormalities

60
Q

Which pregnancies are considered to be at risk?

A

Young/old mom, maternal diseases, Rh isoimmunization, previous poor pregnancy outcomes, suspected intrauterine growth restriction, post-dates pregnancy, multiple gestation

61
Q

What happens to fetal oxygenation during contractions?

A

Oxygenation stops

62
Q

What pattern of loss is observed in a fetus that is hypoxic?

A

FHR reactivity is lost, sucking stops, breathing movement stops, general movement stops, muscle tone is no longer detected

63
Q

When can muscle tone be detected?

A

7-8 weeks

64
Q

When can fetal movement be detected on an ultrasound?

A

8-9 weeks

65
Q

When can fetal breathing movement be detected on an ultrasound?

A

11-12 weeks

66
Q

When can sucking be seen on an ultrasound?

A

12-14 weeks

67
Q

When can fetal heart rate reactivity be detected?

A

28-32 weeks

68
Q

What is done in a nonstress test?

A

External fetal heart rate monitor observes fetal heart rate reactivity

69
Q

What is considered a reactive non-stress test?

A

Increase of 15bpm for 15 seconds with 2 episodes in 20 minutes

70
Q

Why is a contraction stress test used?

A

To determine how the fetal heart responds to uterine contractions that temporarily decrease placental blood flow

71
Q

What is the ideal result of a contraction stress test?

A

No fetal heart rate decelerations with 3 contractions lasting at least 40 seconds

72
Q

What are the 5 parts of a biophysical profile?

A

Fetal heart rate accelerations, fetal breathing movements, gross fetal movement, fetal tone, and amniotic fluid index

73
Q

What is the ideal range for amniotic fluid?

A

500-1000 mL

74
Q

What does a modified biophysical profile include?

A

Combination of a non stress test and an amniotic fluid index

75
Q

How does an ultrasound work?

A

Sound waves bounce off fetus and anatomical structures, creating a “picture”

76
Q

How does an ultrasound determine the fetal age?

A

Crown rump length

77
Q

what is an ultrasound used for in the second trimester?

A

Confirm due date, observe fetal anatomy, location of the placenta, multiple gestation, adjunct to amniocenteses

78
Q

What is an ultrasound used for in the third trimester?

A

Fetal growth and presentation, biophysical profile/amniotic fluid index, suspected intrauterine fundal development, adjunct to external version

79
Q

When will Doppler ultrasound umbilical blood flow studies be done?

A

Pregnant mothers with Hypertension, fetal growth restriction, placental insufficiency

80
Q

Why would an amniocentesis be performed in early pregnancy /late pregnancy?

A

Early: diagnose neural tube defects& Down’s syndrome
Late: lung maturity
Can also be used to test for intrauterine infections and hemolytic disease

81
Q

what lecithin/sphingomyelin ratio indicates lung maturity?

A

2:1

82
Q

What does a positive pg/pi test indicate?

A

Fetal lung maturity

83
Q

What is chorionic villus sampling used for?

A

Prenatal genetic diagnosis

84
Q

How is percutaneous umbilical blood sampling done?

A

Aspiration of fetal blood from the umbilical cord near the placenta

85
Q

What does umbilical blood sampling detect?

A

Blood disorders, acid-base imbalance, infection, or fatal genetic disease

86
Q

Which test predicts severe fetal anemia?

A

Delta OD 450 (middle cerebral artery doppler ultrasound study can also predict fetal anemia)

87
Q

How is the due date calculated using Nagaele’s rule?

A

LMP minus 3 months plus 7 days

Nurs 368 (20 decks)

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