Antepartum Flashcards

Question

second trimester maternal assessment

Answer 1

Vital Signs (pay particular attention to BP) * Weight * Fundal Height

Answer 2

Fundal height * FHR * Fetal activity

Answer 3

Quad Screen and Alpha -Fetoprotein Analysis * CBC, GTT * Antibody screening if Rh negative * External ultrasound – anatomy screening, placental attachment, amniotic fluid volume * STI screening if applicable

Answer 4

Common Discomforts * S/S of PTL * S/S of HTN disorder * General warning signs

Answer 5

110-160 bpm (ATI) * 120-160 bpm (Davis)

Answer 6

Give to Rh-negative women at 28 weeks prophylactically – Also administered to women who had a pregnancy loss, amniocentesis or abdominal trauma

Answer 7

Prevents production of anti-Rho (D) antibodies in Rho(D) negative women exposed to Rho (D) positive blood. – Prevents hemolytic diseases of the newborn in future pregnancies of women who have conceived an Rho (D) positive fetus.

Answer 8

Aspiration of amniotic fluid for analysis. Needle inserted via abdominal wall *Performed after 14 weeks gestation *Done with ultrasound *Patient should EMPTY bladder before test (reduces size and prevents puncture) *Patient must notify MD if experiences: Fever, chills, leaking of fluid, decrease fetal movement, uterine contractions

Answer 9

decreased fetal movement increased bp

Answer 10

Weight * Vital Signs * Compare fundal height with gestational age * Fetal movement * Psychosocial review

Answer 11

Fetal lie * Leopold’s Maneuvers * Kick Count

Answer 12

GBS culture * Clotting factors/Fibrinogen levels * STI cultures (repeating if necessary) * Ultrasound as indicated

Answer 13

Caloric intake * Review Discomforts * Review Warning signs * Signs of Labor * Discuss Feeding preference * Discuss preparedness for newborn

Answer 14

Baseline vital signs – Pelvimetry Uterine growth is related to fetal size and gestational age. Pelvimetry: measuring the diameters of the pelvis

Answer 15

Fetal Assessment: Leopold's Maneuvers Third maneuver: Presenting part First maneuver: Determine part located in the fundus Second maneuver: Location of back Fourth maneuver: Cephalic prominence

Answer 16

indicates fetal wellbeing

Answer 17

Non invasive monitoring of FHR and the FHR response to movement * Assess for intact fetal CNS in 3rd trimester * R/o risk of death for high risk patients * If Reactive, associated w/ fetal survival of 1 week Reactive = good! Means the FHR accelerated two or more times during a 20 – 40 minute period NonReactive = bad! Means that the FHR did not accelerate over a 40 minute period *Send patient for CST, BPP

Answer 18

Nipple  Oxytocin Done after a nonreactive non - stress test (there was no FHR acceleration with fetal movement) Also done if there is decreased fetal movement, IUGR, post dates, GDM, GHTN, maternal chronic HTN, hx of fetal demise, AMA, sickle cell dz NEGATIVE = NORMAL – no decelerations with contractions POSITIVE = PROBLEMS – decelerations that denote issues with placenta, cord, or head compression

Answer 19

Real time ultrasound; Visualizes physical and physiological characteristics of fetus – response to stimuli Criterion Present (2 points) Absent (o points) NST (if used) Reactive (positive = good) Nonreactive (negative = bad) Fetal breathing 1 or more of rhythmic FBM of 30 seconds or more within 30 minutes Absent FBM Gross body movements 3 or more trunk movements in 30 minutes Two of fewer trunk movements Fetal Tone 1 or more episodes of fetal extremity extension with return to flexion, opening closing hand Extension with return to partial flexion, absence of flexion Amniotic Fluid Volume At least 2 pockets of fluid that measure at least 2 cm in two planes perpendicular to each other Does not meet the criteria

Answer 20

Group B Streptococcus – naturally occurring bacteria * Carried in the rectum or vagina * Life-threatening to newborns * Administer antibiotics during labor (Penicillin G)

Answer 21

Decreased incidence of breast and ovarian cancer * Decreased risk of Type 2 diabetes * Cost effective * Bonding * Promotes gradual weight loss

Answer 22

decreased childhood and adult obesity * Decreased risk of type 1 and type 2 diabetes * Decreased risk of SIDS * Decreased food allergies * Bonding * Immunologic properties help prevent infections

Answer 23

Assess for: * Flat or inverted nipples * Abnormal shape * Past breast/nipple surgeries * Small, firm nodules * Tenderness * Heat

Answer 24

First 24 hours - soft and non-tender * Day 2 - slightly firm and non-tender * Day 3 - firm, tender and warm to touch Assess for: * Flat or inverted nipples * Small, firm nodules * Tenderness * Heat * Sore nipples * Cracked or bleeding nipples

Answer 25

3 steps suckling...stimulates pituitary gland pituitary gland releases prolactin and oxytocin these cause synthesis and release of breast milk and contraction of the smooth muscle in the uterus and around the alveoli cells in the breast