Antepartum Flashcards
What does the hormone Human Chorionic Gonadotropin (HCG) do during pregnancy?
It is the hormone that is detected on pregnancy tests
What does the hormone progesterone do during pregnancy? (3)
Helps maintain the uterine lining,
Relaxes smooth muscle,
Help the uterus grow with the baby
What does the hormone oestrogen do during pregnancy? (3)
Helps increase blood supply
Stimulates uterine growth
Helps fetal organ development
What does the hormone prolactin do during pregnancy?
Enlarges the mammary glands
What does the hormone relaxin do during pregnancy? (2)
Softens and lengthens cervix and joints
Inhibits uterine activity that can cause premature labor
What does the hormone oxytocin do during pregnancy? (2)
Causes uterine contractions
Stimulates milk ejection
What is Hegar’s sign
Softening of the isthmus cervix
What is Goodwell sign
The softening of the cervix
What is Chadwick’s sign
Bluish purple color of vagina
Should pregnant people go in Hot tubs?
NO!!
Increases risk of neural tube defects
What are three interventions for N/V
Eating dry crackers before getting up for the day
Eating small frequent meals
Avoid fatty foods
what is normal weight gain in the 1st trimester?
2-4 lbs
What are three interventions to prevent UTI during pregnancy/
Fluid intake 3L/day
Void frequently -Q2
Wipe front to back
Where is the fundus at 16wks?
inbetween the symphysis and umbilicus
What is the quickening?
1st Perception of fetal movement
What is normal weight gain for the rest of the pregnancy (2nd and 3rd trimester)
1 lb per week
What can high levels of alpha-feto protein indicate?
Neural tube defect
what can low levels of alpha-feto protein indicate
Down syndrome
Where is the fundus at 20 weeks?
At the umbilicus
Where is the fundus at 24 weeks?
Above the umbilicus
Is a murmur normal in pregnancy ?
Yes, the heart is shifted up and laterally
How is BP affected during pregnancy?
Systolic remains same
Diastolic gradually increase
During a Glucose screening what BS is abnormal
140 or greater
If the pregy has a negative rH, what med is expected to be given during pregnancy
Rho(D) immune globulin
Where is the fundus at 28 weeks ?
Halfway between the umbilicus and the xiphoid
Where is fundus at 32 weeks ?
The xiphoid process
What are two interventions to help decrease edema
Elevate leg 1-2 times a day
Lay patient in Left lateral position
Where is the fundus at 36-40 weeks
Below xiphoid process ( baby drops)
What should be done if Strep status is unknown?
Treat anyway
What are the presumptive signs for pregnancy (6)
Amenorrhea
Fatigues
N/V
Linea Nigrea
Melasma
Urinary Frequency
What are some probable sign for pregnancy (6)
Chadwick
Goodwell
Hegar
Ballottement
Braxton Hick
Positive pregnancy test
What are some positive signs (3)
Fetal HR- 10-12 weeks
Fetal movement-
Ultrasound visualization-
What medications can cause a inaccurate pregnancy test
Anticonvulsants, diuretics, tranqulizers,
What does High levels of HCG indicate (3)
Multiple pregnancies
Ectopic pregnancy
Genetic issues
What does low levels of HCG indicate
Miscarriage
What is Leopold’s maneuver and what can you find with it?
External palpation of uterus to find the presentation of the baby and Point of maximum impulse
What is Gravida
The number of pregnancies, including current pregnancy
What is para?
The number of pregnancies that reached 20 minutes
What is GTPALM
Gravida- number of pregnancies
Term- 38 weeks and up
Preterm 20-37 weeks
Abortions
Live Birth
Multiple births
What does albumin in a UA indicate?
Preeclampsia
What does glucose in UA indicate?
Gestational Diabetes
How do you calculate EDD?
Day- 3 months+ 7 days
How much folic acid should a pegs have each day?
600mcg
What are some s/s of Preeclampsia (5)
Visual changes
Severe HA
Epigastric pain
Facial swelling
HTN
Do you need a full bladder with a transvaginal ultrasound
NO!
Do you need a full bladder for a transabdominal ultrasound?
Yes
What does CVS check for?
Chromosomal, metabolic, and DNA testing
What are some nursing interventions for CVS (3)
Obtain consents
Give Rho(D) immune globulin if needed
Place patient in lithotomy position
What are some post op teaching for CVS (4)
Report cramping, heavy bleeding, clot to tissue passage, and leakage of fluid
Temp greater than 100.4
Rest for 24 hours
Avoid Exercise, heavy lifting, and sexual intercourse
Should you have a full bladder with an amniocentesis with early pregnancy?
Yes, so you can position the uterus?
Should you have a full bladder with an amniocentesis in late pregnancy?
No, so its will not be punctured
What can amniocentesis test for?
Genetic testing
Hemolytic Diseases
Intrauterine infections
Down syndrome
Evaluating fetal lung maturity (2:1)
What are some post op teaching for amniocentesis?
Rest for 24 hours, no exercise, heavy leaving, or sex
Report DFM
Report cramping, heaving bleeding, clots or tissue passage, leakage of fluid, or temps greater than 100.4
What are some nursing interventions during amniocentesis ?
Obtain consents
Obtain VS and FHR
Administer RhoGAM
Monitor FHR for an hour
Who are considered high risk pregnancies?
(6)
Hypertensive disorders
Diabetes
Multiple Gestations
Lupus
Renal or heart disease
Interruption of O2 pathways
What does a normal fetal kick count
10 kicks in a 1-2 hours
What does a NST check for
It checks for fetal heart rate with fetal movement
What are some pre op nursing interventions for NST
Place ultrasound and tocodynamomter
Tell pt to push button when they feel the baby move
Monitor fetus for 20 minutes
Record fetal heart rate and uterine activity
What does it mean for a reactive stress test
A FHR heart rate that increases 15 beats for 15 secs in 20 minutes (15x15)
Or 10x10
What is a non reactive NST mean
Fewer than 2 accelerations during a 40 minute period
OR
Decelerating that persist for 1 min or longer
What is a Contraction stress test (CST)
Checking FHR in response to contractions
What are some nursing responsibilities for CST (3)
Obtain consent
Monitor VS, FHR, and UA for 20 minutes
Record at least 3 contractions in 10 minutes
What does a negative CST
No late decelerations
What does a positive CST
Late decelerations are present in at least half of the contractions
What does a pegs want on the following test
NST
CST
Reactive
Negative
What is a Biophysical profiles check?
The assessment of fetal biophysical characteristics
Fetal movement- moves 3 limbs
Fetal tone- a limb extension and returns to flexion
Fetal breathing
Amniotic fluid amount
NST- reactive
What are good scores for BPP
8 or 10
What does a BPP score of 2 mean
Immediate delivery
