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ob - 332 > antepartum 2 > Flashcards

antepartum 2 Flashcards

1
Q

n/v

A

increased hcg
only concerned if dehyd and weight loss
crackers/toast before sitting up, small and freq, no crease or spicy or trigger, carbonated good, antiemetic, meds if necessary

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2
Q

urinary freq

A

P on bladder and hormones
q2 hr during day, avoid night time drinking, completely empty

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3
Q

fatigue

A

hormone and life
nap

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4
Q

breast tenderness

A

hormones
supportive bra

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5
Q

vaginal discharge

A

leukorrhea - no odor,
natural - lubricate and prevent infection
daily bathing, cotton, dont douche

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6
Q

nasal stuffy

A

estrogen
cool air vapor, NS nasal spray

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7
Q

heart burn

A

uterus push on stomach, sphincter relax, progesterone
combo, non Na antacid, no spicy, dont lay down after eating, avoid trigger

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8
Q

ankle edema

A

decreased venous return
concern if high BP, wont resolve with rest, generalized
avoid prolonged sit or stand, keep feet and legs elevated, exercise, hydrate

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9
Q

varicose veins

A

exercise, avoid sit or stand

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10
Q

flatulence

A

P
reg bowel habit

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11
Q

hemorrhoids

A

avoid C, gently self reduce, topical ointment, warm soak, sitz bath

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12
Q

constipation

A

hormones (progesterone)
concern if abd pain (contractions)
increase fluid, no roughage, daily exercise, reg bowel habits, laxative, fiber

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13
Q

backache

A

baby weight, lordosis
pelvic title, posture, avoid fatigue, good body mechanics when lifting, no heels
concern if reg intervals or UTI

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14
Q

leg cramps

A

unknown cause
massage, warm soak, stretch, dorsiflex

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15
Q

faint

A

sit and lower head btw knees, avoid standing in 1 place too long

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16
Q

SOB

A

P of uterus on diaphragm
posture, prop up in bed
concern if at rest, doesnt go away, with pain, cough, heart palpitations

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17
Q

difficulty sleeping

A

avoid caffeine, max comfort in bed

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18
Q

round ligament pain

A

weight of uterus stretching round ligaments
warmth to abd, slow change of position
concern if not transient

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19
Q

carpal tunnel

A

avoid repetitive hand movements, may disappear after delivery, Sx

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20
Q

fetal movement counts

A

16-22 wk, same time daily, 1 hr after meal, side lying, call if <10/2hr, eat/drink, quiet room

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21
Q

breast

A

supportive bra, clean, no soap on nipples, breast shield for inverted

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22
Q

clothes

A

no high heels or restrictive

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23
Q

cleanliness

A

bathe daily
avoid hyperthermia 1T (hot tub)

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24
Q

employment

A

work till labor, env hazards

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25
Q

travel

A

no restriction unless complication
car = stop q2 hr and walk for 10 min, seat belt - shoulder and hips

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26
Q

exercise

A

nothing new, +300 kcal/day, dont overheat, walking great!
contraindications: ROM, htn, competent cervix, bleeding, preterm labor or hx of placenta previa after 26th week
benefits: self image, energy, sleep, relieve tension, control weight gain, bowel function, help with recovery PP
kegels!

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27
Q

sexual activity

A

1T: fatigue, n/v
2T: fewer discomforts, vascular congestion increase libido
3T: fatigue, SOB, decreased mobility
fathers feelings: previous relationship, acceptance, change in appearance, pain

28
Q

dental

A

regular, brush after n/v, avoid x ray

29
Q

immunization

A

no live (mmr), flu and Tdap good, U2D before if possible

30
Q

meds

A

highest risk 1T -> organs, nothing 100% safe
pregnancy (dev), lactation, reproductive potential

31
Q

tobacco

A

lbw babies, preterm, prom, fetal demise, placental previa, abruptive placenta, sids

32
Q

OH

A

FAS = growth retardation, facial anomalies, retardation
increased risk of miscarriage, IUFD, lbw

33
Q

caffeine

A

no clear evidence, limit to 200 mg/day, hypersensitive

34
Q

marijuana

A

low research, strength and composition unreliable, other drugs

35
Q

cocaine

A

maternal MI, cardiac arrhythmias, ruptured aorta, seizure, stroke
abruptio placenta, PROM, lbw, sids, heart defect, limb defect
cord sampling -> detect use, best method
urine sampling (- in 24-48 hr, metabolize rapidly)

36
Q

advanced maternal age

A

35+
high risk, well educated, $ secure
miscarriage, high r/o GDM, GHTN, placenta previa, hard labor; c/s multiple births, down (screen, amniocentesis), infertile (meds)
E levels, deal with child when older, peer group

37
Q

adolescent - socioeconomic

A

poverty, AA and H, low edu and community involvement

38
Q

adolescent - behavior

A

multiple partners, low contraceptive use, low knowledge, invulnerability

39
Q

adolescent - psychosocial

A

fam, slef esteem, abuse, punish parents, escape, attention, love

40
Q

adolescent - phys

A

preterm and lbw, preeclampsia-eclampsia, Fe anemia, CPD, OH and drug use, STI

41
Q

adolescent - interventions

A

prenatal: assess and counsel nutrition, assess for high risk, test and educate STD, edu about substance, promote fam adap, prenatal edu
labor: sustained presence, educate choices, help support people
postpartum: contraception, resources, parenting

42
Q

nutrition

A

increase folic acid, Fe, Ca

43
Q

weight distribution

A

fetus, placenta, amniotic fluid = 11 lbs
uterus = 2lbs
blood volume = 4 lbs
breast = 31 lbs
maternal storage = 5-10 lbs
gain: 1-5 in 1T; 1lb/week after

44
Q

obesity

A

abortion, gestational DM, preeclampdia, labor induction, c/s, anomalies

45
Q

fluid

A

rxns, lubricate, transport, temp (8-10, 8 oz (4-6 = h2o))

46
Q

pica

A

cravings (non nutritive) - Fe anemia
clay, soil, powdered laundry starch, soap, baking powder
i guess they are allowed to have some - dont interfere with nutrition and not harmful

47
Q

ultra sound

A

sound waves, abd = invasive, can be done at any time
benefits: tons
non radiating, neural tube defects, skeletal malformations, anomalies

48
Q

nuchal testing

A

screen, NOT diagnostic, done with US
11 -14 wk -> trisomy disorders, >3mm back on fetal neck = at risk
non invasive, 70-80% downs

49
Q

transV US

A

clearer, predict preterm (short cerv or funnel (cone shaped))
need empty bladder

50
Q

doppler blood flow

A

unbilical velocimetry
blood flow changes (mom and baby)
elevations >95% = abn
2T and 3T

51
Q

non stress test

A

fetal and contraction monitor
acceleration of fetal HR with movement or contractions = adequate o2 and CNS intact
<32 wk = 2 FHR, 10 beats above, 10 sec
>32 wk = 2 FHR, 15 beats above, 15 seconds
nonreactive = BPP

52
Q

fetal accoustic stim

A

sound and vibrate to stimulate infant, show accelerations

53
Q

BPP

A

fetal breathing movement, gross body movement, fetal tone, amniotic fluid volume (/8), non stress test (/10)
2 = normal for each category

54
Q

contraction stress test

A

eval O2 and CO2 exchange with placenta
bad = late decels
- = good
+ = bad, maybe prep for c/s
equivocal = uncertain, continue to monitor

55
Q

amniotic fluid analysis

A

diagnostic, genetic abn, invasive, 15-20 wk or 3T
amniocentesis -> lung maturity with L/S (2:1 = mature)

56
Q

chorionic villus sampling

A

10-13 week, invasive
diagnostic = chrom abn
risk = ROM, bleed, intrauterine infection, possible limb reduction and birth defects with early CVS

57
Q

US benefits

A

early identification of pregnancy, FRB and breathing, multigestational, estimate BW, nuchal translucency in 1T, check heart structures, length of nasal bone, check AFI, location of placenta, detection of fetal death, fetal position and presentation, help with amniocentesis, chorionic villus sampling

58
Q

danger zone - fetal movement

A

one of most reliable indicators of fetal wellbeing
16-20 wk
once it starts, it shouldnt stop, feeling will change

59
Q

danger zone - contract/cramp

A

preterm: ok if - rare/occasional, know cause, normal FM and no bleeding or leaking; not ok if - regular, no cause, change in FM, bleeding or leaking
term: hopefully labor! hx if 5 min apart and getting stronger or if water breaks; not ok if - heavy bleeding, change in FM

60
Q

danger zone - leaking fluid

A

preterm: identify source - leukorrhea and urine ok; not ok - foul odor, change in color, itchy/irritate, amniotic fluid
term: source = same; not ok if UTI s/s; amniotic fluid is ok but go to hospital (bacteria)

61
Q

danger zone - bleeding

A

preterm: cause, amount, FM, spotting = activity, sex, exam, if cant identify not okay, more than spotting is not ok
term: cause, amount, FM, spotting = same, with contractions = ok, persistent with no cause = not ok

62
Q

genetic screening - carrier

A

maternal and/or paternal serum or buccal swab
can be done anytime before or during

63
Q

other danger s of pregnancy

A

abd pain, fever, persistent v, dysuria, dizzy, blurred vision, spots before eyes, persistent HA, edema (generalized), muscular irritability or convulsions, epigastric pain, oliguria

64
Q

genetic screening - MSAFP

A

quad screening
maternal serum, 15-22 wk
measures 4 substances
screen for down, edwards, and NTD, not diagnostic

65
Q

genetic screening - NIPT

A

maternal serum, done anytime after 10 wk
screen for down, pataue, edward, and problems with # of sex chromosomes
not diagnostic

ob - 332 (15 decks)

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