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NUR 359: OB > Antepartum > Flashcards

Antepartum Flashcards

1
Q

what groups are considered at risk

A

homeless
single
uninsured
no access to prenatal care

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2
Q

when is a preg considered high risk

A

when the life of the mother or fetus is jeopardized

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3
Q

how long is mom considered high risk for

A

up to 30 days after delivery

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4
Q

maternal complications usually resolve by when?

A

within 1 month after birth

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5
Q

when is a neonate considered high risk?

A

when the neonate does not meet cultural, societal, or familial norms/expectations

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6
Q

what are the leading causes of maternal mortality

A

preg induced HTN
PE
hemorrhage

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7
Q

what factors are r/t maternal death

A 
younger than 20
older than 35
lack of prenatal care
low edu
unmarried
non-white
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8
Q

what is the leading cause of neonate death

A

congenital anomaly

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9
Q

other causes of neonate death

A 
short gest
low birth wt
SIDS
resp distress
effects of maternal complications
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10
Q

what are genetic risk factors

A

heritable factors that originate within the mother or fetus

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11
Q

name demographic risks

A

geo location
socio-eco status
racial disparity
occupational hazards

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12
Q

what are behavioral risk factors

A

behaviors that arise from the mother and/or family and place the fetus at incr risk

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13
Q

name behavioral risks

A

sub abuse

poor maternal nutrition

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14
Q

risk factors are…

A

inter-related and cumulative

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15
Q

how can mom help monitor fetal well being?

A

daily fetal mvmt count

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16
Q

indications for US

A 
-FHR activity
gest age
fetal growth
fetal anatomy
placental position and fx
adjunct to other invasive tests
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17
Q

how do we use the US to determine fetal well being?

A

amnio fluid vol
doppler blood flow analysis
biophysical profile

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18
Q

what is the nurses role during prenatal testing/procedures

A
  • education

- support

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19
Q

what are fetal mvmts and tone

A

the way the baby moves

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20
Q

indications for MRI

A

-fetal structure
- placenta:
position
density
presence of gest tropho disease
- quant if amnio fluid
- maternal structures:
uterus
cervix
adnexa
pelvis
fibroids
- biochemical status of tissues and organs
-soft tissue anomalies
- metab anomalies
- fx anomalies

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21
Q

is the mom exposed to radiation during an MRI

A

no

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22
Q

are MRI’s and US considered invasive procedures

A

no

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23
Q

what is amniocentesis

A

assessment of the babys chromosomes

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24
Q

amniocentesis is guided via

A

US

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25
Q

when is an amnio done

A

on or after week 14

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26
Q

maternal risks a/w amniocentesis

A 
hemorrhage
infec
labor
abruptio placenta
damage to intestines or bladder
amnio fluid embolism
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27
Q

what % is the risk a/w amniocentesis

A

<1%

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28
Q

recommendations for mom after amniocentesis

A
  • rest for the remainder of the day
  • no bending, reaching, climbing stairs
  • restrict taking care of other children- if possible
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29
Q

what should a mom report after an amniocentesis

A

dull back pain

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30
Q

fetal risks a/w amniocentesis

A 
death
hemorrhage
infec (amniotitis)
injury from needle
miscarriage
pre term labor
amnio leakage
31
Q

indications for amniocentesis

A

hx of genetic disorders
fetal maturity
fetal hemolytic disease
ante/intra partal meconium

32
Q

what is lactophinomylin ratio

A

lung maturity

33
Q

what is karyotyping

A

terminating a preg bc the baby is an undesired sex

34
Q

percutaneous umbilical blood sampling is aka

A

cordocentesis

35
Q

what is PUBS

A

insertion of a needle into umbilical vessel under US guidance

36
Q

benefit of PUBS

A

direct access to fetal circulation

37
Q

when can a PUBS be done

A

2nd and 3rd trimester only

38
Q

is a PUBs done often

A

no- very rarely

39
Q

risks a/w PUBS

A

infec
premature ROM
cord prolapse

40
Q

what is chorionic villus sampling (CVS)

A
  • removal of small tissue specimen from fetal portion of placenta
41
Q

where does chorionic villi originate

A

zygote

42
Q

what does chorionic villi tissue reflect?

A

genetic makeup of fetus

43
Q

when can a CVS be done

A

bx 10-12 wks gest

44
Q

benefits of CVS

A
  • earlier dx

- rapid results

45
Q

risks a/w CVS

A

miscarriage

bleeding

46
Q

indication for AFP

A

screening:
NTD’s
abdominal wall defects

47
Q

who is AFP testing recommended for

A

all pregnant women

48
Q

how is AFP collected

A

maternal serum

49
Q

AFP is produced by

A

the fetal liver

50
Q

when is AFP tested?

A

16-18 wks gest

51
Q

AFP blood tests are combined with

A

US results

52
Q

how are the results from an AFP presented?

A
  • a percentage risk of having a baby with down syndrome
53
Q

it is possible to receive what kind of results from an AFP

A

false positive

54
Q

what else is looked at in conjunction with AFP?

A

estriol and HCG

55
Q

if a baby has down syndrome, describe the rship bx afp/estriol/hcg levels

A
  • AFP and estriol will be low

- HCG will be high

56
Q

what is a coombs test used for

A
  • determine RH incompatibility and its severity

- determines other AB’s for incompatibilty w/ moms Ag’s

57
Q

if mom and fetus are Rh incompatible, what will be admin to mom after birth

A

Rhogam

58
Q

indications for electronic fetal monitoring

A
  • assess fetal response to hypoxia and asphyxia
  • fetal well being
  • cxns
  • cns of the baby
59
Q

variability of fhr demonstrates

A

fetal well being
cxns
cns of the baby

60
Q

what is a NST done for

A

fetal activity determination

61
Q

how is a NST performed?

A

mom lays down
2 belts
mom relaxes
vibroacoustic stimulation

62
Q

when is a NST indicated

A
  • 2x per week after week 28 if mom has:
    DM
    HTN
    previous stillborn
63
Q

interpretaion of NST results

A

2 or more accelerations of 15 bpms lasting over 15 secs over 20 mins
demonstrates moderate variability

64
Q

vibroacoutic stimulation

A

5-10 mins getting baseline
get a variability w/ HR
scare baby

65
Q

what is the protocol if there is no activity after vibroacoustic stimulation

A

mom will be sent for more testing- biophysical

66
Q

how long will HCP allow baby to be non-reactive before sending mom for a biophysical

A

40 mins

67
Q

when is a contraction stress test (CST) indicated

A

when a baby fails NST

68
Q

what are the 2 different CST’s

A
  • nipple stim CST

- oxytocin stim CST

69
Q

how is a CST performed?

A
  • monitor for 20 mins
  • get a baseline
  • give 20 units
  • wait a few mins
  • give 10 units
  • assess baby to cxns
  • wait another 20 mins
  • assess baby again
70
Q

interpretation of CST

A

-if baby reacts, test is (-)

71
Q

benefit of CST

A
  • provides a warning of fetal compromise earlier than an NST
72
Q

name biophysical assessment techniques

A

fetal mvmt counts
US
MRI

73
Q

name the biochemical monitoring techniques

A

amnio
PUBS
CVS
maternal serum AFP

74
Q

what interpretations suggest fetal well being

A

reactive NST
and
(-) CST

NUR 359: OB (15 decks)

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