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Maternity > Antepartum > Flashcards

Antepartum Flashcards

1
Q

Presumptive signs of pregnancy

A
  • changes that make her think that she might be pregnant*
  • Amenorrhea
  • Fatigue
  • N/V
  • Urinary frequency
  • Breast changes
  • Quickening:slight fluttering movements of the fetus
  • Uterine enlargement
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2
Q

Probable signs of pregnancy

A
  • Changes that make the examiner suspect a woman is pregnant*
  • Abdominal enlargement
  • Hegar’s sign: softening and compressibility of the lower uterus
  • Chadwick’s sign: deepened violet-blueish color of cervix and vaginal mucosa
  • Ballottement: rebound of unengaged fetus
  • Braxton Hicks contractions: false contractions that are painless, irregular, and usually relieved by walking
  • Positive pregnancy test
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3
Q

Positive signs of pregnancy

A
  • Fetal Heart sounds
  • Visualization of fetus by ultrasound
  • Fetal movement palpated by examiner
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4
Q

Nagele’s rule

A
  • Take the first day of the woman’s last menstrual cycle, subtract 3 months, and then add 7 days and 1 year to determine due date
  • Gravidity: # of pregnancies
  • Parity: # of pregnancies in which fetus reaches 20 weeks
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5
Q

Prenatal assessment frequency

A
  • Prenatal visits are scheduled
    monthly for weeks 16 to 28
    every 2 weeks from 29 to 36 weeks
    every week from 36 weeks until birth
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6
Q

Common discomforts of pregnancy

A
  • N/V
  • Breast tenderness
  • Urinary frequency
  • UTI’s
  • Fatigue
  • Heartburn
  • Constipation
  • Hemorrhoids
  • Backaches
  • SOB
  • Leg cramps
  • Varicose veins and lower extremity edema
  • Braxton hicks contractions
  • Supine hypotension
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7
Q

Expected weight gain during pregnancy

A

Total: 25-35 lbs

  • 2.2–4.4 lbs during the first trimester
  • 1 lb per week for the last two trimesters
  • Underweight: 28-40 lbs
  • Overweight: 15-25 lbs
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8
Q

Nutritional education

A
  • Increase calories
  • Increase protein intake
  • Iron supplements
  • Calcium
  • Adequate fluid intake
  • Limit caffeine
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9
Q

Diagnostic Tests: Ultrasound

A

Def: Ultrasound allows for early diagnosis of complications, permits earlier interventions, and thereby decreases maternal mobility and mortality
- full bladder, supine position
Indications
- confirming pregnancy
- assessing fetal growth and development
- assessing fetal position
- observing fetal movement

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10
Q

Diagnostic Tests: Biophysical Profile

A

Def: visualize physical and physiological characteristics of the fetus and observe responses to stimuli
- it combines FHR monitoring with ultrasound

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11
Q

BPP Cont.

A 
assess fetal well being by measuring five variables with a score of 0 or 2
- Fetal HR
- Fetal breathing 
- Gross body movement
- Fetal tone
- Amniotic fluid volume 
8-10 is normal
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12
Q

Diagnostic Tests: Nonstress Test

A

Def: monitors response of the FHR to fetal movement. It allows the nurse to assess the FHR in relationship to fetal movement
Indications
- decreased fetal movement
- IUGR

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13
Q

Nonstress Test Cont.

A
  • Reactive if the FHR is a normal baseline rate with moderate variability, accelerates at least 15/min for at least 15 seconds and occurs two or more times during a 20 minute period
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14
Q

Diagnostic Tests: Contraction Stress Test

A

Def: determines how the fetus will tolerate the stress of labor
- Normal finding: if within a 10 minute period, with 3 uterine contractions, there are no late decelerations of the FHR

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15
Q

Diagnostic Tests: Amniocentesis

A

Def: used for determining the position of the fetus
- empty bladder, supine position
Interpretation
- AFP can be measured between 16-18 weeks to assess for neural tube defects
- High levels: associated with neural tube defects
- Low levels: associated with chromosomal disorders
A 2:1 L/S ratio indicates fetal lung maturity

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16
Q

Diagnostic Tests: Percutaneous umbilical blood sampling

A

Def: obtains fetal blood from the umbilical cord

- assesses the need for a fetal blood transfusion

17
Q

Diagnostic Tests: Maternal serum alpha-fetoprotein

A

Def: a screening tool used to detect neural tube defects

- high levels indicate NTD’s, low levels indicate chromosomal abnormalities

18
Q

Complications: Spontaneous abortion

A

Def: When a pregnancy is terminated before 20 weeks of gestation

19
Q

Complications: Ectopic Pregnancy

A

Def: an abnormal implantation of a fertilized ovum outside of the uterine cavity, which can result in tubal rupture causing fatal hemorrhage

  • stabbing pain, monitor for indications of shock
  • ultrasound and Methotrexate to dissolve pregnancy
20
Q

Complications: Placenta Previa

A

Def: occurs when the placenta abnormally implants in the lower segment of the uterus near or over the cervical os instead of attaching to the funds

  • painless, bright red vaginal bleeding
  • fundal height greater than expected
  • ultrasound for placement of the placenta
21
Q

Placenta Abruption

A

Def: the premature separation of the placenta from the uterus, can be partial or complete

  • Risk factors: hypertension, trauma, smoking, cocaine
  • sudden, intense, localized, uterine pain with dark red vaginal bleeding
  • board-like abdomen
  • ultrasound for fetal well-being and placental assessment
22
Q

Medical Conditions: Premature Cervical Dilation

A

Def: a condition in which expulsion of the products of conception occurs

  • ultrasound
  • prophylactic cervical cerclage is surgical reinforcement
23
Q

Medical Conditions: Hyperemesis gravidarum

A

Def: excessive nausea and vomiting that is prolonged past 12 weeks of gestation and results in a 5% weight loss
- Lab tests: urinalysis, chem profile, CBC

24
Q

Medical Conditions: Iron-deficiency anemia

A

Def: occurs during pregnancy due to inadequacy in maternal iron stores and consuming insufficient amounts of dietary iron
- to increase absorption, take on empty stomach and with orange juice

25
Q

Medical Conditions: Gestational Diabetes

A

Def: impaired tolerance to glucose with the first onset or recognition during pregnancy

  • routine urinalysis, 1 hour glucose tolerance test
  • initially managed with diet and exercise, then insulin if needed
26
Q

medical Conditions: Gestational Hypertension

A

Def: hypertension that begins after the 20th week of pregnancy and the woman has an elevated blood pressure at 140/90 or greater recorded on two different occasions
- Mild preeclampsia: GH with proteinuria of greater the or equal to 1+
Severe preeclampsia: hypertension, proteinuria greater than 3+, oliguria, visual disturbances, peripheral edema, hepatic dysfunction, and thrombocytopenia
- Eclampsia: preeclampsia with seizures

27
Q

Magnesium Sulfate

A

The medication of choice for prophylaxis or treatment to lower blood pressure and depress the CNS
Signs of toxicity
- absence of patellar deep tendon reflexes
- urine output less than 30 mL/Hr
- respirations less than 12/min
- decreased LOC
- cardiac dysrthmias

28
Q

Preterm Labor

A

Def: uterine contractions and cervical changes that occur between 20 and 37 weeks of gestation
Management of a client who is in preterm labor includes focusing on stopping uterine contractions
- activity restriction
- ensuring hydration
- identifying and treating infection
- monitor FHR and contraction pattern
- fetal tachycardia

29
Q

Premature rupture of membranes

A

Def: the spontaneous rupture of the amniotic membranes 1 hour or more prior to the onset of true labor

  • infection is a major risk
  • client reports a fish or leakage of clear fluid from the vagina
30
Q

Meds: Nifedipine

A
  • A calcium channel blocker that is used to suppress contractions by inhibiting calcium from entering the smooth muscles
31
Q

Meds: Mag sulfate

A
  • A tocolytic that relaxes the smooth muscle of the uterus and thus inhibits uterine activity by suppressing contraction
32
Q

Meds: Indomethacin

A
  • An NSAID that suppresses preterm labor by suppressing uterine contractions
33
Q

Meds: Betamethasone

A
  • The therapeutic action is to enhance fetal lung maturity and surfactant production

Maternity (4 decks)

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