antepartum normal Flashcards

Question

parity

Answer 1

number of pregnancies in which fetus or fetuses have reached viability

Answer 2

pregnancy that goes beyond 42 weeks of gestation

Answer 3

pregnancy that has reached 20 weeks of gestation but ends before 37 weeks 0 days of gestation

Answer 4

woman pregnant for first time

Answer 5

woman who has completed one pregnancy with fetus or fetases who have reached stage of fetal viability

Answer 6

pregnancy from beginning of week 37 of gestation to end of week 42 gestation

Answer 7

capacity to live outside uterus; state to state defined; about 22 to 25 weeks gestation are on the threshold of viability (premature infants are vulnerable to brain injury)

Answer 8

2 digit (gravida, para) 5 digit (gravidty, term, preterm, abortions, living)

Answer 9

amenorrhea n/v breast tenderness, ^size urinary frequency fatigue quickening

Answer 10

change in abd size positive pregnancy test braxton hicks contraction ballottement (16-18wks) goodell's sign (6th wk)

Answer 11

fetal heart rate ultrasound visualization fetal movement

Answer 12

-biological marker for all pregnancy tests - produced by chorionic villi on day of implantation - present in blood (8-10 days after conception), urine (26 days after conception)

Answer 13

ELISA- home preg test, urine RIA- tests beta subunit HCG, maternal serum test

Answer 14

-uteroplacental blood flow established - change in size, shape and position - palpable by 12-14 weeks - @ U by 20-22wks - increase tension on broad and round ligaments - change in contractility - ballotterment -quickiningc

Answer 15

-goodell's sign- softening of cervical tip - endocervical mucous plug forms

Answer 16

chadwick's sign- violet blue color of vaginal and cervical mucosa (vascular, 6-8 wks)

Answer 17

- full, heavy, increase sensitivity - areola pigmented - montgomery tubercles - colostrum

Answer 18

-hypertrophies - sinus arrhythmias, may have pulmonic/apical murmur - increased blood volume and flow (40-45%) - decreased viscosity

Answer 19

- 2nd trimester decreased - 3rd trimester back up to baseline - <140/90 goal - supine hypotension

Answer 20

- decreased H&H (physiologic anemia) - increase WBCs to 15000 hypercoagulable state platelets (sign of pre eclampsia if low)

Answer 21

- change in circumference of thorax r/t estrogen - proliferation of nasal tissues from estrogen lead to nasal stuffiness and increased blood flow/nose bleeds - ear fullness and change in voice - chronic mild hyperventilation, increase sensitivity to CO2; SOB easily (physiologic dyspnea)

Answer 22

- smooth muscle in ureters and kidneys dilate-urine stagnates in renal pelvis decrease bladder tone/ increase capacity

Answer 23

- increase GFR by 50% - increased reabsorption of Na+ - decreased threshold for glucose- spills into urine - protein in urine ABNORMAL (trace to +1 acceptable, anything more warning sign of preE) - most efficient kidney perfusion/function and least edema with lateral recumbent position, worst with supine position

Answer 24

- chloasma melasma linea nigra striiae gravidarum

Answer 25

posture/gain= wide stance; lordosis - rectus abdominus- split

Answer 26

-hormonal headaches - sleep alterations -carpal tunnel

Answer 27

basal metabolic rate- increase by 15-20% Appetite- changes, n/v good sign; decreased 1st tri, pica mouth- epulis, ptyalism esophagus, stomach, intestines- pyrosis, constipation gallbladder and liver- cholecystitis, cholelithiasis, pruritis gravidarum abd discomfort

Answer 28

- measurements used to trend growth - 12-14 wks above symphysis pubis - 20-22 wks at umbilicus - correlates within 2wks of gestation

Answer 29

- 9 months first tri - wks 1-13 - organogenesis - presumptive s/s second tri - wks 14- 26 - increase uterine/fetal size - feels movement 20 wks third tri - wks 27-40 - increase uterus furth displaces structures

Answer 30

Naegele rule - determine first day of last menstrual period - subtract 3 months - add 7 days - plus 1 year

Answer 31

-accepting the pregnancy - identifying with the mother role -reordering personal relationships (feeling loved and valued, partner accepting preg) establishing a relationship with fetus - preparing for childbirth

Answer 32

- accepting the pregnancy(announcement, moratorium, focusing) - identifying with parent role - reordering personal relationships - establishing relationship with fetus - preparing for childbirth; consider individual needs

Answer 33

to promote the health and well-being fo the pregnant woman the fetus, the newborn, and family

Answer 34

preventive care and optimal self care

Answer 35

- sough routinely by middle or high socioeconomic status - povertery of lacking insurance decrease access

Answer 36

lack of motivation to seek care - inadequate finances - lack of transportation - unpleasant clinic peronnel - unpleasant facilities or procedures - inconvenient clinic hours - problems with child care - personal and cultural attitudes

Answer 37

-assessments of fetal well-being -indications: materanl at >/=35 older paternal age (40-50) parents affected by or carriers of genetic disorder women with prior child with structural birth defect of one identified by ultrasound with current pregancncy women with prior child with chromosomal abnormality

Answer 38

- screening for neural tube defects - detects 85-92% of open NTDs and almost all anencephaly - recommended for all pregnant women - performed between 14-20wks gestation

Answer 39

- sampling of chorionic villi by aspiration for genetic disorders or congenital anomalies - earlier diagnosis and rapid results of genetic testing performed between 10-13 wks

Answer 40

-for prenatal screening for genetic disorders or congenital anomalies - amniotic fluid aspiration under ultrasound guidance performed at or after 14 wks

Answer 41

- for fetal lung maturity diagnostic -performed after 24 wks gest - LBC - L/S ratio - PG

Answer 42

- evaluate total amniotic fluid volume by measuring largest pckets in al 4 quadrants and totaling - 8-18 normal - <5cm- oligohydramnios - >35- polyhydramnios

Answer 43

- criteria: fetal breathing movements, fetal movement, tone, AFI - 8-10 normal - 4-6- suspect; deliver or repeat based on situation - <4- strongly suspect, likely deliver

Answer 44

Basis: normal fetus produces heart rate accelerations in response to fetal movement, uterine contractions, stimulation. If they don’t, most often indicates compromise in well-being. Reactive (positive): 2 or more accelerations in 20 mins of testing with normal baseline heart rate & variability.--REASSURING

Answer 45

To identify fetus stable at rest but compromised with stress. Contractions decrease uterine blood flow/placental perfusion. If creates fetal hypoxia→decreased FHR Negative: no late decelerations–REASSURING Positive: repetitive late decelerations–unsatisfactory/suspicious

Answer 46

Mother’s generally recognize 80-90% of movements; movement is correlated with fetal well-being Fetal movement decreases with hypoxemia Methods: Once a day for 60 mins Two or three times daily for 2 hours or until 10 movements All movements in 12-hour period until 10 movements Concerning: Decreased movement No movement for 12 hours (“fetal alarm signal”)

Answer 47

Collaborative care Education for self-management Procedures/testing Medications and herbal preparations Immunizations Alcohol, smoke, caffeine, and drugs Normal discomforts (see Perry Table): what to report? Recognizing potential complications 1st trimester: bleeding 2nd trimester: bleeding, preeclampsia, preterm labor (PTL) 3rd trimester: preeclampsia, infections (UTI)