Approach to OB

Question 1

what are the 4 effects of estrogen in the OB pt

Answer 1

endometrial support for fetus
stimulates pituitary size increase
In GI causes dec tone in lower esoph sphinter
makes them hyper coagulable= inc risk of thrombosis

Question 2

what are the 4 effects of progesterone in the OB pt

Answer 2

endometrial support
lungs:inc tidal volume and alveolar minute ventilation
GI dec tone in LES: gerd
GU: dec bladder and uterter tone - hydronephrosis and inc risk of bateremia

Question 3

What is human chorionic gonadotropin (HCG)?

Answer 3

made by the placenta
supports progesterone synth by corpus luteum
stabilizes the endometrium

Question 4

what is placental growth hormone (formerly human placental lactogen)

Answer 4

supports development
can lead to insulin resistance–>DM
can lead to preeclampsia

Question 5

what is relaxin

Answer 5

from placenta and corpus luteum

modifies SI joint and pubic symphysis in prep for delivery

Question 6

what is Erythropoeitin

Answer 6

Inc RBC mass, increased plasma volume

leads to hemodilution (physiologic anemia)

Question 7

what 4 breast changes occur

Answer 7

become enlarged nodular
areola darken and montgomery glands are more prominent
visible veins
colostrum (formation of milk)

Question 8

what three abdomen changes are seen

Answer 8

striae gravidarum
linea nigra
diastasis recti midline (seperation on midline of rectus abdominus)

Question 9

what is chadwick’s sign?

Answer 9

vagina gets a bluish tint d/t vascularity

Question 10

what is leukorrhea?

Answer 10

profuse white d/c from the vagina inc lactobacilli inc glycogen can lead to canadidias

Question 11

what is Hegar’s sign

Answer 11

softening of the cervix

Question 12

________ develops to seal off the uterine enviroment

Answer 12

cervical mucus plug

Question 13

during the _____ trimester the uterus is confined to the pelvis

Answer 13

1st

Question 14

at ____ to _____ weeks the uterus is externally palpable

Answer 14

12-14 weeks

Question 15

______ during the 1st trimester leads to palpable corpus luteum

Answer 15

adnexa

Question 16

what 7 things need to be addressed for health promotion

Answer 16

• note daily food intake at first visit
• prenatal vitamins
• PMH of DM, eating issues, or barriatric surgery
• BMI
• Anemia

Question 17

What does a pregnant woman need to avoid for listeria precautions (4 groups)

Answer 17

• Raw seafood, eggs, meat
• unpasturized dairy (soft cheeses)
• refridgerated meat spread
• hotdogs, cold cuts, and lunch meats

Question 18

what is an underweight BMI for preg woman? lbs gained?

Answer 18

<18.5

28-40lb

Question 19

what is a normal BMI for preg woman? lbs gained?

Answer 19

18.5-24.9

25-35 lbs

Question 20

What is an overweight BMI for preg woman? Lbs gained?

Answer 20

25-29.9

15-25 lbs

Question 21

What is an obese BMI for preg woman? Lbs gained?

Answer 21

> /= 30

11-20lbs

Question 22

Exercise during pregnancy reduces the risk of… (7)

Answer 22

excess wt gain
gestational DM
preterm birth
varicosities
DVT
prolonger labor
preeclampsia

Question 23

excessive exercise while pregnant can lead to

Answer 23

low birth weight

Question 24

If pregnant woman has not been working out prior to pregnancy what 2 things would you suggest if she wants to work out

Answer 24

IUP specific plans or daily walking

Question 25

regarding exercise what should you avoid after the 1st trimester

Answer 25

avoid being supine and crunches d/t placental flow and inf vena cava compression

Question 26

after the ____ trimester avoid balance exercises

Answer 26

>3

Question 27

what immunization do you need to get between 27-36 weeks

Answer 27

Tdap

Question 28

what 5 immunizations are safe for pregnant women

Answer 28

Influenza, Hep A, Hep B, pneumococcal, meningococcal

Question 29

what 3 immunizations are unsafe for preganancy

Answer 29

(b/c these are live viruses) | MMR, Polio, varicella

Question 30

what is tobacco use associated with (6)

Answer 30

``` low birth weight placenta previa/abruption preterm labor spontaneous abortion in utero death fetal digital abnormalities ```

Question 31

how much alcohol is safe during pregnancy

Answer 31

no amount is safe; fetal alcohol spectrum

Question 32

Illicit drugs often contain _______, these affect _______ and ______

Answer 32

teratogens affect maternal/baby bonding and affect fetal development

Question 33

Can a pregnant woman remain employed?

Answer 33

can work if no contraindications or strenuous labor | just modify as needed

Question 34

It's preferred women don't travel if the are over _____ weeks

Answer 34

>36 weeks

Question 35

while driving seatbelt s/b

Answer 35

under abdomen

Question 36

start at slide 28

Answer 36

IVP