Approach to OB Flashcards

1
Q

what are the 4 effects of estrogen in the OB pt

A

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

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2
Q

what are the 4 effects of progesterone in the OB pt

A

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

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3
Q

What is human chorionic gonadotropin (HCG)?

A

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

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4
Q

what is placental growth hormone (formerly human placental lactogen)

A

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

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5
Q

what is relaxin

A

from placenta and corpus luteum

modifies SI joint and pubic symphysis in prep for delivery

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6
Q

what is Erythropoeitin

A

Inc RBC mass, increased plasma volume

leads to hemodilution (physiologic anemia)

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7
Q

what 4 breast changes occur

A

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

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8
Q

what three abdomen changes are seen

A

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

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9
Q

what is chadwick’s sign?

A

vagina gets a bluish tint d/t vascularity

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10
Q

what is leukorrhea?

A

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

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11
Q

what is Hegar’s sign

A

softening of the cervix

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12
Q

________ develops to seal off the uterine enviroment

A

cervical mucus plug

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13
Q

during the _____ trimester the uterus is confined to the pelvis

A

1st

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14
Q

at ____ to _____ weeks the uterus is externally palpable

A

12-14 weeks

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15
Q

______ during the 1st trimester leads to palpable corpus luteum

A

adnexa

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16
Q

what 7 things need to be addressed for health promotion

A
  • note daily food intake at first visit
  • prenatal vitamins
  • PMH of DM, eating issues, or barriatric surgery
  • BMI
  • Anemia
17
Q

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

A
  • Raw seafood, eggs, meat
  • unpasturized dairy (soft cheeses)
  • refridgerated meat spread
  • hotdogs, cold cuts, and lunch meats
18
Q

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

A

<18.5

28-40lb

19
Q

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

A

18.5-24.9

25-35 lbs

20
Q

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

A

25-29.9

15-25 lbs

21
Q

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

A

> /= 30

11-20lbs

22
Q

Exercise during pregnancy reduces the risk of… (7)

A
excess wt gain
gestational DM
preterm birth
varicosities
DVT
prolonger labor
preeclampsia
23
Q

excessive exercise while pregnant can lead to

A

low birth weight

24
Q

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

A

IUP specific plans or daily walking

25
Q

regarding exercise what should you avoid after the 1st trimester

A

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

26
Q

after the ____ trimester avoid balance exercises

A

> 3

27
Q

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

A

Tdap

28
Q

what 5 immunizations are safe for pregnant women

A

Influenza, Hep A, Hep B, pneumococcal, meningococcal

29
Q

what 3 immunizations are unsafe for preganancy

A

(b/c these are live viruses)

MMR, Polio, varicella

30
Q

what is tobacco use associated with (6)

A
low birth weight
placenta previa/abruption
preterm labor
spontaneous abortion
in utero death
fetal digital abnormalities
31
Q

how much alcohol is safe during pregnancy

A

no amount is safe; fetal alcohol spectrum

32
Q

Illicit drugs often contain _______, these affect _______ and ______

A

teratogens
affect maternal/baby bonding
and affect fetal development

33
Q

Can a pregnant woman remain employed?

A

can work if no contraindications or strenuous labor

just modify as needed

34
Q

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

A

> 36 weeks

35
Q

while driving seatbelt s/b

A

under abdomen

36
Q

start at slide 28

A

IVP