babyyy

Question 1

prenatal care-how many visits?

Answer 1

1-28 wks= every mnth
28-36 wks= every 2-3 wks
36 wks until delivery=every week

Question 2

Nageles rule

Answer 2

LMP-3mnth +7 dyas + 1 yr

ex. if LMP is Aril 14th 2011, then EDC will be Jan 21 2012

Question 3

embryo

Answer 3

fertilization to 8 wks

Question 4

fetus

Answer 4

8 wks till birth

Question 5

previable

Answer 5

<24 wks

Question 6

preterm

Answer 6

24-37

Question 7

term

Answer 7

37-42

Question 8

what are you looking for during prenatal visits?

Answer 8

fetal movement, vaginal discharge +/- bleeding, abdominal crapms or UC
leackage of fluid or signs of ROM

dysuria
blurred vision, HA, rapid weight gain, edema

Question 9

objective findings

Answer 9

weight, fundal height, BP, edema,

dipstick urine protein and glucose

fetal heart tones (heard after 10-12 wks)

Question 10

Fundal hieght

Answer 10

measured w/ tape measure from the top of the pubic symphysis to the top of the fundus

Question 11

at 12 wks, FH?

Answer 11

at the pubic syphysis

Question 12

at 16 wks? FH?

Answer 12

midway btw the pubic and umbilicus

Question 13

at 20 wks fh?

Answer 13

at the umbilicus

Question 14

at 20-32 wks

Answer 14

height above the pubic symphsis should equal GA in wks

Question 15

nutrition for pregos

Answer 15

increased by 300 kcal/day

Iron and folate supplementation is recommentd

Question 16

weight gain through out pregan

Answer 16

normal: 25-35 lbs for the entire pregan

Question 17

first trimester wieght gain

Answer 17

3-5 lbs total

Question 18

second trimester weight gain

Answer 18

0.5lb/wk

Question 19

third trimester weight gain

Answer 19

1 lb/wk

Question 20

prenatal labs initial visit

Answer 20

H/H, type, Rh, antibody screen

cystic fibrosis

papsmear, UA, urine culture, sickle prep

glucose

Question 21

what infectious agents do you need to watch for?

Answer 21

rubella titier, VDRL for syphilis, HBsAG, VZV, PPD,HIV

Question 22

what are some baby sceends that need to be done in the first trimester?

Answer 22

nuchal thickness, PAPP-A, hcG

+: increased nuchal thickness, decreased PAPPA, significanglty increased HCG

down syndrome, trisomeies

Question 23

16-20 wks labs

Answer 23

Quad screen (HCG, AFP, estradiol) to test for Down, Edward’s and neural tube defects

Offer MSAFP

US at 18-20 wks

Question 24

26-28 wks screening

Answer 24

DM! rf or not

RhoGam if pt Rh -

CXR if PPD +

Question 25

34-38 wks screening

Answer 25

CBC, VDRL, cervical chlamydia and gonorrhea **group B streptococcus culture at 35-37 wks

Question 26

when can you visulaize a normal prg?

Answer 26

when BHCG is > 1800-2-- (transvag US) when BHCG is >3500-5000 (see transabdominal US) **discrimatory zone

Question 27

discrimatory zone cut off?

Answer 27

if HCG levels are above cut off an dIUP is not visualized- strong likelihood of an ectopic or other abnormal pregnancy

Question 28

what are the estrogen components of OCP?

Answer 28

ethinyl estradiol or mestrol

Question 29

progesterone compoentne of OCP

Answer 29

19-nortestosertone, including norethindrone acetate, norethindrone, levonorgestrel, ethynodiol diacetate, desogestrel, norgestimate, DL-norgestrel, gestodene, and drospirenone

Question 30

what population has the most use for the minipills

Answer 30

lactating women and those older than 40

Question 31

contraceptive advnatages

Answer 31

 Less benign breast disease, iron deficiency anemia, and pelvic inflammatory disease as well as fewer ovarian cysts - Protection against ectopic pregnancy, reduced risk of ovarian and endometrial cancer, reduced dysmenorrhea and menorrhagia, - and improvements in hirsutism, acne, and symptoms of endometriosis. -Oral contraceptives also may protect against rheumatoid arthritis

Question 32

disadvantages of OCP

Answer 32

increased risk of thromboembolic ddz, abnormal lipids | -possilbe increased risk of breasat cancer, and rarely, HTN, cholelithiasis, benign liver tumores

Question 33

Adverse effects of OCP

Answer 33

missed periods, intermenstural bleeding | bloating, acne, N, HA wieght gain

Question 34

norplant systemt

Answer 34

levonorgestrel ADR: menstrual irregularity, HA, wieght gain

Question 35

transdermal patch?

Answer 35

not effective in women who weiht more than 200 lbs

Question 36

absolute contraindication of an IUd?

Answer 36

- current prego - undiagnosed vaginal bleed - acture infx - past alpingitis - suspected gynecologic malignancy

Question 37

relative CI for IUD

Answer 37

nulliparity, previous ectopic preg or STD, mult sex partners, severe dysmenorrhea, uterina apbnormalites, anemia, vavluar heart dz, young age