Ch. 47 & 48 Role of US in OB/Clinical Ethics for OB US Flashcards
It is important to detect birth defects prenatally with sonography because
obstetric management may be altered to provide the best care for the child
______ refers to abnormal growth patterns of the fetus
intra-uterine growth restriction (IUGR)
When the fetus is abnormally large, it is referred to as
macrosomia
_____ is used to describe which part of the fetus is closest to the cervix (which will come out first)
fetal presentation
_______ is a procedure done under ultrasound guidance in which amniotic fluid is drawn out of the uterus for testing
amniocentesis
The ______ is the filter and means of communication between maternal and fetal blood
placenta
______ is a condition in which the cervix cannot withstand the pressure of pregnancy and dilates prematurely
incompetent cervix
______ is a procedure in which blood is taken from the umbilical cord for testing
cordocentesis
_____ is a procedure done in early pregnancy for genetic analysis and other testing. It involves tissue from the chorionic villi
chorionic villous sampling
In a special ultrasound procedure where the sonographer spends about 30 minutes evaluating the movements of the fetus and the amniotic fluid in addition to doing routing fetal measurements and documentation of fetal anatomy
biophysical profile (BPP)
Increased level of amniotic fluid is called
polyhydramnios
Decreased level of amniotic fluid is called
oligohydramnios
Separation of the placenta from the wall of the uterus is called
placental abruption/abruptio
______ refers to the measurements taken during an OB sonogram to assess fetal growth
fetal biometry
_____ is a condition in which the placenta is situated so that it overlaps the cervix
placental previa
On transabdominal imaging, an over-distended bladder can give a false impression of
placenta previa
Fetal anatomy can be assessed adequately after how many weeks gestation
18 weeks
Why is it important to know the date of the onset of the last menstrual period when performing an OB sonogram
to know if the fetus is normal for age
To date, have there been any proven bioeffects from ultrasound used at diagnostic levels
no
The major biologic effects of ultrasound are believed to be
thermal, cavitation, production and collapse of gas-filled bubbles
Why is doppler considered to have a greater potential for bioeffects than gray scale or m mode
it produces higher energy
How can the sonographer minimize thermal effects
use ALARA principle, decrease dwell time
How should doppler be used in OB sonography
only when there is a valid medical reason
What doppler mode should NOT be used in OB sonography
continuous wave CW
There is no reason to look at the ovaries/adnexae during OB sonogram, the only focus is the fetus
false
Which is the most accurate measurement of gestational age during the first trimester
crown rump length CRL
Name the weeks for each trimester
1st: 1-13, 2nd: 14-26, 3rd: 27-40
Patient trust is built on the expectation that health care professionals will follow established ethical
principles and guidelines
_______ promote excellence and protect patients by encouraging practitioners to reflect on, communicate and demonstrate optimal care
medical ethics
The principles of _______(7)______ must be implemented in the sonography labratory to ensure ethical practice
beneficence, autonomy, respect for persons, veracity, integrity, justice
A code of integrity for sonographers has been adopted by the society of diagnostic medical sonography
false
Bringing about good by maximizing benefits and minimizing possible harm is called
beneficence
_______ is the protection of cherished values that relate to how persons interact and live in peace
morality
______ is adherence to moral and ethical principles
integrity
______ is truthfulness and honesty
veracity
Refraining from harming oneself or others is called
nonmaleficence
______ is defined as a systemic reflection on and analysis of morality
ethics
______ reflects duties and values
morality
Informed consent is an ______ based right
autonomy
By explaining the examination, the sonographer is respecting the patient’s
autonomy
Ethics tries to answer the key question
what is good
Basic principles of medical ethics have been incorporated into ________, _______ and ________ throughout the world
research regulation, professional codes, clinical practices
The _________ is adopted and maintained by the ________
code of ethics for the profession of DMS, SDMS
The principle of morality directs the sonographer to not cause harm
false
Which principle would encourage sonographers to exceed the minimum standards of protocol and seek additional images if needed
beneficence
What does the ALARA principle stand for? Which principle is it an example of
as low as reasonably achievable, nonmaleficence
What is the definition of beneficence
bringing out good by maximizing benefits and minimizing possible harm
The _________ obligates the obstetric sonographer to seek the greatest benefit in the care of pregnant patients
principle of beneficence
Beneficence, like nonmaleficence requires ______, ______ and ________ to ensure that the patient and ______ receive the greatest benefit from the examination
competency, knowledge, excellent sonographic skills, fetus
Fortunately in most situations it is in the patients best interest to respect their ______ to tell the truth and to distribute ______ justly
autonomy, benefits
In the twentieth century, beneficence, or the right to self determination has become a key ethical principle
false
Informed consent is an autonomy based right
true
Veracity means
truthfulness
Integrity means
adherence to moral and ethical principles
Sonographers are justified in disclosing findings of normal anatomy directly to the pregnant woman
true
Length of pregnancy defined in the US as number of weeks from first day of last normal menstrual period (LNMP) is
gestational and menstrual age
List six maternal risk factors that increase chances of producing a fetus with congenital abnormalities
maternal age, hx of tobacco use, exposure to teratogens, maternal hypertension, placental hemmorrhage, drug and alcohol abuse, maternal weight
List 3 questions (besides LMP) that the sonographer should routinely ask the mother when performing an OB sonogram
gravida, parity, pelvic surgeries, c sections, previous us, bleeding, decreased movement, pelvic pain
List 5 indications for second/third trimester sonography
evaluate GA, fetal presentation, evaluate fetal growth, incompetent cervix, suspected fetal demise, suspected multiple gestations
When doing a first trimester sonogram, which of the following should be documented
presence of gestational sac, location of the gestational sac, presence of ovarian masses, fetal heart beat, CRL, presence of yolk sac, amnion/chorion, presence of fluid in the cul de sac, number of gestations, uterine abnormalities
When doing a second/third trimester sonogram, which of the following should be documented
fetal heart beat, details of fetal anatomy, presence of ovarian masses, fetal motion, placental location, umbilical cord, head circumference, femur length, abdominal circumference, biparietal diameter, cervix
