Chapter 3 Prenatal Care

Question 1

Blood type, Rh factor, and presence of irregular antibodies

Answer 1

Determined the risk of maternal-fetal blood incompatibility (erythroblastosis fetalis) or neonatal hyperbilirubinemia

Question 2

CBC with differential, Hgb, and Hct

Answer 2

Detects infection and anemia

Question 3

HGB electrophoresis

Answer 3

Identifies hemoglobinopathies (sickle cell anemia and thalassemia)

Question 4

Rubella titer

Answer 4

Determines immunity to rubella

Question 5

Hepatitis B screen

Answer 5

Identifies carriers of hepatitis B

Question 6

Group B streptococcus (GBS)

Answer 6

Obtain a vaginal/anal culture at 35 to 37 weeks of gestation to check for GBS infection.

Question 7

Urinalysis with microscopic examination if pH, specific gravity, color, sediment, protein, glucose, albumin, RBC’s, WBC’s, casts, acetone, add human chronic gonadotropin

Answer 7

Identifies pregnancy, DM, gestational hypertension, renal disease and infection

Question 8

One hour glucose tolerance
(Oral ingestion with the sample taken 1 hour later)

Answer 8

Identifies hyperglycemia

•done at initial visit for at risk clients
•done at 24-28 weeks of gestation
(Greater than 140 mg/dL required follow up)

Question 9

Three hour glucose (fasting- oral concentrated glucose with venous sample 1, 2, and 3 hours later)

Answer 9

For clients who have elevated 1 hour glucose test as a screening for DM. A diagnosis of gestational diabetes requires two elevated blood glucose readings.

Question 10

Glycoylated hemoglobin (HbA1c)

Answer 10

Indicated for clients who have diabetes mellitus prior to pregnancy

•The best indicator of an average blood glucose level for the past 120 days

•6.5% to 8% indicates diabetes

•Greater than 8% indicates poor control of diabetes

•5.7% or less indicates that the client does not have diabetes mellitus

Question 11

Papabicolaou (Pap) test

Answer 11

Used as a screening tool for cervical cancer. HPV co-testing can also be done.

Question 12

Vaginal/cervical culture

Answer 12

Detects streptococcus beta-hemolytic, bacterial vaginosis, or sexually transmitted infections (gonorrhea and chlamydia)

Question 13

PPD (tuberculosis screening), chest X-ray after 20 weeks of gestation with a positive PPD test

Answer 13

Identifies exposure to tuberculosis

Question 14

Veneral disease research laboratory (VDRL), Rapid plasma reagent (RPR)

Answer 14

Syphilis screening mandated by law

Question 15

HIV

Answer 15

Detects HIV infection (the CDC recommends testing all clients who are pregnant unless the client refuses)

Question 16

Toxoplasmosis, other infections, rubella, cytomegalovirus, and herpes virus (TORCH) screening

Answer 16

Screening for a group of infections capable of crossing the placenta and adversely affecting fetal development

Question 17

Maternal serum alpha-fetoprotein (MSAFP)

Answer 17

Used to rule out Down syndrome (low level) and neural tube defects (high level) screening between 15 to 20 weeks

Question 18

Quad screening

Answer 18

More reliable than MSAFP. Done at 16 to 18 weeks. Includes AFP, inhibit-A, a combination analysis of human chorionic gonadotropin and estriol

Question 19

Common discomfort of pregnancy

Answer 19

Nausea and vomiting
Breast tenderness
Urinary frequency
Urinary tract infections
Fatigue
Heartburn
Constipation
Hemorrhoids
Backaches
Shortness of breath
Leg cramps
Varicose veins and lower extremity edema
Gingivitis, nasal stiffness, and epistaxis
Braxton hicks contractions
Supine hypotension