Chapter 4 - Antepartum Care Flashcards
Iron-deficiency anemia (Hgb + Hct)
hemoglobin less than 11g/dL
hematocrit less than 33%
hematocrit + norm range in women
% of RBC in blood
For women, 35.5 to 44.9%
Pseudo Anemia
hemodilution: decr Hgb + Hct
- due to incr in plasma volume greater than incr in RBC
Respiratory changes
40-50% incr in minute ventilation
-r/t incr in tidal volume fr 35 to 50%
incr in E + P + prostaglandins results w resp system being…
- dyspnea
- nasal + sinus congestion
- epistaxis (nosebleed)
hyperpigmentation is caused by
E + P stim incr melanin deposition
types of hyper pigmentation
linea nigra
melasma (mask of pregnancy)
presumptive signs of pregnancy [SUBJECTIVE]
- amenorrhea
- n/v
- breast change
- fatigue
- incr frequency of urination
- quickening (18-20 wk)
probable signs of pregnancy [OBJECTIVE]
- chadwick
- goodell
- hegar
- uterine/abdominal growth
- hyperpigmentation
- ballottement
- pos preg test results
positive signs of pregnancy [DEFINITIVE]
- auscultatn of FHR (10-12 wk w doppler)
- observtn/palpatn of fetam mvmt
- sonographic visualizatn (cardiac mvmt at 4-8 wk)
chadwick’s sign
bluish-purple coloration of vaginal mucosa, cervix, + vulca
-6-8 wk
goodell’s sign
softening of cervix + vagina w increased leukorrheal discharge
-8 wks
hegar’s sign
softening of lower uterine segment
-6 wks
ballottement
light tap on the cervix causes fetus to rise in amniotic fluid then rebound to the original position
Para
number of BIRTHS after 20 wks
-both live + still birth
primigravida
1st pregnancy
multigravida
pregnant for atleast a second time
T in GTPAL
number of TERM infants born
-bw 38-42 wks
P in GTPAL
PRETERM
-born bw 20-37 6/7 wks
ABCDE’S of abuse
Alone (ur not alone)
Belief (i believe u)
Confidentiality (confidential but mandatory reporting laws)
Documentations (pics + verbatim)
Education (resources + TRO)
Safety (warn neighbors + friends for signs of absue to call 911)
Warning signs of FIRST trimester
- abdominal cramp/pain» threatened abortion, UTI, appendicitis
- vaginal spotting» threatnd abortn
- absence of FHR» abortn
- dysuria, freq, urg» UTI
- prolonged N/V» hyperemesis gravidarum
hyperemesis gravidarum may lead to…
can lead to dehydration, weight loss, and electrolyte imbalances
recommended wt gain for UNDERWEIGHT
28-40 lb total
1-1.3/wk
recommended wt gain for NORMAL BMI
25-35 lb total
0.8-1/wk
recommended wt gain for OVERWEIGHT
15-25 lb total
0.5-0.7/wk
recommended wt gain for OBESE
11-20 lb total
0.4-0.6/wk
quickening
first feeling of fetal mvmt
-18-20 wk
1 hr glucose challense
recommended btw 24-28 wk
Warning signs of SECOND trimester
- absence of fetal mvmt» fetal distress or death
- vaginal bleeding» infection, friable cervix, placenta previa, abruptio placenta, PTL
leopold’s maneuver
ID the position of fetus in utero
-
when is GBS screening done
35-37 wks
Rhogam [Rho(D) Immune Globulin]
admin prophylactically at 28 wk for RH-
-if RH+ bb, then given w/in 72 hr after delivery
S/S of PTL
- rhythmic lower abdominal cramping or pain
- lower backache
- pelvic pressure
- leaking of amniotic fluid
- incr vaginal discharge
S/S of HTN disorders
- severe headache that doesn’t respond to usual relief measures
- visual changes
- facial or generalized edema
CVS testing
10-13 wk
quad screening
16-18
“all hail every infant”
-AFP, HCG, ESTIOL, INHIBIN A”
high AFP may indicate
risk for neural tube defect
low AFP + low ESTIOL may indicate
down syndrome
rhogam is admin…
28 wks then after birth if bb is positive
rpr
screening for syphilis
-2nd trimester
