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N349 OB > Chapter 4 Antepartum Care > Flashcards

Chapter 4 Antepartum Care Flashcards

1
Q

Preconception care

A

interventions that rely on health promotion and risk screening with a goal to change risk factors that negatively impact a pregnancy. Two primary components of preconception care include a physical examination and laboratory/diagnostic testing.

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2
Q

Anticipatory guidance

A

education that prepares women and their families for the process of pregnancy. This includes health maintenance (nutrition, exercise, etc.), self-care, lifestyle choices, contraception, and safety behaviors.

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3
Q

Preconception anticipatory guidance focuses on what?

A

The focus is on enhancing the women’s health by teaching about nutrition, optimal BMI, use of prenatal vitamins, exercise, self-care (avoiding risks), contraception cessation, and timing of conception.

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4
Q

What is the optimal BMI a women should be at for pregnancy?

A

A normal BMI range is 18.5-24.9. The BMI represents a measure of body fat.

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5
Q

What BMI values would increase complications of the pregnancy for women?

A

An underweight BMI ( or equal to 30.0).

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6
Q

Considering pregnancy, Obesity increases a woman’s risk for?

A

infertility, increased risk for antepartum complications (HTN, GDM, preeclampsia, thromboembolism, UTI), complications during childbirth (LGA), cesarean delivery, postpartum hemorrhage, poor wound healing

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7
Q

Papanicolaou smear (Pap smear) screens for?

A

cervical cancer

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8
Q

Presumptive signs of pregnancy

A

all the subjective signs of pregnancy (changes perceived by the woman) which includes: amenorrhea, N&V, breast enlargement/tenderness, fatigue, polyuria (pressure from uterus), Quickening.

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9
Q

Quickening

A

a women’s first feeling of fetal movement. occurs around 18-20 weeks

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10
Q

chadwick’s sign

A

bluish-purple coloration of the vaginal mucosa, cervix, and vulva seen around 6-8 weeks

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11
Q

Goodell’s sign

A

softening of the cervix and vagina with increased leukorrheal discharge, palpated at 8 weeks

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12
Q

Hegar’s sing

A

softening of the lower uterine segment palpated at 6 weeks

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13
Q

Melasma (Chloasma)

A

mask of pregnancy c/b brownish pigmentation over the forehead, temples, cheek, and upper lip

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14
Q

Balottement

A

the inspected rebound of a fetus in the amniotic fluid after lightly tapping the cervix. occurs at 16-18 weeks

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15
Q

Linea nigra

A

dark line that runs from the umbilicus to the pubis.

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16
Q

Probable signs of pregnancy

A

objective signs of pregnancy, includes all changes that can be viewed by a HCP. This includes: Chadwick’s sign, goodell’s sign, hegar’s sign, melasma, uterine/abdominal growth, ballotement, positive pregnancy tests. These signs are not considered diagnostic.

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17
Q

Positive signs of pregnancy

A

objective signs of pregnancy that can only be attributed to the fetus, includes: auscultation of the fetal heart by 10-12 weeks (doppler), observation/palpation of fetal movement, sonographic visualization of the fetus.

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18
Q

For educating women on urine pregnancy tests, you would advise her that?

A

they are best performed using a first morning urine specimen b/c it has the highest concentration of hCG, becomes positive at 4 weeks gestation.

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19
Q

antepartum period

A

prenatal period that begins with the first day of the last normal menstrual period (LMP) and ends with the onset of labor

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20
Q

First trimester

A

first day of LMP through 14 completed weeks

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21
Q

second trimester

A

15 weeks through 28 completed weeks

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22
Q

third trimester

A

29 weeks through 40 completed weeks

23
Q

Naegele’s rule

A

formula for determining the due date based on the LMP. EDD= first day of LMP - 3 months + 7 days

24
Q

Gravida

A

the total number of pregnancies (disregarding when/how the pregnancy ended)

25
Q

para

A

number of births after 20 weekds gestation, whether live or still births. Twins count as 1 birth. A birth before 20 weeks gestation is considered an abortion and isn’t included

26
Q

GTPAL

A

Gravida (pregnancies), term (# of term infants born, after 37 weeks gestation), Para (births), abortion (either spontaneous or induced, before 20 weeks gestation), and living.

27
Q

Nulligravida

A

woman who has never been pregnant or given birth

28
Q

primigravida

A

woman who is pregnant for the 1st time

29
Q

multigravida

A

women who is pregnant for at least the second time

30
Q

changes to breasts

A

increased estrogen/progesterone and vascularity causes enlargement, tenderness, striae (stretch marks). Increased prolactin causes production of colostrum (yellow secretion)

31
Q

Uterine changes

A

braxton-hicks contractions, wall hypertrophies, enlargement/stretching of uterus, weight of uterus increases, becomes more vascular and leads to congestion which causes goodell’s, hegar’s, and chadwick’s signs.

32
Q

Vaginal changes

A

increase in vascularity, increase in discharge (leukorrhea), vagina becomes more acidic (bacteriostatic) which increases risk for candidiasis

33
Q

Cardiovascular changes

A

CO, HR, stroke volume, RBC, WBC, BMR- metabolic rate, plasma/blood volume, heart size, fibrin/fibrinogen all increase.

34
Q

hypervolemia of pregnancy

A

refers to the increase in blood volume by 1500mL to support uterine/placental demands.

35
Q

Physiological anemia of the pregnancy

A

condition where plasma volume increases by 50%, while RBC volume only increases by 33%, leading to hemodilution, and lowered hct/Hgb lab counts. This is also known as pseudo anemia of pregnancy.

36
Q

supine hypotension

A

condition in which the enlarged uterus compresses the inferior vena cava while the woman is supine, leading to a drop in CO and BP, causing the woman to feel dizzy/faint.

37
Q

What factors place the pregnant women at risk for UTIs?

A

UTIs are the most common bacterial infection during pregnancy and they are r/t the pooling of urine that occurs to due progesterone, which reduces the tone of renal structures.

38
Q

Increased vascularity of the gums can cause?

A

bleeding and gingivitis

39
Q

A shift in the center of gravity that occurs with pregnancy places the woman at risk for?

A

falls

40
Q

diastasis recti

A

separation of the rectus abdominus muscle in the midline caused by abdominal distention

41
Q

Current statistics show that the proportion of women with timely prenatal care _______. Also, the proportion of women with late or no care _______.

A

decreased, increased.

42
Q

What is the most likely cause of death in pregnant or recently pregnant women?

A

homicide

43
Q

ABCDES for abused pregnant women

A

A: Alone. Tell the patient that she isn’t alone.
B: Belief: Advise the pt. that this wasn’t her fault
C: Confidentiality. Explain that the info is private but also explain that you must report it.
D: documentation. Describe verbatim the account of abuse, along with approved pictures of the pt.
E: education. Educate about resources and referrals.
S: Safety. The woman is in danger once she tries to leave.

44
Q

Clinical pelvimetry

A

measurement of the dimensions of the bony pelvis through palpation during an internal pelvic examination. This is to ID alterations in pelvic structure that can obstruct the fetus from be birthed.

45
Q

Uterine growth measurement

A

Using a centimeter mx tape to ID the length of the uterus by placing the zero point on the symphysis pubis and extend it to the top of the fundus. After 10-12 weeks, this is a useful gross measurement to help ID a pregnancy that is growing outside of optimal range.

46
Q

When can an ultrasound doppler be used on pregnant women and what is it for?

A

A doppler detects fetal heart tones, which is a positive sign of pregnancy, and can be initially heard by 10 and 12 weeks gestation.

47
Q

Abd. pain and cramping during the first trimester can indicate

A

possible threatened abortion, UTI, or appendicitis

48
Q

Vaginal spotting and bleeding indicate

A

possible threatened abortion

49
Q

Dysuria, frequency and urgency to urinate indicate

A

UTI

50
Q

Prolonged N&V during the first trimester indicates?

A

possible hyperemesis gravidarum, and an increased risk for dehydration.

51
Q

For pregnant women, why is it beneficial to perform Kegel exercises routinely?

A

Kegel exercises maintain pelvic muscle strength, and decreased the risk of uterine prolapse and urinary incontinence.

52
Q

Describe general characteristics of the fetus by the end of the first trimester.

A

The fetus is 3 inches long, weighs 1-2 oz, all organ systems are present, the head is large, and the heartbeat is audible with a doppler.

53
Q

What foods would you instruct the pregnant pt to avoid?

A

unpasteurized juices or dairy products, raw sprouts, soft cheeses like brie or feta, refrigerated/smoke seafood, unheated deli meats or hot dogs.

N349 OB (4 decks)

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