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NURS 4500 > Class 2: Preconception, conception, pregnancy > Flashcards

Class 2: Preconception, conception, pregnancy Flashcards

1
Q

where does fertilization occur?

A

Fallopian tube

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2
Q

how do we test for and confirm pregnancy?

A

hCG in urine and blood, confirmed through fetal heart rate/US

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3
Q

when is the most sensitive time during early pregnancy for teratogens to cause harm?

A

3-8 weeks aka the embryonic phase

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4
Q

what happens to BP during pregnancy?

A

it decreases earlier in pregnancy and can increase in 3rd trimester

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5
Q

what happens to HR during pregnancy?

A

increases by 10-15 bpm

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6
Q

Define: Gravidity

A

pregnancy - number of times a person has been pregnant

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7
Q

Define: Gravida

A

a pregnant person

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8
Q

Provide the correct terms for the following: Someone who has given birth to one full-term baby, and has additionally had 2 miscarriages.

A

primipara, multigravida

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8
Q

define parity:

A

number of times a person has given birth to a live or stillborn fetus of at least 20 weeks gestation

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9
Q

what window is considered preterm? at what point is it “late preterm”?

A

between 20 and 36w6d gestation. at 34 weeks

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10
Q

what is considered “term”?

A

37w to the end of week 40 plus 6 days

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11
Q

what are some things we want to change perhaps if trying to get pregnant?

A

drinking, smoking, MEDICATION

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12
Q

what is a teratogen?

A

environmental substances or exposures that result in functinal or structural disability

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13
Q

we are big sticklers about _______ in pregnancy, and it fluctuates a lot

A

blood pressure

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14
Q

preconception assessments: (5)

A

-height, weight, bmi
-bp
-STI screening
-Pap
-other labs including vaccines up to date

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15
Q

what risks can be modified before pregnancy?

A

nutrition (++folate), exercise, BMI, safer sex, update vaccines, ETOH/smoking, intimate partner violence, oral health, occupation

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16
Q

how much folic acid should a low risk individual take?

A

0.4mg daily 2-3 months prior to conception until 4-6 weeks PP

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17
Q

how many days is a pregnancy?

A

280

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18
Q

when is the 2nd trimester?

A

14-26 weeks

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19
Q

OTC urine pregnancy tests can detect hCG usually when the level is about ______IU/L

A

25

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20
Q

when is the high sensitive period of pregnancy?

A

3-8 weeks or the embryonic period

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21
Q

what are the two layers of the membranes? which is the inner one?

A

amnion and chorion. amnion is inner, surrounding the baby and amniotic fluid

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22
Q

why is amniotic fluid volume important?

A

shock absorption, allows movement, temperature regulation. should be 700-1000ml at term

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23
Q

what develops/blends into the placenta?

A

the chorion

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24
Q

which part of the umbilical cord brings oxigenated blood to the fetus?

A

the vein

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25
Q

what is the maternal side of the placenta called?

A

decidua basalis

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26
Q

when is the placenta complete and functional?

A

12 weeks

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27
Q

true or false: there is no mixing of blood between the pregnant person and the fetus via the placenta

A

true

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28
Q

what happens if the placenta doesn’t implant properly?

A

spontaneous abortion can happen

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29
Q

what happens if the placenta implants “too well” into the uterus?

A

no issues at pregnancy but during delivery, when it detaches it can result in serious bleeding

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30
Q

what requires immediate attention during pregnancy as a warning sign?

A

bleeding

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31
Q

functions of the placenta (5)

A

respiration, nutrition, excretion, endocrine, and storage for fetus (see slide 20)

32
Q

Blood flow through uteroplacental vascular system at 40 weeks ?

A

450-650 ml/min

33
Q

define: polyhydramnios

A

too much amniotic fluid

34
Q

define:oligohydramnios

A

not enough amniotic fluid

35
Q

what comorbidity is linked to polyhydramnios?

A

diabetes

36
Q

respiratory system of fetus not fully developed until _____ weeks. why?

A
  1. not enough surfactant
37
Q

what is the current “age of viability”?

A

22-25weeks

38
Q

what are the limitations to viability?

A

central nervous system function and oxygenation capability of lungs

39
Q

what is hPL?

A

human placental lactogen, contributes to breast development and helps glucose be readily available in moms blood stream

40
Q

what are the six key hormones of pregnancy? (slide 30)

A

hCG, progesterone, oestrogen, prolactin, relaxin, oxytocin

41
Q

what are presumptive signs of pregnancy?

A

subjective “clues” for pregnancy- amenorrhea, breast soreness, n/v, urinary ++

42
Q

what are probable pregnancy signs?

A

not for sure signs but objective and can be measured. hCG test, uterine enlargement, Hegar’s sign, Goodell’s sign, Chadwicks sign

43
Q

what happens to BP during pregnancy? which hormone does this?

A

goes down. progesterone

44
Q

when does uterine growth cause potential venous compression and hypotension?

A

20 weeks

45
Q

what is the best position for optimal bloodflow in pregnancy?

A

left lateral

46
Q

why is chronic mild respiratory alkalosis with metabolic compensation common in pregnancy?

A

due to fetal waste elimination requirements and needing to provide O2 to fetus

47
Q

why is hypercoagulability a potential problem in pregnancy?

A

because body is preparing for placental detachment, but leads to risk of DVT and PE

48
Q

pregnant people may have lower HGB due to_______. what is considered normal in pregnancy?

A

dilution - higher plasma volume. greater than or equal to 110g/l

49
Q

what is considered “physiologic” anemia?

A

110-120 - expected finding due to dilution

50
Q

what is Nagele’s rule?

A

1st day of LMP, subtract 3 months, add 7 days and 1 year

51
Q

do we do a pap screen in initial prenatal visit?

A

only if they are due (q3years)

52
Q

what is GTPAL?

A

gravidity, Term, Preterm, Abortions, Living children

53
Q

what are my “Gs and Ps’?

A

G3P2 (gravidity and parity)

54
Q

when do we start measuring SFH?

A

20 w

55
Q

when do we start leopold;s manuevers?

A

30-32 weeks

56
Q

What is a normal FHR range?

A

110-160 bpm and quite variable

57
Q

when does fundal height no longer correspond to gestational age?

A

after “lightening” around 36 weeks

58
Q

what do I need to make sure happens before measuring fundal heigh?

A

bladder empty

59
Q

if first screen for Gestational diabetes is 8.2mm/L, what would happen?

A

it’s over 7.8, so we would need to do fasting glucose

60
Q

is a ultrasound for biophysical profile (BPP) routine?

A

no, it is for higher risk clients.

61
Q

an RH negative mom is having a first baby. is there any scenario where this fetus is in danger due to antibodies?

A

no, but subsequent fetuses can be at risk if cross-contamination of blood occurs

62
Q

why is Chorionic Villus Sampling done?

A

to diagnose genetic disorders of chromosomal absnormalities in 1st trimester

63
Q

when is amniocentesis done?

A

at 15 weeks on for dx of genetic/chromosomal abnormalities, determine fetal lung maturity, dx fetal hemolytic anemia

64
Q

does everyone need to be screened for syphilis and HIV?

A

providers recommend all pregnancies 3 times in each preganncy (initial, mid, and delivery)

65
Q

what is a big symptom of preeclampsia?

A

headaches and visual disturbances

66
Q

which TYPES of vaccines are not safe for pregnancy?

A

live vaccines

67
Q

Client teaching: when to seek help (7ish points)

A

vaginal bleeding/leaking
abdominal cramping
fever
dysuria
headaches and visual disturbances
persistant vomiting
decreased fetal movement

68
Q

the placenta has ___ artery(ies) and ___ vein(s)

A

2, 1

69
Q

which hormones are from the placenta?

A

progesterone, placental lactogen, estrogen, relaxin, hCG, and IGFs (infant growth factors)

70
Q

a patient has a history of severe acne being treated by a dermatologist and is hoping to become pregnant. what should I teach about?

A

if they are taking oral isotretinoin as treatment, they need to consult their dermatologist to look at other options as this is a teratogen

71
Q

what hormone stimulates fluid reabsorbtion as it rises throughout pregnancy?

A

estrogen

72
Q

How does pregnancy impact the respiratory system?

A

40% increase in tidal volume by end of 1T, progesterone acts at brainstem to increase rate and depth of resps, pressure on lungs can lead to lower atelectasis, chronic mild resp alkalosis

73
Q

how does progesterone affect kidneys?

A

increases GFR

74
Q

why is there an increased risk of gall stones?

A

P causes decreased gallbladder motility, and E causes increased cholesterol

75
Q

how does plasma volume change in pregnancy?

A

increases by 40-50%

76
Q

normal BP in pregnancy (taking trends into consideration)

A

<140/90

77
Q
A

NURS 4500 (6 decks)

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