DIAGNOSTICS (3) Flashcards

chorionic villi sampling - CST

1
Q

transcervical or transabdominal insertion of a needle into the fetal portion of the placenta.

A

chorionic villi sampling

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2
Q

cvs is performed at what weeks gestation?

A

8-12wks

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3
Q

what are examined to detect chromosome abnormalities and genetic disorders such as?

A
  • chorionic villi cells
  • down syndrome
  • cystic fibrosis
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4
Q

this is done at 8-10 wks of pregnancy wherein chorionic cells are located by ultrasound

A

biopsy & analysis of chorionic villi for chromosomal analysis

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5
Q

what is the other term for chorionic villi sampling?

A

biopsy of placenta

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6
Q

as a nurse on duty, what should you instruct your client after the chorionic villi sampling procedure?

A

to report bleeding, infection, or leakage of fluid after procedure

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7
Q

(CVS)
as a nurse on duty, you should be aware of the reportable s/sx the patient should look out for. what are these?

A
  • chills or fever (infection)
  • uterine contraction / vaginal bleeding (threatened miscarriage)
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8
Q

what test involves measurement of AFP, estriol, and hCG in maternal serum?

A

AFP/Triple Screen

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9
Q

at what week of gestation is AFP/Triple Screen is being tested? and what is its purpose?

A
  • 15-20wks
  • screen for fetal structural & chromosomal abnormalities
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10
Q

what is alpha-feto protein?

A

substance produced by the liver that is present in the amniotic fluid and maternal serum

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11
Q

if this is detected as abnormal, the woman is next referred for ultrasound to confirm gestational age and to evaluate neural tube defects & other structural abnormalities.

A

estriol

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12
Q

what is often associated with Trisomy 21 (down syndrome) ?

A

low estriol, elevated hCG, low AFP

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13
Q

what is associated if the fetus has an open spinal or abdominal defect?

A

high in maternal serum (MSAFP)

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14
Q

this test assess fetal well-being that analyses the response of the fetal heart to fetal movement.

A

non-stress test (NST)

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15
Q

what does accelerations of FHR with fetal movement indicates?

A

the fetus has adequate oxygenation and intact CNS

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16
Q

how can you tell that the fetus has a reactive NST? is this a good sign?

A

baby’s heart rate should accelerate by 15 beats for at least 15 seconds, twice in a 20min period. this is a sign that the baby is healthy

17
Q

what does reactive NST indicates?

A

intrauterine survival for one week.

18
Q

as the nurse on duty, what preparation should you do for the mother before the NST?

A

feed with food or fluids before the test to stimulate fetal movements

19
Q

this assesses the ability of the fetus to withstand the stress of uterine contraction done during labor

A

contraction stress test (CST)

20
Q

CST is a means of evaluating the?

A

respiratory function of the placenta

21
Q

induced or spontaneous contraction results in?

A

decrease transport of O2 to the fetus.

22
Q

if placental reserve is insufficient, what can occur?

A

fetal hypoxia and decrease in FHR

23
Q

when is contraction stress test initiated?

A

3 contractions in every 10 minutes.

24
Q

what is accelerations?

A

temporary normal increases in FHR caused by fetal movement / compression of umbilical vein during contraction

25
Q

this is the periodic decreases in FHR resulting from pressure of the fetal head during contractions.

  • begins when contraction starts, ends when contraction ends
A

Early Decelerations

26
Q

what are late decelerations?

A

delayed decelerations until 30-40 seconds after onset of a contraction and continue beyond the end of contraction.

27
Q

what do you call the lowest point of deceleration that occurs near the end of the contraction instead of at its peak?

A

Nadir

28
Q

what sign shows uteroplacental insufficiency ?

A

ominous pattern in labor

29
Q

what is uteroplacental insufficiency?

A

decreased blood flow through the intervillous spaces of the uterus during contractions.

30
Q

late decelerations occur with what? or with abnormal uterine tone caused by administration of what?

A
  • hypertonia
  • oxytocin
31
Q

as the nurse on duty, you saw that your patient is having late decelerations. what nursing intervention would you do?

A
  • stop or slow administration of oxcytocin
  • change position to lateral (left) to relieve pressure from vena cava
  • administer IVF or O2 as prescribed.
32
Q

if late decelerations persist, what should you prepare for? why do you need to do it?

A
  • deliver the infant
  • may lead to fetal death
33
Q

what are variable decelerations?

A

decelerations that occur at unpredictable times in relations to contractions

34
Q

what may cause variable decelerations?

A
  • compression of cord ( cord prolapse )
  • fetus is lying on the cord
  • oligohydramnios
35
Q

as the nurse on duty, you saw that your patient is having variable decelerations. what nursing intervention should you do ?

A
  • change into T-position
  • administer fluids and O2 as prescribed
  • if not relieved, amnioinfusion may be prescribed
36
Q

if the interpretation result of CST shows that there is persistent late decelerations with more than half the contractions, what does this indicate?

A

a positive result. fetus is no longer receiving adequate oxygen. needs to be delivered

37
Q

how can you say that the interpretation result of CST is negative?

A
  • no late decelerations in 10 min period
  • it is safe for the fetus to remain in utero for the next 7 days