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320 Mom/Baby > Exam 1 > Flashcards

Exam 1 Flashcards

1
Q

major developments: 16 wks

A

teeth are formed

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2
Q

major developments: 20 wks

A

starts to suck & swallow, brown fat produced

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3
Q

major developments: 24 wks

A

gas exchange, surfactant in lungs

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4
Q

What is the function of the placenta?

A

Metabolic, gas, and nutrition exchange
Protects from pathogens
Hormone production

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5
Q

Amniotic fluid-function and purpose

A

Protects/cushions fetus
Maintains normal temp
Promotes sym growth/development
Allows movement
Frees cord from compression
Acts as wedge during labor
Normal fetal lung development

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6
Q

Placental Hormones Functions: Progesterone

A

supports/maintains implantation and developing embryo, prevents contractions

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7
Q

Placental Hormones Functions: estrogen

A

stimulates uterine growth/blood flow; supports development of breast/fetus

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8
Q

Placental Hormones Functions: hCG

A

stimulates corpus luteum-progesterone and estrogen (secreted by fertilized egg)

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9
Q

Placental Hormones Functions: Human Placental lactose

A

regulates glucose, proteins, and mineral availability-fetal growth; stims breast development for lactation

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10
Q

Fetal circulation/location of shunts: Ductus arteriosus

A

returning blood bypasses lungs

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11
Q

Fetal circulation/location of shunts: Ductus venous

A

bypasses liver and enters inferior vena cava

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12
Q

Fetal circulation/location of shunts: foramen ovale

A

right and left atria to supply blood to head, upper and lower extremities

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13
Q

Why does fetal PO2 need to be low?

A

important to maintain fetal circulation

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14
Q

TORCH- what does this acronym stand for?

A

Toxoplasmosis-Other (hep B, chlamydia, HIV)- Rubella- Cytomegalovirus- Herpes Simplex Virus

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15
Q

o Teratogens
What weeks gestation is the fetus at most risk?

A

first 8 wks

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16
Q

What is one of the major problems with twins that share the same placenta?

A

Cord entanglement/compression, twin-to-twin transfusion

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17
Q

GBS: What is the treatment?

A

Penicillin/clindamycin

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18
Q

Ultrasound- why are we doing this test during the first trimester and second and third trimester?

A

1st- Confirm viability and gestational age of pregnancy 3rd- Monitor fetal growth

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19
Q

What does a MSAFP test determine?

A

Maternal Serum Alpha-Fetoprotein= blood screening tool to detect neural tube and abdominal defects

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20
Q

Alpha fetal Protein- How would you explain what this is to a patient?

A

Produced by the fetus, don’t want any could indicate defect

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21
Q

Kick counts- what is your patient education?

A

After 28 wks- 10 movements in 2 hrs or 4 in 1hr. if decreased, eat, rest and focus. If not after, further eval is needed (stress test)

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22
Q

NST: What is a Reactive Test

A

FHR increases 15 beats above baseline for 15 seconds twice or more in 20 minutes

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23
Q

NST: What is a non-reactive test?

A

Without sufficient FHR accelerations in 40 minutes and should be followed up with BPP

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24
Q

Amniocentesis- what is a normal L/S ratio

A

2:1

25
Q

Amniocentesis: what does a normal L/S ratio mean

A

fetal lung maturation

26
Q

What are some of the complications associated with an amniocentesis?

A

Risk of maternal and fetal blood mixing

27
Q

CVS- what is it, when and why is this done?

A

Chorionic Villus Sampling Aspiration of placental tissues for chromosomal, metabolic or DNA testing. 10-13 wks gest

28
Q

Biophysical Profile- what is it, what are the components and what is normal/abnormal

A

Assessment of:
 Fetal breathing movements
 Movements of body and limbs
 Fetal tone (extension and flexion of extremities)
 Amniotic fluid volume( pockets of fluid around fetus)
 Heart rate reactivity (NST)

29
Q

What is the benefit of doing this test or doing an amniocentesis?

A

finding genetic disorders

30
Q

FHR How do you measure frequency and duration?

A

Doppler Ultrasound- Electronic Fetal Monitoring

31
Q

Leopold’s Maneuvers determines what things?

A
  • Attitude (position of the fetal body parts in relationship to each other)
  • Lie (longitudinal, transverse)
  • Presentation (part of the fetus that enters the pelvis first)
  • Station (Above ichial spine = -)
  • size
32
Q

What are the four steps of Leopold’s maneuver-what are you looking for in each step?

A
  1. Determine what part is located in the fundus
  2. Determine location of back
  3. Determine fetal presentation above the pelvic outlet
  4. Determine the location of the fetal presentation- vertex, brow, face
33
Q

What reasons would you administer an Amnioinfusion

A

rupture of membranes, relieve cord compression

34
Q

BPP: normal findings

A

NSN=2+ accelerations in 20 min
BREATHING=1+ of 30s+ in 30 mins of breathing movement
ACTIVITY=3+ general movements of body/limbs
MUSCLE TONE=1+ episode of extending/returning to flexion
A.FLUID=1+ pocket of fluid w/vertical access equal to or greater
than 2cm

35
Q

BPP: abnormal findings

A

NSN=less than 2 accelerations in 20 min
BREATHING=fewer than 30s of breathing movement in 30min
ACTIVITY=fewer than 3 movements of body or limbs
MUSCLE TONE=no/slow movement, incomplete cycle
A.Fluid=largest pocket of fluid less than 2cm

36
Q

How do you calculate an estimated due date?

A

Naegel’s rule
-3 months
+ 7 days

37
Q

foods to avoid during pregnancy

A

Avoid high mercury fish
Avoid unpasteurized dairy products (listeria), soft cheeses
Avoid deli meats or hot dogs (nitrates)

38
Q

vaccines Contraindicated

A

Influenza –active virus
MMR
Varicella
Zoster

39
Q

vaccines not recommended

A

Pneumococcal
HPV

40
Q

vaccines recommend

A

Influenza inactive version during any trimester
Hepatitis A & B if high risk condition present
Tdap (27-36 weeks)

41
Q

Quickening- what gestational age does mom feel this?

A

fetal movement 18-20 week primip-14-16 multip

42
Q

signs of pregnancy: presumptive

A

Those changes felt by the woman:
amenorrhea
n/v wk 2-12
breast changes
fatigue
freq urination
quickening
uterine enlargement

43
Q

Signs of Pregnancy: probable

A

those changes observed by an examiner:
Chadwick’s sign=Blue-purple coloration of vaginal mucosa, cervix, vagina 6-8 weeks

Goodell’s sign=Softening of cervix and vagina, increased discharge 6-8 weeks

Hegar’s sign=Softening of lower uterus palpated at 6 weeks
Braxton Hicks contractions=irregular, painless contractions
Ballottement=Tap on the cervix causes fetus to rise in amniotic fluid and then rebound to original position; occurs 16-18 weeks

Positive pregnancy test results=Detection of hCG in urine or blood

44
Q

signs of pregnancy: positive

A

Those signs attributed only to the presence of a fetus:

Auscultation of fetal heart
Observation & palpation of fetal movement
Ultrasound

45
Q

Mom Psych response (each trimester)

A

1st= Uncertain and ambivalent (self, not real)
2nd=Wonder and concern with physiological changes (fetus, real individual)
3rd=Vulnerability and dependence on partner (tired, attachment)

46
Q

Rubella titer immune result

A

1:8

47
Q

causes/prevention of supine hypotension

A

uterus on vena cava; lay on side & fluid bolus

48
Q

Why is pregnancy a hypercoagulability state? What risk factors cause this?

A

Increase risk for thrombosis

Fibrin formation increased
Platelet activation increased
Factors 7,8,9, and 10 increased

49
Q

What is physiological anemia of pregnancy?

A

plasma volume increases

50
Q

Gestational diabetes what week gestation do we test for this?

A

24-28wks

51
Q

what does GPTPAL stand for?

A

G- gravidity (any pregnancy including current)
P- parity (Birth after 20 weeks regardless if born alive or dead)
T- # of term pregnancies (38wks)
P- # of preterm
A- # of miscarriages/abortions
L- # of living children

52
Q

Vaginal/rectal cultures -what is this test for and what gestational week do we perform them?

A

GBS- 36 wks

53
Q

What are some of the significant changes to the cardiovascular system?

A

Increased cardiac output
Pulse increases
BP decreases
Increased blood volume
Plasma volume greater than erythrocytes

54
Q

Normal Pregnancy Lab Values

A

Hemoglobin- 11-13
Hematocrit- 33-39
RBC- 3.8-4.4
WBC- 5.0-12.0
Platelets- 150,000-400,000
Fibrinogen- ↑ levels late in pregnancy( normal non pregnant level 200-400)

55
Q

how do you measure the uterine growth

A

top of pubic bone to top of uterus

should be at umbilicus at 20wks
no more than +/-2 per wk
Too big could be multiples or polyamnio

56
Q

Danger signs to report immediately (image)

A
57
Q

Danger signs to report pt2 (image)

A
58
Q

routine pregnancy screening (image)

A

320 Mom/Baby (2 decks)

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