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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

25
Amniocentesis: what does a normal L/S ratio mean
fetal lung maturation
26
What are some of the complications associated with an amniocentesis?
Risk of maternal and fetal blood mixing
27
CVS- what is it, when and why is this done?
Chorionic Villus Sampling Aspiration of placental tissues for chromosomal, metabolic or DNA testing. 10-13 wks gest
28
Biophysical Profile- what is it, what are the components and what is normal/abnormal
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
What is the benefit of doing this test or doing an amniocentesis?
finding genetic disorders
30
FHR How do you measure frequency and duration?
Doppler Ultrasound- Electronic Fetal Monitoring
31
Leopold’s Maneuvers determines what things?
- 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
What are the four steps of Leopold’s maneuver-what are you looking for in each step?
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
What reasons would you administer an Amnioinfusion
rupture of membranes, relieve cord compression
34
BPP: normal findings
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
BPP: abnormal findings
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
How do you calculate an estimated due date?
Naegel's rule -3 months + 7 days
37
foods to avoid during pregnancy
Avoid high mercury fish Avoid unpasteurized dairy products (listeria), soft cheeses Avoid deli meats or hot dogs (nitrates)
38
vaccines Contraindicated
Influenza –active virus MMR Varicella Zoster
39
vaccines not recommended
Pneumococcal HPV
40
vaccines recommend
Influenza inactive version during any trimester Hepatitis A & B if high risk condition present Tdap (27-36 weeks)
41
Quickening- what gestational age does mom feel this?
fetal movement 18-20 week primip-14-16 multip
42
signs of pregnancy: presumptive
Those changes felt by the woman: amenorrhea n/v wk 2-12 breast changes fatigue freq urination quickening uterine enlargement
43
Signs of Pregnancy: probable
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
signs of pregnancy: positive
Those signs attributed only to the presence of a fetus: Auscultation of fetal heart Observation & palpation of fetal movement Ultrasound
45
Mom Psych response (each trimester)
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
Rubella titer immune result
1:8
47
causes/prevention of supine hypotension
uterus on vena cava; lay on side & fluid bolus
48
Why is pregnancy a hypercoagulability state? What risk factors cause this?
Increase risk for thrombosis Fibrin formation increased Platelet activation increased Factors 7,8,9, and 10 increased
49
What is physiological anemia of pregnancy?
plasma volume increases
50
Gestational diabetes what week gestation do we test for this?
24-28wks
51
what does GPTPAL stand for?
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
Vaginal/rectal cultures -what is this test for and what gestational week do we perform them?
GBS- 36 wks
53
What are some of the significant changes to the cardiovascular system?
Increased cardiac output Pulse increases BP decreases Increased blood volume Plasma volume greater than erythrocytes
54
Normal Pregnancy Lab Values
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
how do you measure the uterine growth
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
Danger signs to report immediately (image)
57
Danger signs to report pt2 (image)
58
routine pregnancy screening (image)

320 Mom/Baby (2 decks)

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