Exam 1 Flashcards
3 types of contraception
Natural
Chemical
Barrier
Emergency contraception
Up to 5 days
Extreme nausea
Clotting risk
Do not smoke
Dysmenorrhea/Pre-menopausal syndrome (PMS)
Menstrual pain
PMS treatment
Increase rest Reduce salt and sugar Exercise Manage stress SSRI meds- extreme
Dysmenorrhea treatment
NSAIDs
Anti-prostaglandin effect
Preconception care vits/supps
400 mcg folic acid
Vegan- B12 and Fe
Genetic problems
Genetic counseling
Testing
Sometimes before QUAD screen
Preconception care labs
CBC
Blood type of both parents (rule out Rh factors)
HIV
STD
Culture, ethnicity and religion
No illegal = okay
Common stressors
Socioeconomic (food) Divorce and remarriage Family violence Addictions Acute or chronic illness Unplanned or unwanted pregnancy Infertility
Initial prenatal assessment
Physical exam Lab: HIV Urine: albumin, glucose, harmful bacteria Mantoux Genetic testing and counseling EDD Initial risk assessment
Return prenatal visits
Weight BP Urine FHT Edema assessment Exposure risk: toxoplasmosis
Obstetrics
Pregnancy and birth
Response to fatherhood/parenthood
1st tri- fear of loss
2nd tri- initial attachment
3rd tri- fear of harming wife or fetus during sexual relation
Throughout- increased romanticism, family participation, anxiety about finances and safe handling baby
Breast health
No malformation..
Indentation
Discharge
Pain
Lactation consultant
Nipples are flat/inverted
Breast surgery
Argumentation
Presumptive signs of pregnancy
Amenorrhea Nausea Frequent urination Fatigue Quickening Breast changes- darker nips Pigment changes
Probably signs of pregnancy
Basal body temp elevation (b4 getting up in am)
Positive test
Cervical, vulvar, vag changes
Uterine changes
Ballottement
Enlargement of abd
Positive signs of pregnancy
Ultrasound
Fetal heartbeat- Doppler, fetoscope
Stages of human development
Conception and sex determination
Zygote and implantation
Period of embryo (critical 0-60 days)
Period of fetus (blood circulation and amniotic fluid)
Blastocyst
7-8 days after fertilization
Implantation risks
Too high= detached, pulled
Too low= no labor, dilation effects placenta
Maternal changes
Increased breast size Abd growth Lordosis Expanded rib cage Changed center of Gravity (shift forward)
Celphalocaudal principle
Infant growth head to toe
Normal FHR
110-160
Fetal circulation complication
Ductus venosus and umbilical arteries close
Circulatory issue
Funny baby color
No energy for baby
Pica
Nonfood craving
Preeclampsia
Hypertension
S/s
Increase facial swelling
Weight gain
QUAD screen tests for
16-18 weeks
High and low AFP, hCG, estriol, high inhibin-A
Mothers age
Ethnicity
When QUAD should be completed
History of birth defects 35+ Harmful med use Diabetes Viral infection during preg High level of radiation exposure
Genetic counseling of positive
Rhogam
Rh- mothers
Keep baby’s blood from interacting with mothers
Can treat idiopathic thrombocytopenic purpura (ITP)
Prevent antibody development to future preg- can terminate
MSFAP
14-22 weeks
High and low alpha-fetoprotein
Possible genetic disorder
High alpha alpha-fetoprotein indication
neural tube defect (spina bifida)
anencephaly
Esophagus defect
Failure of infant abd to close
Most common- incorrect dating of preg
Low alpha-fetoprotein indication
Trisomy 21 (downs)
Trisomy 18 (Edwards syndrome)
GTPAL
G- gestation
T- how many to term (delivered 37-40 weeks)
P- how many preterm (before 37)
A- abortions (spontaneous or Induced)
L- how many preg resulted in living children
Nageles rule
EDD/EDC
Determine first day of last period
Add 7 days
Subtract 3 mo
What causes nausea and trtmt
Increased level HCGF
Small, freq meals
Pregnancy validation
1st tri
1-13
Fetal embodiment
2nd tri
14-27
Fetal distinction
3rd tri
28-term
Anemia
Hemoglobin below 11.0
Hematocrit below 33%
Quickening
First baby movement
17-20 weeks
Danger: 1st tri
Bleeding
Abd cramping
No longer feeling preg
No FHT
Danger: 3rd tri
Bleeding Abd pain PTL, PPROM, PROM Decreased fetal movement Severe headache Vision changes Dizziness Sudden edema Epigastric pain fever, chills, chest pain
PIH
pregnancy induced hypertension
PIH risks
Premature delivery Seizure Placental abruption Stroke Hemorrhage Birth defects
PIH s/s
Headache Visual disturbance Dizziness Fluid retention Weight gain Epigastric pain
+30 systolic
+15 diastolic
PIH treatment
Mg sulfate for seizure prevention
Always have Ca gluconate available!!
Seizure precautions
Low lights
No visitors
Quiet room
Padded bed rails
Glucose testing
Glucose challenge screening (26-28 weeks)
+ then next test is..
Glucose tolerance test
Glucose tolerance test (GTT)
Every hour for 3 hours
Abnormal readings.. Fasting 95+ 1 hr 180+ 2 hrs 155+ 3 hrs 140+
Meds to attempt to stop labor
Terbutaline/ Brethine
Mg Sulfate
Suspected: 1-2 doses betamethasone
Betamethasone
Premature fetal lung development
Speeds up
