Exam 1 blueprint Flashcards
what causes urinary frequency during pregnancy?
uterus pressing on the bladder
how is fundal height measured?
from symphysis pubis to the top of the fundus (in cm)
where should the fundus measure at 20 weeks?
in line with the umbilicus
what should be used to prevent neural tube defects?
folic acid supplements
(400 mcg at childbearing age and 600 mcg once pregnant)
what neural tube defect is characterized by incomplete development of the fetal skull and brain?
anencephaly
which neural tube defect is characterized by an open spine?
spina bifida
which neural tube defect is a defect of the abdominal wall?
omphalocele
what surgical intervention is utilized for reduced cervical competence?
cerclage
what s/s should a patient report following a cerclage?
report pain, increased pressure, ROM and s/s of infection
what is the antidote for magnesium sulfate?
calcium gluconate
what complication of magnesium administration would cause absence of DTR or RR < 12/min?
toxicity
what does the BURP mnemonic stand for for magnesium sulfate toxicity?
B - BP decreased
U - UOP decreased
R - RR < 12
P - patellar reflex absent
what are the indications for magnesium sulfate?
eclampsia and severe eclampsia (seizures)
what type of abortion is characterized by no dilation or passage of tissue and slight bleeding, where pregnancy may continue?
threatened abortion
what type of abortion is characterized by dilation of the cervix, moderate bleeding w/cramping, and definite loss of pregnancy?
inevitable abortion
what type of abortion has retained tissue that causes continued bleeding and possible infection, as well as passage of some tissue, bleeding, cramping and dilation of cervix?
incomplete abortion
what is a complete abortion?
all pregnancy tissue passes through the dilated cervix
what is a missed abortion?
fetus has died (no heart beat), no bleeding or spotting
what is a septic abortion?
severe infection following an abortion that causes a malodorous discharge
what causes supine hypotension?
weight of the gravid uterus compressing the vena cava, reducing the blood supply
how can supine hypotension be alleviated?
lay on side
what type of sign of pregnancy is a positive pregnancy test?
probable
what may cause a false positive pregnancy test?
a hormone secreting tumor
about what week can quickening be felt?
around 20 weeks
what area is most likely to be damaged during childbirth?
perineum (between vaginal opening and anus)
what is suspected if a female of childbearing age complains of unilateral stabbing pain, red/brown spotting and referred pain in the shoulder?
ectopic pregnancy
what medication may be administered for the treatment of a non-ruptured ectopic pregnancy?
methotrexate
what treatment measure is indicated for a ruptured ectopic pregnancy?
laparoscopic salpingectomy (removal of tube)
what pregnancy complication is characterized by very painful, dark
red vaginal bleeding, contractions and a board-like abdomen?
placental abruption
which pregnancy complication is characterized by painless, bright red vaginal bleeding after 20 weeks?
placenta previa
how is placenta previa diagnosed?
ultrasound
what must be avoided if placenta previa is suspected or diagnosed?
NOTHING in vagina (no vaginal exams or sexual intercourse)
what type of birth is indicated for those with placenta previa?
cesarean
what is a medication given for mothers with placenta previa if less than 34 weeks?
why?
betamethasone
promote fetal lung maturity
what should be immediately applied to the mother who is having a placental abruption to monitor the status of the fetus?
EFM (electronic fetal monitor)
what is the earliest genetic testing available?
CVS (chorionic villus sampling)
when can a CVS be performed?
10 - 13 weeks
why should the nurse instruct the mother to drink 1 -2 glasses of water prior to the CVS testing?
a full bladder is necessary
which genetic testing is performed by a passing a catheter through the cervix and into the uterus or through abdominal wall and obtaining a sample of the finger-like projections of the developing placenta?
CVS (chorionic villus sampling)
why may a CVS be performed?
if the mother is at risk for giving birth to a neonate with a genetic chromosomal abnormality
when can an amniocentesis be performed?
15 weeks to birth
when can the AFP (alpha fetoprotein) test be performed?
15 - 18 weeks
what may a high level of AFP indicate?
neural tube defect or open abdominal defect
what may a low level of AFP indicate?
down syndrome
when may a targeted ultrasound be performed?
after 18 weeks
which genetic test is characterized by a complete scan of the fetal anatomy to assess for potential genetic abnormalities?
Level II ultrasound/targeted ultrasound
what are the signs of hemorrhage that may be seen as a result of placental abruption?
- tachycardia
- hypotension
- pallor
- tachypnea
what is the first line management of placental abruption?
immediate birth
what are the nursing interventions for placental abruption?
- palpate uterus for tenderness/tone
- serial monitoring of fundal height
- assess FHR pattern
- emotional support
what medication is given to dissolve the pregnancy of a non ruptured ectopic pregnancy?
methotrexate
what may indicate that an ectopic pregnancy has ruptured?
red vaginal bleeding and potential signs of hemorrhage
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- amenorrhea
presumptive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- N/V and fatigue
presumptive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- urinary frequency or breast changes
presumptive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- quickening
presumptive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- uterine enlargement
presumptive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- positive pregnancy test
probable
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- abdominal enlargement
probable
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- Chadwick’s sign (bluish color of vulva, vagina, cervix)
probable
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- auscultation of fetal heart sounds
positive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- fetal movement felt by examiner
positive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- visualization of fetus by examiner
positive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- deliver of the baby
positive
Determine whether it is a presumptive, probable or positive sign of pregnancy?
- Hegar’s sign (softening of cervix)
probable
what result is indicative of a reactive non-stress test?
FHR increases at least 15/min for at least 15 seconds and occurs at twice during a 20 min period
what do 2 or more accelerations within 20 mins indicate for a non-stress test?
reactive
what type of test may be indicated for a nonreactive non-stress test?
BPP (biophysical profile)
what indicates that a non-stress test is nonreactive?
there are not 2 accelerations within the 20 minute window
is a negative CST normal or abnormal?
normal
is a positive CST normal or abnormal?
abnormal
what test combines a non-stress test and fetal ultrasound?
BPP (biophysical profile)
besides a nonreactive non-stress test, what are 3 indications for a biophysical profile?
- suspected oligohydramnios
- suspected polyhydramnios
- suspected fetal hypoxia
what are the 5 variables of a biophysical profile?
- FHR
- fetal breathing movements
- gross body movements
- fetal tone
- qualitative amniotic fluid volume
what is a normal score of the BPP?
8-10
What is G in GTPAL?
Gravidy (number of pregnancies, regardless of outcome)
What is T in GTPAL?
Term (number of pregnancies delivered past 37 weeks)
What is P in GTPAL?
Preterm (delivered before 37 weeks)
What is A in GTPAL?
Abortion (pregnancy ended before 20 weeks)
What is L in GTPAL?
Living (how many are alive now)
What is L in GTPAL?
Living (how many are alive now)
when may macrosomia occur?
gestational diabetes
what complication may occur as a result of uncontrolled diabetes?
fetal demise
(vasoconstriction reduces blood flow/oxygen/nutrients to baby)
does gestational hypertension have proteinuria?
NO
what diagnosis is suspected for a patient who has a BP of 160/90 and 3+ protein in urine?
preeclampsia
what diagnosis is suspected for a mother at 25 weeks gestation with BP 144/95 and no protein detected by UA?
gestational hypertension
what is indicated by 160/110 and >3+ proteinuria?
severe preeclampsia
what is necessary for the treatment of class A2 gestational diabetes?
medications
how is class A1 gestational diabetes managed?
diet
what BG value for a 1hr GTT indicates the need for a 3hr GTT?
130-140
what is indicated if 3 or more of the values collected during a 3 hr glucose tolerance test are elevated?
gestational diabetes diagnosis
what is the gold standard intervention for diabetics to reduce perinatal mortality and reduce to the prevalence of congenital anomalies?
preconception counseling
