Exam 1 part 3 Flashcards
2nd trimester labs
MSAFP
triple marker screen
quad screen
amniocentesis
Alpha-fetoprotein fetal glycoprotein secreted from fetal yolk sac, Gi and liver
Blood test drawn, gestation detects neural tube defects and abdominal wall defects
Recommended routine screening
Maternal serum Alpha-fetoprotein
when is MSAFP done
at 15-20 weeks
increased levels during MSAFP
NTD
Anencephaly
Omphalocele
Gastroschesis
decreased levels during MSAFP
trisomy 21
Blood test that combines multiple hormones and proteins and preteens with maternal age to detect Trisomy 12, 18, 21, and NTDs
multiple marker screening
what does the triple marker test
Alpha-fetoprotein
Human chorionic gonadotropin
Estriol levels
what does the Quad screen test
Alpha-fetoprotein Human chorionic gonadotropin Estriol levels Inhibin A (detection of trisomy 21)
decreased levels of estriol
suggested abnormality
Used to obtain amniotic fluid and fetal cells for genetic testing, fetal lung maturity, assessment of hemolytic disease in fetus or intrauterine infection
Adjunct with US
needle through abdominal wall then uterine cavity then obtain amniotic fluid
Amniocentesis
Abdominal or pelvic pain during 2nd trimester
PTL
UTI
Pylonephritis
appendix
Absence of fetal movement during 2nd trimester
fetal distress or death
Prolonged N/V during 2nd trimester
r/o hyperemesis
risk for dehydration and PTL
fever and chills during 2nd trimester
infection
Dysuria, frequent, and urgency during 2nd trimester
UTI
Vaginal bleeding during 2nd trimester
infection
Friable cervix
altered placenta
PTL
$ maneuvers which provide information on fetal lie, presentation, position, and engagement
Done during 3rd trimester
Leopolds maneuvers
3rd trimester labs
Repeat CBC, HIV, RPR
RHo Gam
GTT
H GTT
50 gm glucose drink w/ one hour lab draw post drink
1 hour Glucose Tolerance test GTT
when is the GTT test done
24-28 weeks
> 140 GTT
requires 3h GTT
> 200 GTT
Diagnostic for gestational diabetes
Must be fasting
100mg glucose drink w/ fasting
1h 2h and 3h lab draws
2 of 4 must be elevated GDM
3H GTT
Late 3rd trimester labs
Group Beta-Strep GBS
swab from perineum to rectum
test for strep
GBS
fetal effects of positive GBS
meningitis
sepsis
pneumonia
maternal feeling of fetal movements at roughly same time daily after 28 weeks
fetal kick count
monitors fetal heart rate in response to fetal activity
Non stress test NST
use of an auditory stimulator to startle the fetus when NST not-reactive after 20 mins
Applied for 1-2 sec, may be repeated up to 3 times at 1 min intervals for 3 sec
Vibroacoustic stimulation VAS
Monitors FHR in response to spontaneous or stimulated uterine contractions and of the fetus can withstand the stress of lab
Contraction stress test
CST
no late to significant decelerations
negative CST
lacte decelerations noted 50% or more w/ contractions
positive CST
variable to intermittent decels
equivocal-suspicious
Measures the volume of amniotic fluid with UA to assess fatal well being and placental function
Amniotic Fluid index AFI
average AFI
8-24 cm
AFI
Oligohydramnios
AFI > 24 cm
polyhydramnios
Evaluation of fetal status trough US observation of various fetal reflex activities
2pt each
Biophysical Profile
What is being scored during Biophysical profile
reactive NST Fetal breathing fetal movement fetal tone AFI
Abdominal or pelvic pain during 3rd trimester
PTL
UTI
Pyelonephritis
appendicitis
fever and chills during 3rd trimester
Infection
Dysuria, frequency, urgency during 3rd trimester
UTI
Vaginal bleeding during 3rd trimester
Infection
friable cervix
PTL
signs and symptoms of PTL
Rhythmic vaginal discharge
Signs and symptoms of hypertension
HA
Visual changes
facial or generalized edema
the right to self determination
autonomy
for others is the principle that all persons are equally valued
Respect
the obligation to do good
beneficence
the obligation to do no harm
nonmalificence
the principle of equal treatment of others or that others be treated fairly
justice
the faithfulness or obligation to keep a promise
fidelity
the obligation to tell the truth
veracity
the greatest good for the individual or an action that is valued
utility
is a choice that has the potential to violate ethical principles
ethical dilemma
is the integration of the best research evidence, clinical expertise, and patent values in making a decision about the care for patents
evidence based practice
Challenges in research
Gaps in what we know and what we do
Nursing must keep up with research
Consider context of time and patient preferences
Time and cost constraints
is the number of live births per 1000 people
Birthrate
Is the total number of live births per 1000 women of reproductive age
fertility rate
Decrease in maternal and infant mortality rates due to
Better nutrition
Prenatal care
Health care
technology for pre term infants
