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Q4 Women's Health > Exam 2 Prenatal Care > Flashcards

Exam 2 Prenatal Care Flashcards

1
Q

Reasons for prenatal care? (5)

A

1) Early, accurate estimate of gestational age
2) Identify at-risk pts
3) Eval/follow health of mom/baby
4) Anticipate/intervene problems
5) Pt education

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2
Q

Preconception exam should include?

A

General physical (check for cavities)

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3
Q

Preconception exam should always include what lab?

When indicated? (10)

A

HIV

Rubella/Varicella titer
Hep B/C
Gonorr/Chlam cx
TB
RPR
CBC
Fasting blood sugar
Hgb A1C
Cystic fibrosis carrier
Tay Sachs
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4
Q

Preconception care should include what immunizations? (6)

A 
MMR (NOT if already pregnant/must wait 1 mo post)
Varicella
Hep B
Flu
Tdap
\+/- pneumococcal
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5
Q

Preconception folic acid dose?

A

0.4 -0.8 mg/day

4 mg if neural tube defect hx

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6
Q

Prenatal care 1st visit should occur when?

A

By week 10 (1st trimester)

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7
Q

Prenatal care 1st visit history should include? (7)

A 
Full hx including:
STD, PID, Abn paps
Planned vs unintended preggo
Domestic violence
Tobacco/alcohol/drugs
Inheritable dzs
Barriers to care
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8
Q

Prenatal care 1st visit Obstetric Hx includes?

A 
G: # of pregnancies
P: TPAL
T = Full term
P = Preterm (<37wks)
A = Abortions (spont, induced, ectopic)
L = Living
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9
Q

Prenatal care: Estimated Date of Confinement (Delivery) is calculated how?

A

(LMP + 7 days) - 3 months

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10
Q

Early Term is?

A

37 0/7 - 38 6/7 weeks

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11
Q

Full Term is?

A

39 0/7 - 40 6/7 weeks

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12
Q

Late Term is?

A

41 0/7 - 41 6/7 weeks

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13
Q

Postterm is?

A

42 0/7 weeks on

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14
Q

Prenatal care 1st visit Physical Exam should include? (2)

A

General

Pelvic

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15
Q

Prenatal care 1st visit Pelvic Exam should include? (4)

A

Uterine size/shape/adnexa (parts joining it)
Chadwick’s Sign
Hegar’s Sign
Specimen collection

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16
Q

Chadwick’s Sign is?

A

Blue coloring of vagina/cervix from ↑ blood flow

Indicates pregnancy

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17
Q

Hegar’s Sign is?

A

Softening of isthmus (where cervix meets uterus)

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18
Q

What specimens should be collected during 1st visit pelvic? (2)

A

pap

gonor/chlam

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19
Q

Prenatal care 1st visit labs should include? (11)

A 
hCG (ALWAYS!)
Blood type/Rh
Anitbody screen
Rubella/Varicella titers
Syphilis
Hep B
HIV
CBC
UA w/ C&S
TSH
Cystic Fibrosis if pt wants it
20
Q

Prenatal care 1st visit additional lab for at-riskers? (5)

A 
TB
Hep C
Trichomonas
HSV
Hgb A1C
21
Q

Prenatal care 1st visit US done how?

Why?

Cardiac motion visible how soon?

A

Transvag US

Confirm estimated delivery date (IMPORTANT!)

5 - 6 weeks

22
Q

1st trimester is?

2nd trimester is?

3rd trimester is?

A

1 to end of wk 12

13 to end of week 26

27 on

23
Q

Prenatal F/U care schedule?

A

1st 28 wks = Q 4 wks

28-36 wks = Q 2wks

36 wks = Q 1wk

24
Q

Quickening is?

A

1st fetal movements:
@ 18-20 wks w/ 1st preg
@ 16-18 wks w/ add’l pregs

25
Q

Prenatal F/U visits should include? (5)

A 
Hx
BP
Fetal Heart Tones
Fundal height
Extremities
26
Q

Fetal Heart Tones measured how?

When?

Normal bpm?

A

Doppler

wks 10 - 12

120-160 bpm

27
Q

Fundal Height at 12 weeks?

20 weeks?

After 20 weeks?

Drops when?

A

12 wks = pubic symphysis

20 wks = umbilicus

1 cm additional height for each week after 20

Drops @ 36-38 weeks

28
Q

Prenatal Care 3rd Tri should include? (2)

A

Leopold’s Maneuvers

Cervical exam

29
Q

Leopold Maneuvers are?

A

Method of feeling for baby’s position during 3rd trimester

30
Q

Cervical Exam during 3rd Tri assesses what? (4)

A

Effacement (thinning/shortening)
Dilation
Station
Presenting parts

31
Q

Station is?

Measured how?

“Engaged” means?

A

Position of baby’s head in relation to ischial spines of pelvis

Measured -5 to +5

Measurement of 0
Head entered vaginal canal w/i pelvic bones

32
Q

Prenatal Care Routine Screening labs? (6)

A 
Urine protein/sugar EVERY time
Down's @ 1st tri
Gestational DM @ 24-28 wks
CBC for anemia @ 3rd tri
Repeat Rh @ 3rd tri
Group B strep (vag/rectum) @ 35-37 wks
33
Q

If Rh screen is negative, next step?

A

Rh IG @ 28-30 wks

34
Q

Aneuploidy screening is for?

A

Neural tube
Down
Tri 18

35
Q

Aneuploidy screening done when/how? (3)

A

1st tri

Sonogram for nucal translucency w/ blood markers

Maternal Quad Screen for markers AFP, uE3, hCG, inhibin A

36
Q

Cell Free DNA testing is? (5)

A 
Optional for:
35+ yo
Fetal US = ↑ aneuploidy risk
Hx of trisomy
\+ test for aneu
Robertsonian translocation
37
Q

US schedule/purpose? (3)

A

1st tri: dating, location, eval bleeding/pain

2nd tri (18-20wks): growth, anatomy, placenta, P gender

3rd tri: growth, presentation, bleeding, Biophys Profile

38
Q

Biophysical Profile includes? (5)

A 
Non-Stress Test
Fetal Breathing Movements
Fetal Movement
Fetal Tone
Amniotic fluid vol
39
Q

Appropriate Weight Gain by BMI:

<18.5?

18.5 - 24.9?

25 - 29.9?

30+?

A

<18.5 = underweight
gain 28-40 lbs

18.5 - 24.9 = normal
gain 25-35 lbs

25 - 29.9 = overweight
gain 15-25 lbs

30+ = obese
gain 11-20 lbs

40
Q

Fetal Wellbeing Tests? (4)

A

Fetal mvmt/Kick counts
Non-stress Test
Contraction Stress Test
Biophys Profile

41
Q

Compound presentation causes risk of what?

A

Anterior tear of vulva

Posterior tears are more common

42
Q

Parts of pelvis:

Inlet landmarks?

Midpelvis landmarks?

Outlet landmarks?

A

Inlet = Symphysis (top), Sacral promontory (post), pectinate lines (lateral)

Midpelvis = Mid symphysis (top), Midpoint of sacral curve (post), Ischial spines (lateral)

Outlet = Inferior symphysis (anterior), tip of sacrum (post), Ischial tuberosities (lateral)

43
Q

Passage shape best for pregnancy/delivery?

A

Gynecoid

44
Q

Acceptable meds for HTN in pregnancy?

A

NOT ACE inhib! (-prils)

Methyldopa
β-block
CCB

45
Q

Acceptable ABX for pregnancy?

A

NOT TCN (Doxy) during preg and breast feeding!

Topical Erythro, Clinda
Systemic Azythro, Amox

46
Q

Acceptable meds for Bipolar in pregnancy?

A 
NOT 
Valproate
Carbamazepine
Lithium
Lamotrigine

Anti-depressants
Anti-psychs (not during 3rd tri)

Q4 Women's Health (20 decks)

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