FINAL EXAM BROOO Flashcards
What is the teaching for diaphragm method of contraception?
-Round flexible device that covers the cervix
- itted for sized by health care provider
- insert up to 6 hrs before and keep in at least 6 hrs after but no more than 24 hrs (increased risk of UTI)
-Used with spermicidal jelly or cream,
-size refitting if weight fluctuates
- Does not prevent STD, Must be washed after each use with mild soap
-empty bladder before insert
What is the risk for teens and pregnancy?
-Complications common PIH or IUGR
-Denial and late pregnancy care
-Social needs override prenatal care
-Growth and development need as well as support growth of the fetus
UTIs during antepartum period?
High risk for UTIs (symptomatic or asymptomatic. UTI correlated to PREMATURE labor.
§ Symptoms of UTI: frequency with urgency, dysuria, hematuria
§ Teach patients to report all symptoms of UTI, especially the urgency to urinate.
What are the three shunts in utero?
ductus arteriosis, foramen ovale, and ductus venosus
What is ductus arteriosis?
valve that shunts blood around lung
What is foramen ovale?
allows blood flow from right to left atrium
What is ductus venosus?
valve that shunts around the liver
What is education on rh test?
- given to Rh neg mothers at 28 weeks gestation
- and again within 72 hours after birth if Rh+ baby
- usual dose 300mcg IM
- After any invasive procedure (amniocentesis).
What are presumptive signs of pregnancy?
breast changes, amenorrhea, N/V, urinary frequency, fatigue, quickening
What are probable signs of pregnancy?
goodell sign, chadwick sign, hegar sign, positive preg test, braxton hicks contractions, ballotement
what are positive signs of pregnancy?
anything from fetus detected by doctor or movement felt (fetal move palpated, visible)
Veins carry ____ blood in utero?
oxygen
Arteries carry ______ blood in utero?
deoxygenated
In utero, there are ___ arteries and ___ veins?
2 arteries, 1 vein
what is normal weight gain in pregnancy?
2 to 4 lbs in 1st trimester
1 lb/week in 2-3
When does the 1st prenatal visit usually occur?
within first 12 weeks
What are the labs drawn at the 1st prenatal visit?
HCG, CBC w/diff, Blood Type & Rh, RPR, HIV, Hemoglobin Electrophoresis (check anemias), A1C, UA, cervical exam and pap smear,
During weeks 12-28 of pregnancy, how often should prenatal visits be?
once a month
What labs are taken at the monthly visits during weeks 12-28?
UA at every visit
TB skin test, Rubella titer, Hep B test, Triple Screen & MSAFP
Ultrasound
1hr glucola (24-28 weeks)
How often should prenatal visits be during weeks 29-36?
every 2 weeks
What labs are drawn at the biweekly visits?
UA at every visit
Ultrasound if not done before
Type & Rh
How often should prenatal visits be from weeks 36-delivery?
weekly
What labs are taken from 36 weeks-delivery?
GBS, HIV
Possible U/S for presentation
What are expected physiological changes in pregnancy?
-increase in estrogen and progesterone levels
-uterus changes in size, shape, and position
-increase uterine blood flow and stronger muscles for birth process
-vaginal secretions increase
-expansion of vascular volume 45-50%
-cardiac output increase 25-50%
-clotting factors increased
-oxygen consumption increased 15-20%
-breathing changes from thoracic to diaphragmatic
-basal metabolic rate increases 10-20%
-linea nigra
-striae gravidarum
-chloasma
-palmar erythema