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Asthma > First trimester > Flashcards

First trimester Flashcards

1
Q

What are the 3 signs of pregnancy?

A
  1. Presumptive
  2. Probale
  3. Positive
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2
Q

is a urine test quantitative or qualitative

A

qualitative

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3
Q

When is a serum HCG test done

A

when there is no urine test available or its negative and blood is going to the lab anyway

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4
Q

What is the difference between a qualitative and quantitative pregnancy test?

A
  1. Qualitative measures the presence of HCG

2. Quantitative measures the level of pregnancy hormone in the blood

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5
Q

What size is the uterus at 6 weeks gestation

A

the same size as a normal non pregnant uterus

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6
Q

When does the uterus rise out of the pelvis and become an abdominal organ during pregnancy

A

at about 12 weeks

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7
Q

How often/many prenatal visits does a woman having during her pregnancy?

A
  1. every 4 weeks until 28 weeks
  2. every 2 weeks until 36 weeks
  3. Weekly until birth
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8
Q

Does pregnancy protect the female against depression?

A
  1. No it does not
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9
Q

What is preconception care?

A

Counseling and care provided to women and their partner before becoming pregnant.

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10
Q

What is the preconception period?

A

The time before or between pregnancies

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11
Q

What is the typical time frame of implantation bleeding?

A

1-2 weeks after ovulation

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12
Q

The clinician is talking with a person who may become pregnant about exposure to some substances that can cause pregnancy loss. The CNM/WHNP knows that substances considered to be teratogenic:

A

Must have a stage-sensitive effect depending on the time of exposure during pregnancy

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13
Q

During which period is exposure to a teratogen most likely to cause PREGNANCY LOSS? (think about the all-or-nothing principle)

A

At any time during pregnancy

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14
Q

After ovulation, progesterone is first produced by which structure?

A

corpus luteum

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15
Q

Teratogens that affect which organ can cause damage at any time during pregnancy

A

The brain

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16
Q

Which of the following hormones of pregnancy stimulates the corpus luteum to continue to function?

A

Human chorionic gonadotropin

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17
Q

The neural groove is the precursor to the

A

nervous system.

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18
Q

During which period is exposure to a teratogen most likely to cause PREGNANCY LOSS? (think about the all-or-nothing principle)

A

During the first 15 days after conception

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19
Q

Fetal heart begins to beat at how many days

A

21

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20
Q

When is hug detectable in the urine and serum when

A

7 to 9 days after ovulation

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21
Q

The HCG level doubles how many hours until days 63-70

A

31 to 35 hours

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22
Q

Elevated levels of HCG early in pregnancy can be indicative of what?

A
  1. Multiple pregnancy
  2. Hemolytic disease
  3. Hydatiform mole
  4. Down syndrome
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23
Q

HCG that is too low indicates what or that does not double every 2 days?

A
  1. Impending miscarriage

2. Ectopic pregnancy

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24
Q

How long does the prenatal period last?

A

from the first day of the last normal period

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25
Q

Gravida means

A

The total number of times a woman has been pregnant

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26
Q

Para means

A

the number of births

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27
Q

What does term mean

A

The number of term births experienced by a female 37 weeks and beyond

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28
Q

What does A stand for in GPTA

A

The number abortions or miscarriages

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29
Q

L stands for what in GPTAL

A

the number of children living

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30
Q

GPTAL stands for what

A
  1. Gravida number of pregnancies
  2. Para number of births
  3. Term Number of term births 37 weeks and above
  4. A stands for abortions/miscarriages
  5. L stands for living
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31
Q

When is the gestational sac visible on ultrasound?

What would the HCG levels be

A
  1. 4.5 - 5 weeks

2. 1,000

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32
Q

When is a yolk sac visible on ultrasound?

A

5 to 5.5 weeks and the HCG should be 1,000 - 7,200

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33
Q

When is the embryonic/fetal pole visible on ultrasound?

A

at 5-7 weeks and the HCG levels are around 7,200 - 10,800

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34
Q

Embryonic/fetal cardiac activity is seen on ultrasound at how many weeks?

A

6-7 weeks and the HCG levels should be ablve 10,800

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35
Q

What are causes of bleeding in the first trimester?

A
  1. Ectopic pregnancy
  2. Molar pregnancy
  3. incomplete or inevitable loss
  4. STI
  5. Cervical irritation
  6. Implantation bleeding
  7. Fibroids
  8. sub-chorionic hemorrhage
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36
Q

When is ovulation bleeding most common

A

around 2 weeks after ovulation

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37
Q

How do you calculate due date using Nagele’s rule?

A
  1. Add 7 days to the LMP

2. Then subtract 3 months

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38
Q

Which molecule signals the state of the follicular phase?

A

GnRH secretion produces a new follicular

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39
Q

Does progesterone provide negative or positive feedback to the anterior pituitary gland?

A

Negative feedback to prevent secretion of FSH and LH and to prevent the release of multiple follicles

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40
Q

For pregnant women with a subchorionic hemorrhage when is the best out come with this type of hemorrhage usually seen?

A

The outcome is better if they occur before the 20 weeks or early in the pregnancy because the clot is small and usually resolves spontaneously and is reabsorbed

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41
Q

What is the treatment for sub-chorionic hemorrhage

A
  1. Pelvic rest for several weeks and reassurance this condition often resolves spontaneously
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42
Q

For pregnancy loss up to 10-13 weeks ACOG recommends using the term what?

A

Early pregnancy loss

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43
Q

Women without complete abortion can take time to consider their options preferably if their condition is?

A

Stable

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44
Q

Spontaneous expulsion in expectant management declines in what time frame and can take up to how long

A

1 week

a month

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45
Q

Heavy bleeding is defined as

A

soaking through 2 pads in 2 hours

46
Q

A medication that is safe to give for an abortion that does not start on its own is (1) as long as the pregnancy is 13 weeks or less

A

misoprostol

47
Q

What is the time frame for misoprostol to evacuate the uterus?

A

4 to 16 hours

48
Q

What is the normal dosing for misoprostol?

A

Misoprostol can be give orally in doses of 600 mg or 400 mg sublingual.
Oral treatment can be repeated twice within a 3 hour interval, the dosing can be space 6 to 12 hours for those experiencing side effects

49
Q

What is the dosing for intra-vaginal misoprostol

A

800 mg repeating the dose between 3 hours and 7 days after administration

50
Q

`Is fever a side effect of misoprostol

A

yes

51
Q

To improve the health of women of reproductive age before conception thereby improving pregnancy related outcomes. A set of interventions to identify and modify biomedical, behavioral, and social risk to a womans health or pregnancy outcomes through prevention and management.

A

ACNM preconception care definition.

52
Q

What are findings that are suggestive of early pregnancy loss?

A
  1. crown-rump length < 7 mm without a heart beat
  2. Mean sac diameter of 16–24 mm without embryo;
  3. Absence of embryo with heart beat 7–13 days after ultrasound that showed a gestational sac without a yolk sac or 7–10 days after an ultrasound that showed a gestational sac with yolk sac
  4. empty amnion; enlarged yolk sac > 7 mm; small gestational sac in relation to size of embryo; absence of embryo for ≥ 6 weeks after last menstrual period.
53
Q

Describe symptoms of a woman having experiencing an ectopic pregnancy?

A
  1. Spotting
  2. bleeding or no bleeding
  3. The cul-de-sac may be full of blood, causing the posterior vaginal fornix to bulge outward.
  4. Pain in the neck or shoulder, especially on inspiration, may be present as a result of diaphragmatic irritation from blood in the peritoneal cavity.
54
Q

If surgical intervention is not needed for an ectopic pregnancy what medication can be given to dissolve the pregnancy?

A

Methotrexate

55
Q

Describe what an abdominal pregnancy is?

A

An abdominal pregnancy is a pregnancy that began as a tubal pregnancy and ruptured into the peritoneal cavity early enough so that the ovum remains viable and implants in the abdomen

56
Q

What are symptoms of an abdominal pregnancy

A
  1. Signs and symptoms include an inability to outline the uterus
  2. the sensation that fetal parts are just “under the skin” of the woman.
  3. The woman may have severe gastrointestinal symptoms that do not resolve with standard management.
  4. Ultrasound examination does not always suffice for making the diagnosis, especially later in pregnancy
57
Q

Why is abdominal pregnancy dangerous?

A

Abdominal pregnancy is a life-threatening condition due to adverse effects of placental implantation on abdominal organs such as the liver.

58
Q

How is an abdominal pregnancy handled?

A

Birth must be by cesarean, and requires a tertiary setting wherein multiple subspecialists in maternal–fetal medicine and surgery are involved.

59
Q

What is pregnancy of unknown origin?

A

The fetus is not seen on ultrasound and can not be found

60
Q

What is the management of pregnancy of unknown origin

A
  1. expectant management
  2. medical
  3. exploratory d and c
61
Q

What are the complications of expectant management of a spontaneous abortion

A

incomplete abortion and retained POC

62
Q

What is a prudent waiting period before offering intervention in a woman who has chosen expectant management of spontaneous abortion

A

2 week waiting period

63
Q

What is the success rate of misoprostol

A

The success of misoprostol is 80% to 90% within 7 days

64
Q

If a woman has had 3 or more miscarriage’s what is the next step in her management

A

genetic counseling and an endocrine evaluation should be considered

65
Q

What is standard evaluation for a woman with repeated miscarriages?

A
  1. ultrasound to rule out congenital abnormalities of the genital tract
  2. genetic testing
  3. coagulation disorders
  4. autoimmune disorders
  5. Thyroid disorders
66
Q

What is the term for bleeding that occurs between the chorion and myometrium

A

sub chorionic hemorrhage

67
Q

What is the most common Gestational trophoblastic disease

A

hydatidiform mole

68
Q

How does a hydatidiform mole arise

A

conditions that develop from abnormal placental

69
Q

How do gestational trophoblastic neoplasms arise

A

from gestational trophoblastic disease

70
Q

Besides hydatidiform mole what other types of gestational trophoblastic disease is there?

A
  1. gestational choriocarcinoma
  2. invasive moles
  3. placental site trophoblastic tumor.
71
Q

Where does the term hydatidiform mole come from?

A

Greek
hydatisia means drop of water
and the Latin word mola, which means “false conception.

72
Q

How does a hydatidiform mole develop

A

A hydatidiform mole is a process in which a sperm fertilizes an ovum but only sperm DNA is present no embryonic tissue develops

73
Q

How are molar pregnancies classified

A
  1. complete

2. incomplete

74
Q

The public health service in 1989 and 2005 recommended what schedule of visits for pregnant women?

A

8 visits for nulliparous
6 visits for mulitparous
with additional visits at 41 weeks for women with post date pregnancies

75
Q

what are the two ways clinicians date pregnancy

A
  1. LMP

2. ultrasound

76
Q

Why would an estimated due date need to be changed

A

If there is a discrepancy between the LMP and U/S dating of fetal age of more than 5 days

77
Q

LMP/US DATING EXAMPLE 1: For a patient whose ultrasound-based gestational age assessment is 7 2/7 weeks, if the menstrual-based EDB is 1/20/21 and the ultrasound-based EDB is 1/30/21 (those are different by more 5 days and the person is less than 8 6/7 weeks),

A

There LMP due date is 10/20/21 and the U/S due date is 1/30/21 go with the U/S

78
Q

8 5/7 weeks.

What does this mean

A

8 weeks

5 days

79
Q

Which phase in pregnancy marks the beginning of the antepartum period?

A

The start of labor

80
Q

What does G3 P2002 stand for

A

A woman who is currently pregnant with her 3rd baby she gave birth to a full term baby with each prior pregnancy

81
Q

What does G2 P0101 stand for

A

A woman currently pregnant she gave birth to one preterm infant and has one live child

82
Q

G3P1103 stands for

A

A woman currently pregnant with her 3rd pregnancy she gave birth to one full term infant and preterm twins all 3 alive

83
Q

What is the mean menstrual age for pregnancy

A

283 to 284 days

84
Q

By what week of pregnancy is organogenesis completed

A

at the end of 12 weeks

85
Q

the second trimester was 13 to 28 weeks what was the reason

A

28 weeks was the limit of viability prior to the introduction of modern neonatal techniques

86
Q

the first trimester last from

A

1 to 12 weeks

87
Q

when does the 2nd trimester begin

A

13-28 weeks

88
Q

when does the 3rd trimester begin

A

28 to 40 weeks

89
Q

What are the 3 components of the diagnosis of pregnancy

A
  1. confirm the pregnancy
  2. establish gestational age
  3. determine viability
90
Q

What are the two positive signs of pregnancy

A
  1. ultrasound visualization

2. fetal heart tones

91
Q

During pregnancy what hormone is responsible for the softening of the cartilage, joint and ligament laxity

A

Progesterone on cartilage and joints

estrogen and relaxin for ligament laxity

92
Q

What causes hyperpigmentation during pregnancy?

A

Estrogen and progesterone and melanocyte-stimulating hormone induce melanocytes to make and deposit pigment

93
Q

What creates stretch marks during pregnancy?

A

Elastin fibers at the dermal epidermal junction stretch and shift from perpendicular to parallel

94
Q

Why might some pregnant woman experience protein in the urine?

A

Protein reabsorption is not as efficient as it is in the non-pregnant state

95
Q

Why are pregnant women at increased risk for UTI during pregnancy

A

The ureters, urethra and bladder dilate under the influence of progesterone

96
Q

Are urinary tract infections associated with preterm labor

A

yes

97
Q

What is the first endocrine gland to appear in the fetus

A

Thyroid

98
Q

When does the fetus begin to secrete TSH

A

18 to 20 weeks

99
Q

The basal metabolic rate increases in pregnancy by what percentage

A

20 to 25

100
Q

What thyroid hormones should the clinician assess during during pregnancy

A

Tsh
free t4
total t4

101
Q

Why is oral care important during pregnancy

A

mothers can pass oral bacteria onto their babies

102
Q

What laboratory test are recommended for pregnant women

A 
Rh-D
CBC
HBsAg
HIV
Rubella titer
Syphilis
Varicella
Urinalysis
Urine culture
Chlamydia
Gonorrhea
103
Q

When is the Rh D Rhogam given to pregnant women who lack allo-antibodies

A

28 weeks

104
Q

What are pregnancy diagnosis

A
  1. Pregnancy unknown location
  2. Viable intrauterine pregnancy
  3. Threatened spontaneous abortion
105
Q

When are women tested for diabetes during pregnancy

A

First trimester

2nd trimester 24-28 weeks

106
Q

When is a 3 hour GTT obtained

A

a 3 hour GTT is obtained if the BG following a 50-g load is greater than 130 or 140

107
Q

What is alloimmunization

A

Rh (D)-positive cells when exposed to Rh (D)-positive blood—a phenomenon called alloimmunization.

108
Q

Group B strep is a gram positive bacteria that is normally found were

A

Gastrointestinal and genital tract

109
Q

When are women screened for group B strep

A

between 35 to 37 weeks

110
Q

If GBS is identified in a urine culture at any time during a pregnancy, it is a sign of

A

heavy colonization

111
Q

What is the treatment given to women who are GBS +

A

PCN during active labor or after rupture of membranes

Asthma (7 decks)

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