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Obstetrics > Healthy Pregnancy and Assessment of Pregnant Client > Flashcards

Healthy Pregnancy and Assessment of Pregnant Client Flashcards

1
Q

Gravidity

A

Number of pregnancies no matter how long

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2
Q

Parity

A

Number of births of viable age (>20weeks)

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3
Q

Term

A

Number of births > 37 weeks

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4
Q

Preterm

A

Number of births < 37 weeks

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5
Q

Abortus

A

Induced or spontaneous abortion < 20 weeks

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6
Q

Living

A

Number of living children

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7
Q

True or False: Twins count as one pregnancy and 2 births

A

False, twins count as one pregnancy and one birth

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8
Q

Define subjective/presumptive changes that occur during pregnancy

A

symptoms experienced by the pregnant client suggestive of pregnancy; can be caused by conditions other than pregnancy

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9
Q

Amenorrhea, nausea and vomiting, changes in breasts, and quickening are examples __________ changes

A

Presumptive/subjective

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10
Q

Define objective/probable changes that occur during pregnancy

A

Signs perceived by examiners; could be caused by conditions other than pregnancy

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11
Q

Enlargement of the abdomen, braxton hick’s contractions, uterine souffle are examples of ___________ changes

A

objective/probable

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12
Q

Goodell’s sign (probable sign)

A

(probable sign)
softening of the cervix

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13
Q

Hegar’s sign (probable sign)

A

softening of the lower uterine segment

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14
Q

Chadwick’s sign (probable sign)

A

bluish discoloration of the vaginal mucosa and cervix

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15
Q

A positive pregnancy test is an example of a _________ change

A

probable/objective

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16
Q

Define diagnostic/positive changes of pregnancy and list what they are (3)

A

Signs that are completely objective & caused only by pregnancy
· Detection of a fetal heartbeat
· Fetal movements detected by a trained examiner
· Verification of a gestational sac and heartbeat through ultrasound.

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17
Q

When is first trimester?

A

0 to 12 weeks

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18
Q

When is second trimester?

A

13-26 weeks

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19
Q

When is third trimester?

A

27 - 40 (+/- 2) weeks

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20
Q

What is antepartum?

A

period of pregnancy, usually refers to last 20 weeks of the pregnancy

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21
Q

What is intrapartum?

A

labour

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22
Q

What is post partum?

A

period following birth, lasting approximately 6 weeks

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23
Q

What is Nagele’s rule?

A
  1. Take the first day of the LMP
  2. Add a year (?)
  3. Subtract 3 months
  4. Add 7 days
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24
Q

What occurs to the blood volume of a pregnant client

A

increase blood volume 30-50% (~1500 mls)

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25
Q

What occurs to the cardiac output of a pregnant client

A

↑ by 40% - 50%

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26
Q

What maintains normal blood pressure during pregnancy?

A

Peripheral vasodilation

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27
Q

Why does supine hypotension occur in pregnant clients?

A

Vena caval syndrome

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28
Q

True or false: pregnant clients are at increased risk for thrombus formation

A

True
increase in clotting factors / fibrinogen, fibrinolysis inhibition = hypercoagulable state,

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29
Q

When is an increase in WBC seen in a pregnant client

A

2nd and 3rd trimesters

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30
Q

What respiratory changes may you see in a pregnant client?

A

Increased oxygen consumption by 15-20%
SOB caused by displacement of diaphragm

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31
Q

Role of increased progesterone in pregnancy

A

Maintains pregnancy

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32
Q

Role on increased estrogen in pregnancy

A

Enlarges uterus, breasts, genitals

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33
Q

Role of oxytocin at term

A

contractions and let down reflex for lactation

34
Q

How do increased hCG levels effect the GI system

A

Alter carb metabolism

35
Q

What is thought to play a role in morning sickness and when is it the worst

A

Rapid estrogen increase at 6-12 weeks

36
Q

What is the effect of increased abdominal size and decreased muscle tone on the musculoskeletal system of a pregnant client?

A

exaggeration of lumbosacral curve

37
Q

What is the cause of low back pain in pregnant clients

A

compression of lumbar nerve roots

38
Q

Define Supine Hypotensive Syndrome/(Aortocaval Compression)

A

Pressure from the growing fetus and gravid uterus compresses iliac veins and inferior vena cava

39
Q

What is optimal positioning to avoid Supine Hypotensive Syndrome/(Aortocaval Compression)

A

left lateral

40
Q

What are the 4 leopold’s maneuvers?

A
  1. identifies part of baby in upper pole of fundus (vertex v breech presentation)
  2. identifies location of fetal back and limbs (side of abdomen)
  3. identifies presenting part in pelvis and engagement (thumb and fingers above symphysis pubis)
  4. Determine degree of flexion of presenting part
41
Q

When is the preconception phase?

A

3 months

42
Q

Role/amount of folic acid supplementation prenatally

A

0.4mg
Prevention of neural tube defects

43
Q

Role/amount of iron supplementation prenatally

A

16-20mg
Pregnant women experience an increase in blood volume without an increase in RBC

44
Q

Why is it important to assess oral health prenatally?

A

Gingivitis cause preterm babies and LBW

45
Q

What is the normal weight gain for a person with a normal BMI during pregnancy?

A

25-35lbs

46
Q

What is the anticipated weight gain during the 1st trimester of pregnancy?

A

6lbs/0.5 a week

47
Q

What is the anticipated weight gain during the 2nd trimester of pregnancy?

A

12lbs/1 a week

48
Q

What is the anticipated weight gain during the 3rd trimester of pregnancy?

A

12lbs/1 a week

49
Q

Why is the recommended weight gain around 30 lbs when babies usually only weigh around 7 lbs?

A

o Extra fluids, blood, protein = 3.5kg
o Breasts and energy stores = 3kg
o Uterus = 1kg
o Placenta = 1kg
o Baby = 3.5kg
o Amniotic Fluid = 1kg

50
Q

Danger signs in 1st trimester

A
  1. bleeding (miscarriage)
  2. painful urination (UTI)
  3. severe persistent vomitting (hyperemesis gravidarum)
  4. lower abdominal pain with dizziness accompanied by shoulder pain (ruptured ectopic)
51
Q

Danger signs in 2nd trimester

A
  1. regular uterine contractions (preterm)
  2. pain in calf (deep vain clot)
  3. sudden leakage of vaginal fluid (premature membrane rupture)
  4. absence of fetal movement > 12 hours (fetal distress)
52
Q

Danger signs in 3rd trimester

A
  1. sudden weight gain + facial edema + severe upper abdominal pain + headache w visual changes (gestational hypertension/pre-eclampsia)
  2. decrease in fetal movement > 24 hours (fetal demise)
53
Q

Why is Rh type screened in pregnancy?

A

Rh - mother: baby could be Rh + if father was. If cells mixed (abruption of placenta), mother could develop antibodies

54
Q

What infectious diseases are screened for in pregnancy?

A

STI, HIV, Hepatitis B&C, Rubella

55
Q

When is a glucose tolerance test done during pregnancy?

A

24-28 weeks

56
Q

When is a group b strep screening done?

A

35-37 weeks

57
Q

Why is asymptomatic bacteruria screened prenatally?

A

UTI in pregnancy can cause preterm labour

58
Q

What 2 ultrasounds are offered for pregnant clients and what are their purposes?

A

a dating ultrasound between 8-12 week

an anatomy ultrasound between 18 and 22 weeks of pregnancy. (SOGC guidelines)

59
Q

By what week should all women be aware of fetal movement?

A

26-32 weeks

60
Q

At what rate do we recommend mom’s call MRP for decrease in fetal movement?

A

< 6 movements in 2 hours is not enough

61
Q

If a woman is experiencing decrease is fetal movement and goes to the physician, what test would be performed?

A

Non-stress test

62
Q

Why is group b strep screening and treatment done so late in pregnancy?

A

We wait to treat because transmission occurs during labor; bacteria could reappear if treated earlier in pregnancy

63
Q

What are the rx factors for GBS infections?

A

· Preterm labor before 37 weeks gestation (poorly developed immune system)
o (with or without ruptured membranes).
· Term rupture of membranes >18 hrs
· Unexplained, mild fever during labour.
· Previous baby with a GBS infection.
· Previous or present GBS bacteriuria caused by the GBS bacteria.
o Past UTI where bacteria is GBS

64
Q

Purpose of doppler flow study

A

Non Routine test to measure the velocity of blood flow via ultrasound

65
Q

What does a non-stress test access?

A

Fetal heart rate patterns in response to fetal movement

Non invasive, most common method of prenatal testing

66
Q

What is a biophysical profile and what are its 5 components

A

Combination of non stress test and ultrasound to monitor 1. movement
2. tone
3. breathing
4. fluid volume
5. non stress test

67
Q

How much amniotic fluid is present at birth

A

800-1000ml

68
Q

What are the 2 sources of amniotic fluid?

A
  1. fluid from the maternal blood across amnion
  2. fetal urien
69
Q

What is oligohydraminos?

A

Decreased amniotic fluid

70
Q

What is Polyhydramnios/Hydramnios

A

Excessive amniotic fluid

71
Q

What is a marker screening test?

A

Prenatal serum screening

Blood test offred to women to determine risk of aneuploidy

NON DIAGNOSTIC

72
Q

What does a marker screening test done in 1st trimester demonstrate

A

risk of chromosomal disorders and anomalies only

73
Q

What does a marker screening test done in 2nd trimester demonstrate

A

o Additionally with chromosomal disorders can determine ONTD risk

74
Q

Following marker screening tests, what further testing should be discussed in counselling?

A

Amniocentesis, detailed ultrasound-exclude anomalies, nuchal translucency

75
Q

What is a Nuchal Scan for Translucency

A

a collection of fluid under the skin at the back of a fetus’ neck

76
Q

What is determined by a nuchal scan for translucency?

A

From the measured thickness of the nuchal translucency combined with maternal age, the risk of chromosomal abnormality can be calculated

77
Q

How does Non-Invasive Prenatal Testing work?

A

NIPT works by taking a blood sample from a pregnant client and analyzing for abnormalities of specific chromosomes (13, 18, 21, X, Y) associated with conditions like Down syndrome and Turner syndrome

78
Q

True or False: there is a high risk of miscarriage associated with NIPT?

A

carries no risk of miscarriage, because there is no need to pierce the amniotic sac. NIPT can be performed from 9 to 10 weeks in pregnancy, versus 16 weeks for amniocentesis.

79
Q

True or false: NIPT can diagnosis chromosomal anomalies around 9-10 weeks

A

True

80
Q

What is the purpose of an amniocentesis done in the 2nd trimester?

A

Genetic testing

81
Q

What is the purpose of an amniocentesis done in the 3rd trimester?

A

Maturitu

82
Q

What is the L/S ratio?

A

(Lecithin/Sphingomyelin) 2:1=>35 weeks

2 components of surfactant which line alveoli of lungs & reduces surface tension when the infant exhales

Obstetrics (12 decks)

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