laboratory tests Flashcards
The usual schedule for antepartum health care visits is every….
4 weeks for the first 28 to 32 weeks,
every 2 weeks from 32 to 36 weeks
every week from 36 to 40 weeks
it is performed to determine the woman’s blood type in the ABO antigen
system
ABO typing
is done to determine the woman’s blood type in the rhesus antigen system.
Rh typing
Rh positive indicates…?
the presence of the antigen
Rh negative indicates..?
The absence of
the antigen.
If the client is Rh negative and has a negative anti body screen, she will…?
need repeat
antibody screens and should receive Rho(D) immune globulin (RhoGAM) at 28 weeks of
gestation.
If the client has a negative titer (less than 1:8)…?
indicating susceptibility to the rubella virus,
she should receive the appropriate immunization postpartum
The client must be using effective birth control at the time of the immunization and must be
counseled not to become pregnant for 1 to 3 months after immunization
Rubella titer
inquire about sensitivity to eggs
Rubella titer
Rubella vaccine is not given during pregnancy because
the live attenuated virus may crossthe placenta and present a risk to the developing fetus.
decline during gestation as
a result of increased plasma volume
Hemoglobin and hematocrit levels
A decrease in the hemoglobin level to less than _____
hematocrit level to less than ____
it indicates ____
10 g/dL (100
mmol/L)
30%
anemia
done during the initial prenatal examination to screen for
cervical neoplasia
Papanicolaou’s smear
The HCP may prefer to perform this skin test after birth
Tuberculin skin test
Screening is indicated for clients at risk for sickle cell disease.
A positive test may indicate a need for ___________
Sickle Cell screening
further screening
A positive skin test indicates the need for a chest radiograph (using an abdominal
lead shield) to rule out active disease; in a pregnant client, chest radiography
would not be performed until after 20 weeks of gestation (after the fetal organs
are formed).
Tuberculin skin test
Testing for ___________ is recommended for all women
because of the prevalence of the disease in the general population.
Hepatitis B vaccine is not contraindicated during pregnancy
hepatitis antigens
A urine specimen for glucose and protein determinations should be obtained at________
antepartum visit
______ is a common result of decreased renal threshold that occurs during
pregnancy
Glycosuria
If glycosuria persists, it may indicate ______
diabetes
White blood cells in the urine may indicate _____
infection
______ may result from insufficient food intake or vomiting.
Ketonuria
Levels of 2 + to 4 + protein in the urine may indicate ________
infection or preeclampsia.
Outlines and identifies fetal and maternal structures
Ultrasonography
Assists in confirming gestational age and estimated date of delivery and
evaluating amniotic fluid volume (amniotic fluid index), which is done via special
measurements
Ultrasonography
Can be used to determine the presence of premature dilation of the cervix
(incompetent cervix).
A transvaginal ultrasound is used during the first trimester to check the length of
the cervix
ultrasonography
if an abdominal ultrasound is being performed, the woman may need to
_______
drink water to fill the bladder before the procedure to obtain a better image
of the fetus.
Noninvasive assessment of the fetus that includes fetal breathing
movements, fetal move ments, fetal tone, amniotic fluid index,
and fetal heart rate patterns via a nonstress test
Biophysical profile
Noninvasive (ultrasonography) method of studying the
blood flow in the fetus and placenta
Doppler blood flow analysis
performed if fetal blood
sampling is necessary; it involves insertion of a needle directly into
the fetal umbilical vessel under ultrasound guidance.
Percutaneous umbilical blood sampling
_______ is necessary for 1 hour after the PUBS, and a follow-up ultrasound to check for bleeding or hematoma formation is done 1 hour after the procedure.
Fetal heart rate monitoring
Assesses the quantity of fetal serum proteins; abnormal protein
levels are associated with open neural tube and abdominal wall
defect
α-Fetoprotein screening
Assists in screening for spina bifida and Down syndrome
α-Fetoprotein screening
α-Fetoprotein level is determined by a maternal blood
sample drawn between _______ gestation.
16 and 18 weeks of gestation.
Can be used to detect abnormalities related to an inherited
condition
Deoxyribonucleic acid (DNA) genetic testing
Assists in determining if the woman is at risk for having a fetus with ___________ .
Down syndrome (trisomy 21), Edwards syndrome (trisomy 18), or
Patau syndrome (trisomy 13)
This type of testing can be done as early as 7 weeks of
gestation and a blood sample is used
DNA genetic testing
Performed for the purpose of detecting genetic abnormalities; the
HCP aspirates a small sample of chorionic villus tissue at _____
weeks of gestation.
Chorionic villus sampling
10 to 13
Chorionic villus sampling interventions:
The client may need to ___________
to aid in the visualization of the uterus for catheter insertion.
drink water to fill the bladder before the procedure
Aspiration of amniotic fluid; best performed between ______ weeks of pregnancy
because amniotic fluid volume is adequate and many via ble fetal cells are present
in the fluid by this time
15 and 20
Amniocentesis
Performed to determine genetic disorders, metabolic defects, and fetal lung maturity
Amniocentesis
Risks of amniocentesis
a. Maternal hemorrhage
b. Infection
c. Rh isoimmunization
d. Abruptio
placentae
e. Amniotic fluid emboli
f. Premature rupture of the membranes
Amniocentesis
After chorionic villus sampling and amniocentesis, instruct the
client that if______ she must notify the HCP
chills, fever, bleeding, leakage of fluid at the
needle insertion site, decreased fetal movement, uterine
contractions, or cramping occurs,
The client sits quietly or lies down on her side and counts fetal
kicks as instructed.
Instruct the client to notify the HCP if there are fewer than __________ periods or as instructed by the
HCP
10
kicks in 2 consecutive 2-hour
a microscopic slide test to deter mine the
presence of amniotic fluid leakage
Fern Test
strip is used to detect the presence of amniotic
fluid in vaginal secretions
S. Nitrazine test
Sampling of cervical and vaginal secretions for fetal fibronectin (a
protein present in fetal tissues normally found in cervical and vaginal
secretions until _______ of gestation and again at or near term)
16 to 20 weeks
Positive results may indicate the onset of labor in ______- weeks;
negative test results are more predictive that preterm labor will not beg
1 to 3 weeks
Test is performed to assess placental function and
oxygenation
Nonstress test
Test determines fetal well-being.
nonstress test
Test evaluates the fetal heart rate (FHR) response to fetal
movement
nonstress test
Nonstress test normal results
Results Reactive Nonstress Test (Normal, Negative)
“Reactive” indicates a healthy fetus
requires 2
or more FHR accelerations of at least 15 beats/ minute,
lasting at least 15 seconds from the begin ning of the
acceleration to the end, in association with fetal
movement, during a 20-minute period.
nonstress test abnormal
No accelerations or
accelerations of less than 15 beats/ minute or lasting less
than 15 seconds in duration occur during a 40-minute
observation.
Test assesses placental oxygenation and function.
Contraction Stress Test
est determines fetal ability to tolerate labor and deter mines
fetal well-being.
Contraction Stress Test
Test is performed if nonstress test is abnormal
Contraction stress test
Fetus is exposed to the stress of contractions to assess the
adequacy of _____ under simulated labor conditions.
placental perfusion
normal contraction stress test
Negative Contraction Stress Test (Normal) A negative result is
represented by no late decelerations of the fetal heart rate (FHR
Contraction Stress Test (Abnormal)
A positive result is
represented by late decelerations of the FHR, with 50% or more of
the contractions in the absence of hyperstimulation of the uterus
equivocal result (contraction test) contains decelerations, but with less
than ____ of the contractions, or uterine activity shows a
______.
50%
hyperstimulated uterus
An unsatisfactory result (contraction test)
means that adequate
uterine contractions cannot be achieved, or the FHR tracing is of
insufficient quality for adequate interpretation
Gonorrhea laboratory test
vaginal culture (during initial prenatal examination)
syphilis laboratory test
culture of lesions (if present) during initial prenatal examination
Condyloma acuminatum (human papillomavirus) laboratory test
Culture is indicated for clients with positive history or with active lesions
chlamydia laboratory test
vaginal culture for all pregnant clients
trichomoniasis laboratory test
normal saline wet smear
genital herpes simplex virus laboratory test
culture is done of lesions (if present)
HIV laboratory test
ELISA, Western blot, immunofluorescence assay (IFA)
