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concept 3 > maternal exam 1 sammy rak > Flashcards

maternal exam 1 sammy rak Flashcards

1
Q

combined oral contraceptives are made of

A

estrogen and progesterone

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2
Q

the state of pregnancy is called

A

gravidity

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3
Q

woman who has never been pregnant is called

A

nulligravida

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4
Q

woman who is pregnant for the first time is called

A

primigravida (primero gravida)

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5
Q

woman who has tow or more pregnncies

A

multigravida

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6
Q

number of pregnancies that reached viability is called

A

parity

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7
Q

when is a fetus viable

A

22-25 weeks

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8
Q

woman who has never completed a pregnancy with a viable fetus

A

nullipara

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9
Q

completed 1 pregnancy with fetus that reached viability

A

primipara

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10
Q

completed more than one pregnanct with viability

A

multipara

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11
Q

pregnancy has reached 20 weeks of gestations but did not reach 37 wks of gestationn

A

preterm

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12
Q

reached between 34-36 weeks and 6 days

A

late preterm

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13
Q

reached 37 weeks and 38 weeks 6 days

A

early term

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14
Q

reached 39 wks and 40 wks 6 days

A

full term

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15
Q

reached 41 wks-41 wks 6 days

A

late term

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16
Q

reached 42 wks and beyond

A

past term

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17
Q

capacity to live outside the uterus aftr 22-25 wks is called

A

viability

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18
Q

GTPAL stands for

A

gravida
term
preterm
abortions
living children

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19
Q

The T in GTPAL stands for what and how many weeks should it be

A

term (39 wks- 40 wks 6 days)

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20
Q

how soon can hcg be detected

A

7-8 days

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21
Q

what hormone do pregnancy tests test for

A

hcg

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22
Q

what does hcg preserve

A

the corpus luteum

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23
Q

what does the corpus luteum produce

A

progesterone

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24
Q

what does progesterone do for pregnancy

A

maintains it by growing endometrium lining inside uterus and maintain placenta until it matures

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25
Q

how long does hcg increase in pregnant woman

A

60-90 days

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26
Q

what happens if hcg continues to increase after 90 days

A

hydatidiform molar pregnancy

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27
Q

what is a hydatidiform molar pregnancy

A

placenta tissue swells but no fetus is formed so hcg levels continue to rise

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28
Q

what causes hcg to lower after 90 days

A

placenta forms and takes over

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29
Q

hydatidiform molar pregnancy is also known as

A

trophoblastic disease

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30
Q

linea negra is what kind of pregnancy sign

A

presumptive

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31
Q

uterine growth is what kind of pregnancy sign

A

probable

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32
Q

what is ballotement

A

test where uterus is pushed to see if fetus moves and returns again

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33
Q

what kind of sign is ballotement

A

probable

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34
Q

uterus changes during pregnancy

A

size
shape
position
contractibility

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35
Q

what is needed for breast fullness and heaviness

A

supportive bra

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36
Q

what position should you not put a pregnant pt in

A

supine

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37
Q

what happens if a pregnant pt is put in supine position

A

cardiac output is reduced by 30% and pressure is put on vena cava

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38
Q

what position takes postion off of vena cava

A

left side lying

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39
Q

hypotension from supine position is called

A

supine hypotensive syndrome

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40
Q

what kind of murmur is common in pregnancy and what causes it

A

systolic murmur from increased blood flow

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41
Q

increasing clotting factors put pregnant women at risk for what

A

clots

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42
Q

varicose veins in rectum are called

A

hemmorhoids

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43
Q

changes in resp system from pregnancy

A

increased nasal congestion
increased oxygen consumption
respiratory alkalosis

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44
Q

renal system changes during pregnancy

A

urinary frequency
increased GFR (glomerular filtration rate)
stress incontinence (pee when laughing etc)

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45
Q

what trimesters will urinary frequency occur

A

1st and 3rd

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46
Q

skin changes from pregnancy

A

chloasma
linea negra
striae gravidarum
angiomas
palmar erythema
diaphoreses

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47
Q

what is know as the mask of pregnancy

A

chloasma

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48
Q

spider veins are also known as

A

angiomas

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49
Q

muskuloskeletal changes in pregnancy

A

ligament and joint softeninf
lordosis
decreased calcium
decreased potassium

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50
Q

what causes ligament and joint softening during pregnancy

A

relaxin

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51
Q

what causes change in center of gravity in pregnancy

A

lordosis

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52
Q

what causes calf muscle pain in pregnancy

A

decreased calcium

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53
Q

neuro changes during pregnancy

A

depression

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54
Q

endocrine changes during pregnancy

A

thyroid enlargement
increased thyroid actvity
mild hyperthyroid state
lower serum glucose
lower maternal serum glucose levels
diastasis

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55
Q

what is diastasis

A

abs stretch and separate from pregnancy

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56
Q

when does blood glucose levels lower in pregnancy

A

early in pregnacy

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57
Q

what cause increase in glucose levels during pregnacy

A

baby growing

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58
Q

gi changes during pregnancy

A

nausea/vomiting
increased appetite
PICA
bleeding gums
decreased peristalsis

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59
Q

what is PICA

A

eating non edible things (why the hell u PICA that up?)

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60
Q

what causes bleeding gums in pregnancy

A

increased estrogen

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61
Q

what causes decreased peristalsis in pregnancy

A

progesterone

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62
Q

how much weigh gain is expected during pregnancy

A

25-35 lbs

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63
Q

calorie increase of how much for pregnant pt

A

330 calories/day

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64
Q

minimum protein per day for pregnant pt

A

60 g

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65
Q

what should be given daily to prevent neural tube defects to women of child bearing age

A

folic acid

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66
Q

iron education for pregnant pt

A

increase iron (ferrous sulfate)

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67
Q

pregnant teen education about nutrition

A

protein
carbs
calcium
iron

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68
Q

labs to draw at initial visit

A

cbc
blood type
rh status
hcg
rubella titre
hep b
VDRL/RPR
urine culture and screen
urinalysis
pap smear
GC
chlamydia
group b strep

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69
Q

why is rubella titre obtained

A

to see if pt is immunized or has hx of rubella

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70
Q

can u give rubella vaccine to preg pt

A

no

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71
Q

what do VDRL and RPR test for

A

syphyllis

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72
Q

what happens if baby catches group b strep

A

encephalitis
meningitis
brain issues

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73
Q

until what month will preg pt have monthly visits

A

7 th month

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74
Q

after 7th month how frequent will visits be

A

bi weekly

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75
Q

after 8th month how frequent will visits be

A

weekly until delivery

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76
Q

what is PIH

A

pregnancy induced hypertension

77
Q

what are signs of PIH

A

faical/hand edema

78
Q

what do alpha feto protein tests screen for

A

genetic problems

79
Q

what happens if placenta is too low in womb

A

placenta previa

80
Q

what should pt do before amniocentisis

A

empty bladder

81
Q

when should oral GTT (glucose screen) be done

A

24-28 weeks

82
Q

when should GBS (group B strep) be done

A

36 weeks

83
Q

what is a normal fetal heart rate during a non stress test

A

110-160 bpm

84
Q

accelerated fetal heart rates during non stress test are

A

short term rises of atleast 15 bpms for atleast 15 seconds must happen atleast 2x

85
Q

what are the 2 possible non stress test results

A

non reactive
reactive

86
Q

no fetal reaction or no short term rise in bpm is what result for non stress test

A

non reactive

87
Q

how long is fetal hr monitored during non stress test

A

15 mins

88
Q

how to stimulate contractions for contraction stress test

A

natural ocytocin nipple stimulation challenge
low dose of pitocin iv (oxytocin)

89
Q

how many contraction should be monitored during contraction stress test? what happens after each contraction?

A

3 and HR slows down after each one

90
Q

what is hr dropping at peak called and is it a good or bad thing (contraction stress test)

A

early deceleration and its good

91
Q

what is hr dropping after peak called and is it a good or bad thing (contraction stress test)

A

late deceleration and its bad (insufficient nutrition supply from placenta)

92
Q

is a negative contraction stress test good or bad

A

good (no late deceleration)

93
Q

is a postive contraction stress test good or bad

A

bad (persistent late deceleration)

94
Q

situations where rhogam will be given

A

pregnancy
eptopic pregnancy
abortion
miscarriage
amniocentisis
placental abruption

95
Q

placenta previa risk factors

A

hx of c section
hx of placenta precia
multiple gestations
uterine abnormalities
advanced maternal age

96
Q

s/s of plaenta previa

A

painless
bright red vag bleeding
soft non tender uterus/abdomen

97
Q

how to diagnose placenta previa

A

ultrasound

98
Q

interventions for placenta previa

A

peripad count
bed rest
vaginal rest
monitor for shock
monitor fetal hr
administer betamethasone (around 25 wks)
prepare for c section

99
Q

what does l/s measure

A

amount of surfacant in lungs

100
Q

normal l/s ratio

A

2:1

101
Q

what does abnormal l/s ratio mean

A

lungs not mature enough

102
Q

1 cause of abruptio placentae

A

HTN

103
Q

2 or more BP readings over 140/90 indicates

A

gestational HTN

104
Q

gestational HTN risk factors

A

smoking
cocaine
abdominal trauma

105
Q

s/s of abrupio placentae

A

sharp sudden abdominal pain w or w/o bleeding
abdominal distention
board like abdomen
uerine contractions
shock

106
Q

how to diagnose abruptio placentae

A

ultrasound

107
Q

should u perform vaginal exam for abruptio placentae

A

no can cause more bleeding

108
Q

abruptio placentae interventions

A

assess fhr and movement
prep for possible c section
type and screen
cbc
anticoagulants
iv access

109
Q

name the insulin antagonists

A

human placental lactogen
progesterone
cortisool
prolactin

110
Q

what do insulin antagonists cause

A

elevated blood glucose lvls and lipolysis

111
Q

what causes gestational diabeted

A

inadequate insulin production and decreased sensitivity to available insulin causes elevated blood glucose

112
Q

does gestational dm affect the size of the baby

A

yes can cause a bigger baby

113
Q

gestational dm increases the risk of what after pregnancy

A

dm

114
Q

what is macrosomia

A

larger than average fetus

115
Q

weight to be considered macrosomial

A

9 lbs 4 oz or more

116
Q

what is cephalopelvic disproportion

A

baby head too big to fit through pelvis

117
Q

what are congenital anomalies

A

defects that u are born with (“born this way” lady gaga)

118
Q

whatdoes delayed lung maturity cause

A

resp distress

119
Q

too much insulin in mother and babys blood is that causes low surfacant in baby lungs is called

A

hyperinsulemia

120
Q

when does hyperinsulemia start

A

towards end of pregnancy when mother uses insulin

121
Q

oral hyperglycemic used for pregnant pts

A

glyburide

122
Q

what does glyburide do?

A

decreases serum glucose lvls

123
Q

what preg complication can cause frequent yeast infections in preg women

A

gestational dm

124
Q

when would a oral flucose test be performed

A

24 weeks

125
Q

HbA1C lvl higher than 10% indicates what

A

congenital anomalies

126
Q

how is regular insulin given

A

through iv

127
Q

what should you monitor when giving regular insulin

A

potassium lvls

128
Q

gestational dm effects on fetus

A

-macrosomia
-congenital anomalies
-delayed lung maturity
-neonatal hypoglycemia after delivery
-neonatal hyperbilirubinemia

129
Q

how to dx gestational htn

A

2 or more BP readings above 140/90 w or w/o proteinuria & edema

130
Q

when does gestational htn usually appear

A

20 wks or later

131
Q

gestational htn risk factors

A

-primigravida w age extremes (younger than 18 or older than 40)
-chronic medical conditions
-multiple fetuses
-family hx
-protein deficiency

132
Q

facial/hand edema is a sign of what kind of preeclampsia

A

mild preeclampsia & eclampsia

133
Q

generalized pitting edema is a sign of what kind of preeclampsia

A

severe preeclampsia & eclampsia

134
Q

seizures are a sign of what kind of eclampsia

A

eclampsia

135
Q

weight gain is a sign of what kind of preeclampsia

A

mild preeclampsia & eclampsia

136
Q

+30 systolic BP reading from baseline is a sign of what kind of eclampsia

A

mild preeclampsia and eclampsia

137
Q

HTN 160/100 or higher is a sign of what kind of eclampsia

A

severe preeclampsia and eclampsia

138
Q

altered mental status is a sign of what kind of eclampsia

A

eclampsia

139
Q

+15 diastolic over baseline BP reading is a sign of what kind of eclampsia

A

mild preeclampsia and eclampsia

140
Q

increased proteinuria of 5g/24 hrs is a sign of what kind of eclampsia

A

severe eclampsia and eclampsia

141
Q

HELLPS stands for

A

hemolysis of blood cells
elevated
liver enzyme
low
platelets
syndrome

142
Q

HELLPS is a sign of what kind of eclampsia

A

eclampsia

143
Q

what should you monitor in pt w/ HELLPS

A

deep tendon reflexes

144
Q

proteinuria more than 1g/24hrs is a sign of what kind of eclampsia

A

mild preeclampsia and eclampsia

145
Q

headache is a sign of what kind of eclampsia

A

sever eclampsia and eclampsia

146
Q

visual disturbances is a sign of what kind of eclampsia

A

severe preeclampsia and eclampsia

147
Q

low urine output is a sign of what kind of eclampsia

A

severe eclampsia and eclampsia

148
Q

hyperreflexia is a sign of what kind of eclampsia

A

severe eclampsia and eclampsia

149
Q

what kind of environment should eclampsia pt be plaed in

A

low stimuli environment

150
Q

what to monitor in eclampsia pt

A

strict I&O
edema
deep tendon reflexes (DTR)
BP
vitals
baseline weights

151
Q

what kind of protein diet should eclampsia pt follow

A

high protein

152
Q

what kind of sodium diet should eclampsia pt follow

A

low sodium

153
Q

how long should eclampsia pt be on seizure precautions

A

up to 72 hrs post delivery

154
Q

what is the cure for eclampsia

A

delivering baby

155
Q

what does magnesium sulfate (MgSO4) do?

A

lowers BP
anticonvulsant (reduces deep tendon reflexes)

156
Q

antidote for magnesium sulfate

A

calcium gluconate

157
Q

how does magnesium sulfate affect resp rate

A

lowers resp rate

158
Q

how does magnesium sulfate affect heart rate

A

increases it

159
Q

how does magnesium sulfate affect serum glucose

A

increases It

160
Q

what should you monitor when giving magnesium sulfate to pt

A

BP
deep tendon reflexes
resp rate
heart rate
serum glucose

161
Q

should you palpate abdomen when you notice abd distention

A

no

162
Q

how much weight should an pt w underweight BMI gain

A

1 lb/week

163
Q

a BMI of 18.5 indicates

A

underweight

164
Q

a BMI of 26.5 indicates

A

overweight

165
Q

how much weight should a pt w a BMI of 26.5 gain

A

15-25 lbs

166
Q

a BMI of 30 and above indicates

A

obese

167
Q

how much weight should a pt w a BMI of 30 gain

A

11-20 lbs

168
Q

what does nageles rule find

A

estimated due date

169
Q

what does folic acid supplements prevent

A

neural tube defects

170
Q

what should be done w diaphragm (contraceptive) after birth

A

it should be refitted

171
Q

how is magnesium sulfate given

A

iv or im

172
Q

how much mg of calcium should pt take daily

A

1000

173
Q

suggested zinc nutritional intake

A

12 mg/day

174
Q

suggested folic acid intake during pregnancy

A

600 mg

175
Q

suggested folic acid intake during lactation

A

500 mg

176
Q

suggested iron daily intake in women over 19 y/o

A

9 mg/day

177
Q

should you increase iron in pt who is breast feeding

A

no

178
Q

product of protein breakdown is called

A

phenylalanine

179
Q

phenylketonuria (PKU) dietary education

A

avoid protein rich foods

180
Q

can a PKU pt eat beans?

A

no

181
Q

can PKU pt eat cheese?

A

no

182
Q

can PKU pt eat aspartame

A

no

183
Q

how long can pt not ejaculate before semen analysis

A

2-5 days before test

184
Q

can body temp be used to see if a woman is ovulating

A

yes

185
Q

ambivalence is

A

having mixed feelings

186
Q

what does alpha feto-protein test look fpr

A

predicts genitic defects

187
Q

0-13 weeks is what trimester

A

1st trimester

188
Q

27-40 weeks is what trimester

A

3rd trimester

189
Q

14-26 weeks is what trimester

A

2nd trimester

concept 3 (17 decks)

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