maternal exam 1 sammy rak Flashcards
combined oral contraceptives are made of
estrogen and progesterone
the state of pregnancy is called
gravidity
woman who has never been pregnant is called
nulligravida
woman who is pregnant for the first time is called
primigravida (primero gravida)
woman who has tow or more pregnncies
multigravida
number of pregnancies that reached viability is called
parity
when is a fetus viable
22-25 weeks
woman who has never completed a pregnancy with a viable fetus
nullipara
completed 1 pregnancy with fetus that reached viability
primipara
completed more than one pregnanct with viability
multipara
pregnancy has reached 20 weeks of gestations but did not reach 37 wks of gestationn
preterm
reached between 34-36 weeks and 6 days
late preterm
reached 37 weeks and 38 weeks 6 days
early term
reached 39 wks and 40 wks 6 days
full term
reached 41 wks-41 wks 6 days
late term
reached 42 wks and beyond
past term
capacity to live outside the uterus aftr 22-25 wks is called
viability
GTPAL stands for
gravida
term
preterm
abortions
living children
The T in GTPAL stands for what and how many weeks should it be
term (39 wks- 40 wks 6 days)
how soon can hcg be detected
7-8 days
what hormone do pregnancy tests test for
hcg
what does hcg preserve
the corpus luteum
what does the corpus luteum produce
progesterone
what does progesterone do for pregnancy
maintains it by growing endometrium lining inside uterus and maintain placenta until it matures
how long does hcg increase in pregnant woman
60-90 days
what happens if hcg continues to increase after 90 days
hydatidiform molar pregnancy
what is a hydatidiform molar pregnancy
placenta tissue swells but no fetus is formed so hcg levels continue to rise
what causes hcg to lower after 90 days
placenta forms and takes over
hydatidiform molar pregnancy is also known as
trophoblastic disease
linea negra is what kind of pregnancy sign
presumptive
uterine growth is what kind of pregnancy sign
probable
what is ballotement
test where uterus is pushed to see if fetus moves and returns again
what kind of sign is ballotement
probable
uterus changes during pregnancy
size
shape
position
contractibility
what is needed for breast fullness and heaviness
supportive bra
what position should you not put a pregnant pt in
supine
what happens if a pregnant pt is put in supine position
cardiac output is reduced by 30% and pressure is put on vena cava
what position takes postion off of vena cava
left side lying
hypotension from supine position is called
supine hypotensive syndrome
what kind of murmur is common in pregnancy and what causes it
systolic murmur from increased blood flow
increasing clotting factors put pregnant women at risk for what
clots
varicose veins in rectum are called
hemmorhoids
changes in resp system from pregnancy
increased nasal congestion
increased oxygen consumption
respiratory alkalosis
renal system changes during pregnancy
urinary frequency
increased GFR (glomerular filtration rate)
stress incontinence (pee when laughing etc)
what trimesters will urinary frequency occur
1st and 3rd
skin changes from pregnancy
chloasma
linea negra
striae gravidarum
angiomas
palmar erythema
diaphoreses
what is know as the mask of pregnancy
chloasma
spider veins are also known as
angiomas
muskuloskeletal changes in pregnancy
ligament and joint softeninf
lordosis
decreased calcium
decreased potassium
what causes ligament and joint softening during pregnancy
relaxin
what causes change in center of gravity in pregnancy
lordosis
what causes calf muscle pain in pregnancy
decreased calcium
neuro changes during pregnancy
depression
endocrine changes during pregnancy
thyroid enlargement
increased thyroid actvity
mild hyperthyroid state
lower serum glucose
lower maternal serum glucose levels
diastasis
what is diastasis
abs stretch and separate from pregnancy
when does blood glucose levels lower in pregnancy
early in pregnacy
what cause increase in glucose levels during pregnacy
baby growing
gi changes during pregnancy
nausea/vomiting
increased appetite
PICA
bleeding gums
decreased peristalsis
what is PICA
eating non edible things (why the hell u PICA that up?)
what causes bleeding gums in pregnancy
increased estrogen
what causes decreased peristalsis in pregnancy
progesterone
how much weigh gain is expected during pregnancy
25-35 lbs
calorie increase of how much for pregnant pt
330 calories/day
minimum protein per day for pregnant pt
60 g
what should be given daily to prevent neural tube defects to women of child bearing age
folic acid
iron education for pregnant pt
increase iron (ferrous sulfate)
pregnant teen education about nutrition
protein
carbs
calcium
iron
labs to draw at initial visit
cbc
blood type
rh status
hcg
rubella titre
hep b
VDRL/RPR
urine culture and screen
urinalysis
pap smear
GC
chlamydia
group b strep
why is rubella titre obtained
to see if pt is immunized or has hx of rubella
can u give rubella vaccine to preg pt
no
what do VDRL and RPR test for
syphyllis
what happens if baby catches group b strep
encephalitis
meningitis
brain issues
until what month will preg pt have monthly visits
7 th month
after 7th month how frequent will visits be
bi weekly
after 8th month how frequent will visits be
weekly until delivery
what is PIH
pregnancy induced hypertension
what are signs of PIH
faical/hand edema
what do alpha feto protein tests screen for
genetic problems
what happens if placenta is too low in womb
placenta previa
what should pt do before amniocentisis
empty bladder
when should oral GTT (glucose screen) be done
24-28 weeks
when should GBS (group B strep) be done
36 weeks
what is a normal fetal heart rate during a non stress test
110-160 bpm
accelerated fetal heart rates during non stress test are
short term rises of atleast 15 bpms for atleast 15 seconds must happen atleast 2x
what are the 2 possible non stress test results
non reactive
reactive
no fetal reaction or no short term rise in bpm is what result for non stress test
non reactive
how long is fetal hr monitored during non stress test
15 mins
how to stimulate contractions for contraction stress test
natural ocytocin nipple stimulation challenge
low dose of pitocin iv (oxytocin)
how many contraction should be monitored during contraction stress test? what happens after each contraction?
3 and HR slows down after each one
what is hr dropping at peak called and is it a good or bad thing (contraction stress test)
early deceleration and its good
what is hr dropping after peak called and is it a good or bad thing (contraction stress test)
late deceleration and its bad (insufficient nutrition supply from placenta)
is a negative contraction stress test good or bad
good (no late deceleration)
is a postive contraction stress test good or bad
bad (persistent late deceleration)
situations where rhogam will be given
pregnancy
eptopic pregnancy
abortion
miscarriage
amniocentisis
placental abruption
placenta previa risk factors
hx of c section
hx of placenta precia
multiple gestations
uterine abnormalities
advanced maternal age
s/s of plaenta previa
painless
bright red vag bleeding
soft non tender uterus/abdomen
how to diagnose placenta previa
ultrasound
interventions for placenta previa
peripad count
bed rest
vaginal rest
monitor for shock
monitor fetal hr
administer betamethasone (around 25 wks)
prepare for c section
what does l/s measure
amount of surfacant in lungs
normal l/s ratio
2:1
what does abnormal l/s ratio mean
lungs not mature enough
1 cause of abruptio placentae
HTN
2 or more BP readings over 140/90 indicates
gestational HTN
gestational HTN risk factors
smoking
cocaine
abdominal trauma
s/s of abrupio placentae
sharp sudden abdominal pain w or w/o bleeding
abdominal distention
board like abdomen
uerine contractions
shock
how to diagnose abruptio placentae
ultrasound
should u perform vaginal exam for abruptio placentae
no can cause more bleeding
abruptio placentae interventions
assess fhr and movement
prep for possible c section
type and screen
cbc
anticoagulants
iv access
name the insulin antagonists
human placental lactogen
progesterone
cortisool
prolactin
what do insulin antagonists cause
elevated blood glucose lvls and lipolysis
what causes gestational diabeted
inadequate insulin production and decreased sensitivity to available insulin causes elevated blood glucose
does gestational dm affect the size of the baby
yes can cause a bigger baby
gestational dm increases the risk of what after pregnancy
dm
what is macrosomia
larger than average fetus
weight to be considered macrosomial
9 lbs 4 oz or more
what is cephalopelvic disproportion
baby head too big to fit through pelvis
what are congenital anomalies
defects that u are born with (“born this way” lady gaga)
whatdoes delayed lung maturity cause
resp distress
too much insulin in mother and babys blood is that causes low surfacant in baby lungs is called
hyperinsulemia
when does hyperinsulemia start
towards end of pregnancy when mother uses insulin
oral hyperglycemic used for pregnant pts
glyburide
what does glyburide do?
decreases serum glucose lvls
what preg complication can cause frequent yeast infections in preg women
gestational dm
when would a oral flucose test be performed
24 weeks
HbA1C lvl higher than 10% indicates what
congenital anomalies
how is regular insulin given
through iv
what should you monitor when giving regular insulin
potassium lvls
gestational dm effects on fetus
-macrosomia
-congenital anomalies
-delayed lung maturity
-neonatal hypoglycemia after delivery
-neonatal hyperbilirubinemia
how to dx gestational htn
2 or more BP readings above 140/90 w or w/o proteinuria & edema
when does gestational htn usually appear
20 wks or later
gestational htn risk factors
-primigravida w age extremes (younger than 18 or older than 40)
-chronic medical conditions
-multiple fetuses
-family hx
-protein deficiency
facial/hand edema is a sign of what kind of preeclampsia
mild preeclampsia & eclampsia
generalized pitting edema is a sign of what kind of preeclampsia
severe preeclampsia & eclampsia
seizures are a sign of what kind of eclampsia
eclampsia
weight gain is a sign of what kind of preeclampsia
mild preeclampsia & eclampsia
+30 systolic BP reading from baseline is a sign of what kind of eclampsia
mild preeclampsia and eclampsia
HTN 160/100 or higher is a sign of what kind of eclampsia
severe preeclampsia and eclampsia
altered mental status is a sign of what kind of eclampsia
eclampsia
+15 diastolic over baseline BP reading is a sign of what kind of eclampsia
mild preeclampsia and eclampsia
increased proteinuria of 5g/24 hrs is a sign of what kind of eclampsia
severe eclampsia and eclampsia
HELLPS stands for
hemolysis of blood cells
elevated
liver enzyme
low
platelets
syndrome
HELLPS is a sign of what kind of eclampsia
eclampsia
what should you monitor in pt w/ HELLPS
deep tendon reflexes
proteinuria more than 1g/24hrs is a sign of what kind of eclampsia
mild preeclampsia and eclampsia
headache is a sign of what kind of eclampsia
sever eclampsia and eclampsia
visual disturbances is a sign of what kind of eclampsia
severe preeclampsia and eclampsia
low urine output is a sign of what kind of eclampsia
severe eclampsia and eclampsia
hyperreflexia is a sign of what kind of eclampsia
severe eclampsia and eclampsia
what kind of environment should eclampsia pt be plaed in
low stimuli environment
what to monitor in eclampsia pt
strict I&O
edema
deep tendon reflexes (DTR)
BP
vitals
baseline weights
what kind of protein diet should eclampsia pt follow
high protein
what kind of sodium diet should eclampsia pt follow
low sodium
how long should eclampsia pt be on seizure precautions
up to 72 hrs post delivery
what is the cure for eclampsia
delivering baby
what does magnesium sulfate (MgSO4) do?
lowers BP
anticonvulsant (reduces deep tendon reflexes)
antidote for magnesium sulfate
calcium gluconate
how does magnesium sulfate affect resp rate
lowers resp rate
how does magnesium sulfate affect heart rate
increases it
how does magnesium sulfate affect serum glucose
increases It
what should you monitor when giving magnesium sulfate to pt
BP
deep tendon reflexes
resp rate
heart rate
serum glucose
should you palpate abdomen when you notice abd distention
no
how much weight should an pt w underweight BMI gain
1 lb/week
a BMI of 18.5 indicates
underweight
a BMI of 26.5 indicates
overweight
how much weight should a pt w a BMI of 26.5 gain
15-25 lbs
a BMI of 30 and above indicates
obese
how much weight should a pt w a BMI of 30 gain
11-20 lbs
what does nageles rule find
estimated due date
what does folic acid supplements prevent
neural tube defects
what should be done w diaphragm (contraceptive) after birth
it should be refitted
how is magnesium sulfate given
iv or im
how much mg of calcium should pt take daily
1000
suggested zinc nutritional intake
12 mg/day
suggested folic acid intake during pregnancy
600 mg
suggested folic acid intake during lactation
500 mg
suggested iron daily intake in women over 19 y/o
9 mg/day
should you increase iron in pt who is breast feeding
no
product of protein breakdown is called
phenylalanine
phenylketonuria (PKU) dietary education
avoid protein rich foods
can a PKU pt eat beans?
no
can PKU pt eat cheese?
no
can PKU pt eat aspartame
no
how long can pt not ejaculate before semen analysis
2-5 days before test
can body temp be used to see if a woman is ovulating
yes
ambivalence is
having mixed feelings
what does alpha feto-protein test look fpr
predicts genitic defects
0-13 weeks is what trimester
1st trimester
27-40 weeks is what trimester
3rd trimester
14-26 weeks is what trimester
2nd trimester
