Maternity/Infant Health (Exam Two) Flashcards
List factors that place a pregnancy in the high-risk category.
- Genetic disorders
- Nutritional status
- Substance abuse
- Family history
- Environmental hazards
List the categories of risk for pregnancy.
- Biophysical
- Psychosocial
- Sociodemographic
- Environmental
List risk factors that may cause intrauterine growth restriction in a pregnancy.
- Poor nutrition
- Multifetal pregnancy
- Gestational hypertension
- Smoking
What antepartum test is used to monitor the fetus in pregnancies that are complicated by conditions that may affect oxygenation?
Daily fetal movement count (DFMC)
The nurse knows the physician will require what if a mother experiences fewer than three kicks in one hour?
Nonstress test (NST)
Diagnostic ultrasonography provides the health care provider with what critical information?
- Fetal activity
- Gestational age
- Fetal growth curves
- Fetal anatomy
- Placental anatomy
- Fetal well-being
- Visual assistance for more invasive testing
What diagnostic test could be performed to confirm a pregnancy or determine gestational age of the fetus?
Ultrasound examination
Transvaginal ultrasonography allows health care providers to evaluate what?
Pelvic anatomical features in greater detail
Intrauterine pregnancy may be diagnosed earlier using what diagnostic test?
Transvaginal ultrasonography
Doppler blood flow analysis is often associated with and used to confirm what fetal condition?
Intrauterine growth restriction (IUGR)
What diagnostic test allows the examiner to study the blood flow in the fetus and the placenta?
Doppler blood flow analysis
What is a biophysical profile?
Noninvasive dynamic assessment of a fetus based on acute and chronic markers of fetal disease
What fetal markers does a biophysical profile include?
HINT: Fetal vital signs
- Amniotic fluid volume
- Fetal breathing movement
- Fetal movement
- Fetal tone
- Fetal heart rate
What biophysical profile result is considered normal?
8 to 10 with normal amniotic fluid volume
Which trimester(s) is biophysical profile used most frequently?
Second and third trimesters
Why is the biophysical profile used most commonly in the second and third trimesters?
Most reliable indicator of fetal well being
List the major uses of ultrasonography in the first trimester?
- Confirm pregnancy
- Confirm viability
- Determine cause of vaginal bleeding
- Detect maternal abnormalities
The nurse knows an amniocentesis can be performed on a woman during what time frame of pregnancy?
After week 14 of pregnancy
List indications for performing an amniocentesis.
- Prenatal diagnosis of genetic disorders or congenital anomalies
- Assessment of pulmonary maturity
- Diagnosis of fetal hemolytic disorders
Assuming the amniotic fluid volume is adequate, what is the normal range for a biophysical profile score?
8 to 10
What is the most common reason for performing an amniocentesis?
Assess fetal lung maturity
During which trimester or weeks is the maternal serum alpha-fetoprotein (MSAFP) screening conducted?
From week 15 to week 20 of gestation
At what gestational week is Chorionic villus sampling usually performed?
10 weeks gestation
What is the most widely used method for fetal blood sampling and transfusion?
Percutaneous umbilical blood sampling (PUBS)
Describe the Coombs’ test.
Screening tool for Rh incompatibility
If the maternal titer for Rh antibodies is greater than ______, then an amniocentesis is indicated.
1:8
The non-stress test is considered ___________ when two or more fetal heart rate accelerations of at least 15 beats per minute occur in a 20-minute period.
Reactive (normal)
The non-stress test is considered ___________ if the heart rate does not accelerate during fetal movement.
Nonreactive
Describe a negative result for a nipple-stimulated contraction stress test.
- Three contractions in a 10 minute time frame
- No decelerations are observed
Describe a positive result for a nipple-stimulated contraction stress test.
- Three contractions in a 10 minute time frame
- Presence of repetitive late decelerations
____________ ________ are a major cause of perinatal morbidity and mortality worldwide due to the following.
Hypertensive disorders
What is considered the most common medical complication of pregnancy?
Hypertension
Hypertension present before pregnancy or diagnosed before week 20 of gestation is referred to as _________ _________.
Chronic hypertension
T/F: Chronic hypertension may occur independently or simultaneously with preeclampsia.
True
The onset of hypertension without proteinuria or other systemic findings diagnostic for preeclampsia after week 20 of pregnancy is indicative of what disorder?
Gestational hypertension
What fetal complications are associated with maternal hypertension?
- Intrauterine growth restriction (IUGR)
- Preterm birth
Dipstick value of 3+ protein in the urine is indicative of what disorder and should be of great concern to the nurse?
Preeclampsia
List other indicators for preeclampsia aside from proteinuria.
- New-onset cerebral or visual disturbances
- Thrombocytopenia
- Elevated AST/ALT
- New development of renal insufficiency
Describe eclampsia.
Onset of seizure activity or coma in a woman with preeclampsia
What type of precautions should be in place for a patient with preeclampsia and eclampsia?
Seizure precautions
What is the highest priority for the nurse if a patient begins to have a seizure?
- Stay with patient
- Call for help
List risk factors for developing preeclampsia.
- Age <19 or >40
- African American decent
- Multiples pregnancy
- First pregnancy
- History of preeclampsia
Women with preeclampsia usually deliver __________.
Preterm
Regarding the placenta, a patient with preeclampsia is at an increased risk for developing what?
Placental abruption
List the signs and symptoms of placental abruption.
- Bright red bleeding
- Severe pain
- Rigid abdomen
- Increased contractions
Describe HELLP syndrome.
- Hemolysis
- Elevated liver enzymes
- Low platelet count
List adverse prenatal outcomes associated with HELLP syndrome.
- Placental abruption
- Renal failure
- Maternal and fetal death
Describe hyperreflexia, or +3 brisk reflexes.
- More brisk than expected
- Slightly hyperactive
List signs and symptoms of magnesium toxicity.
- Severe hypotension
- Low respiratory rate
- Absent reflexes
If a patient is receiving a magnesium infusion and begin to develop signs and symptoms of toxicity, what should the nurse do first?
Stop the infusion!
What medication(s) is commonly used to treat hypertension in severe preeclampsia?
- Hydralazine
- Methyldopa
List postpartum complications commonly associated with chronic hypertension.
- Pulmonary edema
- Renal failure
- Heart failure
- Encephalopathy
A pregnancy that ends as a result of natural causes before 20 weeks gestation is referred to as what?
- Miscarriage
- Spontaneous abortion
If the body begins to show signs it may miscarry, the cervix remains closed, and is accompanied by pain and bleeding, this is referred to as what?
Threatened miscarriage
When some products of conception remain inside of the uterus, and there is extended vaginal bleeding and pain, this is known as a what?
Incomplete miscarriage
When a baby has died, but remains in the uterus, this is known as what?
Missed miscarriage
How many miscarriages must occur in a row to be considered recurrent miscarriages?
3 or more
