Maternity/Infant Health (Exam Two) Flashcards

1
Q

List factors that place a pregnancy in the high-risk category.

A
  • Genetic disorders
  • Nutritional status
  • Substance abuse
  • Family history
  • Environmental hazards
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2
Q

List the categories of risk for pregnancy.

A
  • Biophysical
  • Psychosocial
  • Sociodemographic
  • Environmental
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3
Q

List risk factors that may cause intrauterine growth restriction in a pregnancy.

A
  • Poor nutrition
  • Multifetal pregnancy
  • Gestational hypertension
  • Smoking
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4
Q

What antepartum test is used to monitor the fetus in pregnancies that are complicated by conditions that may affect oxygenation?

A

Daily fetal movement count (DFMC)

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5
Q

The nurse knows the physician will require what if a mother experiences fewer than three kicks in one hour?

A

Nonstress test (NST)

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6
Q

Diagnostic ultrasonography provides the health care provider with what critical information?

A
  • Fetal activity
  • Gestational age
  • Fetal growth curves
  • Fetal anatomy
  • Placental anatomy
  • Fetal well-being
  • Visual assistance for more invasive testing
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7
Q

What diagnostic test could be performed to confirm a pregnancy or determine gestational age of the fetus?

A

Ultrasound examination

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8
Q

Transvaginal ultrasonography allows health care providers to evaluate what?

A

Pelvic anatomical features in greater detail

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9
Q

Intrauterine pregnancy may be diagnosed earlier using what diagnostic test?

A

Transvaginal ultrasonography

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10
Q

Doppler blood flow analysis is often associated with and used to confirm what fetal condition?

A

Intrauterine growth restriction (IUGR)

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11
Q

What diagnostic test allows the examiner to study the blood flow in the fetus and the placenta?

A

Doppler blood flow analysis

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12
Q

What is a biophysical profile?

A

Noninvasive dynamic assessment of a fetus based on acute and chronic markers of fetal disease

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13
Q

What fetal markers does a biophysical profile include?

HINT: Fetal vital signs

A
  • Amniotic fluid volume
  • Fetal breathing movement
  • Fetal movement
  • Fetal tone
  • Fetal heart rate
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14
Q

What biophysical profile result is considered normal?

A

8 to 10 with normal amniotic fluid volume

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15
Q

Which trimester(s) is biophysical profile used most frequently?

A

Second and third trimesters

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16
Q

Why is the biophysical profile used most commonly in the second and third trimesters?

A

Most reliable indicator of fetal well being

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17
Q

List the major uses of ultrasonography in the first trimester?

A
  • Confirm pregnancy
  • Confirm viability
  • Determine cause of vaginal bleeding
  • Detect maternal abnormalities
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18
Q

The nurse knows an amniocentesis can be performed on a woman during what time frame of pregnancy?

A

After week 14 of pregnancy

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19
Q

List indications for performing an amniocentesis.

A
  • Prenatal diagnosis of genetic disorders or congenital anomalies
  • Assessment of pulmonary maturity
  • Diagnosis of fetal hemolytic disorders
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20
Q

Assuming the amniotic fluid volume is adequate, what is the normal range for a biophysical profile score?

A

8 to 10

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21
Q

What is the most common reason for performing an amniocentesis?

A

Assess fetal lung maturity

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22
Q

During which trimester or weeks is the maternal serum alpha-fetoprotein (MSAFP) screening conducted?

A

From week 15 to week 20 of gestation

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23
Q

At what gestational week is Chorionic villus sampling usually performed?

A

10 weeks gestation

24
Q

What is the most widely used method for fetal blood sampling and transfusion?

A

Percutaneous umbilical blood sampling (PUBS)

25
Q

Describe the Coombs’ test.

A

Screening tool for Rh incompatibility

26
Q

If the maternal titer for Rh antibodies is greater than ______, then an amniocentesis is indicated.

A

1:8

27
Q

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.

A

Reactive (normal)

28
Q

The non-stress test is considered ___________ if the heart rate does not accelerate during fetal movement.

A

Nonreactive

29
Q

Describe a negative result for a nipple-stimulated contraction stress test.

A
  • Three contractions in a 10 minute time frame

- No decelerations are observed

30
Q

Describe a positive result for a nipple-stimulated contraction stress test.

A
  • Three contractions in a 10 minute time frame

- Presence of repetitive late decelerations

31
Q

____________ ________ are a major cause of perinatal morbidity and mortality worldwide due to the following.

A

Hypertensive disorders

32
Q

What is considered the most common medical complication of pregnancy?

A

Hypertension

33
Q

Hypertension present before pregnancy or diagnosed before week 20 of gestation is referred to as _________ _________.

A

Chronic hypertension

34
Q

T/F: Chronic hypertension may occur independently or simultaneously with preeclampsia.

A

True

35
Q

The onset of hypertension without proteinuria or other systemic findings diagnostic for preeclampsia after week 20 of pregnancy is indicative of what disorder?

A

Gestational hypertension

36
Q

What fetal complications are associated with maternal hypertension?

A
  • Intrauterine growth restriction (IUGR)

- Preterm birth

37
Q

Dipstick value of 3+ protein in the urine is indicative of what disorder and should be of great concern to the nurse?

A

Preeclampsia

38
Q

List other indicators for preeclampsia aside from proteinuria.

A
  • New-onset cerebral or visual disturbances
  • Thrombocytopenia
  • Elevated AST/ALT
  • New development of renal insufficiency
39
Q

Describe eclampsia.

A

Onset of seizure activity or coma in a woman with preeclampsia

40
Q

What type of precautions should be in place for a patient with preeclampsia and eclampsia?

A

Seizure precautions

41
Q

What is the highest priority for the nurse if a patient begins to have a seizure?

A
  • Stay with patient

- Call for help

42
Q

List risk factors for developing preeclampsia.

A
  • Age <19 or >40
  • African American decent
  • Multiples pregnancy
  • First pregnancy
  • History of preeclampsia
43
Q

Women with preeclampsia usually deliver __________.

A

Preterm

44
Q

Regarding the placenta, a patient with preeclampsia is at an increased risk for developing what?

A

Placental abruption

45
Q

List the signs and symptoms of placental abruption.

A
  • Bright red bleeding
  • Severe pain
  • Rigid abdomen
  • Increased contractions
46
Q

Describe HELLP syndrome.

A
  • Hemolysis
  • Elevated liver enzymes
  • Low platelet count
47
Q

List adverse prenatal outcomes associated with HELLP syndrome.

A
  • Placental abruption
  • Renal failure
  • Maternal and fetal death
48
Q

Describe hyperreflexia, or +3 brisk reflexes.

A
  • More brisk than expected

- Slightly hyperactive

49
Q

List signs and symptoms of magnesium toxicity.

A
  • Severe hypotension
  • Low respiratory rate
  • Absent reflexes
50
Q

If a patient is receiving a magnesium infusion and begin to develop signs and symptoms of toxicity, what should the nurse do first?

A

Stop the infusion!

51
Q

What medication(s) is commonly used to treat hypertension in severe preeclampsia?

A
  • Hydralazine

- Methyldopa

52
Q

List postpartum complications commonly associated with chronic hypertension.

A
  • Pulmonary edema
  • Renal failure
  • Heart failure
  • Encephalopathy
53
Q

A pregnancy that ends as a result of natural causes before 20 weeks gestation is referred to as what?

A
  • Miscarriage

- Spontaneous abortion

54
Q

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?

A

Threatened miscarriage

55
Q

When some products of conception remain inside of the uterus, and there is extended vaginal bleeding and pain, this is known as a what?

A

Incomplete miscarriage

56
Q

When a baby has died, but remains in the uterus, this is known as what?

A

Missed miscarriage

57
Q

How many miscarriages must occur in a row to be considered recurrent miscarriages?

A

3 or more