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XIO > maternity week 2 > Flashcards

maternity week 2 Flashcards

1
Q

morning sickness, heartburn, etc. cause

A

unknown, likely hormones

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2
Q

how many ppl plan to get pregnant?

A

about 50%

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3
Q

main issues w/ pregnancy (the usual)

A

HTN and diabetes

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4
Q

what is purpose of prenatal care?

A

Purpose of PNC: To reduce risks to pregnant person and fetus.
Routine assessments and screenings that increase in frequency.
Individualized counseling related to diagnoses and prenatal testing.
Patient education.
Individual vs. Group setting

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5
Q

CENTERING PREGNANCY® PRENATAL CARE

A

Evidence-based model
Group visits w/ pregnant people w/ similar EDD
Improves health outcomes/reduces disparities
Greatest impact for Black childbearing people
Often CNM led (best for Black community)

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6
Q

prenatal scheduled visits (one, a month to 28 days, 2 weeks to 36, then weekly)

A
  • First visit within the first trimester (12 weeks)
  • Monthly visits weeks 16 through 28
  • Every 2 weeks from weeks 29 to 36
  • Weekly or bi-weekly visits week 36 to birth
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7
Q

baby is viable at

A

24 weeks

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8
Q

if bleeding in the middle of the night before 24 weeks, go to

A

labor and delivery

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9
Q

midwife vs doctor

A

can have medication with both

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10
Q

first prenatal visit

A

Confirm pregnancy: Blood or urine pregnancy test
Determine Estimated Due Date (EDD - estimated due date), EDC, EDB - same thing)
Screening exams: blood tests, weight/BMI, urine dip, STI tests, full physical assessment/pelvic exam
Health Baseline: Baseline VS, reproductive history, medications, substance use, nutritional status, comorbidities (including age) (Ricci p. 370, Fig12.2, Health History Summary)
Comprehensive history taking: Family structure, psychosocial risk factors (Ricci p. 366, Fig. 12.1: Preconception screening tool)

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11
Q

urine

A

checking protein, glucose, specific gravity,

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12
Q

nagele’s rule

A

Last Menstrual Period (LMP)
Plus 7 days
Minus 3 Months
= Estimated Due date

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13
Q

stress test at when? (Stressed not quite at 28 weeks later)

A

24 weeks and above

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14
Q

at least 15 bmp

A

above the baseline for 15 min (stress test, look this up in the book)

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15
Q

BPP

A

NST, breathing movement, fetal tone, fetal movements

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16
Q

follow up visits

A

Weight tracking
Assessment physical and emotional well being
VS/BP
Urine checked for protein, glucose
Additional blood tests PRN
Education
Additional tests 2nd/3rd tri: GBS, Gestational Diabetes Screening
Rhogam (immunoglobulin) PRN
Planning for birth/preferences - usually 3rd trimester - pain management at birth, etc.
Genetic Testing

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17
Q

RH test**

A

COOMBs test - anytime the blood is mixed with RH - mom, will get a coombs test.

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18
Q

follow up visits - fetus

A

Fetal growth: fundal height
Fetal wellbeing subjective: FHR via U/S or doptones
Fetal wellbeing subjective: fetal movement (a “VS”) - (quickening) - fist baby 20 weeks, 2nd - 12 weeks
Genetic Screening exams/results

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19
Q

fundal height at what time

A

12-14 weeks (check this)

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20
Q

potential complications

A

Infection: All trimesters
Spontaneous Abortion (SAB)/Miscarriage: 1st
Hyperemesis: All trimesters
Pyelonephritis: All trimesters
IUFD: 2nd/3rd tri
Kidney Stones: All trimesters
Gestational Diabetes: 3rd tri (but could be
earlier)
PPROM: 2nd/3rd
Hypertensive disorders: All trimesters

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21
Q

pylonephritis main symptom

A

pain

22
Q

hypertension++ what is the number? (The normal number)

A

140/90

23
Q

Hypertensive Disorders of pregnancy - death++

A

Hypertensive Disorders of pregnancy 2nd leading cause of morbidity.

24
Q

3rd Trimester Testing:
Group B Strep++

A

Vaginal/Rectal Swab at 35-37 weeks
Considered GBS+ if urine contains GBS in first tri
Affects 50% of pregnant people
GBS normal vaginal flora
GBS+: ABX prophylaxis in labor

25
Q

rhogam - dose (rhogam costs $300)

A

300 mcg IM, deltoid

26
Q

interventions for morning sickness

A

Eat dry carbs in AM before getting up
Avoid empty stomach/eat small frequent meals
Avoid: strong smelling foods/fatty, fried foods
Ginger
Vit B6, & doxylamine (unisom), or Zofran may be prescribed
PNV to maintain adequate nutrition

27
Q

physical changes - Round ligament pain (my stomach is round)

A

abdominal pain. 2nd and 3rd trimester a lot of abdominal pain. (exercise and belt for patients)

28
Q

sexual changes***

A

no problem having sex during pregnancy.

29
Q

only time sex can be harmful is…

A

if pt has history of preterm labor.

30
Q

MMR and varicella -can you give during pregnancy?

A

given during pregnancy bc they are live vaccines.

31
Q

genetic screening

A

Screening test vs. Diagnostic Tests
Screening for neural tube defects, trisomy 21 and other chromosomal abnormalities.
Screening tests may be followed by diagnostic tests.
Individual counseling based on risk factors/beliefs/preferences to guide decision-making.

screening tests lower risk, diagnostic higher risk

32
Q

earliest test - Cell-free fetal DNA: 8-10 weeks

A

Blood draw from pregnant person
Detects fetal cells in maternal circ
High sensitivity to Tri 21 (99.9%)

33
Q

diagnostic - Amniocentesis

A

Amniocentesis:
15-20 wks gestation (may be done 11-14 w/ higher SAB risk.
Risk of SAB similar to CVS
Amniotic fluid anayzed for chromosomal abnormalities, infection, Rh sensitization
3rd tri: used to test for lung maturity

34
Q

diagnostic - Chorionic Villus Sampling (cronion is early, it’s genetics)

A

Chorionic Villus Sampling:
10-13 wks of gestation
Placenta specimen obtained trans-abd. or trans-vag.
Genetic material analyzed for common chromosomal abnormalities.
Does not detect neural tube defects.
Risks: damage to structures, 0.5-1.0% risk of miscarriage (SAB).

35
Q

Excessive intake - how big will the baby be? (The baby weighs 4000 tons)

A

baby over >4000 grams

36
Q

more at risk for malnutrition during pregnancy

A
  • Adolescence or less than 2 years post menarche
  • Frequent pregnancies: three within 2 years
  • Poor fetal outcome in a previous pregnancy
  • Poverty/food insecurity
  • Poor diet habits with resistance to change
  • Use of tobacco, alcohol, or substances
  • Weight at conception under or over normal weight
  • Problems with weight gain
  • Weight loss during pregnancy
37
Q

nutrtional risk during pregnancy - what weight gain is dangerous?

A

Weight gain of more than 3 kg (6.6 lb)/month after the first trimester
Weight gain of less than 1 kg (2.2 lb)/month after the first trimester
Multi-fetal pregnancy
Low hemoglobin and/or hematocrit values (biochemical measure
Diabetes
Chronic illness, including an eating disorder, that affects intake, absorption, or metabolism of nutrients

38
Q

nutritional assessment

A

Anthropometric: obtain baseline and serial weight/BMI
Obtain diet record
Review supplement intake
Formulate individualized plan of care based on objective/subjective data
Education on food choice/calorie intake: additional 300 kCal (2nd/3rd tri.)
Physical assessment: head to toe/signs of malnutrition?

39
Q

calcium - what nut has it?

A

Sources: dairy, almonds, canned fish, dried beans/lentils

40
Q

folic acids (black eyed peas on acid)

A

Leafy greens, black-eyed peas and other legumes, citrus, peanuts, liver
Deficiency: risk for NTD

41
Q

iron

A

Animal meats, leafy greens, eggs, tofu, tempeh, fortified foods (but whole foods are better)
Vit C aids absorption
Low iron=anemia

42
Q

folic acid*****

A

Necessary for RBC formation
 risk of NTD (neural tube defect)
People who may become pregnant should take supplement

43
Q

alcohol*****

A

No safe amount in pregnancy

44
Q

Artificial Sweeteners

A

Unknown effects: may be linked to higher birthweight/childhood obesity
No nutritional value

45
Q

mercury

A

May lead to pregnancy complications & childhood developmental delays
Limit fish to 2x/week & avoid fish higher in mercury

46
Q

Listeriosis

A

Unpasteurized & raw foods, deli meats, refrigerated smoked fish, deli salads, “old” food, poorly refrigerated
May pass through placenta
Risk of miscarriage, stillbirth, neonatal demise

47
Q

Psychological Adaptation to Pregnancy: Stages

A

(1st - 3rd trimester)

Ambivalence
Introversion
Acceptance

48
Q

Psychological Adaptation to Pregnancy: 2nd trimester

A

Establishing a relationship with the fetus
Fetal movement/fetus as separate being
Pregnancy/fetus main focus
Attention to own mother and others who are pregnant (more outward focus)

49
Q

Psychological Adaptation to Pregnancy: 1st Trimester

A

Introversion: Focus on self.
The baby isn’t real
Ambivalence: Examines what needs to be given up
Emotional lability
Change in body image.

50
Q

Psychological Adaptation to Pregnancy: 3rd Trimester

A

Tired of being pregnant
Prepares realistically for the birth and parenting
May be unconfident about parenting
Identifying with the mother/parent role
Reordering of relationships

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