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NM 702 Prenatal Care > Module 2 > Flashcards

Module 2 Flashcards

1
Q

GTPALM

A 
G= # of pregnancies
T= # of births @ term
P= # of births pre-term (20.0-36.6 wks)
A= # of abortions/miscarriages/ectopics (prior to 20 wks)
L= # of children currently living
M= # of births resulting in multiples (twins, triplets, etc.)
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2
Q

uterus fruit size @ 6 weeks

A

small orange

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3
Q

uterus fruit size @ 8 weeks

A

large/navel orange

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4
Q

uterus fruit size @ 10 weeks

A

grapefruit

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5
Q

uterus fruit size @ 12 weeks

A

cantaloupe

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6
Q

confounding variables to palpating the uterus in the 1st trimester

A

 Uterine position
 Bladder status
 Maternal habitus

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7
Q

anatomical location of uterus @ 12 weeks

A

@ the symphysis publis

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8
Q

anatomical location of uterus @ 14 weeks

A

2-3 fingerbreadths above the symphysis publis

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9
Q

anatomical location of uterus @ 16 weeks

A

½ way between symphysis pubis and umbilicus

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10
Q

anatomical location of uterus @ 20 weeks

A

@ the Umbilicus

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11
Q

fetal movements felt by almost all pregnant women at this gestation

A

20 weeks

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12
Q

Process of protecting infants too young to be vaccinated by vaccinating all those in contact with the infant.

A

cocooning

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13
Q

vaccine given @ 27-36 weeks for every pregnancy to build up baby’s antibodies to help prevent pertussis (whooping cough)
 Passive antibody transfer

A

Tdap

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14
Q

cannot give ______ vaccines in pregnancy

A

live

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15
Q

S.H.A.R.E acronym for vaccine education in pregnancy

A

o Share the reason why vaccine is recommended
o Highlight positive personal experiences with vaccination
o Address the woman’s questions and concerns
o Remind that vaccine-preventable diseases still exist
o Explain potential costs of getting disease

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16
Q

Risk Factors for ___________:

Preterm birth, underweight, smaller lungs, sick more often, increased risk of SIDS

A

Smoking in pregnancy

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17
Q

5 A’s of smoking cessation education

A 
	Ask
	Advice
	Assess
	Assist
	Arrange
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18
Q

5 R’s of smoking cessation education

A 
	Relevance
	Risks
	Rewards
	Roadblocks
	Repetition
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19
Q

o Tolerance: How many drinks does it take to make you feel high?
o Annoyed: Have people annoyed you by criticizing your drinking?
o Cut Down: Have you ever felt that you should cut down on your drinking?
o Eye Opener: Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?

A

T-ACE Tool to evaluate alcohol use in pregnancy

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20
Q

Another way to discuss substance use in pregnancy

A

The AUDIT Tool

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21
Q

Non-Pharm Remedies for _________:

Acupuncture, acupressure, ginger root (250mg capsules QID), vitamin B6 (pyridoxine, 25mg 2-3 times a day)

A

Nausea

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22
Q

interferes with organogenesis during the embryonic period – birth defects (cleft palate, cardiac anomaly, facial abnormality, or dysmorphic effect)

A

teratogenesis

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23
Q

1st discovered teratogen

A

rubella (viral)

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24
Q 
Mechanisms of most \_\_\_\_\_\_\_:
o	Folate antagonism
o	Neural crest cell disruption 
o	Endocrine disruption of sex hormones
o	Oxidative stress
o	Vascular disruption
o	Specific receptor- or enzyme-mediated reactions
A

teratogens

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25
Q

exerts effects on growth or fetal development in 2nd or 3rd trimester (i.e. fetal growth restriction)
• Example: Tetracycline
• Can also be teratogens

A

fetotoxicity

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26
Q

Background risk of congenital anomalies secondary to unknown causes

A

~3-4% of all births

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27
Q

Drugs & chemicals account for ~__% of all identified birth defects

A

1%

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28
Q

period b/t fertilization and implantation

• “all or none” effect

A

Pre-embryonic

29
Q

period b/t implantation & 9 post-conception weeks

• Period of greatest concern for exposure to pharmaceuticals

A

Embryonic

30
Q

period after 10 post-conception weeks

• Time when fetus is most susceptible to growth restriction & developmental or behavioral abnormalities

A

Fetal Period

31
Q

like other rare adverse drug effects, these are a post hoc phenomenon

A

teratogens

32
Q

higher doses of _________ are needed for pregnant women

A

antibiotics and other hydrophilic drugs

33
Q 
absorption of:
inhaled drugs
intramuscular drugs
transcutaneous lipphilic and hydrophilic drugs
are all \_\_\_\_\_\_\_\_\_\_\_ during pregnancy
A

increased

34
Q

__________ of absorption occurs in pregnancy due to calcium and iron in PNV

A

inactivation

35
Q

there is a potential need to increase dose of hydrophilic drugs in pregnancy due to:

A

dilutional effect of plasma volume increase

36
Q

increased incidence of free drugs if highly protein bound (highly protein bound drugs will have more pharmacologic activity) in pregnancy due to:

A

plasma albumin concentrations decrease

37
Q

-tripling of half-life of caffeine
-increased half-life of other agents such as sertraline (Zoloft)
in pregnancy due to:

A

CYP450 enzyme activity changes because of increased estrogen and progesterone levels

38
Q

decreased effect of renal drugs because of rapid clearance in pregnancy is due to:

A

GFR increases throughout pregnancy by 50% at term

39
Q 
Increased caloric intake for a singleton pregnancy and normal BMI
o	Standard increase: \_\_\_\_ kcal/day
o	1st trimester: \_\_\_\_\_ kcal/day
o	2nd trimester: \_\_\_\_ kcal/day more
o	3rd trimester: \_\_\_\_\_ kcal/day
A

o Standard increase: 300 kcal/day
o 1st trimester: NONE kcal/day
o 2nd trimester: 340 kcal/day more
o 3rd trimester: 450 kcal/day

40
Q

Increase water intake in pregnancy because:

A

increase in blood volume
increase inamniotic fluid production
increase in BMR
**Prevents UTIs and constipation

41
Q

This forms structural basis for new cells and tissues in mother and fetus
o RDA = 71g/day

A

Protein

42
Q

Carbohydrates RDA in pregnancy =

A

175 g/day

43
Q

__________ women are more likely to be lactose intolerant than America women of northern European descent

A

African American
Hispanic American
American Indian

44
Q

o Can decrease childhood asthma

o Essential for brain & eye development & neurodevelopment

A

Fatty acids

45
Q

o Important for structure, growth, and development of fetal central nervous system and retina
o Forms a major part of fetal neural tissue that maintain optima neurotransmitter function
o Maternal benefits
 Decreases risk of PTB, LBW, preeclampsia
o Infant/child benefits
 Increased IQ, fine motor, social development, decreased asthma, increased visual acuity

A

DHA and EPA

46
Q

RDA of DHA and EPA =

A

500-600 mg daily

47
Q

Be wary of ________ supplements though to obtain DHA because of high levels of vitamin A

A

cod liver

48
Q

Sources of DHA and EPA

A

Cold water fish & breastmilk

49
Q

pregnanc women should eat ___ fish meals per week

A

2

50
Q

Caffeine intake should not exceed _____ mg/day

A

200

51
Q 
What to check in \_\_\_\_\_\_\_\_\_ assessment:
o	Weight & BMI
o	Skin
o	Hair
o	Nails
o	Thyroid
o	Heart
o	Mucosa
o	Assess for nutritional risk factors based on assessment
A

Nutritional

52
Q 
Subjective Date for \_\_\_\_\_\_ Assessment
o	Diet recall
o	Hominy days eat fast food
o	Food purchase/storage ability
o	Cultural/religious/ethnic food preferences
o	Food intolerances (likes/dislikes)
o	Supplements & meds
o	Substance abuse
o	Activity levels
o	Who cooks/does food shopping
A

Nutritional

53
Q 
\_\_\_ Trimester Dietary Counseling Considerations:
o	Protein
o	Folic acid
o	Vitamin B12
o	Zinc
A

1st

54
Q 
\_\_\_ Trimester Dietary Counseling Considerations:
o	Protein
o	Iron
o	Calcium
o	Magnesium
o	B vitamins
o	Omega-3 (DHA)
A

2nd & 3rd

55
Q

Maternal ______ intake needs to double in pregnancy

A

iron

56
Q

Need for additional _____ begins in 2nd trimester

A

iron

57
Q

Iron RDA= ______ mg of daily

A

27-30

58
Q

Vitamin ___ helps increase absorption of non-heme iron

A

C

59
Q

If low iron, evaluate response to iron supplementation in ____ weeks

A

2-4 weeks

60
Q

Sources of Vitamin A:
_______ can be teratogenic
vs
________ should not lead to toxicity

A

Retinols (can be teratogenic)

beta-carotenes/plant sources (should not lead to toxicity)

61
Q

RDA = _____ IU/day (not to exceed ______ IU) for pregnant/lactating women 14-50 years old

A

600 (4000 IU)

62
Q

Associated with a decrease in maternal hypertension and preterm birth when administered alone

A

Vitamin D

63
Q

Vitamin D with added Calcium increases risk of:

A

preterm birth

64
Q 
\_\_\_\_\_\_\_\_ is important for:
	Bone health
	Glucose regulation
	Immune function
	Good uterine contractility in labor
A

Vitamin D

65
Q

Calcium RDA = _____ mg/day for pregnant/lactating women aged 19-50
Calcium RDA = _____ mg/day for pregnant/lactating women aged 14-18

A

1,000 (not to exceed 2500)

1,300 (not to exceed 3000)

66
Q

o Associated with lower risk for neural tube defects

o Take as soon as start trying to conceive

A

Folic Acid

67
Q

Folic Acid RDA= _____ mcg (_____ mcg if history of neural tube defects)

A

400 mcg (4000 mcg)

68
Q

In pregnancy: at least _____ minutes of moderate-intensity physical activity most or all days of the week (_____ minutes/week)

A

20-30 (150 min/week)

NM 702 Prenatal Care (8 decks)

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