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NM 702 Prenatal Care > Module 5 > Flashcards

Module 5 Flashcards

1
Q

GI motility ________ during pregnancy

A

decreases

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2
Q

GI motility decreases during pregnancy due to high levels of __________ (hormone) in the system

A

progesterone

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3
Q

diaphoresis, pallor, SOB are all symptoms of _______________ in pregnancy

A

vena cava compression

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4
Q 
\_\_\_\_\_\_\_\_\_\_\_\_\_ in pregnancy results in these symptoms:
reflux/heartburn
bloated feeling
delayed emptying
nausea
constipation
flatulence
hemorrhoids
A

decreased GI motility

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5
Q

leg cramps are best relieved by:

A

dorsiflexion of the foot and stretching calf muscle

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6
Q

round ligament pain usually starts in the _________ trimester

A

late 1st/early 2nd

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7
Q

What causes normal heart palpitations in pregnancy?

A

increased blood volume

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8
Q

RBC mass _________ in pregnancy

A

increases

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9
Q

WBC count will _________ in pregnancy

A

increase

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10
Q

Hct will ___________ in pregnancy

A

decreases

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11
Q

Hgb will ___________ in pregnancy

A

decreases

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12
Q

plasma volume will ___________ in pregnancy

A

increases

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13
Q

serum ferritin will ____________ in pregnancy

A

decreases

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14
Q

HR _________ by about 10-20 bpm by week 32 of pregnancy

A

increases

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15
Q

BP __________ and reaches nadir at mid-pregnancy

A

decreases

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16
Q

cardiac output ___________ 30-50% with most of this happening by 8 weeks gestation

A

increases

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17
Q

a __________ murmur is usually heard during the 2nd and 3rd trimesters

A

systolic

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18
Q

mild dilation of kidney in pregnancy (hydronephrosis) is considered ___________ in pregnancy

A

normal

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19
Q

Due to the effects or progesterone, maternal vascular resistance ______________

A

decreases

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20
Q

a decrease in maternal vascular resistance, results in blood vessels ___________ and _____________

A

widening and relaxing

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21
Q

rapid increase in blood volume in pregnancy results in a ___________ venous return from the lower extremities, which can cause vasovagal episodes/fainting

A

slower

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22
Q

symptom related to increased blood volume and heart rate in pregnancy, hormones, increased sympathetic nervous system activity

A

heart palpitations/arrythmias

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23
Q

heart palpitations/arrythmias are most common during ______ weeks when hypervolemia peaks and stroke volume is highest.

A

28-32

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24
Q 
symptoms of \_\_\_\_\_\_\_\_\_\_\_\_:
“fluttering”
skipping a beat then “catching up”
“pressure” in neck
beating “fast”
A

heart palpitations/arrythmias

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25
Q

danger signs associated with heart palpitations/arrythmias

A

SOB, dizziness, or a history of heart problems

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26
Q

treatment of heart palpitations/arrythmias

A

explain normalcy, reassurance

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27
Q

Split first sound due to earlier valve closure and increased blood flow starts between ___-___ weeks

A

12-20

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28
Q

decrease in ____ is caused by lag in compensatory changes for decreased SVR, vasodilation, and hormonal factors

A

BP

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29
Q

this is caused by increased venous return and increased right ventricular output

A

increase in cardiac output

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30
Q

increases by about 25% when turned onto left side

A

Cardiac output

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31
Q

compression of ____________ results in decreased venous return, decreased stroke volume, and decreased cardiac output.

A

vena cava

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32
Q 
Relief measures for \_\_\_\_\_\_\_\_\_\_\_\_:
Elevation of the legs
lyingon the left side with feet elevated on a pillow
avoid standing for prolonged periods
avoid crossing legs when sitting down
walk or exercise daily
weight management
keep legs elevated while lying down
avoid tight knee-high socks or stockings
wearcompression hoses with pressure gradient
A

Varicosities

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33
Q 
Relief measures for \_\_\_\_\_\_\_\_\_\_\_\_\_:
well-ventilated environment
no prolonged standing
arise from bed slowly
walk in place while standing
adequate hydration
compression hoses
avoid overheating
A

dizziness/syncope

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34
Q

lung volume __________ in pregnancy which improves alveolar gas exchange

A

increases

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35
Q

reserve lung volume __________ in pregnancy

A

decreases

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36
Q

Minute ventilation _________ in pregnancy and changes start by 8 weeks gestation

A

increases

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37
Q

Pregnant women hyperventilate in pregnancy due to effects of ___________ on respiratory center

A

progesterone

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38
Q

Pregnant women are normally in a state of compensated respiratory ___________ due to effects of progesterone and increased minute volume

A

alkalosis

39
Q

PCO2 is _______than pre-pregnancy (starts in first trimester)

A

lower

40
Q

_________ affiliation of oxygen for hemoglobin causes more oxygen to be available for the fetus

A

Decreased

41
Q

The respiratory effects on acid-base balance in pregnancy are stimulated by the _________ in maternal pH

A

increase

42
Q

Caused by increased progesterone which increases sensitivity to CO2 and leads to hyperventilation in an attempt to maintain normal PO2 levels; increased respiratory drive and load, mechanical changes

A

Shortness of Breath

43
Q

Treatment for SOB

A

Explain normalcy
Reassurance;
Educate on positions to expand lung capacity (sleep sitting up, raising arms, etc.)

44
Q

dangers signs associated with SOB in pregnancy

A

tachypnea with respiratory rates > 20, coughing, chest pain, fever/chills, dizziness

45
Q

caused by increased capillary permeability, fall in colloid osmotic pressure, increased femoral venous pressure

A

edema

46
Q

edema effects ___% of pregnant women

A

75

47
Q

Treament for ______:
Ted hose (reduce venous pooling and increase SVR)
don’t reduce fluid intake
water immersion for 20 minutes chest-deep
exercise (walking)
elevate legs

A

Edema

48
Q

danger signs associated with edema

A

when accompanied by other signs and symptoms of preeclampsia in later pregnancy.

49
Q

Changes which causes increase in ____________:
Major change is dilation of renal pelvis and ureters
Kidneys become hypertrophic
Ureters enlarge and can become compressed which leads to hydronephrosis
Bladder tone decreases

A

urinary frequency

50
Q

Renal System Functional Changes that lead to increase in ______________:
hemodynamics changes
glomerular filtration changes
tubal handling changes of some substances

A

urinary frequency

51
Q

Urodynamic Changes that lead to increase in _____________:
Urine output increases
Flow time and time to maximal flow increases

A

urinary frequency

52
Q

GI changes in pregnancy result in part from effects of ________ hormone on the liver

A

estrogen

53
Q

Changes of the __________:
Decrease in lower sphincter tone and non-propulsive motor activity
Change in the esophageal-gastric angle as the diaphragm flattens

A

esophagus

54
Q 
Changes in the \_\_\_\_\_\_\_\_\_\_\_\_\_:
Decreased motility, hypotonic
Tendency toward less gastric acidity
Duodenal villi enlarge
Increased transit time in colon:
Constipation
Hemorrhoids
A

Stomach/Intestines

55
Q

Changes in the ____________:
Muscle tone and motility decrease
Gallstones
Pruritus

A

Gallbladder

56
Q

Changes in the _________:
Moves up and out toward both the front and back
Function is essentially unchanged

A

Liver

57
Q

onset of N/V in pregnancy

A

5-6 weeks

58
Q

peak of N/V in pregnancy

A

9-11 weeks

59
Q

___-___% of women have N/V into 3rd trimester

A

15-20

60
Q

____% of women have N/V until delivery

A

5

61
Q 
outcomes associated with \_\_\_\_\_\_\_\_\_:
Fewer birth defects
Larger placenta
Decreased miscarriage rate
Decreased preterm birth
Less low birth weight
Less stillbirth
A

N/V in pregnancy

62
Q

The higher the score of this test, the higher the likelihood of ER visits, hospitalizations, and the lower the quality of life.

A

Pregnancy Unique Quantification of Emesis (PUQE)

63
Q 
Objective Data for \_\_\_\_\_\_\_\_:
Urine Ketones
Skin Tone
Mucosa 
Weight
Labs (rarely)
A

N/V in pregnancy

64
Q 
Differential Diagnoses for \_\_\_\_\_\_\_\_\_\_\_:
Hyperemesis
Multiple gestation
Molar Pregnancy
HELLP
Pre-eclampsia
A

N/V in pregnancy

65
Q 
Medical Diagnoses for \_\_\_\_\_\_\_\_\_\_\_\_:
Bulimia
Anorexia
Pyelonephritis
Gallbladder Disease
Hepatitis
Appendicitis
Hyperthyroidism
Migraine
Tumor
A

N/V in pregnancy

66
Q

Incidence of Hyperemesis in pregnancy: ___-___%

A

0.3-2%

67
Q 
Criteria for Dx of \_\_\_\_\_\_\_\_\_\_\_\_:
Persistent N&V prior to 22 weeks gestation
Weight loss over 5% of body weight
Electrolyte imbalance
Dehydration and/or persistent ketonuria
A

Hyperemesis Gravidium

68
Q 
Adverse Effects of \_\_\_\_\_\_\_\_:
heartburn
belching
reflux
arrhythmia
headache
affects platelet aggregation
A

Ginger

69
Q

Safety Considerations for ___________:
Don’t combine with Dramamine (interaction unknown)
Don’t take with hypoglycemic drugs or insulin (could potentiate effects)
Don’t take with other meds that impair clotting (Garlic, Ginsing, Ginkgo biloba)
Use with caution in patients on anti-arrhythmic drugs or CNS depressants
Increases gastric acid, so don’t take with H2 blockers or proton pump inhibitors
May interact with other medications
Use with caution in patients taking Heparin, Coumadin, Aspirin

A

Ginger

70
Q

Standard dose of Ginger for N/V in pregnancy

A

1 gm/day

71
Q

Standard dose of B6 for N/V in pregnancy

A

up to 100 mg daily (25 mg TID or 50 mg BID)

72
Q

effective for N/V, use with caution in certain populations, available in many forms

A

ginger

73
Q

better than placebo, about same effectiveness as ginger, works best for nausea, not for vomiting

A

B6

74
Q

most studied N/V relief, effective, safe, can cause drowsiness, FDA approved for prescription form

A

B6 + Unisom (doxylamine)

75
Q

ligament laxity in pregnancy is caused by ___________ (hormone)

A

estrogen

76
Q

lower back pain in pregnancy is caused by __________ joint mobility

A

increased

77
Q

treatment for _____________:
350 mg. magnesium before bed (weak evidence)
adequate calcium in diet (not supplementation)
stretching before bed (placebo?)

A

leg cramps

78
Q 
treatment for \_\_\_\_\_\_\_\_\_\_:
listen
change sleep habits
reassurance
consultation for medication
A

restless leg syndrome

79
Q

etiology of carpal tunnel syndrome in pregnancy

A

increased fluid volume compressing median nerve

80
Q

symptoms of ____________:
numbness/tingling in thumb/index finger/middle fingers
wrist pain
loss of grip strength/dexterity

A

carpal tunnel syndrome

81
Q

lower back pain in pregnancy is contributed to ___________________ required to counterbalance the weight of the growing uterus

A

lumbar lordosis

82
Q

pelvic girdle pain can often be misdiagnosed as:

A

sciatica

83
Q

most headaches in pregnancy are __________ headaches

A

tension

84
Q

most women with history of migraines, have __________ frequency and severity of headaches in pregnancy

A

decreased

85
Q 
treatment for \_\_\_\_\_\_\_\_\_\_\_:
keep food diary for 24 hrs
exercise 30 min per day
acetominophen
massage
acupuncture
warm compress
relaxation exercises
increase rest
regular exercise 
avoid environmental triggers
avoid food triggers
A

headaches

86
Q 
danger signs of \_\_\_\_\_\_\_\_\_\_\_\_:
no relief w/ analgesia
new onset w/ neuro symptoms
sudden severe onset
increase in BP
proteinuria
papilledema (swelling of optic nerve)
A

headaches in pregnancy

87
Q

cause of increased ____________ in pregnancy:
increased blood flow through the skin
vasodilation resulting from effects of progesterone
increased basal metabolic rate

A

warmth/perspiration

88
Q 
treatment for \_\_\_\_\_\_\_\_\_\_\_\_:
wear light clothing
ensure adequate hydration
lower environmental temp 
bathe/shower as often as needed
A

warmth/perspiration

89
Q

cause of ______________ in pregnancy:
increased levels of estrogen and progesterone which enables the milk ducts and milk-producing cells to form in preparation for breastfeeding
increased blood flow in the breasts
extra layers of fat are added
existing cysts/galactoceles/fibroadenomas enlarge

A

breast tenderness

90
Q

bleeding gums is caused by the hormone:

A

estrogen

91
Q

low back pain in pregnancy is exacerbated by:

A

lax abdominal muscles

92
Q

___________ accompanying heart palpitations requires an office visit

A

dizziness

93
Q

dependent edema in pregnancy is associated with:

A

maternal obesity

94
Q

typical b6+unisom dose

A

25 mg B6 QID + 1/2 tab unisom

NM 702 Prenatal Care (8 decks)

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