Module 5 BBB Third Trimester

Question 1

Why would may a rh- patient need RhoGAM during pregnancy?

Answer 1

-Routine administration at 26-28 weeks
-Abdominal trauma (car accident, abuse)
-Amniocentesis
-Vaginal bleeding
-threatened pregnancy loss

Question 2

Why do we give RhoGAM?

Answer 2

To protect a future pregnancy, it prevents the production of antibodies forming against rh+ fetal blood.

Question 3

You patient at 28 weeks has an H/H of 11.2/33.0. Her new OB labs showed 12.6/33.2. What is your assessment of the change?

Answer 3

This is an expected drop

Question 4

Your patient is 30 weeks pregnant and O-. What documentation is an expected finding on her chart?

Answer 4

That she received RhoGAM at or since her lat visit

Question 5

Your patient had GBS in her urine during her initial OB labs. What is the POC?

Answer 5

She will receive GBS prophylaxis during labor

Question 6

If a patient passes an early 1-h GTT, what does that negative screen indicate?

Answer 6

They likely did not have DM II at the beginning of their pregnancy

Question 7

When does BP rise to prepregnancy levels?

Answer 7

32 weeks

Question 8

What is the total pregnancy weight gain recommendation for BMI 30.3?

Answer 8

11-20lb

Question 9

Should we be concerned about urinary trace protein in third trimester?

Answer 9

No

Question 10

T/F: A strong evidence base indicates daily fetal movement counting during the third trimester reduces perinatal mortality

Answer 10

False

Question 11

Your 30-week patient states, “I feel the baby moving, but I don’t feel it every day.” Is this normal?

Answer 11

No-by 28 weeks they should feel movement every day

Question 12

Where can you usually best auscultate the FHR?

Answer 12

the fetal back

Question 13

What is the generally accepted normal FHT range in third trimester?

Answer 13

110-160

Question 14

How can a patient relieve leg cramps?

Answer 14

Dorsiflexion of the foot and stretching in the calf muscle

Question 15

What patients should be re-screened for STIs in third trimester?

Answer 15

Those at high risk

Question 16

Which BPP component is so important that an abnormality in that component requires consultation with an OB colleague, no matter how the other elements are scored?

Answer 16

AFI/AFV

Question 17

Your 38 week patient had a fundal height of 35 cm and an AFI of 4.1. How would we assess and manage this patient?

Answer 17

The AFI is low and needs immediate follow up

Question 18

What is the normal AFI range?

Answer 18

5-25

Question 19

A patient at 35 weeks calls concerned about babies movement. In spite of paying close attention to all the baby’s large and small movements, they feel a decrease in the number of movements, compared with the usual pattern. How should we respond?

Answer 19

This is NOT expected, and they should come in for an NST

Question 20

How do we properly collect a GBS swab?

Answer 20

Insert several cm into the vagina and then into the rectum

Question 21

How accurate are self-collected GBS tests?

Answer 21

The same as provider collected

Question 22

During an NST, the FHR is 150s with one FHR acceleration. What is the appropriate response?

Answer 22

Continue for NST 20 minutes

Question 23

During an NST, the FHR is 150s with one FHR acceleration. You continue for 20 minutes and again get one acceleration. How is this documented and what is the next step?

Answer 23

Non-reactive->BPP

Question 24

Which element in urine is associated with UTI?

Answer 24

Nitrites