Module 5 Unit A

Question 1

Given normal pregnancy physiology, what should the clinician expect for blood pressures in the third trimester.

Answer 1

Should increase to prepregnant level at around 32 weeks gestation

Question 2

How does maternal position affect blood pressure in the third trimester?

Answer 2

Lying on the left side: blood pressure can be lower by as much as 10 mmHG systolic and 15 mmHg diastolic.

Heavy pregnant uterus presses on the vena cava when a person is lying on their back: can result in supine hypotensive syndrome/dizziness/tachycardia/nausea

Gravid uterus can interfere with venous return from the lower extremities: causing edema

Question 3

What method should the clinician use to assess weight gain in the third trimester

Answer 3

• Check pre pregnancy BMI and determine if it was underweight, normal weight, overweight, or obese.

-Check amt of weight gained in first trimester and compare it to the recommended amount form the BMI category

Check the total weight gain (current weight-prepregnant weight), to gauge whether the person is on track given the current gestational age for the BMI category.

Check the amount gained since last visit to gauge whether the person is on track with the recommended 3rd trimester lbs/week for the BMI category

Question 4

WHich STI screening tests are repeated in the third trimester and in which patients

Answer 4

HIV: if at high risk for acquiring HIV infection

Syphilis: rescreen if at high risk for syphilis, those who live in areas with high numbers of syphilis cases, and/or who were not previously tested, or had a positive test in the first trimester

Gonorrhea: rescreen if at continue high risk

Chlamydia: rescreen if < 25 years of age or at continued high risk

Hepatitis B (HBV): test those who were not screened prenatally, those who engage in behaviors that put them at high risk for infection, and those with signs or symptoms of hepatitis at the time of admission to the hospital for delivery.
Risk factors: having had more than one sex partner in the previous six months, evaluation or treatment for an STD, recent or current injection-drug use, an HBsAg- positive sex partner

Question 5

Who should be screened for GBS with a vaginal/rectal swab in late pregnancy and what is the acceptable gestational age range for screening

Answer 5

All pregnant individuals should be screened with a vaginal/rectal swab for GBS at

36 0/7 - 37 6/7v weeks gestation

Question 6

Who should NOT be screened for GBS with a vaginal/rectal swab in late pregnancy