Normal prenatal care, pregnancy, post-partum

Question 1

What do the following have in common: vomiting, vaginal discharge, bleeding or fatigue, breast tenderness

Answer 1

Early first trimester symptoms of pregnancy

Question 2

important part of first assessing a patient

Necessary to determine estimated date of confinement (EDC)

Answer 2

gestational age

Question 3

How do you determine estimated date of confinement using Naegele’s rule?

Answer 3

add 7 days to the LMP than subtract 3 months

Question 4

Method of determining due date using a transvaginal ultrasound at 3-4wks

Answer 4

crown rump length

Question 5

Optimal time to estimate gestational age using femur length or crown rump length

Answer 5

13-25 wks

Question 6

What is it critical to screen for during the first prenatal visit?

Answer 6

domestic violence

Question 7

Risks of multiple gestations (twins, triplets, ect)

Answer 7

preterm birth and intrauterine growth retardation

Question 8

A procedure to get fetal DNA for testing for Down’s and other abnormalities.

Answer 8

chorionic villous sampling

Question 9

Why should chorionic villous sampling be delayed until after 10 weeks of pregnancy?

Answer 9

increased risk of pregnancy loss

Question 10

Normal fetal heartrate

Answer 10

110-160 bpm

Question 11

What is checked in the urine specimen with each visit?

Answer 11

glucose and protein

Question 12

Why is a CBC ordered with first visit?

Answer 12

to detect anemia and screen for thalassemia

Question 13

Why must a pregnant woman be immunized for rubella and varicella post-partum?

Answer 13

it’s a live vaccine

Question 14

Why is the hepatitis B antigen test (HepBsAg) administered?

Answer 14

check for chronic infection (indicated if HepBsAg + only)

Question 15

Puts pregnant woman at higher risk for UTI/pyelonephritis. Associated w/ increased risk of preterm birth, low birth weight, and perinatal mortality

Answer 15

asymptomatic bacteriuria

Question 16

What is needed in order to initiate treatment of asymptomatic bacteriuria in a pregnant woman?

Answer 16

2 consecutive voided specimens w/ same bacterial strain or 1 cath specimen w/ 1 isolated bacterial species

Question 17

What antibiotic class should not be used to treat asymptomtatic bacteriuria in pregnant woman?

Answer 17

fluoroquinolones

Question 18

Why do you need to know a pregnant patient’s blood type?

Answer 18

in case they need a transfusion

Question 19

When do you draw another antibody screen in a Rh negative mother?

Answer 19

at 28 wks. If still negative give Rhogam

Question 20

What condition lowers maternal serum alpha fetal protein (MSAFP)?

Answer 20

Down’s

Question 21

What is the scheduling of prenatal visits?

Answer 21

every 4 wks until 28wks then every 2wks until 34-36 wks then every wk

Question 22

What do the following have in common: vaginal bleeding, cramping, fever, passing clots or tissue, dizziness, fainting or abdominal pain

Answer 22

warning signs if occur during pregnancy

Question 23

Associated with neural tube defects if exposure during first trimester

Answer 23

hot tubs and saunas

Question 24

Can cause sharp groin pain as uterus grows

Answer 24

round ligament. reassure patient

Question 25

When is bleeding during pregnancy termed a threatened abortion?

Answer 25

before the 20th week (25-50% result in loss of pregnancy)

Question 26

Rate of uterine growth after 20wks gestation

Answer 26

1cm per week

Question 27

When does the mother usually feel baby move (quickening)?

Answer 27

18-20 weeks

Question 28

Included in 2nd trimester education

Answer 28

signs and symtpoms of preterm labor

Question 29

Abnormal results from glucose challenge test at 28 weeks

Answer 29

> 130

Question 30

Name of maneuvers used to determine position of the fetus

Answer 30

Leopold

Question 31

Recommended universal screening at 35-37 weeks gestation. If positive, treated with PCN

Answer 31

Group B streptococcus

Question 32

contractions without a change in cervical dilatation or effacement

Answer 32

Braxton Hicks contractions (false labor)

Question 33

Used to evaluate well-being of the fetus if woman presents with decreased fetal mov’t and fetal heart tones

Answer 33

nonstress test

Question 34

After 18 weeks, what position should a woman always lay in to avoid compression of IVC

Answer 34

lateral decubitus

Question 35

Is the following normal or abnormal for a nonstress test: the FHR accelerates AFTER movement for at least 3 episodes and there are no concerning decreased in heart rate

Answer 35

normal