OB Flashcards
Lifespan of ovum and sperm
ovum = 24 hours sperm = 72 hours
progesterone
a thermogenic hormone that raises the temperature, an objective sign that ovulation has occurred
psychosocial changes of pregnancy
1st trimester
2nd trimester
ambivalence is normal in 1st but not in second.
when does menstruation occur
14 days after ovulation
verifying pregnancy
- what hormone
- how long until this hormone is elevated
- what meds can cause a false-positive/false-negative
- human chorionic gonadotropin (hCG)
- 6-11 days in serum and 26 days in urine
- Anticonvulsants, diuretics, tranquilizers
what is Nageles rule
used to estimate date of birth. Subtract 3 months and add 7 days to first day of last menstrual period
Non-stress test
- what is it
- normal finding
- abnormal
- positioning the client
- intervention if no accelerations
- noninvasive way of monitoring response of FHR to fetal movement
- a normal finding is 2 or more accelerations (increase in FHR of atleast 15 that lasts 15 seconds) within a 20 minute period
- does not do above. Indication of Contraction stress test (CST) or biophysical profile (BPP)
- semi fowlers or left lateral
- give a snack
Contraction stress test
- methods
- indications
- normal finding
- abnormal finding
- nipple stimulation or oxytocin IV
- non reactive NST
- negative = 3 contractions over 10 mins with no decelerations
- a positive CST = late decelerations occur with 50% of contractions is suggestive of uteroplacental insufficiency
Biophysical profile
- what is it
- normal vs abnormal
- uses ultrasound to visualize physiological characteristics of fetus. A score of 0 or 2 is given for each category
- (a)breathing: 1 episode of 30 seconds in 30 mins
(b) gross body movements-atleast 3 body or limb extensions with return to flexion in 30 mins
(c) fetal tone: atleast 1 episode of extension with return to flexion
(d) reactive NST
(e) amniotic fluid volume:atleast 1 pocket of fluid greater then or equal to 2 cm or more then 5 cm total
Amniocentesis
- what can it do
- when is it done
- why would it be done in late pregnancy
- detects presence of AChe in neural tube defects and can identify genetic diseases (trisomy 21, 18, 13)
- performed at 14-16 weeks
- assess fetal lung maturity LLS ratio of 2:1 indicates fetal lung maturity
Rho(d) immune globulin (Rhogam).
give to Rh-negative mothers. Must be an RN b/c its a blood product
Percutaneous umbilical blood sampling (PUBS)
1.what does it do
directly access fetal circulation and can be used for fetal blood sampling -> transfusion
Chorionic villi sampling
- what is it
- whats it for
- when is it done
- obtaining a sample of chorionic villi tissue (placental)
- assess for fetal genetic abnormalities
- first trimester
Maternal serum alpha fetoprotein screen (MSAFP)
- what is it for
- when should it be performed
- what do low levels indicate
- what do high levels indicate
- screening tool for neural tube defects (NTD)
- 16-18 weeks
- down syndrome
- neural tube defect
normal fetal assessments
HR
normal kick count
FHR =110-160
10 kicks/2 hr (most active after meals and in the evening)