Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

NP > OB and Pregnancy > Flashcards

OB and Pregnancy Flashcards

1
Q

Fetal heart tones can be detected by:

A

10 - 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

When is the fundus at the symphysis pubis?

A

12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Where is the fundus at 20 weeks?

A

at the umbilicus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are Leopold maneuvers? when are they possible?

A

systematic palpation to determine fetal positioning possible after 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

During which trimester is fetal movement typically felt?

A

second trimester

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is lightening and when does it typically occur?

A

lightening is when the baby settles lower into the pelvis usually 2-4 weeks before labor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What weeks are the second trimester?

A

14 to 26 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are two indications for amniocentesis?

A

family history of chromosomal abnormalities

advanced maternal age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

When is amniocentesis typically performed?

A

15 - 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

When is triple or quad screen (aka multiple marker test) performed?

A

15 - 20 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What tests are included with triple or quad screens?

A

hCG

estriol

alpha-fetoprotein

inhibin-A

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What types of disorders are the triple/quad screen looking for?

A

chromosomal abnormalies and neural tube defects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When is the ORAL GLUCOSE TOLERANCE TEST typically performed? When might it be performed early?

A

28 weeks (which is early in the 3rd trimester)

can be done at 20 weeks if family history of diabetes or in obese mother ( > 200 pounds)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

When is RhoGAM given?

A

28 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

When is hgb/hct measured?

A

28-36 weeks depending on previous levels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When is an elevated alpha-fetoprotein NOT a concern?

A

In multiple births, an elevated value is expected.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What weeks are the every-two-week visits?

A

28 to 36 weeks

prior the visits are every 4 weeks

after the visits are every week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

How is the due date calculated?

A

Naegele’s rule LMP - 3 months + 7 days =

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Typical bleeding in ectopic pregnancy?

A

dark brown to tarry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What named SIGN may be found in ectopic pregnancy?

A

Hegar’s sign softening of cervico-uterine junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What four diagnostic tests are performed by the NP in ectopic pregnancy and what is the motivation?

A

hCG

CBC

blood type

Ultrasound

Preparing for surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where do 95% of ectopic pregnancies occur?

A

the fallopian tubes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Approximately what percentage of pregnancies will result in spontaneous abortion (miscarriage)?

A

15%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the cause of the majority of losses in the first trimester?

A

random chromosomal abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What are some causes of fetal loss in the second trimester? (3)

A

o infection

o cervical incompetence

o uterine abnormalities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Fetal age of viability

A

24 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Medications used for medical abortion

A

o mifepristone (blocks progesterone)

AND

o misoprostol (prostaglandin that relaxes uterus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is another use for misoprostol?

A

it is used to prevent NSAID related ulcers (it is a prostaglandin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the definition of PREGNANCY INDUCED HYPERTENSION?

A

BP > 140/90

OR systolic rise > 30 mm/Hg or diastolic rise > 15 mm/Hg

at least 2 readings, a minimum of 6 hours apart

30
Q

What are the five risk factors for PREGNANCY INDUCED HYPERTENSION?

A

o youngest and oldest moms

o newest and most experienced moms (1st, 5th+)

o personal or family history of PIH, HTN, renal, CV

o diabetes

o autoimmune (like lupus)

31
Q

How is a patient with PIH monitored for progression to HELLP syndrome?

A

Liver Function Tests

32
Q

How is a patient with PIH monitored for progression to pre-eclampsia?

A

24 urine for protein

33
Q

Why might an ultrasound be done on a patient with PIH?

A

to monitor for lag in fetal growth as a result of PIH

34
Q

If rest at home is unsuccessful in patient with PIH, and condition worsens, what bedrest position will be used?

A

left lateral recumbent

35
Q

What is a common initial sign of PRE-ECLAMPSIA?

A

sudden weight gain - can’t get rings OFF or shoes ON

36
Q

Define PRE-ECLAMPSIA

A

PIH + PROTEINURIA + generalized EDEMA after 20 weeks gestation

37
Q

Parameters for weight gain in PRE-ECLAMPSIA

A

greater than 2 lbs / wk or 6 lbs / mo

38
Q

What effect does pre-eclampsia have on DTRs and what is the significance?

A

WNL progressing to 3-4+ this indicates a pre-seizure state (which would signal progression to eclampsia)

39
Q

What are four means of monitoring the health of the baby in PRE-ECLAMPSIA?

A
  • weekly non-stress tests
  • biophysical profile
  • kick counts
  • ultrasound - fetal growth and placental condition
40
Q

What may be given to stimulate lung maturity as maternal condition worsens? Up to what gestational age? How many doses?

A

B-methasone x 2 doses given to those under 34 weeks gestation

41
Q

Define ECLAMPSIA

A

PIH + Pre-eclampsia + SEIZURE

42
Q

What three prodromal symptoms may occur before seizure in ECLAMPSIA?

A
  • severe, unrelenting headache
  • vision changes
  • worsening RUQ or epigastric pain
43
Q

What is the usual blood pressure in ECLAMPSIA?

A

consistently 160/90 (stage 2 HTN)

44
Q

What is the anticipated testing for eclampsia?

systems of concern? (3)

specific tests (6)

A

Examination of liver, coagulation, and kidney status:

  • CBC
  • LFTs with full chem profile
  • coagulation profile
  • 24 hour urine for protein
  • creatinine clearance
  • uric acid
45
Q

What is used to “break” a seizure in a paitent with eclampsia?

A

Magnesium sulfate

second line: valium

46
Q

What does HELLP stand for?

A

H EL LP

Hemolysis,

Elevated

Liver enzymes &

Low

Platelets

47
Q

What does a person with HELLP sydrome look like?

A

“a person with liver failure that might bleed.. and that’s exactly what they are.”

  • Barkley
48
Q

Signs and symptoms of HELLP (4)

A

nausea, maybe vomiting

jaundice

extreme fatigue

ill-feeling

49
Q

What are typical LFTs in HELLP?

A

very elevated

normal AST and ALT = 35 - 40

in HELLP, will be in the 100s

50
Q

Which is PAINFUL -

previa or abruption?

A

Abruption is painFUL

Previa is painLESS

51
Q

When does previa often occur?

A

Late second, early third trimester

Often after intercourse

52
Q

Increased incidence of previa is seen in patients with one or more of these three very uterine-focused factors:

A
  • previous C section or previa
  • multiparity
  • malpresentation (breech or transverse)
53
Q

How great is the risk to the fetus in placenta previa?

A

often little risk

except if bleeding is severe

or other cause of distress exists

54
Q

What diagnostic and monitoring tools are used for placenta previa?

A
  • ultrasound
  • external fetal monitor
  • CBC if bleeding is continuous or severe
55
Q

What is the vaginal management of placenta previa?

A

Vaginal rest

NO bimanual exam

Speculum only to determine extent of bleeding

56
Q

Is hospitalization expected when bleeding from placenta previa?

A

yes

57
Q

How is the health of the fetus monitored during bleeding with placenta previa?

A

non-stress test

biophysical profile

58
Q

When does placental abruption usually occur?

A

second or third trimester

59
Q

Is abruption an obstetrical emergency?

A

YES

risks both to mother and fetus

including the risk of death

60
Q

What syndrome might uncontrolled hemorrhage

caused by abruption result in?

A

disseminated intravascular coagulation (DIC)

61
Q

What are four contributing factors to abruption?

think of the abruption picture

A
  • trauma
  • hypertension
  • cocaine, alcohol, cigarette use
  • uterine tumor or structural abnormality

(think crack head with uterine tumor who gets hit in the belly…and already had HTN…how could she not have an abruption??)

62
Q

Is placental abruption painful?

A

yes, very

63
Q

Is heavy, bright red bleeding always

apparent in placental abruption?

A

No, if it is concealed there may be

minimal to moderate bleeding

but then the uterus will be rigid

64
Q

Is there usually fetal compromise

associated with abruption?

A

very much so

fetal heart tones may be absent

fetal death is very likely unless mom was already hospitalized at the time

65
Q

Can an abruption be diagnosed by ultrasound alone?

A

No

66
Q

What bloodwork would be ordered for placental abruption?

A
  • CBC
  • type
  • Rh
  • coagulation profiles

preparing for surgery and transfusion

67
Q

What is the time frame associated with premature labor?

A

21 - 36 weeks gestation

68
Q

Risk factors for premature labor?

the long list that can result in premature labor

several in common with abruption risk factors

A
  • history of preterm labor
  • UTI / STD
  • multiple gestation
  • low income
  • poor weight gain / poor nutrition
  • cocaine, smoking
  • uterine structural abnormalities
  • cervical trauma
  • adolescent or advanced maternal age (like PIH)
69
Q

Are cervical changes associated with the contractions of premature labor?

A

yes

diliation and/or effacement

70
Q

What tocolytic therapy may be utilized in premature labor?

A

**terbutaline **

which is a **beta agonist **

NP (76 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions