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Peds/OB > OB Exam 1 > Flashcards

OB Exam 1 Flashcards

1
Q

What is the goal to genetic testing?

A

Identify risk

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2
Q

Your client wants to know how to tell if she is ovulating. Select all that apply:
A. Cervical mucus is thick, sticky, and opaque white
B. Basal body temp drops slightly, then spikes 1/2 a degree
C.menstural period is just starting, spotting
D.positive test for spike in LH
E. Levels of progesterone are decreasing

A

B,D

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3
Q

How long is an egg fertile for after ovulation?

A

12-24 hours

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4
Q

Where does fertilization occur?

A

Outer 1/3 of fallopian tube

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5
Q

how long does it take a zygote to travel to the uterus?

A

3-4 days

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6
Q

Morula

A

“Solid ball of cells”, gives rise to blastocyst= embryoblast(embryo) and trophoblast (placenta)

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7
Q

when does blastocyst implant into endometrium?

A

6-10 days after conception, usually into fundus

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8
Q

How long does the sperm remain viable in female reproductive tract?

A

At least 2-3 days
(possibly 3-5 days)

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9
Q

Which is counted as the first day of the menstrual cycle?
A. First day of bleeding during menses
B. Day of ovulation
C. Last day of bleeding during menses
D. Day before the menstrual bleeding starts

A

The first day of bleeding during menses

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10
Q

How long after intercourse could she get pregnant?

A

Sperm can reach site of fertilization in 5 minutes; conception likely up to a week after intercourse (sperm viable 3-5 days in female tract) and implantation (pregnancy) 2-3 weeks after

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11
Q

How long after ovulation could she get pregnant?

A

five days before ovulation, the day of ovulation, and one day after ovulation (sperm can live 3-5 days, ova fertile for 24 hours)

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12
Q

What is included in genetic counseling?

A

Information, education, and support

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13
Q

How many pregnancy genetic tests are there?

A

4

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14
Q

What is the first (earliest) genetic test that can be done in pregnancy?

A

CVS (chorionic villus sampling)

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15
Q

When can a CVS be done?

A

10-13 weeks

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16
Q

What is a CVS?

A

Chorionic villus sampling: tissue sample of the placenta
Indicated: risk for giving brith to neonate with genetic chromosomal abnormality (cannot determine spina bidifida or anencephaly)
Full bladder necessary for testing

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17
Q

What are the four pregnancy genetic tests?

A

Chorionic villus sampling, amniocentesis, alpha-fetoprotein, and level 2 ultrasound/targeted ultrasound

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18
Q

What is an amniocentesis?

A

Sample of amniotic fluid, empty bladder needed (avoid puncture)

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19
Q

When is an amniocentesis done?

A

15-20 weeks

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20
Q

What is an AFP test?

A

Alpha-fetoprotein test of maternal blood

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21
Q

When is an alpha-fetoprotein test done?

A

15-18 weeks

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22
Q

When is a level 2 ultrasound (targeted ultrasound) done?

A

After 18 weeks

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23
Q

What is a level 2/targeted ultrasound?

A

Complete scan of fetal anatomy

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24
Q

What area is more likely to be damaged during childbirth?

A

Perineum

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25
Q

What is the pear shaped organ?

A

Uterus

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26
Q

Organ made of hollow smooth muscle with constant rhythmic contractions, lined with cells responsive to hormones

A

Uterus

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27
Q

What is a gynecoid pelvis?

A

Perfect shape and angle that is most optimum condition for vaginal delivery

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28
Q

Presumptive signs of pregnancy

A

Amenorrhea, fatigue, N/V, urinary frequency, breast changes, quickening(Could be gas), uterine enlargement

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29
Q

What is quickening?

A

The mother feels the movement of the baby

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30
Q

Probable signs of pregnancy

A

Abd enlargement, Hegar’s sign, Chadwick’s sign, Goodell’s sign, Braxton Hicks contractions, positive pregnancy test, fetal outline felt by examiner(could be tumor, anatomy)

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31
Q

Confirmation of pregnancy: positive indicators

A

Auscultation FHR, fetal movements felt by examiner, visualization of embryo/fetus by ultrasound

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32
Q

Risk for CVS

A

Spontaneous abortion, risk for fetal limb loss (greatest risk=prior to 9 weeks), miscarriage, chorioamnionitis and rupture of membranes

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33
Q

Risk for amniocentesis

A

Amniotic fluid emboli, maternal/fetal hemorrhage,maternal/fetal infection ,inadvertent fetal damage/anomalies involving limbs, fetal death, inadvertent maternal intestinal/bladder damage,miscarriage/preterm labor,premature rupture of membranes,leakage of amniotic fluid

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34
Q

key points for amniocentesis

A

Empty bladder prior to procedure
Baseline vitals and FHR prior to
Monitor vs, FHR, uterine contractions throughout and 30 min following
Client rest for 30 min
Administer Rho(D) immune globulin to client if they are Rh-Negative

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35
Q

Risk for AFP test

A

Low AFP= Down syndrome
High AFP= neural tube defects

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36
Q

Placenta previa vs placental abruption

A

Placenta implants in lower segment of uterus covering cervical opening vs premature separation of placenta from uterus

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37
Q

Presentation for placenta previa

A

Painless, bright red vaginal bleeding during 2nd and 3rd trimester; higher than expected fundal height; fetus may be breech, oblique, or transverse

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38
Q

Risk factors for placenta previa

A

Previous previa, uterine scarring, advanced maternal age (>35), multi fetal pregnancy, multiple gestations, smoking

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39
Q

Presentation for placental abruption

A

Partial or complete detachment of placenta after 20 weeks; sudden onset of intense localized uterine pain, dark red vaginal bleeding, “board-like” with palpation, contractions with hypertonicity, fetal distress

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40
Q

Risk factors for abruptio placentae

A

Maternal HTN, trauma (MVA=biggest), cocaine(substance abuse), history of abruption, smoking, PROM(premature rupture of membranes), Multifetal pregnancy

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41
Q

Tx plans for placenta previa

A

Assess bleeding, leakage, or contractions; fundal height; NO vaginal exams; prepare to give IVF, blood products, betamethasone, prepare for c section, bed rest, nothing inserted into vagina

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42
Q

Tx plans for placental abruption

A

Palpate uterus for tenderness, serial monitoring for fundal height, FHR monitoring, emotional support, Delivery is only management for abruption

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43
Q

Ectopic pregnancy

A

Abnormal implantation of ovum outside of uterine cavity; second most frequent cause of bleeding in early pregnancy

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44
Q

expected findings for ectopic pregnancy

A

Unilateral stabbing pain, tenderness in lower quadrant, scant dark red or brown vaginal spotting
If ruptured, bleeding is red

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45
Q

Tx for ectopic pregnancy-ruptured

A

Methotrexate (dissolves pregnancy) and laparoscopic salpingectomy

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46
Q

Tx for ectopic pregnancy-non ruptured

A

Methotrexate and salpingostomy to salvage fallopian tube

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47
Q

Hegar’s sign

A

softening and compressibility of lower uterus

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48
Q

Chadwick’s sign

A

Deepened violet-bluish color of cervix and vaginal mucosa

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49
Q

Goodell’s sign

A

Softening of cervical tip

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50
Q

Non-stress test

A

Monitors FHR in response to fetal movement; client pushes button when she feels fetal movement
Reactive vs non reactive

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51
Q

Positive non-stress test

A

Reactive= two or more accelerations within a 20 min period

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52
Q

Negative nonstress test

A

Non reactive= fewer than two accelerations in 40 min period

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53
Q

Contraction stress test

A

Nipple stimulated and oxytocin stimulated
(Contractions must be started)
Analysis of FHR response to contractions, determines how fetus will tolerate labor stress

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54
Q

What should be avoided with contraction stress test?

A

Hyperstimulation of uterus (contraction longer than 90 seconds or five or more contractions in 10 min)

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55
Q

When is oxytocin stimulated contraction stress test used?

A

If nipple stimulation doesnt work. More difficult to stop… can lead to preterm labor

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56
Q

Contraindications for oxytocin-stimulated contraction stress test

A

Placenta previa, vasa previa, preterm labor, multiple gestations,previous classic incision from c section, reduced cervical competence(insufficiency)

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57
Q

Quad marker screening

A

Blood test to provide info about likelihood of fetal birth defects- DOES NOT DX
Can be used instead of maternal AFP blood level, yields more reliable results

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58
Q

What does quad marker screening test for?

A

Human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP), estriol, inhibin A

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59
Q

Low levels of AFP indicate

A

Risk for Down syndrome

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60
Q

high levels of AFP indicate

A

Risk for Neural tube defects

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61
Q

Higher than expected levels of hCG and inhibin A indicate…

A

Risk for Down syndrome

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62
Q

lower levels than expected for estriol can indicate…

A

Risk for Down syndrome

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63
Q

Positive and negative contraction stress test

A

reactive and nonreactive

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64
Q

When is a BPP ordered?

A

Non reactive stress test, suspected oligohydramnios or polyhydramnios, suspected fetal hypoxemia or hypoxia

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65
Q

What is a BPP?

A

Biophysical profile ; uses ultrasound to visualize physical and physiological characteristics of fetus, observes for fetal response to stimuli, combo of FHR and fetal ultrasound monitoring

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66
Q

What is the BPP assessing?

A

FHR, fetal breathing, body movements, fetal tone (flexed?), amount of amniotic fluid

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67
Q

BPP scoring

A

8-10=normal, low risk of chronic fetal asphyxia
4-6= abnormal, suspect chronic fetal asphyxia
Less than 4= strongly suspect chronic fetal asphyxia—>possible delivery
each category=0-2

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68
Q

If quad marker screening tool shows abnormalities…

A

Diagnostic tools (depending on gestation) needed for Dx (amino or CVS)

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69
Q

Maternal alpha-fetoprotein results

A

High levels indicate neural tube defect/open abdominal defect
Low levels can indicate Down syndrome
ONLY A SCREENING TOOL

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70
Q

Stages of fetal development

A

Two stages: embryonic and fetal

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71
Q

embryonic stage

A

Day 15-8 weeks gestation
Most critical time in development of organ systems
Most vulnerable to malformations caused by environmental teratogens

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72
Q

what stage is the most critical time in development of organ systems?

A

Embryonic: All organ systems are present by end of 8 weeks

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73
Q

What stage is most vulnerable to malformations caused by environmental teratogens?

A

Embryonic

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74
Q

During embryonic stage, the amniotic fluid…

A

Cushions against impact to maternal abdomen
Maintains stable temp
Allows symmetric development(neutral position for fetus to develop properly, defies gravity)
Prevents membranes from adhering to fetal parts
Allows room and buoyancy for fetal movement

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75
Q

Hormones produced by placenta

A

Chorionic gonadotropin
Prolactin
Estrogen
Progesterone
Relaxin

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76
Q

When is quickening felt?

A

Subsequent=18-19 weeks
First-time moms= 20-22 weeks

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77
Q

Monozygotic twins

A

“Identical”
1ovum/1sperm->2 babies

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78
Q

Dizygotic twins

A

“Fraternal”
2 ova/2 sperm->2 babies

79
Q

Risks for monozygotic twins

A

TTTS (twin to twin transfusion syndrome), sFGR (selective fetal growth restriction), low birth weight, preterm birth, umbilical issues (tangled/compressed), oligo/polyhydramnios, heart defects, brain defects, neural tube defects, postpartum hemorrhage (large placenta/(s) )

80
Q

Risks for dizygotic twins

A

least amount of risk associated
umbilical cord issues (tangled/compressed), fetal growth restriction (limited room), low birth weight, preterm birth, placenta issues (placenta previa, abruptio placentae,etc)

81
Q

When is the fertile period for the menstrual cycle?

A

12-14 days before new menstrual cycle; five days leading up to ovulation, day of ovulation, and day after ovulation (abt 7 day window)

82
Q

Describe the menstrual cycle

A

Three phases: menstrual, proliferative, and secretory ; two cycles: ovarian and endometrial ; average of 28 days

83
Q

whole body effects of ovulation

A

Temp drops before ovulation, then spikes 1/2 degree after ovulation
Cervical mucus changes from thick to thin-> clear and stretches like egg white

84
Q

spinnbarkeit

A

Sign of ovulation: cervical mucus changes from thick, sticky, and white to thin, clear, and stretches like egg white

85
Q

How long does it take for an egg to implant?

A

6-10 days after conception

86
Q

How do hormones impact menstrual cycle and how they change

A

regulate menstrual cycle
GnRH released and triggers release of
FSH(inc size and number of follicle cells) and LH(inc antral fluid to burst follicle to ovulate) to stimulate ovarian follicle to ovulate and release estrogen(rebuilding endometrium) and progesterone(maintaining uterine lining for implanting)
if no implanting-> levels of estrogen and progesterone drop-> menstruate, prostaglandins cause contractions of myometrium to release the endometrial lining

87
Q

Estrogen function-menstrual cycle

A

Maturing of egg follicle

88
Q

Progesterone function- menstrual cycle

A

Thickens endometrium to ready for zygote

89
Q

Progesterone function- after implantation (pregnancy)

A

Relaxes uterus to maintain the pregnancy

90
Q

Prostaglandins function-menstrual cycle

A

Help release of egg in ovulation

91
Q

Prostaglandins function- pregnancy

A

Increases labor contractions and opening of cervix for birth

92
Q

what hormone(s) decrease to trigger the shedding of the endometrium?

A

Estrogen and progesterone

93
Q

What happens when estrogen drops (before progesterone begins)

A

Ovulation

94
Q

Placenta functions

A
  1. Transfers oxygen and nutrients to fetus
  2. Removes waste products and CO2 into maternal blood
  3. Makes hormones
  4. Transfers antibodies from mother to fetus
95
Q

Placenta….

A

Prevents direct contact between fetal and maternal blood (placental barrier)

96
Q

What roles does placenta play

A

Transfers oxygen and nutrients, removes waste, makes hormones, transfers antibodies form mother to fetus and serves as a direct contact barrier between fetal and maternal blood

97
Q

hormones produced by placenta

A

Chorionic gonadotropin, prolactin, estrogen, progesterone, relaxin

98
Q

Progesterone promotes growth…

A

Of the lobes, lobules, and alveoli in the lungs

99
Q

During pregnancy… renal filtration is… and urinary production…

A

Increased filtration, urine production amount is the same

100
Q

Describe umbilical cord

A

Two arteries, one vein-> vessels surrounded by Wharton’s jelly
“AVA”
Lifeline

101
Q

Cholasma

A

Inc of pigmentation on the face (pregnancy mask) Lightens and goes away

102
Q

Linea Nigra

A

Dark line of pigmentation form umbilicus to pubic area, lightens and goes away

103
Q

Striae gravidarum

A

Stretch marks, dont go away, but lighten

104
Q

Umbilical arteries…

A

Carry deoxygenated blood away from the fetus to placenta (mother)

105
Q

Umbilical vein…

A

Brings oxygenated blood from mother to fetus “main vein”

106
Q

describe embryo at 5 weeks

A

Marked C-shaped body and rudimentary tail

107
Q

Describe embryo at 7 weeks

A

Head is rounded and nearly erect. Eyes shifted forward and closer together, eyelids begin to form

108
Q

describe embryo at 8 weeks

A

Every organ system present, HR detectable by Doppler, eyes ears nose and mouth recognizable

109
Q

At about 20 weeks gestation…

A

Quickening, primitive breathing movements (alveoli filled with fluid), vernix caseosa, lanugo

110
Q

The more premature… the …. Vernix caseosa is present

A

MORE

111
Q

The further along the baby is developed… the… lanugo is present

A

Less

112
Q

fetal stage

A

9 weeks-pregnancy ends
Amniotic fluid first from diffusion from maternal blood then fetus’ urine, volume inc weekly to about a quart

113
Q

What is amniotic fluid

A

First from diffusion from maternal blood then fetus’ urine
Regulates temp, cushions, allows movement, allows symmetrical development, barrier to infection

114
Q

Amniotic fluid function

A

Regulates temperature, cushions, allows movement, barrier to infection

115
Q

What hormone is produced during pregnancy

A

Human chorionic gonadotropin (hCG)

116
Q

Danger signs during middle pregnancy-report!

A

Facial edema, blurred vision, seeing floaters, edema in hands, severe headaches, epigastric pain-> HTN condition or preeclampsia (middle of pregnancy)

117
Q

Danger signs during pregancy-beginning-report!

A

Burning during urination
Severe vomiting
Diarrhea
Fever/chills
Abd cramping, vaginal bleeding(early vs late means diff things)
Gush of fluid from vagina(27 weeks)

118
Q

Naegele’s rule

A

Take LMP date (beginning) and subtract 3 months and add 7 days and one year (if applicable)= due date

119
Q

How to calculate GTPAL

A

G= how many pregnancies(total)
T=term deliveries (after 37 weeks)
P=preterm(before 37 weeks)
A=abortion
L=living children

120
Q

Supine hypotension

A

Weight of baby and uterus compresses on IVC and SVC and causes hypotension

121
Q

Relaxin effects musculoskeletal system

A

Causes pelvic joints to relax and gait to change

122
Q

How is supine hypotension alleviated?

A

Have mother lay on her left side(best side bc vena cava runs on right side=optimal blood flow but right works too)

123
Q

Progression of HTN

A

GHTN—>preeclampsia->severe preeclampsia-> eclampsia

124
Q

Gestational HTN

A

Begins after 20 weeks
140/90 or greater (about twice, 4-6 hrs apart within a week)
NO proteinuria
BP return to baseline postpartum

125
Q

Preeclampsia

A

Gestational HTN with proteinuria > or = to 1+. Report transient headaches might occur with episodes of irritability . Edema can be present
BP higher than 140/90
Tx= bed rest and increase circulation to kidneys and uterus

126
Q

Severe preeclampsia

A

BP=160/110 or greater, proteinuria greater than 3+, oliguria, creatinine higher than 1.1
-headaches, blurred vision, hyperreflexia(clonus), extensive peripheral edema, epigastric pain, RUQ pain(enlarged liver, inc ALT and AST), thrombocytopenia

127
Q

Eclampsia

A

Severe preeclampsia with onset of seizures and/or coma. Preceded by headache, severe epigastric pain, hyperreflexia, hemoconcentrations (possible warning manifestations of convulsions)
After 20 weeks, up to 6 weeks postpartum

128
Q

HELLP syndrome

A

Variant of GHTN=hematologic conditions coexist with severe preeclampsia and hepatic dysfunction. Dx by laboratory not clinically

129
Q

Components of HELLP syndrome

A

H: hemolysis->anemia and jaundice
EL:elevated liver enzymes (ALT,AST, epigastric pain, N/V)
LP: low platelets (thrombocytopenia, abornmal bleeding and clotting time, bleeding gums, Petechiae, possible DIC)

130
Q

Difference between polyhydramnios and oligohydramnios

A

Oligo=low fluid
Poly=too much fluid

131
Q

Hyperemesis gravidarium

A

Continuous and excessive vomiting causing weight loss, dehydration, electrolyte imbalances, and malnutrition; high hCG levels

132
Q

assessment for hyperemesis gravidarum

A

S/s dehydration, fluid/electrolyte imbalance
Weight loss

133
Q

Tx for hyperemesis gravidarium

A

-LR
-vitamin B6 (pyridoxine) and other supplements as needed
-antiemetic (metoclopramide)
NPO diet
Nausea medicine-ondansetron
Gradually reintroduce food

134
Q

What are the different types of abortions?

A

Spontaneous vs. elective

135
Q

spontaneous abortion

A

Natural causes that end pregnancy
First trimester- before 20 weeks

136
Q

types of spontaneous abortions

A

Threatened, inevitable, incomplete, complete, missed, septic, and recurrent

137
Q

Threatened abortion

A

Possible mild cramps, slight spotting, no tissue passed and cervical opening closed; pregnancy still safe

138
Q

mild to moderate cramps, moderate bleeding, May or may not have tissue passed and dilated cervical opening; case of “when” it happens

A

Inevitable spontaneous abortion

139
Q

severe cramps, heavy/profuse bleeding, tissue is passed, dilated with tissue in cervical canal or passage of tissue; some tissue remains

A

Incomplete spontaneous abortion

140
Q

Complete spontaneous abortion

A

Mild cramps, minimal bleeding, tissue passed, and no cervical opening (closed after tissue passed)

141
Q

Missed spontaneous abortion

A

No cramps, minimal to no bleeding(spotting), retention of tissue (none passed), closed cervical opening; usually feel no changes, typically found in US with no FHR; no signs of distress

142
Q

Various cramp intensities, possible malodorous discharge, various amounts of tissue passed, cervical opening usually dilated

A

Septic spontaneous abortion

143
Q

Recurrent spontaneous abortion

A

Cramps and bleeding varies, tissue has passed, cervix usually dilated

144
Q

Tx for each abortion

A

-Ultrasound=priority(is placenta intact?)-?fetus viable?
-Cervical exam (if threatened->avoid!)
-D&C or D&E
-Prostaglandins (stimulate labor to let body take care of it naturally i.e. missed spontaneous abortion)

145
Q

nursing care for spontaneous abortions

A

-Perform pregnancy test
-Observe color and amt of bleeding (count pads)
-Maintain client on bed rest (esp if threatened abortion)
-avoid vaginal exams
-determine how much tissue passed and save for examination (genetic issue?)
-assist with termination of pregnancy(if missed/incomplete)
-client education and support

146
Q

Education for clients-spontaneous abortion

A

-Notify provider if heavy,bright red vaginal bleeding, elevated temp, foul-smelling vaginal discharge
-small amt of discharge normal for 1-2 weeks
-take prescribed abx
-refrain from bath tubs, sexual intercourse, placing anything into vagina for 2 weeks
-discuss grief and loss with provider before attempting another pregnancy

147
Q

Risk factors for spontaneous abortions

A

Chromosome abnormalities
Maternal illness
Advanced maternal age
Premature dilation
Chronic maternal infections
Maternal malnutrition
Trauma (MVA, DV)
Substance use

148
Q

What is gestational diabetes

A

Impaired glucose tolerance, first recognized or begins during pregnancy; pregnancy hormones—>insulin insensitivity
Two classes: A1-no meds and A2-meds

149
Q

How is GDM diagnosed?

A

1 hr Oral glucose test(blood taken 1 hr after 50 g oral glucose) if elevated(>130-140), then a 3 hour glucose tolerance test administered(fasting, 100g oral glucose, sugar taken before and after glucose); if two or more out of the four BGL are elevated, Dx of GDM

150
Q

GDM and the fetus

A

Macrosomia(big baby), birth trauma(shoulder dislocation), electrolyte imbalance, hypoglycemia (dec sugar after cord cut after birth from moms sugar, risk at 24-48 hr)

151
Q

How is GDM treated?

A

Manage sugar with insulin and lifestyle changes

152
Q

Magnesium sulfate

A

anticonvulsant used to prevent seizures for eclampsia pts

153
Q

What is magnesium sulfate used for

A

Anticonvulsant, prophylaxis/tx to depress CNS and prevent seizures (eclampsia and severe eclampsia)

154
Q

Magnesium sulfate toxicity

A

BURP
BP dec
Urine output dec
RR <12
Patella reflex absent

155
Q

What do you monitor for a pt on magnesium sulfate?

A

VS, I&O, headache, visual disturbances, contractions, FHR and activity

156
Q

What are signs of magnesium sulfate toxicity

A

Absence of deep tendon reflexes
Urine output <30mL/hr
RR <12/min
Dec LOC
Cardiac dysrhythmias
Hot flashes
Double vision
Slurred speech

157
Q

Magnesium sulfate antidote

A

Calcium Gluconate
D/C infusion, administer antidote

158
Q

Cerclage

A

Stitch in cervix to keep it closed until time for delivery

159
Q

What is cerclage used for

A

Tx for cervical insufficiency(besides progesterone if she’s low)(no signs of labor, but feels pressure and cervix opens, preterm delivery due to weakness)

160
Q

What s/s do pt need to report with cerclage

A

S/s infection, abnormal discharge, foul odor, pain, contractions, “pressure” pink-stained discharge or bleeding, rupture of membranes

161
Q

How does pregnancy affect BP?

A

inc cardiac output, blood volume, HR, heart muscle enlargens for circulation for two; begins around/after 20 weeks

162
Q

What pregnancy category medications are safe?(BP)

A

Methyldopa (antihypertensive)
Nifedipine (CCB and antihypertensive)
Hydralazine (vasodilator)
Labetalol (BB)

163
Q

what medications are not safe for pregnant HTN pts?

A

ACEs and ARBs!
(-pril and -sartan)

164
Q

How do we advise pts about BP meds?

A

do not take anything ending in -pril or -sartan; do not take antihypertensive if BP systolic 100 or below
Take BP and HR before BB- hold if les than 60 or systolic 100
Orthostatic hypotension- move positions slowly
Report SOB with BB

165
Q

What are neural tube defects?

A

severe birth defects that affect the brain, spinal cord, or spine (Spina Bifida, anencephaly, encephaloceles, chiari malformation)

166
Q

Spina bifida

A

spinal column doesn’t close completely, which can cause nerve damage and paralysis of the legs

167
Q

Chiari malformation

A

Brain tissue extends into the spinal canal

168
Q

Anencephaly

A

Most of the brain and skull don’t develop, and babies are usually stillborn or die shortly after birth

169
Q

Encephaloleces

A

Portions of the brain and meninges protrude due to defects in the cranium

170
Q

How can neural tube defects be prevented?

A

tale 400 mcg folic acid daily, avoid hot temperatures while pregnant (saunas hot tubs etc), control diabetes, avoid opioids, avoid anticonvulsants and other medications that may cause them

171
Q

What is fundal height?

A

Measured in cm from symphasis pubis to top of uterus. Cm should match weeks in pregnancy ex: 36cm=36 weeks; helps gauge how baby is growing

172
Q

How is Fundal height measured, and how do we know it is on track?

A

Fingers above and below umbilical cord, tape measure from pubis symphasis to fundus

173
Q

What is urinary frequency during pregnancy?

A

The uterus sits behind bladder, first trimester it pushes on the bladder

174
Q

When does urinary frequency during pregnancy get better or end?

A

When uterus gets big enough to rise above the bladder

175
Q

What is a fetal demise?

A

When a baby dies in the womb after 20 weeks, or stillborn

176
Q

How is fetal demise diagnosed?

A

Death of a baby after 20 weeks (before=miscarriage)
-vaginal bleeding, a uterus that is smaller than expected, or a lack of fetal movement, no FHR, non reactive stress test

177
Q

Which physiological change is common in the cardiovascular system during pregnancy?
-inc lung capacity
-inc cardiac output
-dec blood volume
-dec HR
-inc iron absorption

A

Inc cardiac output

178
Q

Which sign refers to the deepened violet-bluish color of the cervix and vaginal mucosa during pregnancy?
-Braxton hicks contractions
-Hegar’s sign
-Goodell’s sign
-Chadwick’s sign

A

Chadwick’s sign

179
Q

Which of the following is a presumptive sign of pregnancy?
-Hegar’s sign
-Quickening
-fetal heart sounds
-visualization of the embryo

A

Quickening

180
Q

What is a common discomfort of pregnancy related to the musculoskeletal system?
-heartburn
-leg cramps
-round ligament pain
-N/V
-headache

A

Round ligament pain

181
Q

What’s physiological change occurs in the uterus during pregnancy?
-dec in uterine weight
-thickening of the uterine wall
-inc in uterine muscle tone
-reduced uterine blood flow

A

Thickening of the uterine wall

182
Q

What is an indicator of potential preeclampsia during pregnancy?
-mild back ache
-facial edema and severe headaches
-constipation
-round ligament pain

A

Facial edema and severe headaches

183
Q

What does BPP assess?
-fetal heart rate
-maternal blood pressure
-fetal breathing, body movements, tone
-maternal weight gain

A

Fetal breathing, body movements, tone

184
Q

What is the main benefit of conducting a nonstress test (NST)?
-determines the gestational age of fetus
-assesses the response of fetal heart rate to fetal movements
-it measures the amount of amniotic fluid
-it evaluates the size of the uterus

A

It assesses the response of fetal heart rate to fetal movements

185
Q

Which of the following is NOT a contraindication for an oxytocin-stimulated contraction stress test?
-placenta previa
-multiple gestations
-previous vaginal birth
-reduced cervical competence

A

Previous vaginal birth

186
Q

In a contraction stress test, which condition should be avoided?
-hyperstimulation of the uterus
-fetal movement
-maternal position changes
-continuous FHR monitoring

A

Hyperstimulation of the uterus

187
Q

At what gestational age is chorionic villus sampling (CVS) ideally performed?

A

10-13 weeks

188
Q

In a quad marker screening, which combination of results suggests an increased risk for Down syndrome?

A

Low AFP, high hCG, high inhibin A, low estriol

189
Q

What is the second most frequent cause of bleeding in early pregnancy?

A

Ectopic pregnancy

190
Q

Which medication is used for medical management of an unruptured ectopic pregnancy?

A

Methotrexate

191
Q

What is the primary characteristic of bleeding associated with placenta previa?

A

Painless and bright red blood

192
Q

Which of the following is NOT a risk actor for placenta previa?
-previous previa
-advanced maternal age (>35)
-first pregnancy
-multiple gestations

A

First pregnancy

193
Q

Which statement about abruptio placentae is correct?
-it typically occurs before 20 weeks gestation
-it is characterized by painless vaginal bleeding
-the uterus may feel “board-like) on palpation
-vaginal examinations are recommended for diagnosis

A

The uterus may feel “board-like” on palpation

194
Q

What is the only definitive management for abruptio placentae?

A

Delivery

Peds/OB (12 decks)

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