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Preconception Flashcards

1
Q

Importance of PRECONCEPTION?

A

critical pd. of human development

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2
Q

Whats the PURPOSE of preconception care?

A

improve pregnancy outcome by addressing modifiable risk factors & planning for non modifiable risk factors

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3
Q

What teachings is recommended for ALL women of childbearing age?

A

ALL women should obtain preconception care expecially if they have hx of : spontaneous abortion, preterm birth, congenital birth defect or chronic illness.

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4
Q

Whats included in Preconception Care?

A

It consist of health promotion activities & risk assessments prior to pregnancy.

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5
Q

What vaccines are contraindicated during pregnancy?

A

MMR, Varicella

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6
Q

3 Health promotions included in preconception care

A

Adopting healthy behaviors, Avoid unintended pregnancies, Immunization & protection of other infectious disease

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7
Q

Risk Assesments done during Preconception Care (6)

A

Medical Hx, Physical Exam, Lab Tests, Teratogen Exposure, Psychosocial Issues, Nutrition

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8
Q

When are genetic screenings performed?

A

They are done prior to conception to discover Non-modifiable risks to pregnancy.

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9
Q

Examples of Genetic Screenings

A

Neural Tube Defect (NTD)
Cardiac defect
Down Syndrome
Tay-Sachs (Jewish, Cajun, or French-Canadian)
Sickle Cell Disease or trait (African)
Hemophilia
Muscular Dystrophy
Cystic Fibrosis
Huntington Chorea
Mental Retardation
Autism
Thalassemia (if Italian, Greek, Mediterranean or Asian)
Hx of genetic or congenital abnormalities

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10
Q

Whats the science of genetics?

A

Explain underlying causes of inherited congenital disorders and patterns which are passed from generation to generation.

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11
Q

TRUE or FALSE: Not all congenital disorders are inherited; some result from a prenatal event.

A

TRUE

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12
Q

Can genetic screening identify congenital disorders inherited from prenatal events?

A

NO

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13
Q

When is Genetic Counseling provided?

A

Once genetic testing is complete to discuss risks.

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14
Q

When is genetic testing performed?

A

Its recommended if a positive screen occurs but ideally done prior to pregnancy to allow individuals and families to identify, understand, and sometimes control their inherited health risks, in order to make informed reproductive decisions

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15
Q

Is genetic testing a choice?

A

YES

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16
Q

What does a genetic counselor provide?

A

With results of testing, assists to interpret the results and informs of potential options.

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17
Q

Whats ‘Nondirectiveness’?

A

Respects the right of individuals and families to make autonomous decisions.
*nurse’s primary function during this process is to provide emotional support

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18
Q

When is the baby the most vulnerable to teratogenic substances?

A

First half of the pregnancy; 1st trimester

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19
Q

What are some examples of modifiable risk factors to pregnancy outcomes?

A

unhealthy BMI, unhealthy diet, smoking, alcohol intake, nonuse of folic acid supplements, and older maternal age.

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20
Q

What are some examples of non-modifiable risk factors to pregnancy outcomes?

A

age & family history

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21
Q

Reproductive changes w/ pregnancy

A

Uterus increases in size changes shape & position. Ovulation & mensus ceases during pregnancy.

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22
Q

Cardiovascular changes w/ pregnancy

A

CO increases by 30-50%, BV increases by 30-45% at term to meet metabolic needs. HR increases beginning week 5

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23
Q

Respiration changes w/ pregnancy

A

O2 needs increase. During last (3rd) trimester; size of chest enlarges allows lung expansion as uterus pushes upwards

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24
Q

Musculoskeletal changes w/ pregnancy

A

Body alterations & weight increases
adjustment in posture pelvic joint relax

25
GI changes w/ pregnancy
N & V d/t hormonal changes & increase in pressure w/in the abdominal cavity Constipation d/t increase transit time of food through GI tract & thus increased water absorption
26
Renal changes w/ pregnancy
Filtration Rate increases secondary to influence of pregnancy hormones & increase in BV and metabolic demands Urine frequency increases (diuresis)
27
Endocrine changes w/ pregnancy
Placenta becomes an endocrine organ that produces large amounts of HcG, progesterone, estrogen, human placental lactogen & prostaglandins. Hormones are very active function to maintain pragnancy & prepare body for delivery.
28
What does GTPAL stand for
Gravidity, Term birth, Preterm birth, Abortions/miscarriage, Living children
29
Whats Nageles Rule
1st day of last menstrual cycle - 3mo + 1yr & 7days
30
Hemoglobin lab values
12-16 g/dL Women residing in high altitudes may show higher hgb
31
Rhesus (Rh)
The Rh factor is either positive (meaning the person has the antigen) or negative (meaning the person does not have the antigen)
32
TORCH
identify toxoplasmosis, rubella, cytomegalovirus, and herpes
33
HepB screen
Surface antigen HBsAg negative. Women w/ risk factors are aslso tested for hepC (spread w/ direct contact w/ blood)
34
Rubella titer
Hemagglutination-inhibition (HAI) test–1:10 or above indicates woman is immune
35
HIV screen
Negative
36
Syphilis & Gonorrhea
Serologic tests for syphilis (STS), complement fixation test, Venereal Disease Research Laboratory (VDRL) test—nonreactive. Negative.
37
Urinalysis/Urine culture
Normal color, specific gravity; pH 4.6–8. Negative for bacteria.
38
Quadruple screen:
detect aneuploidy and neural tube defects; may be used in areas in which NT testing is not available.
39
1 Hour glucose
(done between 24 and 28 weeks’ gestation) Plasma glucose level greater than 140 mg/dL (gestational diabetes mellitus [GDM])
40
Prenatal vitamins
give body minerals & vitamins needed for a healthy pregnancy
41
Common discomforts during pregnancy
Nasal congestions (epistaxis) bleeding gums SOB Fatigue Supine hypotension syndrome Backache N &V Heartburn/reflux Urinary frequency Constipation Hemorrhoids & varicose veins Braxton Hicks contractions Skin changes & leg cramps
42
Supine hypotension syndrome teachings
Lie in side-lying or semi-fowlers position with knees flexed slightly.
43
Heartburn/ Reflux teachings
Eat small frequent meals, do not let your stomach to get too empty or too full, contact HCP before taking anti-acids. Do not lie down immediately after eating, as this can exacerbate reflux
44
N & V teachings
Eat crackers or dry toast before rising in the morning, avoid having an empty stomach and ingesting spicy, greasy or gas forming foods. Encourage fluids between meals.
45
Normal Changes
N & V Breast tenderness Urinary Frequency UTI's Fatigue Heartburn Constipation Backaches SOB Lef Cramps Varicrose in lower extremities Gingivitis, nasal stiffness, epistaxis Braxton Hicks contractions Supine hypotension Hemorrhoids
46
1st Trimesters Warning Signs
Severe monitoring (hyperemesis gravidarum) Burning during urination diarrhea (infection) fever or chills abdominal cramping/vaginal bleeding
47
2nd & 3rd Trimesters Warning Signs
Gush or fluid from vagina abruption or pevia from placenta (ab pain) changes in fetal activity ( decrease movement= fetal distress) severe headache elevated temp. Dysuria blurred vision clammy pale skin, weakness, tremor, lightheadedness (hypoglycemia) Flushed dry skin, fruity breath, increased thirst and urination (hyperglycemia)
48
Whats the recommended weight gain during pregnancy ?
25-35 lbs 1.1-4.4 lbs during the 1st Trimester & after that 1lb every wk for the other two trimesters
49
What are Non-Meat iron sources ?
lentils, chickpeas, beans, kale, raisins, fortified cereals & bread, dried apricots & figs, pumpkin seeds, cashew nuts
50
What interferes with the absorption of Iron?
milk, caffeine, tea, colas, meat
51
Non-Dairy source of Calcium
fortified orange juice fortified soy milk nuts legumes dark leafy veggies
52
Why is Folic acid in pregnancy important?
crucial for neurologic development and prevention of fetal NTD
53
Vegan diet during pregnancy should include:
bread, cereal, rice, pasta, fruits, vegetables, legumes, tofu, nuts, nut butter
54
Pregnant/ breastfeeding mothers & young children SHOULD NOT eat what?
swordfish, shark, tilefish, or king mackerel they contains high levels of methylmercury
55
To promote good nutrition and avoid the risks of mercury:
eat at least 8 oz and up to 12 oz/week (two average meals) of shellfish and fish that are lower in mercury
56
What fish are lower in mercury
canned light tuna, shrimp, salmon, herring, sardines, pollack, and trout *Albacore (white) tuna has more. Only 6 oz/week is recommended
57
Whats Prenatal testing?
Testing to identify a fetus with a genetic disease or condition. Some prenatal testing is offered routinely; other testing may be initiated due to family history or maternal factors
58
What does VEAL CHOP stand for?
Variable decels Cord compress Eearly decels Head compress Aaccelerations Ok Late decels Placenta

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