Pregnancy

Question 1

certain medications and supplements may make the pill less effective

Answer 1

rifampin, St. John’s wort, some anti-seizure medications

Question 2

single-hormone contraceptive pills

Answer 2

progestin-only

must be taken at the same time every day

Question 3

combined-hormone therapy

Answer 3

contain estrogen and progestin

* most common side effects, which usually clear up after two to three months, may include bleeding between periods; breast tenderness; nausea and vomiting (take at bedtime to help control this)
* contraindicated with family history of stroke, migraines, hypertension, diabetes, chronic renal disease, thrombophlebitis, tobacco use (particularly if older than 35 years-old)

Question 4

Intrauterine devices (IUD)

Answer 4

Small T-shaped plastic device inserted into the uterus to prevent pregnancy

◦	May cause heavier menstrual bleeding, severe cramping, and bleeding between periods

	◦	Two types of devices sold in the U.S.
	◦	
	▪	the ParaGard IUD contains copper
	◦	
	▪	the Mirena IUD releases a small amount of progestin

Question 5

Abortion Methods

Answer 5

first trimester: menstrual extraction; dilation and curettage (D&C); suction or vacuum aspiration; mifepristone (RU-486) and misoprostol (Cytotec) - when 8 weeks pregnant or less

	second trimester: dilation and evacuation (D&E); saline injection; prostaglandins (vaginal)

Question 6

Balanced diet, including folic acid (which is critical prior to pregnancy and during

Answer 6

the first trimester)

	recommendation: women of childbearing age should have a daily intake of 400 mcg 

	if there is iron deficiency anemia, then the daily dose of folic acid is 1 mg/day

Question 7

nausea, vomiting, “morning sickness” in first trimester is attributed to

Answer 7

hCG

hCG is detected by lab tests for pregnancy as early as 6 days after conception in blood and 26 days after conception in urine

Question 8

gravida

Answer 8

comes from the Latin word gravidus. It is used to describe a woman who is pregnant and is also a medical term for the total number of confirmed pregnancies a woman has had, regardless of the outcome of the pregnancy. For example, a woman who is pregnant for the first time will be termed a primigravida, which means first pregnancy.

Question 9

Para

Answer 9

refers to the total number of pregnancies that a woman has carried past 20 weeks of pregnancy. This number includes both live births and pregnancy losses after 20 weeks, such as stillbirths. The term primipara may be used to describe a woman who has had one delivery after 20 weeks, and multipara is used for a woman who has had two or more births. Nulliparous is the term that describes a woman who has never given birth after 20 weeks of pregnancy.

Question 10

probable

Answer 10

changes observed by examiner

* Chadwick's sign: increased vaginal vascularity contributes to bluish purple hue of the cervix, vagina and vulva
* Hegar's sign: increased vascularity and softening of uterine isthmus
* Goodell's sign: cervical softening caused by stimulation from estrogen and progesterone

Question 11

positive

Answer 11

signs attributed only to presence of fetus, e.g., fetal heart tones, visualization of fetus, palpating fetal movements

Question 12

Naegele’s Rule

Answer 12

Due date:

first day of last normal period + 7 days- 3 months + 1 year

Question 13

Leopold maneuvers

Answer 13

palpate the fundus to determine which fetal part occupies the fundus

	palpate each side of the maternal abdomen to determine which side the fetal spine and extremities are on

	palpate above the symphysis pubis to locate the fetal presenting part

	while applying pressure on the fundus with one hand, index finger and thumb of other hand palpates the presenting part to confirm presentation and engagement

Question 14

heart rate first detected

Answer 14

12 to 14 weeks gestation

Question 15

quickening

Answer 15

is the moment in pregnancy when the pregnant woman starts to feel or perceive fetal movements in the uterus

Question 16

quad screen

Answer 16

at 16 to 18 weeks gestation - to test for chromosomal and congenital malformations

* human chorionic gonadotropin (hCG)
* alpha-fetoprotein (AFP)
* estradiol (E2)
* inhibin A

Question 17

OB Interventions

Answer 17

“Seven Rs”:

• Relationship
• Respond (to questions and concerns)
• Review and reinforce (includes anticipatory guidance)
• Recommend (diet, vitamins, exercise)
• Risk data (collection)
• Return scheduling
• Referral resources

Question 18

delivery process

Answer 18

• Fetal Station: the relationship between the presenting part of the baby with the mother’s pelvis
• Fetal Lie: the relationship between the head to tailbone axis for both the fetus and the mother
• Fetal Attitude: the relationship of the fetal body parts to one another
• Fetal Presentation: portion of the fetus that enters the pelvic inlet first (cephalic, breech, shoulder)

Question 19

Laboratory tests 1st Trimester

Answer 19

urinalysis for glucose, protein, blood, and bacteria

	urine or blood hCG levels

	complete blood count

	blood types and Rh factor    

	rubella titer

	screening for syphilis

	cervical culture for Chlamydia and gonorrhea

	hepatitis B surface antigen (HBsAG)

	hepatitis B surface antibody (HBsAB)

	Pap smear

	tuberculin skin test

	HIV antibody (with client permission)