PREGNANCY Flashcards

1
Q

Hep A, Hep B, influenza inactivated), meningococcal, polio, tetanus Tdap (only in 3rd trimester)

A

Immunizations in pregnancy

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2
Q

Oral polio, HPV, flu mist (influenza), MMR (no pregnancy attempt after 28 days of rubella vaccine), Varicella zoster 3 months

A

Contraindicated Immunizations in pregnancy

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3
Q

Penicillin’s, cephalosporins, macrolides, and nitrofurantoin (not on patients with glucose 6 phosphate deficiency)

A

Safe Abx in pregnancy

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4
Q

ARBS, ACEI, Fluoroquinolone, tetracyclines NSAIDS, Sulfa,

A

Not 100 % safe in pregnancy

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5
Q

PLUS 9 months add 7 days

A

Naegles rule

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6
Q

primigravida in third trimester, multipara, >35 years old, sudden onset recurrent headaches, blurred vision, pitting edema, weight gain, RUQ pain, shoulder pain, lower back pain, hyperreflexia, decrease in urine output, BP elevated, N/V, occurs after 20 weeks pregnancy induced hypertensive condition, resolves after pregnancy

A

Preeclampsia

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7
Q

HTN, proteinuria, and edema

A

Preeclampsia Dx

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8
Q
  • hospitalization
  • antihypertensive medications- methyldopa/aldomet, CCB, labetalol
  • bedrest, laying on left side recumbent position off of vena cava, seizure precautions, balance diet high intake of protein low salt, antihypertensive, education, only CURE deliver fetus, refer to OB
A

Preeclampsia Tx

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9
Q

Seizures or coma in patient with previous preeclampsia

A

Eclampsia

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10
Q

Caused by idiopathic, PID, IUD, estrogen/progesterone

A

Ectopic pregnancy

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11
Q
  • 50% no known risk factor,
    >35 years of age, nonwhite females, PID, endometriosis, previous ectopic pregnancy, IUD, pelvic or tubal surgery, cigarette smoking, infertility, invitro fertilization, leading cause of death for women in first trimester
A

Ectopic pregnancy - High risk

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12
Q

Vaginal bleeding, cramping without cervical dilation

A

Threatened abortion

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13
Q

Vaginal bleeding, cramping with cervical dilation

A

Inevitable abortion

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14
Q

Moderate to diffuse bleeding, passage of tissue, uterine

contractions

A

Incomplete abortion

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15
Q

Produced by placenta

A

Hcg in urine pregnancy test

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16
Q

Produced by fetal liver

A

Alpha feta proteins

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17
Q

91% effective, estrogen/progestrin disadvantages- pill daily,
thrombophlebitis/embolism, liver adenomas, stroke, gall bladder disease, no std protection, NO smoking may result in cardiovascular side effect, contraindicated in <6- week post-partum, breast cancer,

A

Oral contraceptives

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18
Q

91% effective, estrogen/progestrin, disadvantages same as above, patch may fall off and must be reapplied, patch once a week

A

Contraceptive patch

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19
Q

91% effective estrogen/progastrin, insert day after menses, disadvantages- uncomfortable inserting, ring falls out for less than 3 hours, rinse off and reinsert,

A

Contraceptive vaginal ring

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20
Q

91% effective, disadvantages taken daily, chance of ectopic pregnancy,

A

Progestin oral

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21
Q

94% effective, injectable progestin for 13 weeks, disadvantage is bone loss,
fertility may not return for 1 year,

A

Deprovera

22
Q

99% effective, placed subcutaneously in upper arm and releases hormones for 3 years, quick return to fertility, bleeding is side effect

A

Etonogestrel implant

23
Q

Mirena, progesterone, 99.8% effective, disadvantages expel

intrauterine device, sepsis, cervical infection, ectopic pregnancy, infertility.

A

Intrauterine device

24
Q

88% effective, spermicide, prevents stds, must be refitted, bladder infections, yeast infection, bacterial infection.

A

Diaphragm

25
Q

plan B, take within 72 hours of unprotected sex or of 2 days of skipped birth control, take second pill 12 hours later, rule out preexisting pregnancy first

A

Morning after pill

26
Q

3rd trimester, sudden onset of bleeding, contracted uterus, feels hard, painful, dark red colored vaginal bleeding.
Dx - CBC, PTT abdominal US and blood transfusion
Tx - baby must be delivered to save mothers life c section, refer to ED,

A

Placenta abrupto

27
Q

smoking, cocaine use, no seatbelt, HTN

A

Placenta abrupto - risk factors

28
Q

Abnormally implanted placenta, multipara in 2nd/3rd trimester new onset of painless bleeding, worsened by intercourse, blood is bright red, uterus is soft nontender, cervix is not dilated

A

Placenta previa

29
Q

Bedrest, magnesium for cramping, vaginal or rectal insertion is contraindicated, if cervix is dilated or hemorrhaging, fetus must be delivered c section to save mothers life, refer to ED, no bimanual examinations, abdominal US only,

A

Placenta previa Tx

30
Q

Palpation of fetus by provider, US and visualization of fetus, fetal heart tones 10 -12 doppler, 20 weeks stethoscope

A

Positive sign of pregnancy

31
Q
  • Goodell sign-cervical softening
  • Chadwick sign- blue coloration of cervix/vagina,
  • Hegar sign- softening of uterine isthmus
  • Enlarged uterus,
  • ballottement,
  • Urine /serum pregnancy
  • Beta HcG is in molar pregnancies and ovarian cancer
A

Probable signs

32
Q

Quickening, amenorrhea, N/V, breast changes

A

Presumptive sign

33
Q

Normal in pregnancy

A

S3 heart murmur

34
Q

Due to high estrogen

A

Chloasma/meloasma

35
Q

Screened for Tay sachs disease

A

Jews

36
Q

GTPAL gravida-number of Prego’s, term-number carried past 37, preterm- number carried till 20 weeks, abortion- deliveries before 20, living- number of living children

A

Obstetric history

37
Q

(prepregnant state) takes 6 weeks

A

Uterine involution

38
Q

Give to all Rh-negative mothers at 28 weeks then 72 hours after delivery,
destruction of Rh positive fetal RBC’s presenting in mom’s circulatory system

A

RhoGam

39
Q

Is used to test for autoimmune hemolytic anemia, positive direct coombs (infant) test means you have antibodies that act against your RBC’s, Indirect coombs test is for mother, coombs test can also tell us if there is high bilirubin watch for anemia and jaundice

A

Coombs test

40
Q

High risk for developing type 2 diabetes, neural tube defects, congenital heart disease, birth trauma, eclampsia, Risk factors are previous pregnancy, obesity, ethnicity.

A

Gestational diabetes

41
Q
  • Screen at first visit or 24-28 weeks gestation
  • 1st step is 75g OGTT (screening and diagnosis),
  • 2nd step is 50 OGTT nonfasting (screening),
  • if abnormal follow up with 100 OGTT (fasting)
A

Gestational diabetes Dx

42
Q

Bluish coloration of cervix

A

Chadwick sign

43
Q

Softening of cervix

A

Hegars sign

44
Q

In first trimester is type 2 diabetic

A

Diabetes

45
Q

High risk for pyelonephritis Dx - urine C&S, urine dipstick,
refer to ED if pyelonephritis
Tx - nitrofurantoin, Augmentin, cephalosporin, no sulfa

A

Asymptomatic bacteriuria

46
Q

In pregnancy is 10x3 not normal 10x5

A

UTI

47
Q

Weeks is above synthesis pubis

A

Fundus at 12

48
Q

Weeks is between the synthesis pubis and umbilicus

A

Fundus at 16

49
Q

Weeks is at the umbilicus

A

Fundus at 20

50
Q

During breast feeding is normal but not clicking noises

A

Swallowing noises

51
Q

Common in first 2 months, skin fissures on nipples, staph or MRSA pathogen, flu like symptoms malaise, adenopathy in the axilla of affected breast,
Dx - clinical diagnosis, CBC shows leukocytosis, Milk C4S, if severe refer to ED, prevent by frequent and complete emptying,
Tx - dicloxacillin or cephalosporin, if MRSA treat with Bactrim or macrolide

A

Breastfeeding mastitis