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OB > Pregnancy Care and Nutrition > Flashcards

Pregnancy Care and Nutrition Flashcards

1
Q

how many weeks is considered full term for a pregnancy

A

40 weeks

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2
Q

what does EDD stated for

A

estimated date of delivery

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3
Q

how is the EDD calculated

A

it is calculated from the LMP by counting back 3 months and add 7 days

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4
Q

what does gravida mean

A

number of pregnancies

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5
Q

term for number of pregnancies

A

gravida

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6
Q

term for no pregnancies

A

nulligravida

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7
Q

what does nulligravida mean

A

no pregnancies

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8
Q

term for 1 pregnancy

A

primigravida

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9
Q

what does primigravida mean

A

1 pregnancy

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10
Q

what does multigravida mean

A

two or more pregnancies

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11
Q

term for two or more pregnancies

A

multigravida

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12
Q

what is the term for number of pregnancies in which fetus has reached viability

A

parity

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13
Q

what does parity mean

A

pregnancies that have reached viability (whether stillborn or alive or whether twins or not)

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14
Q

what does nulliparous mean

A

no births

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15
Q

what does viability mean

A

the capacity of fetus to live outside uterus

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16
Q

at how many weeks is viability considered to be reached or at what weight

A

22 to 24 weeks or more than 500g

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17
Q

how many weeks is considered preterm

A

20 - 36 and 6

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18
Q

how many weeks is considered early term

A

37 - 38 and 6

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19
Q

how many weeks is considered full term

A

39 - 40 and 6

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20
Q

how many weeks is considered late term

A

41 - 41 and 6

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21
Q

how many weeks is considered post term

A

42 and beyond

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22
Q

T of TPAL refers to

A

term births

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23
Q

P of TPAL refers to

A

preterm births

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24
Q

A of TPAL refers to

A

abortions

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25
Q

L of TPAL refers to

A

living children

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26
Q

TPAL calculate:
1 delivery at 40 wks, living
1 delivery at 25 wks, living
currently pregnant

A

G3P1102

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27
Q 
TPAL calculate
twins born at 28 wks, both living
1 miscarriage
1 abortion
1 delivery at 41 wks, living
currently pregnant
A

G5P1123

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28
Q 
TPAL calculate
1 delivery 39 wks (yesterday), living
1 delivery 27 wks, living
1 first trimester elective abortions
1 spontaneous abortion (miscarriage) at 15 wks
A

G4P1122

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29
Q

changes that are subjective and felt by the woman are considered to be _____ indicators

A

presumptive

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30
Q

amenorrhea, nausea and vomiting, fatigue, breast tenderness are all considered _____ indicators

A

presumptive

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31
Q

if changes can be caused by something other than pregnancy they are considered to be _____ indicators

A

presumptive

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32
Q

changes that are physical and observed by the provider are considered to be ______ indicators of pregnancy

A

probable

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33
Q

positive pregnancy test, Braxton-hicks contractions, hegar sign, goddells sign are all examples of ______ indicators of pregnancy

A

probable

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34
Q

the softening of the lower uterine segment at 6 weeks is ____ sign?

A

hegar sign

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35
Q

the deep violet blue color of the cervix and vaginal mucosa at 6-8 weeks is _____ sign

A

chadwicks sign

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36
Q

the soften of the cervical tip at 6 weeks is ______ sign

A

goddells sign

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37
Q

changes that are directly attributed to the fetus are considered to be _______ indicators of pregnancy

A

positive indicators

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38
Q

fetal movement felt by examiner, fetal heartbeat distinct form mothers are examples of _____ indicators of pregnancy

A

positive

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39
Q

how reliable is an ultrasound at visualizing the fetus at 8-9 weeks

A

100%

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40
Q

at how many weeks can the fetus be visualized by ultrasound

A

8-9 weeks

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41
Q

at how many weeks can the fetus be detected by doppler

A

8-17 weeks

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42
Q

at how many weeks can the fetus be detected by fetal scope and stethoscope

A

16-20 weeks

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43
Q

sensation described by patients as fluttering is referred to as

A

quickening

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44
Q

what kind of indicator is quickening considered

A

presumptive unless it is felt by provider or verified by ultrasound

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45
Q

when are quickenings felt by a multiparous woman

A

16 weeks

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46
Q

when are quickenings felt by a nulliparous woman

A

20 weeks

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47
Q

what 4 factors determine quickening

A

location of placenta, the mothers BMI, fetal position, and parity

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48
Q

when the placenta is on the ____ side of the uterine wall she may not feel fetal movement or quickenings

A

anterior

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49
Q

what adaptations to pregnancy occur in the breasts

A
  • fullness/heaviness
  • heightened sensitivity (tingling or sharp pain)
  • areolae pigmentation
  • leaking colostrum
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50
Q

adaptations to pregnancy in the cardiovascular system

A
  • increase blood volume
  • increased cardiac output
  • slight hypertrophy of heart (enlargement)
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51
Q

what shifts up and to the left due to the displacement of the diaphragm when a woman is pregnant

A

the point of maximal impulse (PMI)

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52
Q

after 20 weeks the pulse increases by ______bpm until term

A

10-15

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53
Q

what affect does pregnancy have a womans blood pressure throughout her pregnancy

A

it decreases by 5-10 both systolic and diastolic in 2nd trimester and then returns to normal after 20 weeks

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54
Q

what 2 c’s of the CV system are also affected by a woman’s pregnancy

A

circulation and coagulation times

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55
Q

WBC cell counts _____ during womans 2nd trimester until birth

A

increase

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56
Q

by how much does a womans blood volume increase by during pregnancy and why

A

by 40-50% in order to meet needs of hypertrophy of vascular system and fetal tissue

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57
Q

dependent edema, varicose veins, and hemorrhoids in pregnant woman are a result of

A

pressure put on the iliac veins and the inferior vena cava which reduce blood flow to the legs

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58
Q

why does a womans hematocrit and hemoglobin decrease during pregnancy

A

because they are more diluted due to the increased blood volume

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59
Q

physiologic anemia refers to what occurring in pregnant woman

A

decreased hct and hgb due to dilution of blood

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60
Q

when does physiologic anemia occur in pregnancy (what trimester(s))

A

2nd and 3rd trimester

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61
Q

why should a pregnant woman who is over 20 weeks be cautious to lie flat on their back

A

because it can cause supine hypotensive syndrome

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62
Q

what is supine hypotensive syndrome

A
  • drop in BP as a result of compression of the vena cava
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63
Q

while palpating a pt abdomen they report they are feeling dizzy and faint, and their arms and legs are tingling, what would you expect to be occuring

A

supine hypotensive syndrome

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64
Q

does the height of the fundus equal the number of weeks gestation

A

yes

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65
Q

chloasma, linea nigra, and striae gravidarum are all examples of what

A

integumentary adaptations to pregnancy

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66
Q

general hyperpigmentation during pregnancy is referred to as

A

chloasma

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67
Q

pigmented line from pubic area to fundus is called

A

linea nigra

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68
Q

stretch marks are called

A

striae gravidarum

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69
Q

changes in posture, changes in center of gravity, relaxation and softening of pelvic joints are examples of what

A

musculoskeletal adaptations to pregnancy

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70
Q

what hormone causes the relaxation and softening of the pregnant woman’s pelvic joints

A

relaxin

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71
Q

what causes the respiratory adaptations to pregnancy

A

the elevation of the diaphragm to make room for the growing fetus

72
Q

a person who craves non food items is lacking what

A

iron

73
Q

when you have non food cravings it is called

A

pica

74
Q

decreased appetite in first trimester, nausea, vomiting, pica, spongy swollen gums, distended gall bladder and liver, constipation are all examples of

A

GI adaptations to pregnancy

75
Q

excessive vomiting and dehydration in first trimester is referred to as

A

hyperemesis gravidarium

76
Q

what can happen as a result of hyperemesis gravidarium

A

5% weight loss and electrolyte imbalance

77
Q

what treatment options are available for hyperemesis gravidarium

A

NPO, phenergen, reglan, Zofran, IV fluids, doc I/O

78
Q

what fetal structures can an ultrasound test

A

heart, kidneys, bladder, ventricles

79
Q

what 5 main things does an ultrasound test

A 
fetal structure
fetal size
placenta
quantity of amniotic fluid
maternal structures
80
Q

what maternal structures are observed during ultrasound

A

uterus, cervix, adnexa, and pelvis

81
Q

what does an ultrasound look at with regards to the placenta

A

its position, its density, an the presence of gestational trophoblastic disease

82
Q

at how many weeks is an ultrasound usually done by

A

18 weeks

83
Q

is a screening the same as a diagnostic test

A

no

84
Q

what screening is know as the first trimester screen

A

fetal nuchal translucency (FNT)

85
Q

what is involved in the fetal nuchal translucency screening

A

It is an intravaginal ultrasound that measures fluid in the babys subQ space on their neck

86
Q

what measure of FNT is considered abnormal and combined with other factors can predict down syndrome

A

greater than 2.5 mm

87
Q

at what point is the FNT screen performed

A

11 - 13.6 weeks

88
Q

benefits of FNT screening

A
  • essentially non-invasive

- early diagnosis means less bonding, more privacy, termination easier and safer

89
Q

disadvantages of FNT screening

A
  • patient must present early
  • not access neural tube defects
  • not diagnostic
  • difficult when more than one fetus
  • can identify babies that would have been miscarriage
90
Q

what does AFP stand for (fetal test)

A

alpha-fetoprotein test

91
Q

what does the AFP test for

A

blood test that evaluates the plasma protein, alpha-fetoprotein, produced by the fetal liver

92
Q

if there are increased levels of AFP what could it indicate

A

neural tube defects, multiple gestation

93
Q

decreased levels of AFP could indicate

A

down syndrome

94
Q

is AFP testing recommended for all pregnant woman and at what weeks is it done

A

yes all pregnancies at 15-18 weeks

95
Q

advantages of AFP testing

A
  • noninvasive as blood is taken form mother

- relatively inexpensive

96
Q

disadvantages of AFP testing

A
  • late diagnoses
  • no diagnostic or 100% accurate
  • unnecessary amniocentesis
97
Q

chorionic villus sampling is performed at what point

A

10-12 weeks

98
Q

what does chorionic villus sampling detect

A

fetal karyotype, sickle-cell anemia, phenylketonuria, down syndrome, Duchenne muscular dystrophy, other genetic disorders

99
Q

fetal test that can detect sickle cell-anemia, phenylketonuria, down syndrome, muscular dystrophy and others

A

chorionic villus sampling

100
Q

advantages to chorionic villus sampling

A

early diagnosis and rapid results

101
Q

disadvantages to chorionic villus sampling

A
  • maternal hemorrhage or infection

- fetal limb defects, pregnancy loss, leak of amniotic fluid, injury from needle

102
Q

when is amniocentesis performed

A

15-20 weeks

103
Q

which fetal test is done with full bladder

A

chorionic villus sampling

104
Q

which fetal test is done with an empty bladder

A

amniocentesis

105
Q

for which test would RhoGAM be admin if the mother were Rh-

A

chorionic villus sampling, amniocentesis

106
Q

test that checks for genetic disorders, fetal lung maturity, fetal hemolytic disease, meconium, gender determination

A

amniocentesis

107
Q

test with maternal complications such as hemorrhage, infection, labor, abruption placentae, intestinal or bladder damage, or amniotic fluid embolism

A

amniocentesis

108
Q

test with fetal complications that include hemorrhage, infection, injury from needle, miscarriage or preterm labor, leakage of amniotic fluid

A

amniocentesis

109
Q

difference between amniocentesis and chorionic villus sampling

A

amniocentesis needle inserted through abs and draws amniotic fluid
chorionic villus sampling is inserted through vagina and samples the chorionic villus surrounding the fetus

110
Q

what does PUBS stand for

A

percutaneous umbilical blood sampling

111
Q

what does PUBS test involve

A

inserting needle directly into fetal umbilical vessel and drawing blood

112
Q

what is the PUBS test primarily used for

A

to detect inherited blood disorders such as hemophilia

113
Q

hemophilia is associated with which fetal test

A

PUBS

114
Q

main complications of PUBS test

A

fetal hemorrhage and infection

115
Q

advantage to PUBS test

A

fetus can be treated before birth

116
Q

disadvantages of PUBS

A

miscarriage rate after PUBS is 2%, risk infection, bleeding, ruptured membranes, late diagnosis

117
Q

folic acid is also called

A

folate

118
Q

what is the importance of folic acid during pregnancy

A

daily dose of 0.4 mg of folic acid can prevent neural tube defects

119
Q

when does the neural tube develop

A

17-30 days of gestation

120
Q

what can result if there is abnormal neural tube development

A

spina bifida

121
Q

what is the ideal weight gain in the first trimester

A

3-4 lbs

122
Q

obese women should gain how much weight over course of pregnancy

A

15 lbs

123
Q

normal weight women should gain

A

25-35 lbs

124
Q

low weight women should gain

A

28-40 lbs

125
Q

underweight BMI

A

below 18.5

126
Q

normal BMI

A

18.5 - 25

127
Q

overweight BMI

A

25-30

128
Q

obese BMI

A

over 30

129
Q

how many extra calories is a woman to eat a day in order to gain the proper weight

A

300kcals/day

130
Q

what is the minimum daily calorie intake in order to avoid negative nitrogen balance

A

1800kcals/day

131
Q

folate recommendations

A

400 IU/day or 0.4 mg

132
Q

what must be taken with iron supplement

A

something acidic or with orange juice, vitamin C is needed

133
Q

what increases the absorption of iron

A

calcium

134
Q

how long does first stage of labor last

A

6-20 hours

135
Q

second stage of labor can last how long

A

5 min to 2 hours

136
Q

third stage of labor last

A

5-30 minutes

137
Q

fourth state of labor last how long

A

1-4 hours

138
Q

what does the first stage of labor involve

A

transition from 1cm to fully dilated

139
Q

what does the second stage of labor involve

A

pushing from fully dilated until delivery

140
Q

what does the third stage of labor involve

A

baby’s delivery until placenta delivery

141
Q

what does the fourth stage of labor involve

A

period of maternal adjustment

142
Q

what phases make up the 1st stage of labor

A

latent phase
active phase
transition phase

143
Q

which phase of labor is encouraged to be done at home

A

latent phase

144
Q

0-3 cm dilated is what phase

A

latent phase

145
Q

latent phase characterized by

A

10-30 second contractions
5 minutes apart
0-3 cm dilated

146
Q

active phase characterized by

A

40-50 second contractions
2-4 min apart
4-7 cm dilated

147
Q

transition phase characterized by

A

90 second strong contraction
1-2 min apart
8-10 cm dilated

148
Q

when is episiotomy performed

A

during crowning when the perineal musculature is distended

149
Q

what is an episiotomy

A

incision into perineum to enlarge vaginal outlet

150
Q

what may be attempted before an episiotomy

A

warm compresses or stretching with oil

151
Q

what is the most common degree of an episiotomy

A

2nd degree

152
Q

the risk of what increases as the length of the third stage of labor increases

A

hemorrhaging

153
Q

when does third stage of labor end

A

when placenta is delivered

154
Q

during third stage of labor how often are vitals taken

A

q 15 minutes

155
Q

vitals done how often in fourth stage of labor

A

first hour: q 15 min x 4
second hour: q 30 min x 2
third to sixth: every hour

156
Q

what assessments are necessary during 4th stage of labor

A

fundal firmness, fundal location, bladder fullness, lochia

157
Q

what would you do if the fundus is boggy

A

first check to see if bladder is full, if not then massage until it is firm

158
Q

nursing care during active phase

A

change of positions, pain meds, epidural, breathing technique, ice birthing ball, effleurage

159
Q

96% of birth presentations are

A

cephalic - head first

160
Q

cephalic presentation is what

A

head first

161
Q

3% of birth presentations are

A

breech - buttocks first

162
Q

what is breech presentation

A

butt or feet first

163
Q

what does fetal lie tell you

A

the relation of the baby’s spine to the spine of mom

164
Q

longitudinal lies are what

A

vertical

165
Q

longitudinal lies can be either

A

breech or cephalic

166
Q

what is a transverse lie

A

baby is sideways

167
Q

can mother have baby vaginally if the lie is transverse

A

no, vaginal birth cannot occur

168
Q

station refers to

A

relation of babys largest presenting part to the ischial spines either above below or in line with

169
Q

what are primary powers

A

involuntary contractions

170
Q

what are secondary powers

A

bearing down efforts once cervix is dilated

171
Q

what is effacement

A

measured from 0-100% and is thinning of cervix

172
Q

what usually occurs first dilation or effacement

A

effacement

173
Q

hat is dilation

A

widening of cervix

174
Q

another term for effacement is

A

cervical ripening

175
Q

oxytocin is always administered via

A

IV infusion pump

176
Q

is informed consent necessary for oxytocin

A

yes

177
Q

side effect of epidural

A

hypotension

OB (7 decks)

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