Prenatal Flashcards
Gravidity
total number of pregnancies
Parity
of pregnancies after 20 wks gestation
Term
pregancies betwen 37-40 wks gestations
abortions
of induced or sponteatnous terminations of pregnancy before 20 weeks
pregnancy screening lab tests
CBC, blood type, Rh, antibody screen, urine dip, aueuploidy screen, rubella titer, syphilis serology, HBV suf antigen, pap smear, chlamydia, gonorrhea screening
history dependent labs for pregnant patients
sickle cell screen for AA, TB screen, HIV test, urine toxicology, DM, herpes culture, serum iron, thyroid, toxoplasmosis titer, KOH wet prep
nausea and vomiting in pregnancy
hyperemesis gravidarum, multiple gestation, hydatidiform gestation, molar pregnancy, intestinal obstrustion, gastroenteritis, choleycystitis, pancreatitis, hepatitis, diabetes, thyroid disfunction, mirain, food poisioning, emotional problems, eating disorders
inherited thrombophilias
Factor V leiden, prothromin A20210, Antithrombin III, Protein C, Protein S, homocysteine
acquired thrombophlias
pregnancy, imobilization, trauma, posterperative state, high estrogen, malignancy, nephrotic syndrome, heparin-induced, myeloproliferative DOs, paroxysmal nocturnal hematuria, CHF, afib,
muscle cramps objective data
worrisome sx include + homan’s sign, unilateral swelling or tenderness, dim pulses in LE, erythema, numbness, or pale appearing calf or leg.
muscle cramps differential dx
electrolyte imbalances, thromboembolic dz, varicosites, dehydration, arthritis, sciatica, nerve root compression
numbness and tingling in the hands objective data
tinel’s sign and phalen’s test, upper extremity grip and finger strength, ability to oppose thumbs to fingers. evaluation for thenar atrophy and dry skin on the thumb, index and middle fingers (median nerve distribution).
numbness/tingling in hands differential dx
carpal tunel syndrome, muskuloskel pain, arthritis, infection, cervical neck injury or dz, nerve damage, cardiac problems, thoracic outlet syndrome, hyperventilation
Dyspnea in pregnancy
may be associated with activity, or may follow eating, drinking or potential allergy exposure,
dyspnea differential dx
pregnancy related dyspnia, URI, nasal congestion, asthma, bronchitis, pneumonia, pulmonary embolus, cardiac disease, anemia, anxiety, hyperventilation, aspiration, anaphylaxis
fatigue in pregnancy
usually occurs in first and third trimesters, screen with CBC, thyroid function tests
fatigue differential diagnosis
fatigue d/t pregnancy, anemia, thyroid disorder, other pathological states
urinary frequency considerations
check for cva or suprapubic tenderness, CBC, glucose levels, urine dip, UA/cx/sens
urinary frequency diff dx
pregnancy related urinary frequency, UTI, pyelonephritis, kidney stone, diabetes
urinary incontinence considerations
often with coughing, sneezing or laughing d/t intraabdominal pressure and enrlarged utureus, special attention to urine that doesn’t smell like urine, increased incontn. with lying down, or gush with initial standing which may indicate rupture of membranes
urinary incont objective findings
r/o uterine contactions or irritability. R/o amniotic fluid pooling, nitrazine and fern tests differentiate between vag discharge and amniotic fluid,
urinary incontinence diff dx
stress urinary incont, rupture of membranes, leukorrhea, vaginitis
complications of pregnancy
anemia, gestational diabetes, hypertension, vaginal bleeding, vaginal infections, UTI, size not equal to dates, preterm labor
vaginal infection differential dx
leukorrhea, vaginitis, cervicitis, gonorrhea, chlamydia, UTI, rupture of membranes, condyloma acuminatum, genital herpes or cervical dysplasia/neoplasia
conditions assoc with intrauterine growth restriction
hypertension, multiple gestation, placental abnormality, intrauterine infection, fetal abnormalities, renal dz, DM, lupus, sickle cell anemia, tobacco, substance abuse, malnutrition, maternal heart disorders, thrombophilias, chronic lead poisoning
