prenatal

Question 1

prenatal care goals: 1st trimester

Answer 1

• screen for maternal risk, problems(ectopic pregnancy, htn, comorbid disorders)- screen for fetal genetic abnormalities- prevent fetal phenotype abnormalities

Question 2

prenatal care goals: 2nd trimester

Answer 2

“golden trimester” - LOTS of teaching- ultrasound- screen for fetal phenotype abnormalities- continued monitoring mom/fetus

Question 3

prenatal care goals: 3rd trimester

Answer 3

• monitor for gestational hypertension (major mom morbidity)- prevent preterm birth (major neonatal morb/mortality)- monitor fetal health

Question 4

ectopic pregnancy

Answer 4

fertilized ovum implants outside of uterine cavity: abdomen, uterine tubes, and ovariessignificantly increased in last 30 years due to chlamydia, gonnorhea scarring tubes

Question 5

traditional visit schedule

Answer 5

outdated.q4 weeks until 28q2 until 36q week

Question 6

centering pregnancy

Answer 6

superior prevention of preterm birth- individual care until 15 weeks- 15-36: group of 8 to 12 women - q4 until 3rd trimester; then q22 hour visits, lots of dialogues, belly checks

Question 7

fetal testing during pregnancy should be offered to…

Answer 7

ALL WOMEN UNIVERSALLY REGARDLESS OF AGE

Question 8

majority of babies with trisomy 21

Answer 8

in moms

Question 9

dental problem significance

Answer 9

consistent with preterm birth - gum infection inflammatory response can spread through bloodstream

Question 10

progesterone during pregnancy effect

Answer 10

slows down gastrointestinal system = constipation

Question 11

systolic murmur in pregnant women significance

Answer 11

okay, especially past 20 weeks - she has an extra liter of blood circulating

Question 12

physiologic hydronephrosis

Answer 12

ureters very dilated, easier for germs to mve from bladder up to kidney - urine culture!

Question 13

ultrasound uses

Answer 13

dating, viability, rule out ectopic pregnancyaccurate within 1 week, prefer over naegele

Question 14

hcg significance

Answer 14

fetal viability - large amounts cease period. corpus luteum creates progesterone 8-12 weeks then disintegrates, when placenta takes over. once baby’s heart starts beating –> ultrasound time

Question 15

ectopic pregnancy s/s

Answer 15

pain (spontaneous, adnexa)slowly rising hcgsometimes bleedingcan cause death: can rupture major vessels leading to severe bleeding

Question 16

naegle’s rule

Answer 16

1st day of LMP - 3 months + 7 daysLMP + 7 days + 9 months

Question 17

fundal height changes

Answer 17

1cm per week 18-36

Question 18

fetal heart tones heard

Answer 18

12 weeks (doppler)20 (fetoscope)

Question 19

urine testing nota bene

Answer 19

no longer routine for healthy women

Question 20

warning signs: 1st trimester

Answer 20

extreme pain (ectopic!)bleeding (more than spotting)can’t hold down liquids/solids for SEVERAL hoursillness (UTI, swelling of one calf)

Question 21

warning signs: 2nd trimester

Answer 21

bleedingcessation of fetal movement after quickeningany major illnesses

Question 22

warning signs: 3rd trimester

Answer 22

bleedingdecreased fetal movement (10x 12 hours)severe abdominal painrupture of membranesptl symptoms (contractions > 5 per hour, backache, pelvic pressure)gestational hypertension signs

Question 23

fetal testing: 1st trimester

Answer 23

goals: chromosomal abnormalities. catch early = options!- fetal cells in maternal blood- chorionic villus testing (risk of miscarriage)- nuchal fold skin testing

Question 24

fetal testing: 2nd trimester

Answer 24

phenotype testing:- maternal serum alpha-fetoprotein/quad screen (open neural tube defects)- trisomy 21, 13chromosomal testing:- amniocentesis (diagnosis, not screening - high risk for miscarriage)

Question 25

fetal testing: 3rd trimester

Answer 25

goal: fetal wellbeing. it’s viable!diabetes @ 28 weeksGBS @ 35-37repeat GC/CT/STIs if at risk

Question 26

Rh+ fetus immune response (2 stages)

Answer 26

1st: IgM (acute infection, doesn’t cross placenta)2nd: IgG (memory; crosses placenta)

Question 27

weight gain: underweight

Answer 27

28 - 40 lbs

Question 28

weight gain: normal

Answer 28

25 - 35 lbs

Question 29

weight gain: overweight

Answer 29

25 - 42 lbs

Question 30

folic acid significance

Answer 30

decrease in neural tube defects

Question 31

not breastfeeding weight loss recommendation

Answer 31

500 cal decrease + healthy diet

Question 32

listeria significance

Answer 32

listeriosis is bad for baby, crosses placenta and causes major problems.in: deli-style meats, unpasteurized soft cheese, high-mercury fish

Question 33

psychological adjustment: 1st trimester

Answer 33

ambivalence normal

Question 34

psychological adjustment: 2nd trimester

Answer 34

attachment

Question 35

psychological adjustment: 3rd trimester

Answer 35

mothering role