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Clin Med 1 Final > Prenatal Care > Flashcards

Prenatal Care Flashcards

1
Q

Preconception: Risk Profile

A

work related exposure, risk for modifiable infectious diseases, hereditary disorders, nutritional status, domestic abuse risk, substances, psychiatric disorder risk, pre-term risks

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2
Q

preconception: work risks

A

working more than 36 hours a week or more than 10 hrs a day, heavy lifting, excessive noise, 4+ hrs of standing, mental stress, cold work environment, exposure to toxins - anesthesia, solvents, pesticides

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3
Q

preconception: infectious disease risk

A

rubella, varicella, TB, HIV, Hep B&C, STDS - syphillis, chlamydia, gonorrhea, herpes simplex, substance abuse - esp. IV drug use, periodontal disease

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4
Q

preconception: genetic risk

A

hemophilia, muscular dystrophies, CF, mental retardation, Tay-Sachs, Hemoglobinopathies

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5
Q

preconception: Nutritional Status, BMI

A

folic acid: 400-800 micrograms 1 month prior and 3 months after conception, BMI: 18-25, 25 - gestational diabetes, hypertension and preeclampsia, problems in labor and delivery

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6
Q

preconception: domestic abuse

A

pregnancy is a risk factor, have a clear plan for referring victims and perpetrators, screening questions

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7
Q

preconception: medication use

A

pregnancy rating (A,B,C,D,X), inventory all prescription, OTC, herbal and vitamins

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8
Q

preconception:substance

A

alcohol - Fetal alcohol spectrum, none is safe, past use = pregnancy use, tobacco- stop/reduce #, discuss cessation at every visit, low-birth weight infants

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9
Q

preconception: psychiatric disorder risk

A

depression, anxiety increase risk for post-partum, pregnancy, labor/delivery, post-partum are stressful, assess coping and support

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10
Q

preconception: pre-term labor risks

A

demographics - african-american, LSES, low educational level, 35 yo, unmarried
hx- cervical issues, prior loss or preterm, low BMI, mental illness
lifestyle - substance use, domestic violence, stress
infection/inflammation - bacterial vaginosis, systemic illness/fever, periodontal disease, UTI, STI

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11
Q

preconception visit education

A

fertile window and LH monitoring, healthy habits - diet, exercise, stress reduction, preventative screenings and immunizations, when to follow-up

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12
Q

pregnancy symptoms

A

amenorrhea, N+V, breast tenderness and tingling, urinary frequency and urgency, wt gain, fetal movements - quickening @ 18 wks gestation

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13
Q

positive signs of pregnancy

A

detection of fetal heart tones - doppler 8-10 wks, TVU at 5-6 wks, fetal movements, palpation of fetal parts, ultrasound confirmation

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14
Q

lab diagnosis of pregnancy

A

pregnancy tests - home:urine, diagnostic lab: urine/serum, Beta-hCG (human chorionic gonadotropin) - produced by placenta, peaks at 10 weeks and doubles every 48 hrs, IUP on TVU at 1500-2000 mIU/mL, fetal heartbeat on TVU At 5000 mL, monoclonal antibody testing - urine: qualitative at 5-50 mIU/mL, serum (5-7 days after conception): 2-4 mIU/mL

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15
Q

hCG tests is positive

A

consider how to convey info, calculate EDD and gestational age

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16
Q

gestation

A

40 weeks (280 days) from LMP

17
Q

gestational age

A

weeks and # of days -9 4/7

18
Q

Estimated Date of Delivery (EDD)

A

nagel’s rule - add 7 days to first day of LMP, count back 3 months
35 day cycles - add 14 days
21 day cycle - add 0 days

19
Q

confirm gestational age

A

physical assessment - fetal heart tones with doppler ultrasound:8-10 weeks, uterine size - 8 weeks at pubic symphysis, ultra sound - crown-rump length btwn 7-14 weeks gestation is most accurate

20
Q

embryo vs. fetus

A

embryo: until 8 weeks
fetus: after 8 weeks

21
Q

prenatal care focus

A

complete history - common symptoms, physical assessment, labs, testing, education and counseling

22
Q

prenatal hx: medical and surgical

A

medical and surgical - uterine surgery, c-sections, diabetes, hypertension, heart disease, asthma, epilepsy, thyroid disease, DVT, psychiatric problems

23
Q

prenatal hx: reproductive hs

A

gravity - # pregnant
parity - # births
G__ P #Term #Preterm #Abs #Living

24
Q

prenatal: infectious diseases

A

HIV, syphilis, rubella, hep B, varicella, toxoplasmosis, listeria, parvovirus, CMV

25
Q

Prenatal social hx: substance use

A

tobacco- miscarriage, prematurity, low birth weight, alcohol-growth retardation, neurobehavioral effects, fetal alcohol syndrome, other substances and presciptions

26
Q

prenatal exposures to toxins

A

occupation, house -pets and hobbies, dietary- caffeine, megavitamins, heavy metals - avoid shark, swordfish, tiles fish, king mackerel

27
Q

prenatal lifestyle recommendations

A

regular moderate exercise - avoid hyperthermia, weight - nutritional deficiencies, caffeine, supplements, calories, pscyhosocial - positive, stress-free, supportive environment, readiness for childbirth and parenting

28
Q

Prenatal PE

A

Head to toe - weight, BMI, BP, thyroid, cardiac, respiratory, abdomen - fetal heart tones, breasts, pelvic exam - pelvimetry, pap, bimanual exam and uterine size

29
Q

prenatal labs

A

pelvic ultrasound, CBC, Gestational DM, infections - GC, chlamdia, syphilis, HIV, urine culture, hepatitis, rubella,varicella

30
Q

prenatal counseling and education

A

nutrition - 300 mg iron, 1000 mg CaCO3, 400-800 mcg daily, decrease caffeine, sexual activity, travel, work, normal changes, smoking/alcohol/drug use cessation, injury prevention, social support, anticipated schedule of visits and course of care, when to call

31
Q

prenatal care

A

0-32 weeks: every 4 weeks, 32-36 weeks - every 2 weeks, 36 weeks to delivery - every week (8-11 visits)

32
Q

fetal aneuploidy screening

A

10-18 weeks

33
Q

abdominal ultrasound

A

20 weeks

34
Q

gestational diabetes

A

24-28 weeks

35
Q

Rh or D - incompatibility follow-up

A

28 weeks

36
Q

Group B streptococcus

A

35-37 weeks

37
Q

Late 3rd trimester

A

follow-up concerns, review S+S that are normal and those that are emergent, labor, hospitalization, mode of delivery, analgesia, post-partum, childbirth prep classes, breast feeding, infant care plan

Clin Med 1 Final (6 decks)

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