Prenatal care Flashcards
Folic acid requirements?
.4 mg or 4 mg 4 weeks before conception and then 3 months after fertilization
Iron Requirements?
30 mg
Calcium Requirements?
1200 mg
Protein requirements?
80 mg
Average weight gain of pregnant mother?
25-35 pounds
What BMI is associated with cardiac defects, NTD, and anomalies?
> 30
What vaccinations should be given and should not be given?
TdAP and Flu after first trimester
NO live vaccines
When should you test for Group B Strep? and what do you use to treat?
35-36 weeks. Penicillin
Antibiotics that are OK during pregnancy?
PNC, erythromycin, cephalosporins, macrolides, nitrofuratonin
Antibiotics that need to be avoided during pregnancy?
aminoglycosides, quinolones, and tetracyclines
Presumptive signs of pregnancy?
N/V, fatigue, urinary frequency, breast changes, amenorrhea, quickening (fetal movement)
Probable signs of pregnancy
Pelvic organ changes, abdominal enlargement, uterine souffle, pigmentation changes, braxton hicks contrnactions, ballottement, positive pregnancy test
Positive symptoms of pregnancy
Fetal heart tones, US visualizations, fetal outline palpation, laboratory test
What is parity?
result of pregnancy >20 weeks
What is GTPAL
Gavid, term, preterm, abortion, living
How long is a woman post part?
6 weeks
Nagal’s rule to determine date of pregnancy
LMP minus three months plus 7 days. only 3-5% on actual due date
Length of trimesters?
0-13, 14-28, 28- delivery
Who is at risk for chromosomal abnormalities?
Moms over 35 and dads greater than 55
Who is at risk for hemoglobinopathies?
AA, jewish/french canadians, mediterrian decent (beta thalassemia)
Initial labs for all patients?
Type and Rh, CBC, rubella, RPR, Hep B, HIV, UA, pap smear and wet prep
When should a woman seek care?
Vaginal bleeding, fever >101, abdominal pain/cramping, UTI, severe N/V, headache unrelieved by tylenol, vaginal leadkage
When should MSAFP be done?
15-22 weeks?
When should U/S be done?
18-2- weeks
When should another CBC be done?
24-28 weeks
When should glucose tolerance test be done?
24-28 weeks
When do you give Rhogam?
28 weeks if negative and then three days before delivery
When do you test for group B strep?
35-36 weeks
What should weight gain be like?
One pound per month until third trimester than 1 pound per week
What are signs of labor?
ligtening, increase activity, ripening of cervix, uterine contractions, bloody show, rupture of membranes
What do contractions look like in labor?
Increasing duration and frequency of contractions. Should last 60 seconds and be regular.
False labor and contractions?
Rest may stop them, walking may increase them, NO cervical dilation
Frequency of visits?
Q4 weeks for first two trimesters
Q2 weeks till 36 weeks
Q1 week until birth
What is concidered term?
37-41 weeks
What 6 things should be checked each visit?
Vitals, weight, urinalysis, edema, uterine size, and fetal hear ttones
When should you start feeling fetal movement?
20 weeks
Uterine height?
Pubic symphysis to top of funds
Should be at umbilicus @ 20 weeks. Each additional week is another centimeter
What are three ways to date pregnancy?
Fundal height
Quickening 18-21 weeks
Fetal heart tones- Doppler at 10 weeks and fetoscope at 20 weeks
Normal weight for fetus?
2500-4000 g
HR for fetus?
110-160
What is a biophysical profile?
Combines non-stress testing with ultrasound readings. Can assure fetal wellbeing for 3 days
What are screening tests for chromosomal abnormalities?
Quad test late- 15-20 weeks
NSAFP 15-20 weeks
Nuchal Transparency- 10-14 weeks
HCG/PAPP-A 10-14 weeks
Diagnostic test for abnormalities?
- chorionic villus sampling 10 weeks
- Amniocentisis 15-20 weeks
Glucose challenge? When, how much, and good range
24-28 week, 50gm, less than 140 is normal
Where do you measure fetal station from?
Ischila spine
What pain medication can be used during pregnancy?
Tylenol
What medications should be avoided?
ASA, NSAIDs, peptobismal, anticofulsants
What medications are teratogens?
Lithium, isoteritonin, coumadin, ACE inhibitors, tetracycline
Common complaints in first trimester?
Ptyalism, stuffy nose, ambivalance, N/V, heaviness of breasts, increased urination
Common complaints in second trimester?
Low quad pain from round ligament (right), excess bile, more edema, nesting
Common complaints in third trimester?
Constipation, hemorrhoids, difficultiy urinating, pain over pubis, swelling over feet, lower leg, it over stomach
Medications for HTN in pregnancy?
Methyldopa, CCB
Medications to be avoided in pregnancy?
BB in first trimester, diuretics, ACE/ARBS
Preterm labor date?
before 37 weeks
Risks for preterm labor?
chorioamniocentesis, uterine abnormaliteis, multiple gestations, polyhdraminos, UTI, Genetis
Treatment for preterm labor?
MSO4, indocin, difedipine, betamethasone, terbutaline
When does N/V start usually and when does it end?
9-18 weeks
What are the drugs for peripartum N/V
Vit B6 10-50 mg QID
Doxylamine 12.5 mg QID Antihistamine
Promethazine 12.5-25 mg
What does the Kleihauer-Betke test do?
Determine the amount of immunoglobulin needed (Rhogam) if there is maternal bleeding/fetal bleeding.
Most likely diagnosis of third trimester bleeding? Painful and non painful?
Nonpainful- placenta prevea
Painful- Placental Abruption
What fish should a mother eat?
STKMS- high mercury fish
Swoardfish, tilefish, King mackerel, shark
How much low mercury fish and tuna can a mother eat?
12 and 6 oz
