Prenatal Care Flashcards
1
Q
3 Categories of Pregnancy Signs
A
1) Presumptive
2) Probable
3) Positive
2
Q
Presumptive Signs
A
- Amenorrhea
- N/V: ~50%
- Breast tenderness (mastodynia)
- Urinary Sx
- Fatigue
- Quickening (Can be confused with peristalsis)
- 18wk w/primapara
- 14-16 w/multipara
- Skin Changes
- Increased basal body temperature
3
Q
Skin changes associated w/pregnancy
A
- Cholasma ~16+wk
- Linea nigra
- Stretch marks (Stiae)
- Spider telangiectases
4
Q
Probable signs of pregnancy
A
- Enlarged ABD
- Ballottement
- Change in uterine shape, size, consistency
- Softening of cervix (Goodell’s sign: 6-8wk)
- Blueish discoloration of cervix (Chadwick’s sign)
- Softening and palpability of Uterine Isthmus (Hegar’s Sign)
- Uterine contractions (28wk)
- Leukorrhea
5
Q
Positive signs of pregnancy
A
- FHT
- Palpable outline of the fetus/movement
- Ultrasound of fetus
- hCG: Urine (99.5% sensitive); Serum (98%)
6
Q
Fetal Heart Tones
A
- Audible at 10wk gestation by doppler
- 12wk from LMP
7
Q
When Fetal Heart Tones Can Be Felt by Examiner
A
- 17-19wk
8
Q
Ultrasound confirmation of Pregnancy Dx
A
- Gestational sac and cardiac activity @ 5-6wk
- Fetal pole with movement/heart 7-8wk
- Limb buds at 7-8wk
- Finger/Limb movement @ 9-10wk
9
Q
Pregnancy Test Overview
A
- hCG first detectable in urine/serum @ 7-8d after ovulation/conception
- test by 3wk after conception or 5wk after LMP
- Peak levels at 60-90d post-conception
- Blood levels parallel urine
10
Q
Accuracy of UPT
A
- Menstrual day 20-26: 60%
- Menstrual day 28: 90%
- 7 Days late: 97%
11
Q
When to check if periods are irregular
A
- Wait the number of days of the longest cycle in last 6mo. If negative, repeat test.
12
Q
Prenatal Care Facts
A
- Somewhat controversial
- Insufficient data to recommend for or against
- Probably beneficial to high risk pt’s
- Ongoing assessment of mother’s physical/emotional health; fetal health and development
13
Q
Frequency/Type or PNC
A
- Preconception
- Regular visits (7-11x/pregnancy)
- Initial visit -> q4-6wk until 28wk -> q2-3 34-36wk -> weekly after 36wk
- Usual Practice: routine visits for prenatal education and reassure; Provision of screening tests; Problem-oriented; Condition-specific visits
14
Q
Initial PNC Visit
A
- Prior to 12wk gestation
- Written information: pregnancy care services, proposed schedule of visits; screening offered; Lifestyle issues
15
Q
1st Antepartum Visit
A
- Dx & Dating of pregnancy
- Contraceptive/gynecologic/med/surg Hx
- Thorough H&P