Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Women's Health Rotation > Prenatal Care/Normal Pregnancy > Flashcards

Prenatal Care/Normal Pregnancy Flashcards

1
Q

When is a pregnant woman considered to be at term?

A

37-42 wks completed gestational age

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Latent phase of labor

A

The initial part of labor where the cervix mainly effaces (thins) rather than dilates (usually cervical dilation <6 cm)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Active phase of labor

A

The portion of labor where dilation occurs more rapidly, usually when the cervix is >6 cm dilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Arrest of active phase

A

No progress in the active phase of labor (greater than or equal to 6 cm) with ruptured membranes for 4 hrs with adequate contractions, or 6 hrs of inadequate contractions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Stages of labor

A

First stage: onset of labor to complete dilation of cervix
Second stage: complete cervical dilation to delivery of infant
Third stage: delivery of infant to delivery of placenta

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Fetal heart rate baseline

A

Normally between 110-160 bpm. Fetal bradycardia is a baseline <110 bpm, and fetal tachycardia is exceeding 160 bpm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Decelerations

A

Fetal heart rate episodic changes below the baseline.
3 types: early (mirror image of uterine contractions), variable (abrupt jagged dips below the baseline), and late, which are offset following the uterine contraction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Accelerations

A

Episodes of the fetal heart rate that increase above the baseline for at least 15 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the 3 Ps that should be evaluated in labor?

A

Powers
Passenger
Pelvis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

How are adequate uterine contractions defined?

A

Contractions every 2-3 minutes, firm on palpation, and lasting for at least 40-60 seconds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

On a fetal heart rate monitor, what is indicative of a nomal well-oxygenated fetus?

A

A nl baseline between 110-160 bpm, with acceleration, and variability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common deceleration?

What does it indicate?

A

Variable

Cord compression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do late decelerations along with decreased variability indicate?

A

Acidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What do late decelerations indicate?

A

Fetal hypoxia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What do early decelerations indicate?

A

They are benign

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Normal duration of labor in latent phase, nullipara

A

Less than or equal to 18-20h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Normal duration of labor in latent phase, multipara

A

Less than or equal to 14h

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Normal duration of labor in active phase, nullipara

A

Continued progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Normal duration of labor in active phase, multipara

A

Continued progress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Normal duration of labor in second stage, nullipara

A

Less than or equal to 3h

Less than or equal to 4h if epidural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Normal duration of labor in second stage, multipara

A

Less than or equal to 2h

Less than or equal to 3h if epidural

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Normal duration of labor in third stage, nullipara

A

Less than or equal to 30 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Normal duration of labor in third stage, multipara

A

Less than or equal to 30 min

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Category I fetal heart rate pattern

A

Reassuring- normal baseline and variability, no late or variable decelerations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Category II fetal heart rate pattern

A

Bears watching- may have some aspect that is concerning but not ominous

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Category III fetal heart rate pattern

A

Ominous and indicates a high likelihood of severe fetal hypoxia or acidosis- examples include absent baseline variablity with recurrent late or variable decelerations or bradycardia, or sinusoidal heart rate pattern (this requires prompt delivery if no improvement)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Reasons for C-section delivery

A 
Labor dystocia
Abnormal fetal heart rate pattern
Fetal malpresentation
Multiple gestation
Suspected fetal macrosomia
28
Q

What is the purpose of prenatal care?

A

To educate and build rapport with the pt and family
Establish gestational age
Screen for possible conditions that may impact maternal and fetal health
Monitor the progress of the pregnancy

29
Q

Cardiovascular changes in pregnancy

A

CO and plasma volume increased 50%
Systemic vascular resistance decreased
MAP unchanged/slightly lower
Diastolic pressure decreases in 1st and 2nd trimester then returns to pre-pregnant level around 36 wks

30
Q

Respiratory changes in pregnancy

A

RR unchanged
Tidal volume increased
Minute ventilation increased
O2 consumption increases

31
Q

ABG in pregnancy

A

pH 7.45
PCO2 28
HCO3 18

32
Q

Renal changes in pregnancy

A

GFR increased 50%
Serum Cr decreased
Renal calyces, pelves, and ureters undergo marked dilation
Increase in urinary stasis predisposes to UTI

33
Q

Hematologic changes in pregnancy

A

Hgb decreased slightly
Platelet decreased slightly
Leukocyte count slightly increased

34
Q

GI changes in pregnancy

A

Delayed stomach emptying
Decreased lower esophageal sphincter tone
Decreased gut motility- constipation
Increased appetite
Reflux may start or worsen
Intestinal transit time increases dramatically in 3rd trimester
Gallbladder dilates
Appendix may be displaced to the right flank
Hemorrhoids

35
Q

Ramifications of low Hgb

A

Preterm delivery
Low fetal iron stores
Identify thalassemia

36
Q

Next step in low Hgb

A

Mild therapeutic trial of iron

Moderate ferritin and Hb electrophoresis

37
Q

Ramifications of negative rubella screen

A

Nonimmune to rubella

38
Q

Next step in neg rubella screen

A

Stay away from sick individuals

Vaccinate postpartum

39
Q

Ramifications of neg Rh factor screen

A

May be susceptible Rh disease

40
Q

Next step with neg Rh factor screen

A

If antibody screen neg, give RhoGAM at 28 wk, and if baby is Rh-pos, then also after delivery

41
Q

Ramifications of positive antibody screen

A

May indicate isoimmunization

42
Q

Next step in pos antibody screen

A

Need to identify the antibody, and then titer

43
Q

Ramifications of pos HIV ELISA

A

May indicate infection with HIV

44
Q

Next step with pos HIV ELISA

A

Western blot or PCR

If pos, place pt on anti-HIV meds, offer elective Caesarean, or IV ZDV in labor

45
Q

Ramifications of pos RPR or VDRL

A

May indicate syphilis

46
Q

Next step with pos RPR or VDRL

A

Specific antibody such as MHA-TP, and if pos, then stage dz
<1 yr, PCN x1
If >1 yr or unknown, PCN IM each wk x 3

47
Q

Ramifications of pos gonorrhea screen

A

May cause preterm labor, blindness

48
Q

Next step in pos gonorrhea screen

A

Ceftriaxone IM

49
Q

Ramifications of pos chlamydia screen

A

May cause neonatal blindness, pneumonia

50
Q

Next step in pos chlamydia screen

A

Azithromycin or amoxicillin orally

51
Q

Ramifications of pos hep B surface antigen

A

Pt is infectious

52
Q

Next step in pos hep B surface antigen

A

Check LFTs and hep serology to determine if chronic carrier vs active hepatitis
Baby needs HBIG and hep B vaccine

53
Q

Ramifications of pos Pap smear

A

Only invasive cancer would alter management

54
Q

Next step in pos Pap smear

A

ASC-US: re-Pap postpartum

LGSIL, HSIL: colposcopy

55
Q

Ramifications of pos urine culture

A

Asymptomatic bacteriuria may lead to pyelonephritis

56
Q

Next step in pos urine culture

A

Treat with antibiotic and recheck urine culture

57
Q

Ramifications of pos nuchaltranslucency

A

May indicate trisomy

58
Q

Next step in pos nuchaltranslucency

A

Offer karyotype and f/u ultrasounds

59
Q

Ramifications of pos trisomy screen

A

At risk for trisomy or NTD

60
Q

Next step in pos trisomy screen

A

Basic u/s for dates; if dates confirmed, offer genetic amniocentesis

61
Q

Ramifications of pos 1h diabetic screen

A

May indicate gestational diabetes

62
Q

Next step in pos 1h diabetic screen

A

Go to 3h GTT

63
Q

Ramifications of pos 3h GTT (2 abnormal values)

A

Gestational DM

64
Q

Next step with pos 3h GTT

A

Try ADA diet, monitor BGs, if elevated may need meds or insulin

65
Q

Ramifications of pos GBS culture

A

GBS colonizing genital tract

66
Q

Next step in pos GBS culture

A

PCN during labor

Women's Health Rotation (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions