Prenatal care part 1 Flashcards

1
Q

Risk factors for fetal abnormalities

A
  • Advanced maternal age
  • previous pregnancy affected by chromosomal abnormalities
    *recurrent history of early pregnancy loss
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2
Q

Screenings performed at a preconception visit

A

HIV, STD, TB, the antibody for Rh factor, any genetic disorder influenced by race or ethnicity

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3
Q

How long do you wait for pregnancy after receiving a live vaccine

A

1 month

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4
Q

what is the recommended dose of folic acid a pregnant lady should take

A

> 0.4-0.8

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5
Q

when does antepartum surveillance begins

A

1st prenatal visit

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6
Q

what is hyperemesis gravidarum

A

extreme nausea and vomiting, top reason to cause the pregnant women to go to the hospital

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7
Q

What are some of the symptoms present in the 1st trimester

A

amenorrhea, breast tenderness, fatigue, edema, weight gain, morning sickness

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8
Q

When does hyperemesis gravidarum begin?

A

1st trimester

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9
Q

2nd and 3rd trimester signs and symptoms

A

back pain, leg cramps, round ligament pain, varicose veins

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10
Q

treatment for round ligament pain

A

yoga/stretching/change positions GRADUALLY

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11
Q

quickening

A

begins 16-18 weeks at times until 20 weeks

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12
Q

when can examiners feel quickening

A

24 weeks

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13
Q

Striae gravidarum

A

pigmented line down the midline of a pregnant women

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14
Q

what causes the striae in the middle of the abdomen

A

increase in progesterone

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15
Q

when is the 1st trimester

A

0-13 weeks and 6 days

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16
Q

when is the 2nd trimester

A

14 weeks - 27 and 6 days

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17
Q

when is the 3rd trimester

A

28-40 and 6 days

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18
Q

what is considered preterm

A

born before 37 weeks

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19
Q

what is considered full term

A

39- 40 weeks and 6 days

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20
Q

components of 1st prenatal visit

A

medical/obstetric history, psychosocial history, calculated EDD, US, lab test, selective screenings

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21
Q

What does the HPI always have to include

A

maternal age, gravity/parity status, LMP, estimated gestational age, CC

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22
Q

GTPAL

A

G- total number of pregnancies
T - full term babies (37-40 weeks)
P - preterm babies (20-37 weeks)
A- abortion and miscarriages
L- living children

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23
Q

Gravida

A

a woman who is or has been pregnant

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24
Q

primigravida

A

a woman who is in or who has experienced her 1st pregnancy

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25
Q

multigravida

A

a woman who has been pregnant more than once

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26
Q

null gravida

A

a woman who has never been pregnant

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27
Q

primipara

A

a woman who has given birth to only 1 child

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28
Q

multipara

A

a woman who has given birth 2 or more times

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29
Q

nullipara

A

a woman who has never given birth or who has never had a pregnancy progress beyond the gestational age of abortion

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30
Q

how to calculate EDD

A

1st LMP - 3months + 7 days

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31
Q

What is the most accurate in calculating gestational age?

A

US

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32
Q

how much should a pregnant woman gain?

A

25-35lbs

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33
Q

what is the total weight an obese woman should gain when they are pregnant

A

11-20lbs

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34
Q

when does BP typically decrease

A

at the end of the 1st trimester

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35
Q

what is considered gestational HTN

A

after 20 weeks, persistent systolic of >140 or diastolic of >90 WITHOUT proteinuria

36
Q

what does the 1st prenatal visit obstetric exam include

A

pelvic exam, cervical assessment, fetal HR

37
Q

when can you use Doppler US to detect FHR

A

8-10 weeks

38
Q

Narrowest fixed distance through which the fetal head must pass during vaginal delivery

A

obstetric conjugate

39
Q

which pelvic type is the most common

A

round/gynaecoid

40
Q

which is pelvis shape is the second most common

A

anthropoid

41
Q

which pelvic shape requires C-section or is the most difficult

A

platypelloid

42
Q

what is chadwick sign

A

bluish discoloration of the vaginal mucosa

43
Q

when is the chadwich sign seen

A

8-12 weeks

44
Q

what is Goodell sign

A

softening and cyanosis of the cervix

45
Q

when is goodell sign seen

A

6-8 weeks

46
Q

what is hegar sign

A

softening of the uterus at the junction with the cervix (cervical isthmus)

47
Q

when is hegar sign felt

A

6-12 weeks

48
Q

what is the normal fetal HR

A

110-160

49
Q

what is the FHR in 1st weeks

A

150-170

50
Q

where can you feel the fundus when the gestational age is 20 weeks

A

umbilicus

51
Q

From where do you measure the fundal height

A

top of the uterine fundus to the pubis symphysis

52
Q

when is the fundal height in cm roughly equal to the weeks of gestational age

A

16-36 weeks

53
Q

what is the goal fetal presentation

A

occiput anterior

54
Q

when can you feel lightening

A

about 36 weeks

55
Q

What is lie

A

long axis of fetus relative to longitudinal axis of uterus

56
Q

what is presentation

A

the fetal part that directly overlies the pelvic inlet
- cephalic/breech

57
Q

position

A

relationship of the fetus’s head in comparison to the maternal pelvis
- occipital anterior

58
Q

Sunny side up

A

cephalic posterior (back of the head is on the back of the mom’s pelvis)

59
Q

What is Leopod’s maneuvers

A

series of 4 palpitations to determine fetal lie, presentation and position

60
Q

when can you use the Leopold maneuvers

A

20 weeks

61
Q

when can you conduct an external cephalic version

A

36-38 weeks if breeched

62
Q

Transabdominal can visualize pregnancy at what weeks

A

5-6 weeks

63
Q

when do you use transvaginal US

A

if transabdominal US is inconclusive, can detect at 4-5 weeks

64
Q

what is the most accurate method of estimating gestational age

A

US assessment of crown to rump length

65
Q

how long should you exercise if the patients does not have any medical or obstetric complications

A

30 minutes per day of the week

66
Q

pica

A

inclination for non-nutritional substances such as ice, food, starch, clay

67
Q

what should a pregnant woman avoid eating

A

unpasteurized/raw food, thoroughly wash fresh fruits, avoid fish high in mercury, avoid soft cheese

68
Q

how much folic acid should a pregnant woman take a day

A

400ug/day for low risk and 4mg/day for high risk

69
Q

which med is the pain reliever of choice in pregnant woman

A

acetaminophen

70
Q

what is the antihistamine of choice in a pregnant woman

A

chlorpheniramine

71
Q

which antidiarrheal med is the TOC for pregnant woman

A

kaopectate

72
Q

what are the first choice antidepressant for pregnant woman

A

SSRI and SNRI

73
Q

fetal alcohol syndrome

A

growth restriction, facial abnormalities, CNS dysfunction

74
Q

what is the most common developmental delay that is preventable

A

alcohol

75
Q

what are considered teratogens to a pregnant woman

A

ionizing radiation, methyl mercury, herbal remedies

76
Q

Sexual activity in pregnant woman

A

no restrictions during pregnancy

77
Q

when is sexual activity restricted in a pregnant woman

A

placenta previa, vaginal bleeding, premature rupture of the membrane, history of preterm labor

78
Q

Most airline permit travel for up to how many weeks

A

36 weeks

79
Q

travel is avoided in which types of pregnant women

A

HTN, poorly controlled DM, sickle cell disease

80
Q

how long is the leave of absence

A

4-6 weeks

81
Q

benefits of breastfeeding

A

nutrition, passive immunity, decrease rates of DM, HTN and heart disease

82
Q

CI to breastfeeding

A

maternal infection, medication, if an infant has galactosemia

83
Q

what vitamin need to be supplemented for infants who are breast feeding in the 1st year

A

vitamin D 400IU

84
Q

vaccines not recommended

A

HPV, MMR, live flu, varicella, travel vaccines

85
Q

when is circumcision performed

A

2 days of life

86
Q

primigravida

A

a woman who is in or who has experienced her 1st pregnancy