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MIDTERM-JULS-2ND-1STSEM > Prenatal check up, Nutritional requirements, Labor & Delivery > Flashcards

Prenatal check up, Nutritional requirements, Labor & Delivery Flashcards

LABOR ANDDELIVERY ANDPOSTPARTUM

1
Q

NUTRITIONAL COUNSELING DURING PREGNANCY

there are two life forms that need to take nutritional intake.

A

mother and
fetus

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2
Q

Calories:

calories per day (non-pregnant)

A

2,000

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3
Q

Calories:

calories per day
(pregnant).

A

2,300 (minimum) 2,500

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4
Q

Calories:

– common board
exam answer

A

2,500 calories

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5
Q

Iron:

____ mg(non-pregnant) to ____ mg (pregnant)

A

30mg(non-pregnant) to 60 mg (pregnant)

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6
Q

FolicAcid:

A

400 mcg

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7
Q

Calcium:

A

1,200mg

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8
Q

Potassium:

A

atleast 700 mg

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9
Q

Elemental Iodine:

A

at least 1 capsule of 250 mg
per pregnancy– taken at the 2nd trimester (4th
month) of pregnancy

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10
Q

Vitamin A:

A

10,000 units– taken at the 2nd
trimester (4th month) of pregnancy

Bawal inumin sa 1st trimester kasi
magkakaroon ng teratogenic effect.

Increased fluid and fiber is also vital during pregnancy.

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11
Q

DIFFERENT EXAMINATIONS DURING PREGNANCY

A

ULTRASOUND VS. AMNIOCENTESIS

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12
Q

Visualization

A

ULTRASOUND

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13
Q

Non-invasive

A

ULTRASOUND

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14
Q

Advice to** increase fluid intake** since increased fluid intake increases visualization

A

ULTRASOUND

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15
Q

Ilang weeks during pregnancy and cut-off to
increase fluid intake?–

A

20 weeks

Pinagpatigil na since enough na ang kanyang amniotic fluid.

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16
Q

fluid intake

If less than 20 weeks

A

increase fluid intake

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17
Q

fluid intake

If 24 weeks na siyang pregnant and maliit pa ang tiyan niya, and the doctor suspects oligohydramnios.

A

require the pregnant women to
increase fluid intake to increase visualization.

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18
Q

How much fluid are you going to give?

A

average of 1,000 mL (1L) to 1,500 mL (1.5L)

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19
Q

How to give?

How much fluid are you going to give?
average of 1,000 mL (1L) to 1,500 mL (1.5L)

A

1 cup (240 mL) every
15 minutes 1 ½ hours prior to
ultrasound.

Meronganimna15minutessaloobng
isa’t-kalahating oras. (240 x 6 = 1,440
mL)

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20
Q

Aspiration

A

AMNIOCENTESIS

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21
Q

Only ____ mL of amniotic fluid is
allowed to be aspirated during the procedure.

A

15-30 mL

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22
Q

Invasive

A

AMNIOCENTESIS

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23
Q

Requireinformed consent

A

AMNIOCENTESIS

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24
Q

Performed at the lower abdomen of the
pregnant mother.

A

AMNIOCENTESIS

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25
Q

Void before the procedure since the site for
aspiration is close to the urinary bladder.

A

AMNIOCENTESIS

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26
Q

To locate the placenta

A

ULTRASOUND

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27
Q

To determine amount of babies

A

ULTRASOUND

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28
Q

To measure the amount of
amniotic fluid.

A

ULTRASOUND

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29
Q

To determine the gender of the
baby.

A

ULTRASOUND

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30
Q

To determine placental grading.

A

ULTRASOUND

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31
Q

To determine fetal lung maturity.

A

AMNIOCENTESIS

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32
Q

To determine neural tube defects.

A

AMNIOCENTESIS

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33
Q

To determine chromosomal
defects.

A

AMNIOCENTESIS

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34
Q

Requires accompaniment of
ultrasound to locate the placenta
and to avoid puncturing the
bladder

If the mother has placenta previa,
puncture at the upper abdominal
segment.

A

AMNIOCENTESIS

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35
Q

measure the amount of calcium (for fetal bone development) at the back at the placenta.

A

Placental Grading

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36
Q

most common type of neural tube defect.

A

Spina Bifida

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37
Q

SpinaBifida

A

Meningocele
Myelomeningocele

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38
Q

a birth defect where there is a
sac protruding from the spinal column.

A

Meningocele

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39
Q

Myelomeningocele

A

defect of the backbone
(spine), spinal cord and spinal canal. Most
serious form of spina bifida.

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40
Q

substances detected in the
amniotic fluid to determine fetal lung maturity.

A

Lecithin and Sphingomyelin

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41
Q

Lecithin and Sphingomyelin

NORMAL RESULT:

A

2 (Lecithin) : 1 (Sphingomyelin)

2 is to 1
2 : 1

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42
Q

best position for ultrasound

A

Dorsal Recumbent Position

However, you need to elevate 1 buttock– put a small rolled towel under the right buttock.

Rationale: Kapag umangat ang right
side, displaced ang uterus so that the
** inferior vena cava** will not be
compressed. This prevents vena caval
syndrome.

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43
Q

CVS

A

CHORIONIC VILLI SAMPLING (CVS)

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44
Q

MSAFP

A

MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

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45
Q

To determine chromosomal defects.

CHORIONIC VILLI SAMPLING (CVS) VS. MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

A

CHORIONIC VILLI SAMPLING (CVS)

46
Q

10th-12thweek

CHORIONIC VILLI SAMPLING (CVS) VS. MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

A

CHORIONIC VILLI SAMPLING (CVS)

47
Q

Normal Result: Negative (means
nochromosomal defect)

CHORIONIC VILLI SAMPLING (CVS) VS. MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

A

CHORIONIC VILLI SAMPLING (CVS)

48
Q

Insertion of catheter into the
vagina until it reaches the chorion

CHORIONIC VILLI SAMPLING (CVS) VS. MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

A

CHORIONIC VILLI SAMPLING (CVS)

49
Q

Requires accompaniment of
ultrasound

CHORIONIC VILLI SAMPLING (CVS) VS. MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

A

CHORIONIC VILLI SAMPLING (CVS)

50
Q

To determine chromosomal and neuraltubedefects.

A

MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

51
Q

14th-16thweek

A

MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

52
Q

Normal Value: 38 - 45ng/dl of
blood
<38=chromosomal defect
>45=neuraltube defect

A

MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

53
Q

Blood sampling

A

MATERNAL SERUM
ALPHA-FETOPROTEIN (MSAFP)

54
Q

NST

A

NON - STRESS TEST

55
Q

CST

A

CONTRACTION STRESS TEST

56
Q

Will not stress the baby

NON-STRESS TEST (NST) VS. CONTRACTION STRESS TEST (CST)

A

NON-STRESSTEST(NST)

57
Q

Non-stimulation of the nipple of
the mother.

NON-STRESS TEST (NST) VS. CONTRACTION STRESS TEST (CST)

A

NON-STRESSTEST(NST)

58
Q

To determine reaction of fetal
heart rate to fetal activity
(movement).

NON-STRESS TEST (NST) VS. CONTRACTION STRESS TEST (CST)

A

NON-STRESSTEST(NST)

59
Q

NON-STRESSTEST(NST)

30th-32ndweek

NON-STRESS TEST (NST) VS. CONTRACTION STRESS TEST (CST)

A

NON-STRESSTEST(NST)

60
Q

Normal Result: Reactive, Positive,
Fetal Heart Rate Acceleration

NON-STRESS TEST (NST) VS. CONTRACTION STRESS TEST (CST)

A

NON-STRESSTEST(NST)

61
Q

Eat meals prior to examination to
wake up the baby.

NON-STRESS TEST (NST) VS. CONTRACTION STRESS TEST (CST)

Kelangan
tumaas ang glucose levelng
mommy para magising si baby.

If hindi nakakain, bigyan ng juice
para mabilis.

Dapat at least 10 minutes gising
and baby. Get the FHT and give a
buzzer to a patient. Kapag
naramdaman ni patient na
gumalaw ang baby, instruct her
to press the buzzer to alert the
nurse.

After 10 minutes, bibilangin ng
nurse ang fetal heart rate.

If hindi parin gumagalaw ang
baby, possible na hindi kumain
ang nanay and it means tulog pa
ang baby. Para magising agad
ang baby, ring a bell above the
abdomen of the mother.

If 140 ang unang kuha , dapat
madagdagan ito ng 15 bpm after
10 mins na gumagalaw ang baby
para maging positive ang test.
Kapag greater than or equal kay
155, reactive and kapag less than
155 non-reactive ang baby

If non-reactive ang results, the
baby is depressed. Another test is
needed which is CST

A

NON-STRESSTEST(NST)

62
Q

Will stress the baby (contraction
stresses the baby).

A

CONTRACTION STRES STEST (CST)

63
Q

Stimulation of the nipple of the
mother (nipple-rolling ) to
stimulate uterine contraction.

A

CONTRACTION STRES STEST (CST)

64
Q

To determine reaction of fetal
heart rate to uterine contraction.

A

CONTRACTION STRES STEST (CST)

65
Q

34th-36thweek

Bakit late ginagawa?
–During the test you will stimulate
contraction. If sobrang lakas na
contraction ang ma stimulate,
posibleng mag-rupture ang bag
of water which can lead to labor.
If ma-deliver man ang baby,
mataas na ang surfactant.

24th week–production of
surfactant starts

A

CONTRACTION STRES STEST (CST)

66
Q

Normal Result: No deceleration
of Fetal Heart Rate

A

CONTRACTION STRES STEST (CST)

67
Q

The mother is not in labor during
the test.

The mother will roll her nipple for
10 minutes to stimulate uterine
contraction. Ensure privacy of the
patient.

Nipple rolling will send a signal to
the PPG to produce small
amounts of oxytocin that causes
mild uterine contraction.

Strong uterine contraction is
present in actual labor and it can
decrease fetal heart rate.

Procedure:
Allow the patient to rest before
the procedure.

Get the fetal heart rate and
maternal vital signs.

Instruct the patient to change
into the patient’s gown.

Instruct the patient to roll her
nipples for 10 minutes. Provide
privacy.

Wait for a window of 3-5minutes
na may contraction. The baby
needs to be exposed to
continuous uterine contractions.

Sample FHR: 140bpm
Normal Result: Still 140bpm
hindi dapat mag bagoang FH

Implication if there is
deceleration of FHR
-Hindi pa nag lalabor,
bumabagal na ang FHR,
mild uterine
contractions palang.
Kapag naglabor na at
strong uterine
contractions na, mas
lalong bababa ang FHR
which can be fatal to
the fetus (fetal distress).

This test can predict the   possibility of fetal distress during   normal delivery.
A

CONTRACTION STRES STEST (CST)

68
Q

Expulsion of the product of conception.

A

LABOR AND DELIVERY

69
Q

LABOR AND DELIVERY

LENGTH OF GESTATION

A

○ 9 Months
○ 35-42 weeks
○ 280 days

70
Q

The number 1 hormone that prevents contraction

A

Progesterone

71
Q

The 4 hormones that promote contraction

A

Oxytocin,
Estrogen, Prostaglandin, Fetal Cortisol

During pregnancy, progesterone levels are high. It
overpowers the 4 hormones that promote contraction
which results in the minimal uterine contraction during
pregnancy.

72
Q

painless, irregular
contractions during pregnancy.

A

Braxton Hicks Contractions

73
Q

relaxing/loosening of pelvic joints

A

Lightening

74
Q

Around____lbs of weight loss happens prior to
labor and delivery.

Happensbecauseofincreased tension and
fatigue and loss of appetite.

A

2-3lbs

75
Q

Effacement and Dilatation

A

Cervical Changes

76
Q

Last minute preparation for labor and
delivery.

A

Nesting Behavior

77
Q

becoming regular and painful

A

Braxton Hicks Contraction

78
Q

FALSE VS. TRUE LABOR

Pain is originating from the back
to the abdomen.

A

TRUE LABOR

79
Q

FALSE VS. TRUE LABOR

Pain is intensified by walking

A

TRUE LABOR

80
Q

FALSE VS. TRUE LABOR

BOW ruptured

A

TRUE LABOR

81
Q

FALSE VS. TRUE LABOR

Sedation does not affect
contraction.

A

TRUE LABOR

82
Q

FALSE VS. TRUE LABOR

Contractions are progressive or
regular

A

TRUE LABOR

83
Q

FALSE VS. TRUE LABOR

Presence of bloody show
(natanggal ang operculum
thickened cervical mucus)

A

TRUE LABOR

84
Q

FALSE VS. TRUE LABOR

Pain is relieved by walking

A

FALSE LABOR

85
Q

FALSE VS. TRUE LABOR

Pain originates from the
abdomen.

A

FALSE LABOR

86
Q

FALSE VS. TRUE LABOR

Sedation decreases contraction

A

FALSE LABOR

87
Q

FALSE VS. TRUE LABOR

Intact BOW

A

FALSE LABOR

88
Q

FALSE VS. TRUE LABOR

No cervical changes.

A

FALSE LABOR

89
Q

FALSE VS. TRUE LABOR

Contractions are not progressive
and irregular.

A

FALSE LABOR

90
Q

Ifthe cervix is 5cm dilated and 50% effaced and the BOW
is intact, the pregnant woman is in

A

TRUE LABOR.

91
Q

Is it possible that the woman is experiencing true labor
even if the bag of water is intact?

A

Yes

Yung intact na bag of water, ang nagpapatagal
sa delivery ng nanay. Some doctors would
rupture the bag of water themselves
(amniotomy).

92
Q

THEORIES OF LABOR ONSET

A
  • PROSTAGLANDIN THEORY
  • OXYTOCIN THEORY
  • UTERINESTRENGTH THEORY
  • PLACENTAL DEGENERATION THEORY and PROGESTERONE
    DEPRIVATION THEORY
93
Q

THEORIES OF LABOR ONSET

To prevent uterine rupturing of the uterus, the
endometrium produces prostaglandin to aid in
uterine contraction.

A

PROSTAGLANDIN THEORY

94
Q

At the same time, the PPG also releases oxytocin
to aid in uterine contraction.

A

OXYTOCIN THEORY

95
Q

As the baby grows, the uterus stretches and it
gets thinner.
The uterus stretches until it reaches its
maximumpoint of being stretched.

A

UTERINE STRENGTH THEORY

96
Q

When the placenta reaches 9months, it is aging.
Therefore, its ability to produce progesterone
decreases. Thus, this will not allow prevention of
contraction.

A

PLACENTAL DEGENERATION THEORY and PROGESTERONE
DEPRIVATION THEORY

97
Q

4 STAGES OF LABOR AND DELIVERY

A

STAGE OF DILATATION
STAGE OF EXPULSION
STAGE OF PLACENTAL DELIVERY
STAGE OF RECOVERY

98
Q

Starts with true labor contraction and ends with full
dilatation of the cervix.

A

STAGE OF DILATATION

99
Q

Considered the longest stage of labor and delivery

A

STAGE OF DILATATION

100
Q

3 PHASES of STAGE OF DILATATION

A

○ Latent
○ Active
○ Transitional

101
Q

Starts with the full dilatation of the cervix and ends with
the delivery of the baby.

A
102
Q

Starts with the delivery of the baby and ends with the
delivery of the placenta.

A

STAGE OF PLACENTAL DELIVERY

103
Q

Starts with the delivery of the placenta and ends with the
first 2 hours of post-delivery.

A

STAGE OF RECOVERY

104
Q

5 Ps OF LABOR AND DELIVERY

A

POWER
PASSAGEWAY
PASSENGER
PSYCHE
PLACENTAL FACTOR

105
Q

Forces are work that push the baby out.

A

POWER

106
Q

SOURCES OF POWER DURING LABOR

A
  1. Uterine Contraction
  2. Ability of the mother to bear down or push
107
Q

Source: Fundus, Myometrium, Upper
Uterine Segment
Frequency: Increment to Increment
Interval: Decrement to Increment
Primary source of power

A

Uterine Contraction

108
Q

– promote contraction
Syntocinon—-
Pitocin
Oxytocin– EINC
Methergine

A

Oxytocic Drugs

● Oxytocin na ang ginagamit sa EINC
since bawal ang IV incorporation. Kaya
di na ginagamit si Syntocinon at
Pitocin.
● Main Reason: Kapag nag-incorporate
ng Syntocinon at Pitocin, it augments labor (Masyadong lumalakas ang
uterine contraction during labor and
delivery. Kaya nauubos na ang ability
ng uterus to contract after delivery.
Kaya ang main side effect ng
Syntocinon at Pitocin ay postpartum
bleeding

109
Q

prevent contraction
(pampakapit)

Duvadilan
(most used)
Dactyl OB
Yutopar

Bricanyl/Terbutaline
widely
(also
used for asthmatic patients)

A

Tocolytic Drugs

110
Q

Correct way of pushing: Ideally, mouth
open muna para di masyadong
malakas. If hindi kaya, then mouth
close para lumakas.

A

Ability of the mother to bear down or push

111
Q

SAMPLEBOARDQUESTION:
The woman is experiencing threatened
abortion. The doctor ordered the nurse to
administer Terbutaline/Bricanyl SC. The patient
asked the nurse, “why are you giving me
Terbutaline?” What is your response?

a. It relaxes the smooth muscles of the
uterus.
b. It promotes bronchodilation.
c.Both A and B
d. None of the above

A

a. It relaxes the smooth muscles of the
uterus.

MIDTERM-JULS-2ND-1STSEM (4 decks)

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