T4-Advanced Organizer Part 2 Flashcards
What could make a pt susceptible to toxoplasmosis?
- eating raw or undercooked meat
- coming in contact with contaminated soil
- infected animal (Cat) feces
Why may a pt need an RPR test?
testing for syphilis
What is the test for syphilis?
RPR test
When does an RPR test occur?
Why?
(test for Syphilis)
- all women at prenatal visit
- high risk at 3rd trimester and at L&D suite
What will occur if mom has positive RPR test at delivery?
(positive for syphilis)
- will transmit across placenta at 18 weeks gestation
- congenital anomalies/congenital syphilis can occur
How can congenital syphilis be tested?
Test cord blood
What is HSV2?
Herpes Simplex Virus
What may be needed prior to birth if a mother has HSV2??
When?
Prophylactic Acyclovir at 36 weeks
Why is acyclovir used prophylactically in HSV2?
decreases viral shedding during delivery
When may a c section be needed with HSV2?
if lesions are present
What kind of fetal monitoring needs to be used if the mom is positive for HSV2?
external!!!
Internal monitoring increases risk of infection of fetus
Medications needed for HIV positive pregnant woman?
- Zidovudine orally beginning at 14 weeks gestation
- admin. IV during labor
What meds will the neonate be given if mom was HIV positive?
administer drug for for 6 weeks total (book)
billings says at 6 week checkup… but idk
What are the goals to protect a fetus of an HIV positive mom?
prevent opportunistic infections:
-avoid procedures that increase the risk of perinatal transmission
What procedures could increase the risk of an infant contracting a disease from the mother in utero?
- amniocentesis
- internal fetal monitoring (electrodes on fetal scalp break fetal skin barrier)
What needs to be AVOIDED at delivery when a pregnant mother is HIV positive?
-no internal monitoring
-no episiotomies (lesa maternal blood around birth canal)
-MINIMIZED neonatal
exposure to maternal blood
-NO PITOCIN (strong contractions can cause vaginal tears
What meds given during labor of HIV positive mom?
IV Zidovudine
HIV and breastfeeding?
NO breastfeeding
PP for mom post-delivery that is HIV positive?
- protective isolation if immunosuppresed
- NO BREASTFEEDING
- monitor for INFECTION
What is most important for PP for neonate born from HIV positive mom?
BATH BABY prior to invasive procedures
Vit K, heel sticks, venipuncture
What is the most accurate test of neonate to determine HIV status?
HIV-1 DNA PCR assay
performed on neonatal blood, NO CORD BLOOD
When does Hep B testing occur?
-all pregnant women at first prenatal visit
at risk:
- 3rd trimester
- upon entering L&D suite
What it the main effect of a pregnant woman having Hep B on the fetus?
premature birth
What is Hep B?
Infection of the liver–can be fatal
Can Hep B be prevented?
YES!!!
-get Hep B vaccine (can get within 14 days of exposure to prevent infection)
Can a Hep B vaccination hurt the fetus?
NO!!
not known to hurt the fetus
Treatment for Hep B infection?
No specific treatment
-recovery is spontaneous in 3 to 16 weeks
What should a women who has contracted the Hep B virus do?
(no treatment)
-increase rest periods
-eat high protein, low fat
-increase fluid intake
avoid ETOH
What is the pregnant patient who uses COCAINE at risk for?
placental abruption
What does alcohol use by a pregnant woman cause?
Fetal alcohol syndrome
3 categories r/t fetal alcohol syndrome?
- prenatal/postnatal growth restriction
- CNS malfunction
- Craniofacial features
What craniofacial features may occur due to fetal alcohol syndrome?
- microcephaly
- small eyes/short palpebral fissures
- thing upper lip
- flat midface
- indistinct philtrum
Nicotine is a _________.
DRUG!!
Why is nicotine a drug?
stimulant drug that is found in tobacco
-addictive substance that creates physiological and psychological dependence
What is an amniocentesis?
Procedure in which a needle is inserted through the abdominal and uterine walls under ultrasound guidance into the amniotic fluid; some fluid is withdrawn
Why get an amniocentesis?
Used for assessment of fetal health and maturity
-may use to check for malformations. genetics issues
What us am amniotomy?
Artificial rupture of membranes, using a plastic amnihook or surgical clamp
How is a AROM performed?
via amniotomy
What is an amnioinfusion?
Infusion of room-temp isotonic fluid (usually NS or LR) into the uterine cavity if the volume of AF is low, in an attempt to increase the fluid around the umbilical cord
Why perform an amnioinfusion?
prevent compression during uterine contractions
When is an amniocentesis performed?
after 14 weeks gestation
Why would an amniocentesis be performed EARLY in the pregnancy?
to detect chromosomal abnormalities
Why would an amniocentesis be performed LATE in the pregnancy?
to determine fetal lung maturity with L/S ratio to detect the amount of surfactant production in fetal lungs
What is an AFP useful for?
Prenatal diagnosis of genetic disorders or congenital anomalies
NTD in particular
What is L/S ratio important for?
Assessment of pulmonary maturity
What is in the amnio fluid?
Why important?
fetal cells!! (hair, skin, etc)
-allows for genetic testing
How does the amnio fluid need to be handles immediately after obtaining for testing?
Brown bag!!
Keep away form light source and transport in brown bag until it gets to the lab
How is amniocentesis performed?
When?
Done after 14 weeks
Needed inserted into uterus, AF withdrawn with syringe
Why wait until after 14 weeks for amniocentesis?
Uterus is ABOVE symphysis pubis and fluid amounts are adequate
