T4: Assessment for High Risk Pregnancy

Question 1

high-risk pregnancy

Answer 1

when the life of the mother, fetus, or newborn are in danger, care of high-risk pregnancy requires an entire health care team.

Question 2

Biophysical risks

Answer 2

Factors that originate within the mother or fetus and affect the development or functioning of either one or both

Question 3

Psychosocial risks

Answer 3

Maternal behaviors and adverse lifestyle
o Negative lifestyle behavior, emotional distress, depression, domestic violence, alcohol abuse, inadequate social support

Question 4

Sociodemographic risks

Answer 4

Arise from the mother and her family
o None or lack of prenatal care, low income, minorities, advanced maternal age (>35 years of age), teen pregnancy

Question 5

Environmental factors

Answer 5

Hazards in workplace and in the environment
o Smoking, chemicals, radiation, illicit drugs

Question 6

Daily fetal movement count (DFMC)

Answer 6

maternal assessment of fetal activity; the number of fetal movements within a specified time are counted; also called “kick count”

Question 7

education for daily fetal movement count (DFMC)

Answer 7

everyday mom chooses time that is convenient for her, mom takes juice/water and stays on her side for 1 hour, BABY IS TO MOVE 5 TIMES IN THE HOUR (this is reassuring)

Question 8

if the Daily fetal movement count (DFMC) is <5..

Answer 8

then mom can stay there for another hour and baby can “catch up”

Question 9

what is considered “reassuring” for Daily fetal movement count (DFMC)

Answer 9

times in 1 hour or 10 times in 2 hours

Question 10

what is considered the most valuable tool for antepartum/biophysical assessment

Answer 10

ultrasound

Question 11

level 1 US

Answer 11

standard, basic US and it will measure fetal presentation (head, buttocks, foot, ect.), placental position, cardiac activity, fetal growth, and number of fetuses

Question 12

level 2 US

Answer 12

limited US performs ONE specific piece of information, such as ONLY figuring out fetal presentation.

Question 13

level 3 US

Answer 13

o more DETAILED US, MFM (maternal fetal medicine) uses this, it is VERY detailed and takes up to 2 hours, can measure Doppler blood flow, measurement of head chest and extremities, maternal uterine arteries, umbilical arterial flow, CAN BE USED TO DIAGNOSE IUGR

Question 14

IUGR (intrauterine growth restriction)

Answer 14

fetal undergrowth from any cause

Question 15

what do we do for IUGR babies

Answer 15

These babies do better on the outside so they often times will deliver them

Question 16

a Biophysical profile (BPP) involves what two tests

Answer 16

an US and non-stress test

Question 17

what is the purpose of a Biophysical profile (BPP)

Answer 17

ordered for fetal well-being

Question 18

what is the max score for a Biophysical profile (BPP)

Answer 18

10 points (<6 means that prolong monitoring is needed)

Question 19

what are the two tools used for biophysical profile (BPP)

Answer 19

US and fetal heart monitor

Question 20

amniocentesis

Answer 20

needle puncture of the amniotic sac to withdraw amniotic fluid for analysis

Question 21

amniotic fluids determines…

Answer 21

there are genetic disorder, congenital abnormalities, neural tube defects, cystic fibrosis or sickle cell disease

Question 22

what should be done after an amniocentesis

Answer 22

MOM SHOULD STAY ON FETAL MONITOR FOR 1-2 HOURS AND A PRESSURE DRESSING SHOULD BE APPLIED

Question 23

education after amniocentesis

Answer 23

if needle site continues to leak they need to return to hospital because there is a risk for infection

Question 24

Oligohydramnios

Answer 24

<300mL of amniotic fluid (too little amniotic fluid)

Question 25

oligohydraminos is associated with

Answer 25

renal anomaly because amniotic fluid is the baby urine

Question 26

1 artery and 1 vein indicates

Answer 26

KIDNEY DEFECT

Question 27

polyhydraminos

Answer 27

> 1500mL of amniotic fluid (too much amniotic fluid)

Question 28

L/S ratio (Lecithin/Sphingomyelin) indicates

Answer 28

FETAL LUNG MATURITY
if the ratio is between 2.0-2.5 it indicates baby lungs ARE matured

Question 29

CST/Oxytocin test

Answer 29

ordered for fetal well-being, low dose oxytocin or nipple stimulation is done to see if baby can handle contractions

Question 30

positive CST test means

Answer 30

means baby CANNOT tolerate labor (because they have decelerations with contractions)

Question 31

Chorionic villus sampling (CVS):

Answer 31

THEY TAKE SAMPLE FOR PLACENTA and test it to tell us if there are any genetic disorders

Question 32

when is a Chorionic villus sampling (CVS) done

Answer 32

FIRST TRIMESTER (1-13 weeks, usually between 10-13 weeks)

Question 33

Percutaneous umbilical blood sampling (PUBS) or cordocentesis

Answer 33

sample of fetal blood is taken for testing

Question 34

Alpha-fetoprotein (AFP) is recommended to be performed when?

Answer 34

recommended to be performed 15-20 weeks gestation to be most reliable

Question 35

Alpha-fetoprotein (AFP)

Answer 35

measures fetoprotein and tells us if there are any abdominal wall defects also screened for neural tube defects

Question 36

Goal of electronic fetal monitoring

Answer 36

to determine if the intrauterine environment is supportive to the fetus

Question 37

Vibroacoustic stimulation

Answer 37

used if there is minimum variability you use a “buzzer” to stimulate fetus

Question 38

results of vibroacoustic stimulation

Answer 38

YOU WANT AN ACCELERATION WHEN STIMULATED, if there is a deceleration it tells us something is wrong with baby

Question 39

Contraction stress test (CST) can be done either through

Answer 39

can be done either through nipple stimulation or oxytocin stimulation