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OB > Test 1 Blueprint (3) > Flashcards

Test 1 Blueprint (3) Flashcards

1
Q

What causes morning sickness?

A
  • often unknown
  • hormonal changes, possibly hCG
  • emotions
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2
Q

What causes fatigue?

A
  • often unexplained
  • increased estrogen, progesterone, and hCG
  • elevated body temp
  • psychologic response to pregnancy
  • physical adaptations
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3
Q

What causes urinary frequency?

A

1) vascular enlargement and altered bladder function from hormones
2) pressure on bladder from enlarged uterus

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4
Q

What causes pyrosis (heartburn)?

A

progesterone slows GI tract motility and digestion, reverse peristalsis, relaxes cardiac sphincter, enlarged uterus presses upward on stomach

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5
Q

What causes hemorrhoids and varicosities?

A

hereditary

pressure from enlarged uterus, gravity, and bearing down

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6
Q

What causes backache?

A

lumbar lordosis, change in center of gravity, relaxation of symphyseal and sacroiliac joints from hormones (relaxin)

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7
Q

What causes insomnia?

A

fetal movements
muscle cramping
urinary frequency
SOB

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8
Q

What causes leg cramps?

A

Compression of nerves to lower extremities b/c of enlarging uterus
Too little calcium, too much phosphorus
Fatigue, poor peripheral circulation, pointing toes
Drinking too much milk

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9
Q

What causes supine hypotensive syndrome?

A

uterus pressing on vena cava when woman supine, decreasing perfusion to uterus and placenta, baby can become hypoxic

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10
Q

Other pregnancy discomforts:

A

vaginal discharge
skin changes
nasal stuffiness

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11
Q

What signs/symptoms should be reported to doctor immediately?

A

UTI
PIH
Preeclampsia

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12
Q

What can result from frequent UTI’s?

A

preterm labor

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13
Q

What do UTI’s include?

A
  • asymptomatic bacteriuria
  • cystitis
  • pyelonephritis
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14
Q

Asymptomatic bacteriuria is diagnosed when:

A

10,000 organisms/mL

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15
Q

All women screened for asymptomatic bacteriuria when?

A

first prenatal visit

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16
Q

What problems are associated with asymptomatic bacteriuria?

A

preterm labor

low birth weight

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17
Q

What is a bladder infection called?

A

cystitis

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18
Q

S/S of cystitis:

A 
dysuria
urgency/frequency
lower abdominal/suprapubic pain
Pathogens in urine
hematuria
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19
Q

What is a kidney infection called?

A

pyelonephritis

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20
Q

What is the leading cause of septic shock during pregnancy?

A

pyelonephritis

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21
Q

Complications of pyelonephritis?

A

anemia
septicemia
transient renal dysfunction
pulmonary insufficiency

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22
Q

What can pyelonephritis cause?

A

fetal death
intrauterine growth restriction
preterm labor

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23
Q

S/S of pyelonephritis?

A 
abrupt fever
shaking
chills
aching of lumbar area/costovertebral angels tender 
anorexia
N/V
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24
Q

Pregnancy induced hypertension (PIH) is a precursor to ____.

A

preeclampsia

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25
Q

PIH can lead to:

A
  • preeclampsia
  • stroke
  • acute kidney injury
  • heart failure
  • placental abruption
  • death
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26
Q

Fetal risks associated with PIH:

A

IUGR
death
preterm labor

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27
Q

S/S of PIH:

A

visual disturbances
periorbital edema
fluid volume deficit

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28
Q

Who is more at risk for preeclampsia?

A

pregnant women with PIH

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29
Q

What occurs with the liver in preeclampsia?

A

HIGH liver enzymes

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30
Q

What med is given to women with PIH or preeclampsia?

A

Magnesium sulfate

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31
Q

What is the purpose of mag sulfate?

A

prevent seizures

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32
Q

HELLP syndrome is:

A

H: hemolysis
EL: elevated liver enzymes
LP: low platelets

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33
Q

What are the 5 cardinal signs of preeclampsia?

A

1) proteinuria
2) edema
3) HTN
4) HA, dizziness
5) blurred vision

34
Q

Signs of ECCLAMPSIA:

A 
persistent HA
blurred vision
severe epigastric pain (RUQ)
altered mental status
seizures
35
Q

Amniotic fluid is slightly ____ (pH).

A

alkaline

36
Q

What color does amniotic fluid turn litmus (nitrazine) paper?

A

blue

37
Q

What is ballottement? What type of pregnancy sign is it?

A

gentle tapping on cervix, fetus bounces away then back

PROBABLE sign

38
Q

What is the first recognition of fetal movements called? When does it occur?

A

quickening

16-20 wks (14-16 wks for multips)

39
Q

What is a concern when the membranes rupture?

A

umbilical cord prolapse

cuts off baby’s blood and oxygen

40
Q

What is the purpose of the mucus plug?

A

prevent bacteria from entering the uterus

41
Q

Why is measuring fundal height important?

A

assesses fetal well being and determines age

42
Q

When the fundal height is stable or decreased, this could indicate…

A

intrauterine growth restriction (IUGR)

43
Q

Excessive increase in fundal height could indicate…

A

polyhydramnios

multifetal gestation

44
Q

What lab values are important to know in pregnancy:

A 
Hct
Hgb
Rh
Rubella
RPR and VDRL (syphilis)
1 hr and 3 hr glucose tolerance
Urinalysis
45
Q

What lab values indicate anemia?

A

Hgb less than 10 g/dL

Hct less than 30%

46
Q

What does ABO typing test for? Rh typing?

A 
ABO = blood type (A,B,AB,O)
Rh = antigen (-,+)
47
Q

If the rubella titer is negative it will read as ____. What does this mean?

A

lower than 1:10 dil

means susceptible to rubella

48
Q

When can a pregnant woman get the rubella vaccine?

A

Never! Wait until postpartum.

49
Q

If canker sore is present, test for syphilis with which tests?

A

RPR or VDRL

50
Q

When must the mother be treated to avoid spreading syphilis to the fetus?

A

by 18-20 weeks

51
Q

All women take which glucose tolerance test? When?

A

1 hour

24-28 wks gestation

52
Q

Who must take a 3 hr glucose tolerance test?

A

At risk pts

If failed 1 hr

53
Q

Glycosuria is ___ in the urine.

A

sugar

54
Q

What causes glycosuria?

A

decreased renal threshhold

55
Q

What may glycosuria indicate?

A

diabetes

56
Q

What can proteinuria be a sign of?

A

infection or preeclampsia

57
Q

Proteinuria is seen with a value of:

A

2+ to 4+ on dipstick

58
Q

Ketonuria may result from insufficient ____ intake or ____.

A

food

vomiting

59
Q

WBCs in urine may indicate ____.

A

infection

60
Q

What are Braxton Hicks contractions?

A

irregular uterine contractions
no cervical change
- increases blood flow to uterus
- strengthens muscles for birth process

61
Q

Education for Braxton Hicks contractions:

A

drink water to help with BP and amount of amniotic fluid

62
Q

BMI: underweight

mom needs to gain:

A
  • gain in entire 1st Tri: 2.2-4.4 lb
  • gain in 2nd, 3rd Tri: 1-1.3 lbs/wk
  • total during pregnancy: 28-40 lbs
63
Q

BMI: normal

mom needs to gain:

A
  • gain in entire 1st Tri: 2.2-4.4 lbs
  • gain in 2nd, 3rd Tri: 0.8-1 lb/wk
  • total during pregnancy: 25-35 lb
64
Q

BMI: overweight

mom needs to gain:

A
  • gain in entire 1st Tri: 1.1-4.4 lbs
  • gain in 2nd, 3rd Tri: 0.5-0.7 lbs/wk
  • total during pregnancy: 15-25 lb
65
Q

BMI: obese

mom needs to gain:

A
  • gain in 1st Tri: 1.1-4.4 lbs
  • gain in 2nd, 3rd Tri: 0.4-0.6 lb/wk
  • total during pregnancy: 11-20 lb
66
Q

How to determine EDC using Naegles Rule:

A

subtract 3 months from FIRST DAY OF LAST PERIOD

add 7 days

67
Q

Agents that cause birth defects are called:

A

teratogens

68
Q

During the first 2 weeks of development the embryo is not usually susceptible to ____.

A

teratogens

69
Q

Teratogens in 3-8 weeks can result in:

A

major congenital anomalies

70
Q

Teratogens in 9-38 weeks can result in:

A

functional defects and minor anomalies

71
Q

Severity of exposure to teratogens related to:

A

1) timing of exposure
2) different susceptibility or organ system
3) strength of teratogen

72
Q

What areas are the most vulnerable to malformation upon teratogen exposure?

A

developing areas with rapid cell division

73
Q

Caffeine can cause:

A

heart dysrhythmias

74
Q

Drug use can cause:

A

birth defects
SROM
vaginal bleeding

75
Q

How far before pregancy should rubella vaccine be given?

A

at least 3 months prior

76
Q

Why should pregnant women avoid changing the litter box?

A

risk of toxoplasmosis

77
Q

How should a pregnant woman lay to increase venous flow?

A

on her side

78
Q

How may a pregnant woman have pseudoanemia?

A

increase in vascular anemia –> increase in RBCs –> hemodilution –> Hgb & Hct levels decrease –> pseudoanemia of pregnancy

79
Q

Education for diaphragm use:

A
  • insert into vagina up to 6 hours before sex
  • use with spermicidal jelly/cream
  • leave in place 6-8 hours after sex
  • increases risk of UTI
  • may need new size if weight fluctuates
  • does not prevent STD
  • must be washed with mild soap and water, dried, kept away from heat
80
Q

What nutritional concerns with vegetarian pregnant woman?

A
  • risk for B12 deficiency; need supplement
  • sources of B12: milk, eggs, meat (liver)
  • Deficient B12 may result in neurologic deficits: maternal-infant megaloblastic anemia; infant-neuron-development delays
81
Q

Fetus viable at ___ weeks, ___ g.

A

20 wks

500 grams

OB (12 decks)

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