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NURS: 2146 OB > Test 2 Pregnancy & Prenatal > Flashcards

Test 2 Pregnancy & Prenatal Flashcards

1
Q

Which vaccine is a Live vaccine needed before pregnancy

A

MMR

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2
Q

White people need Preconception testing for which disease esp.

Blacks

A

Cystic Fibrosis

1 in 25

Sickle cell

1 in 12

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3
Q

Which vitamin is needed prenatal

Why?

Dosage…

A

Folic acid B9

Neural tube defects (Spinal Bifida)

400 micrograms

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4
Q

1st trimester anticipated weight gain

A

4 lbs

Food aversion makes many women lose weight 1st trimester

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5
Q

Tay-Sachs
Canavan
Familial dysautonomia
Gaucher’s
Nieman-Pick
Maple syrup urine

Prenatal screening for which ethnic group?

A

Ashkenazi Jews

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6
Q

Hemoglobin E/beta thalassemia disease

Which ethnic group Prenatal Screening

A

Southeast Asian

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7
Q

Underweight
Normal
Over
Obese

How much weight in 2nd and 3rd tri should each category gain?

How much weight should each category gain per week

A

Underweight 28 - 40
Normal 25 - 35
Over 15 - 25
Obese 11 - 20

Underweight 1
Normal 1
Over 0.6
Obese 0.5

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8
Q

Fertile window starts ___ days prior to ovulation and ends on the day of ovulation - (egg is released from an ovary and into the fallopian tube during a woman’s menstrual cycle)

A

5 days prior to ovulation

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9
Q

Assume 28 day cycle

Which day is ovulation?

Which days are Fertile?

A

Ovulation day 14

Fertile around day 9

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10
Q

Early preggers HCG Human Chorionic Gonadotropin is produced by the trophoblastic cells surrounding the embryo

HCG doubles every 48 - 72 hrs.

<6,000 hcg levels increase by atleast ___ % every 2-3 days

Hcg levels that don’t rise properly can lead to….

A

60

Miscarriage

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11
Q

Pregnancy test measure Hcg and are 97% accurate

How quickly?

A

1 week after fertilization

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12
Q

Signs felt by early preggers

A

Thirsty
Vivid dreams
Missed period
Increase sense of smell
FOOD AVERSIONS
Sad
Breast change
Increase urination
Cramps
Nausea
Fatigue
Increase Body Temp

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13
Q

Objective signs of preggers

Compressibility and softening of cervical isthmus. (Portion of cervix between uterus & vaginal portion of cervix)

A

Hegar sign

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14
Q

Hegar

A

Objective signs of preggers

Compressibility and softening of cervical isthmus. (Portion of cervix between uterus & vaginal portion of cervix)

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15
Q

Goodwill Sign

A

Softening of vaginal portion of cervix from increased vascularity

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16
Q

Normal RR in preggers

HR

What happens with BP

Cardiac output?

A

12 - 24

Up to 110

Lower BP

Cardiac output Doubles

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17
Q

Are varicose & spider veins expected during preggers

How about dizzy / fainting

A

Yeppers

They happen

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18
Q

Softening of cartilage caused by ______ allows for Body to adapt to growing baby and gives woman a Pregnancy Waddle

A

Rise progesterone

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19
Q

Ligament that connects Uterus to Labia Majora ……

Pain in the area gets worse each pregnancies BURNING CRAMP

A

Round ligament pain

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20
Q

Increase or Decrease

WBC
Clotting factors
Plasma

A

WBC UP
Clotting factors UP
Plasma UP - Result Dilution Anemia- RBC Stays the same and plasma volume increases

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21
Q

Values

Non preggers

Hemoglobin 13.3
Hemocrit 38 - 45
WBC 4 - 11
Fibrinogen 300
Platelets 140 - 440

A

Hemoglobin 11
Hemocrit 32 - 34
WBC 6 - 14
Fibrinogen 450
Platelets 150 - 400

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22
Q

Chloasma ….

A

Mask of preggers

Due to increased Perfusion & Vascularness to skin (Releases Heat)

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23
Q

Linea Nigra….

A

Hypermelanosis up the abdomen

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24
Q

Why Hydronephrosis (excess fluid in a kidney due to a backup of urine)
in 90-95% of women?

A

Increased Perfusion to kidneys
Increase GFR/ Urine output

Ureter compression from the uterus

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25
Q

Stress incontence happens from…

A

Decreased bladder tone

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26
Q

Describe Gastrointestinal Adaptation

A

Decreases smooth muscle relaxation / Decreased Peristalsis

Increased

N/V
Heartburn
Constipation
Hemorroides
Gallstones

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27
Q

______ increases prolactin

Thyroid, increases thyroxine increases _____

Parathyroid does…

Ovaries / Placenta…

A

Pituitary Gland

Basal metabolic rate

Increases PTH for increased calcium & phosphorus

Increases Estrogen, Progesterone, Relaxin

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28
Q

Fundus height continues to rise until …

Reasons for a higher fundal height?

Lower?

Typically which week does it stop growing

A

Fetus engages in Pelvis prior to delivery

High fundal height = Multiple babies, big baby, Molar Preggers (tumor that develops in the uterus as a result of a nonviable pregnancy)

Lower: IUGR Intrauterine growth restriction, SGA, Fetal demise

36th week

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29
Q

Fundal height between 20th - 36th week

A

Matches number of weeks

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30
Q

A variation of ___cm could suggest an issue with fetal dev

A

2cm

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31
Q

Are painful breast and nipples ever normal in preggers

A

Yes esp in 1st trimester

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32
Q

Psychological Adpation

1st

2nd

3rd

A

1st Ambivalent/ Focuses on herself

2nd ID with mother role, Reorder personal relationships

3rd: Prepare for birth, fantasy about baby, Nesting

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33
Q

1st trimester

Week 1 - 4

Weeks 3 - 8

Week 5 - 8

9 - 12

A

Week 1 - 4
Implantation
3rd week primitive heart beat

Weeks 3 - 8
All major organs formed

Week 5 - 8
Heart begins to pump
Arms & legs bud
Facial features begin to form

9 - 12

Extremities developed
External Genital differentiate

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34
Q

Weeks most susceptible to Teratogens

A

3 - 8

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35
Q

2nd Trimester

13 - 16

17 - 20

21 - 24

25 - 28

A

13 - 16
Fetus begins to move
Urine formation begins

17 - 20
Meconium begins collecting in bowels

21 - 24
Skin wrinkled, red, vernix, lanugo

25 - 28
Eyes partially opened
Resp. System still immature

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36
Q

3rd trimester

29 - 32

33 - 36

37 - 40

A

29 - 32
Toe nails & testies descended

33 - 36
Skin thicker, Fat accumulation, Excelente chance of survival

37 - 40
Baby gains fat
Nails extend beyond nail bed

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37
Q

Wharton’s Jelly

A

Gelatinous mucosal tissue that cushions and insulated the umbilical cord vessels

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38
Q

Umbilical cord shunts Deoxygenated blood where

A

Placenta

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39
Q

3 structures shunt blood away…

A

Ductus arteriosus
Foramen Ovale
Ductus venosus

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40
Q

Prenatal care

1st trimester: First Visit to confirm pregnancy? May include US

2ND: Follow up every ___ weeks.
US scheduled at ____ weeks.

3rd: Follow up visit every 2 weeks once mom is ____ weeks pregnant.
After ____ weeks it is weekly visit

A

1st: between 8 - 10 weeks

2nd: Follow up every 4 weeks past initial visit. Anatomy US is scheduled between 18 - 20 weeks.

3rd: Follow up visit every 2 weeks once 28 weeks. After 36 weeks it’s weekly visit

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41
Q

First trimester: Weeks _____
Second trimester: Weeks _____
Third trimester: Weeks _____

A

First trimester: Weeks 1–12
Second trimester: Weeks 13–26
Third trimester: Weeks 27–40

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42
Q

1st visit

What happens

A

Prenatal panel
Pelvic exam
Confirm pregnancy
H&P
Abuse screening
STI

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43
Q

STI

Often no symptoms
Cervical culture
Blood test, VDRL, RPR
Molecular testing or Wet prep slide of vaginal discharge

A

OK

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44
Q

How to lower risk of giving HVI to new born

A

Antivirals during preggers
C/S
No breastfeeding

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45
Q

State Naegales rule…

A

Based on 28 day cycle

Subtract 3 months from 1st day of previous Menstrual Period & Add 7 days

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46
Q

Caloric increase needed by trimester

A

1st None
2nd 340/day
3rd 450/day

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47
Q

Foods to avoid

A

Shark,swordfish, king mackerel, tile fish.

Lunch meat / hotdogs unless steaming hot

Soft cheese unless made with pasteurized milk

Pate, meat spread, smoked seafood

Unpasteurized milk, dairy, cider

Max 12 oz shrimp, salmon, pollock, catfish, and canned tuna per week

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48
Q

Iron

Standard dose….

Special case dose…

Tips…

A

30mg Ferrous Sulfate 2nd & 3rd Tri
If anemic take 60 - 120mg

Cannot be supplied completely by diet

Take on empty stomach

Take with OJ to help absorption

Don’t Take with calcium supplements, milk, tea, coffee decreases absorption

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49
Q

Foods that contain iron

A

Meats, green leafy veg, eggs, grain, enriched products, dried fruits, tofu, legumes, nuts

50
Q

Preggers is an immunosuppressed state

True or False

A

True

51
Q

Which vaccines are safe to get when preggers…

Which are strong NO

A

Covid, Flu, Tdap

HPV, MMR, VARICELLA, ZOSTER

Others are maybe

52
Q

Fetal Testing

Ultrasound

Type of test (Screening/ Diagnostic)

How it works?

Preformed when?

A

Screening

Visible build up of fluid on neck maybe sign of a disorder

11 - 14 weeks

53
Q

Amniocentesis

Screening or Diagnostic test

What does…

Needle through belly extracts amniotic fluid

Performed at….

A

Diagnostic

ID chromosomal abnormalities, inherited, and spinal column / brain defects

Performed at 15 - 20 weeks

54
Q

Chorionic Villus Sampling CVS

Screening or Diagnostic

How is it performed?

What it does…..

Performed at….

Risks….

A

Diagnostic

Tissue from the placenta check for genetic or chromosomal abnormalities in a fetus.

ID chromosomal & inherited diseases

Performed 10 - 12 weeks

Risk miscarriage 1 out of 500. Bigger risk than amniocentesis 1 out of 1,000

55
Q

Maternal blood test.

Also allows for chromosomal abnormalities screening

Maternal blood contains fetal DNA which passes through the placenta

Performed at….

Detects 99% of Downs - up to 50% of positives are false

A

10 weeks or later

56
Q

Fetal test…

A

NIPT : Innatal, Maternity21

blood test that analyzes fetal DNA in the mother’s blood to screen for chromosomal abnormalities such as Down syndrome (trisomy 21), trisomy 18, and trisomy 13.

Purpose: It’s non-invasive and provides early risk assessment for genetic conditions, typically performed as early as 10 weeks into pregnancy.

Maternal Serum AFP

level of alpha-fetoprotein, a protein produced by the fetal liver, in the mother’s blood.

Purpose: High or low levels may indicate neural tube defects (like spina bifida), abdominal wall defects, or chromosomal abnormalities. It’s usually part of the second-trimester quad screen.

CVS

placental tissue (chorionic villi) is removed for testing.

Purpose: 10-13 weeks
Detect chromosomal or genetic disorders, such as cystic fibrosis or Down syndrome.

Amniocentesis

15-20 weeks to diagnose chromosomal abnormalities, neural tube defects, and genetic conditions.

fetal lung maturity in later pregnancy if preterm delivery is being considered.

BPP Biophysical profile

five factors—fetal heart rate, breathing movements, body movements, muscle tone, and amniotic fluid level

3rd trimester

NST

monitors the fetal heart rate in response to fetal movements using external monitoring

3rd trimester

57
Q

Why are the first & second ultrasound performed

A

1st Confirm IUP Intrauterine pregnancy

2nd Anatomy Scan

58
Q

GTT

Fasting 1 hr and possibly 3 hr repeat test for gestational diabetes in ___ trimester

A

2nd

59
Q

Blood test

A

CBC
T&S
Rubella
HIV
VDRL/RPR
Hep B
HSV 1&2

60
Q

GBS Culture when

What if positive

A

35 - 37 weeks / vag & rectum

If positive mom recieves PCN while in active labor Q4H until delivery

First dose 5 million units & additional dose 2.5 million units

61
Q

Why call a provider if patient has
Headache not helped by tylenol
Visual disturbances
SOB & RUQ pain

A

Preeclampsia

62
Q

Prenatal panel (10)

A

Blood Type and Rh Factor: Determines the mother’s blood type (A, B, AB, or O) and Rh status (positive or negative) to assess the risk of Rh incompatibility with the fetus.

Complete Blood Count (CBC): Measures hemoglobin, hematocrit, and red and white blood cell counts to check for anemia, infections, and overall blood health.

Rubella Immunity: Tests for immunity to rubella (German measles), as a rubella infection during pregnancy can cause birth defects.

Hepatitis B and C Screening: Checks for hepatitis B and C infections that could affect the fetus.

HIV Screening: Screens for HIV, as early treatment can reduce the risk of mother-to-child transmission.

Syphilis Screening: Tests for syphilis, which can be treated during pregnancy if detected early.

Varicella Immunity: Tests for immunity to chickenpox, which can cause complications if contracted during pregnancy.

Urine Culture: Checks for urinary tract infections (UTIs), protein, glucose, or ketones, which could indicate gestational diabetes or other concerns.

Cystic Fibrosis Screening: Offers genetic testing to see if the mother is a carrier of cystic fibrosis.

Thyroid Function Tests: Checks thyroid hormone levels, as thyroid dy

63
Q

Taylor Sachs disease

Describe

A

Degenerative neurological

Die young

64
Q

Obese women usually (Gain or Lose) weight during preggers

A

Lose

65
Q

How long can sperm live in women’s reproductive tract

A

Up to five days

66
Q

Chemical pregnancy…

A

Pregant according to the Pee preggers test but the baby doesn’t survive.

No implementation

hcg increases but no baby comes

67
Q

N/V starts when in preggers

A

6 weeks

68
Q

Probable preggers signs (4)

A

Hegars
Goodwill
Chadwick (Bluish cervix, vagina, vulva)

Positive Hcg test

69
Q

Due to ____ there is a change in the center of gravity in a preggers, causing falls.

Falls are more likely to result in injury due to____

A

Both

Softening of cartilage

70
Q

Hemoglobin is decreased bc of increased plasma (dilation of RBC concentration) which number would be a concern and what is the remedy

A

10 or below

Iron

71
Q

Fundus before preggers is found where

A

Pubis symphysis

72
Q

Meaure uterus from these landmarks

Uterus size and gestational age correlation

A

Top of pubic bone / Fundus

Size will be the same as length in cm

73
Q

Montgomery glands do what?

A

Lubricate the nipple

74
Q

Milky discharge may start as early as…

A

15 weeks

75
Q

When does the primitive heart begin to beat….

When does the babies heart begin to pump….

A

1 - 4

5 - 8

76
Q

When does quickening happen?

A

13 - 16 weeks

77
Q

By ___ weeks the baby has a good chance for survival if it is a normal weight

A

22 - 24

More likely 24

> 500 g

78
Q

AFI normal range

Probably more correct than other card

A

8 - 25

79
Q

Oligohydramnios

Maybe a problem with this organ in the baby

A

Kidneys

They are taking amniotic fluid in but not peeing it out

80
Q

Excessive amniotic fluid >25 AFI
Maybe this problem with the mom

A

DM

81
Q

Facilitates nutrient, oxygen, waste exchange between mother and fetus

A

Placenta

82
Q

Is there contact between mother and baby’s blood?

A

No, there is diffusion of nutrients

83
Q

Conditions that damage blood vessels also damage the placenta.

Give 2 examplez

A

HTN & DM

84
Q

Placental insufficiency can cause IUGR

T OR F

A

T

Insufficient Uterine Growth Restriction

85
Q

Fetal circulation

Vein carry oxygenation blood & Arteries carry Deoxygenated blood

T or f

A

T

86
Q

Study fetal blood circulation videos

Fetal Shunts on power point

A

On test

87
Q

The three fetal shunts are specialized structures that allow blood to bypass certain areas in the developing fetal circulation, optimizing oxygen delivery and nutrient flow before birth.

These shunts are crucial because the fetal ____ & ____ are not fully functional until after birth

A

lungs and liver

88
Q

__________

Location: Connects the umbilical vein directly to the inferior vena cava.

Function: Allows oxygenated blood from the placenta to bypass the fetal liver and flow directly into the fetal heart, ensuring the oxygen-rich blood reaches vital organs faster.

Closure After Birth: Closes shortly after birth, becoming the ligamentum venosum in the liver.

A

Ductus Venosus

89
Q

Ductus Venosus

Location:
Function:
Closure After Birth:

A

Location: Connects the umbilical vein directly to the inferior vena cava.

Function: Allows oxygenated blood from the placenta to bypass the fetal liver and flow directly into the fetal heart, ensuring the oxygen-rich blood reaches vital organs faster.

Closure After Birth: Closes shortly after birth, becoming the ligamentum venosum in the liver.

90
Q

_____

Location: An opening between the right and left atria in the fetal heart.

Function: Allows oxygenated blood to flow directly from the right atrium to the left atrium, bypassing the non-functioning fetal lungs, which are still filled with fluid.

Closure After Birth: Usually closes within the first few days or weeks after birth due to changes in pressure, forming the fossa ovalis.

A

Foramen Ovale

Location: An opening between the right and left atria in the fetal heart.

Function: Allows oxygenated blood to flow directly from the right atrium to the left atrium, bypassing the non-functioning fetal lungs, which are still filled with fluid.

Closure After Birth: Usually closes within the first few days or weeks after birth due to changes in pressure, forming the fossa ovalis.

91
Q

Foramen Ovale

Location:
Function:
Closure After Birth:

A

Foramen Ovale

Location: An opening between the right and left atria in the fetal heart.

Function: Allows oxygenated blood to flow directly from the right atrium to the left atrium, bypassing the non-functioning fetal lungs, which are still filled with fluid.

Closure After Birth: Usually closes within the first few days or weeks after birth due to changes in pressure, forming the fossa ovalis.

92
Q

_________

Location: Connects the pulmonary artery to the aorta.

Function: Diverts most of the blood away from the lungs and into the aorta, as the fetal lungs are not yet used for oxygen exchange.

Closure After Birth: Begins to close within hours after birth due to increased oxygen levels, eventually forming the ligamentum arteriosum

A

Ductus Arteriosus

Location: Connects the pulmonary artery to the aorta.

Function: Diverts most of the blood away from the lungs and into the aorta, as the fetal lungs are not yet used for oxygen exchange.

Closure After Birth: Begins to close within hours after birth due to increased oxygen levels, eventually forming the ligamentum arteriosum

93
Q

Ductus Arteriosus
Location:
Function:
Closure After Birth:

A

Ductus Arteriosus

Location: Connects the pulmonary artery to the aorta.

Function: Diverts most of the blood away from the lungs and into the aorta, as the fetal lungs are not yet used for oxygen exchange.

Closure After Birth: Begins to close within hours after birth due to increased oxygen levels, eventually forming the ligamentum arteriosum

94
Q

Pregnancy test
CBC
Prenatal panel
Dating ultrasound
Maternal blood serum
Nuchal translucency (NT) is ….

A

a prenatal screening ultrasound measurement that assesses the fluid-filled space at the back of a fetus’s neck.

Checks for chromosomal abnormalities and heart defects

95
Q

Cell free DNA
Chorionic Villus Sampling

Are non routine test preformed when…

A

1st trimester

Cell free DNA

non-invasive prenatal screening (NIPS) test that analyzes small fragments of fetal DNA circulating in the mother’s blood. This test can detect chromosomal abnormalities.

Purpose: Screens for condition NOT diagnosis

CVS

An invasive diagnostic test where a small sample of cells (chorionic villi) is taken from the placenta and analyzed for genetic abnormalities.

Purpose: Diagnoses chromosomal abnormalities and genetic disorders, including Down syndrome, cystic fibrosis, and certain inherited conditions. CVS

96
Q

Glucose challenge test if fail….

A

Glucose tolerance test

97
Q

Redo PP Prental test

A

Be more specific

98
Q

Baby kick test

What is normal

A

> 10 per hour

99
Q

Biggest cause of death to preggers women

A

Homicide

100
Q

Tdap vaccine is given during this trimester.

Which disease is the concern

A

3rd

Pertussis (Whooping Cough)

101
Q

This diagnostic test ____ is used to determine fetal lung development in 3rd trimester

A

Amniocentesis

102
Q

Advantage of Amniocentesis over Chorionic Villus Sampling

A

Can detect neural tube defects (Spina bifida) CVS cant

103
Q

Screening test done mostly on moms who are DM or placental deteriorating.

5 category test

Fetal movements
Fetal tone
Fetal breathing movements
Amniotic fluid volume
Non-stress test

Less than 10 depending on GA recommended delivery, possibly

A

Biophysical profile

104
Q

AFP

Maternal Serum Alpha fetoprotein test

High levels might indicate….

A

Neuraltube defects #1 thing AFP is screening for

105
Q

GBS can cause these problems in babies

A

Meningitis / pneumonia

106
Q

With fetal tachycardia do this assessment on the mom

A

Temp.

Infection

107
Q

Palpation of fundus with toco

Describe firmness of mild, moderate, hard

A

Mild Nose
Moderate chin
Hard forehead

108
Q

To ensure your tracing baby’s not moms HR apply….

A

OX meter on mom

109
Q

IUPC goes where..

A

Between uterine wall and baby’s head

110
Q

Good acid base balance, best predictor of fetal oxygenation is….

A

Moderate Variability 6-25 BMP change

111
Q

2 causes of minimal variability

A

Sleeping baby / Drugs

112
Q

Connects pulmonary artery & descending aorta

Causes blood flow to bypass the Non-functioning Lungs

Closes by first breaths & increased pressure in aorta within 15 - 24 hrs of birth.

MURMURS maybe heard until closed

A

Ductus Arteriosus

113
Q

Flap between Right and left atria

Closes when left atria faces increase pressure after birth

Closed within minutes of birth

A

Foramen Ovale

114
Q

Directs blood from Umbilicus vein away from liver to inferior vena cava

Once Umbilicus cord is clamped little blood enters..

A

Ductus Venosus

115
Q

Routine prenatal testing & Nonroutine

1st trimester

A

Pregnancy test
Blood test CBC / T/S
Urine test
US placement/ dating

NonRoutine

Cell free DNA
Chorionic Villus Sampling

116
Q

Prenatal testing 2nd trimester

Routine & nonroutine

A

Routine

Urine fetal hr
Glucose challenge test - if failure GTT
Quad screen
Anatomical US

NonRoutine

GTT
Amniocentesis

117
Q

Routine & nonroutine prenatal testing

3rd trimester

A

Urine
FHR
Group B strep
Kick count

NonRoutine

US
Nonstress test
Contraction stress test
Biophysical profile

118
Q

Give Rho-gam when (2)

Why not give Rho-gam

A

28 weeks & within 72 after birth

Positive blood type mom don’t need Rho-gam.

119
Q

How to test for

Gonorrhea

Syphilis

Trichomonas

A

Gonorrhea: Cervical Culture

Syphilis: Blood test (VDRL/RPR)

Trichomonas: Molecular test/ Wet prep slides Vag discharge

120
Q

Anemia due to blood dilution in ___ semester.

Take 400 micrograms Iron daily

A

2nd

NURS: 2146 OB (15 decks)

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