UNIT 1 Flashcards
What does GTPAL stand for?
G: Gravida
T: Term births
P: Preterm births
A: Abortions/miscarriage
L: Living children
What is the Negele Rule used for?
adding 7 days to the first day of the last menstrual period
subtracting 3 months
adding 1 year
What are the functions of amniotic fluid?
- Temp regulation
- Protection from injury
- Combination of fetus and mother (fluid electrolyte balance)
- Waste replenishment every 3 hours
- Prevent amniotic banding
- Antibiotic properties
- weightless prevent malformations
What color of amniotic fluid indicates stress and potential aspiration risk?
Dark or meconium-stained fluid
means the baby has been under stress
What does a foul smell of amniotic fluid suggest?
Possible infection
oligo means what when referring to the amniotic fluid?
there is too little amniotic fluid
indicative of kidney issues
poly means what when referring to amniotic fluid?
there is too much amniotic fluid
indicative of GI issues
What is the structure of the umbilical cord?
Contains 2 arteries and 1 vein
What is the function of the umbilical vein?
Carries oxygenated blood to the baby
What is the function of the umbilical arteries?
Carries deoxygenated blood away from the baby
What is Warton jelly?
A protective substance around the umbilical vessels that prevents damage
What does ‘nuchal cord’ refer to?
When the umbilical cord is wrapped around the baby’s neck
What does the acronym TORCH stand for in prenatal care?
Toxoplasmosis
Other (e.g., syphilis, HIV)
Rubella
Cytomegalovirus
Herpes Simplex Virus
How is Toxoplasmosis transmitted?
Through cats, undercooked meat, seafood, deli products, and soil
What are the ‘Others’ category of TORCH?
sexually transmitted diseases (safe sex practices)
HIV
Hepatitis B
HPV
Syphilis
Gonorrhea
What is the significance of the rubella vaccine for pregnant women?
Pregnant women without immunity should not receive the vaccine during pregnancy (can cause fetal demise)
What is the primary concern with Cytomegalovirus during pregnancy?
It can be devastating if the mother has never been infected before
Which viruses are transmitted through bodily fluids?
HSV
Syphilis
HIV
Hepatitis
Which viruses are transmitted through skin to skin contact
HSV
syphilis
HPV
What is the recommended treatment for gonorrhea and chlamydia in newborns?
Erythromycin ointment in the eyes
can infect baby through the birth canal
Syphilis treatment?
PCN, azithromycine, doxycycline
has different stages
stage 1 rash
stage 2
stage 3 untreatable
HIV effect on mother and baby?
no breastfeeding (spread through breast milk and placenta)
take meds before, during, after pregnancy
DON’T MIX BLOOOD
c-section
antivirals = retrovir
What are the signs of preeclampsia?
Decreased perfusion
Proteinuria
Risk of seizure
Blurred vision
What is the risk associated with eclampsia?
Seizures
vomiting (protect airway)
caused by uncontrolled preeclampsia
What is the significance of fundal height measurements?
Used to determine fetal age and growth during pregnancy
At what gestational age is the fundal height at the level of the umbilicus?
20 weeks
At what gestational age is the fundal height at the xiphiod process?
36weeks
At what gestational age is the fundal height 3-4 fingers below the xiphoid process?
40weeks
At what gestational age is the fundal height at the pubis?
12weeks
what is lightening?
the baby starts to move down
prepping for birth
pressure moves to hips
lower extremity swelling
breathing better
What is the glucose test schedule during pregnancy?
24-28 weeks
non-fasting 50g glucose drink
1 hr test
What does a result over 140 in the glucose test indicate?
Requires a 3-hour glucose tolerance test
what is the 3 hour glucose tolerance test?
3 hr test
100g glucose drink
test at 1hr 2hr anf 3hr
if fail 2/3they have gestational diabetes
indicative of type 2 diabetes
What is the purpose of RhoGAM administration?
To prevent Rh incompatibility by preventing the mother from making antibodies against the baby
when is RhoGAM given?
28wk and 72 hr after delivery
after trauma/accident
after amniocentesis
after possible blood mixing
who is RhoGAM given to?
Rh- moms with a Rh + baby
What is the role of amniocentesis in pregnancy?
2nd trimester genetics, miscarriage
3rd trimester lung maturity
Complications of amniocentesis?
infection
PTL
injury to baby
miscarriage
What are the signs of placental abruption?
Severe abdominal pain
Hard abdomen
Hypovolemia
Might not see any bleeding
What is a placental abruption?
detachment of partial or all of the placenta from implantation
typically after 20 weeks
What is the treatment for cervical insufficiency?
Bed rest
cerclage
Tocolytic meds
What does cervical insufficiency mean?
the cervix can’t retain a pregnancy
when is a cerclage placed?
before pregnancy
emergent= at 12 weeks
removed at 37weeks
What does the term ‘lightening’ refer to in pregnancy?
When the baby moves down into the pelvis, causing increased pressure on the hips
What is the common treatment for gestational diabetes?
Diet modification
possibly insulin therapy
What are the potential effects of magnesium sulfate during labor?
Flu-like symptoms
Risk of toxicity (decreased DTR, respiratory rate under 12, urine< 30ml, over level 8, can’t purse lips)
What should be monitored when administering Brethine?
Tachycardia
hypotension
blood sugar levels
palpitations
What is the risk associated with using tocolytic medications?
maternal preeclampsia/eclampsia
fetal demise, anomoly, PROM, chorioamnionitis
What is the significance of the Coombs test?
To determine if there is a blood mix between mother and baby
direct-baby
indirect-mom
What is the recommended action for a Rh-negative mother with an Rh-positive baby?
Administer RhoGAM to prevent antibody formation
What are the symptoms of ectopic pregnancy?
Vaginal bleeding
Hypotension
Tachycardia
Referred shoulder pain
Cullens sign
What is the typical management for molar pregnancy?
D&C (dilation and curettage)
D&E (dilation and evaluation)
monitoring hCG levels
What is placental previa?
When the cervical os is partially or completely covered by the placenta
What is the danger of untreated group B strep during pregnancy?
sepsis
meningitis
osteomyelitis
complications in newborns
Fill in the blank: The sound of maternal blood flow to the placenta is called _______.
Uterine souffle
Fill in the blank: The sound of fetal blood through the umbilical cord is called _______.
Funic souffle
If AFT levels are high, what is the baby at risk for?
trisomy 21, downs
If AFT level are low, what is the risk?
neural tube defects
When do they test for STDs?
1st and 3rd trimester
When do they test for Group B strep?
36-37 weeks
status can change
can cross the placenta, rupture risks infection(sepsis, meningitis)
Treatment of Group B strep?
ampicillin or vancomycin
NST assesses what?
fetal well being
HR incr 2 times in 20 min
15bpm for 15 seconds
if non reactive–> 5 part real time test
What tests do they use to assess for amniotic fluid?
nitrazine
amnisure
What are the three signs of pregnancy?
presumptive
probable
positive
What indicates a presumptive sign of pregnancy?
weight gain
missed period
stretch marks
s/s
What indicates a probably sign of pregnancy?
positive pregnancy test
heagars sign
goodells sign
Chadwicks sign
What indicates a positive pregnancy?
see the baby on u/s
hear fetal heart bead
feel fetal movements
What are some physiological changes with pregnancy?
relax of smooth muscle
indigestion
increase blood volume (vena cava syndrome)
SOB
lightening
chloasma
linea nigra
stretch marks
PICA
What are some nursing interventions for mom suffering from indegestion?
small meals
high fiber
ginger in diet
sit upright after eating
What us PICA?
mom craves non food items
indicative of nutritional deficiency or anemia
What is chronic HTN?
HTN that has occurred before 20 weeks
What is gestational HTN?
HTN develops after 20weeks
140/90 on 2 different occasions
What is HELLP syndrome?
uncontrolled eclampsia
Hemolysis
Elevated
Liver enzymes
Low
Platelet
What is the most common anemia in pregnancy?
Iron deficiency
Hbg <10
Hct < 35
iron supplements with orange juice not milk
What are the treatments for an etopic pregnancy?
methotrexate (no sun, no alcohol, no pregnancy for 3 mo)
salpingostomy
salpingectomy
risk of infection
What is Gestational Trophoblastic Disease?
molar pregnancy
cell growth of trophoblastic cells
body thinks its pregnant but its not
incr risk of cancer
dx transvaginal u/s
no pregnancy for 1 yr
What is ABO incompatibility?
when mom is type O and baby is type A, B or AB
mom has antibodies against A, B and AB
we must monitor for hemolysis
Coombs test
Can mom have a vaginal delivery if the placenta is partial or complete?
no, she will have to have a c-section
marginal may move, vaginal
Indicator of placenta previa?
painless bleeding
no sex, no transvaginal u/s
When is mom screened for Group B strep?
at 35-37 weeks because her status can change
What can happen if mom has Group B strep?
monitor babies close
c section
UTI, chorioamnionitis
ampicillin or vancomycin
What happens with glucose regulation in pregnancy?
1st trimester its normal
2nd & 3rd trimester insulin resistance
blood sugar incr
makes large babies
What to tell the patient if PTL occurs?
lay of left side, and drink water
if it goes away tell provider next visit
if it returns call provider
if it doesn’t go away call provider
What do they usually use for PTL?
magnesium sulfate (5-7days)
to delay birth/labor
DONT GIGVE AT 20wk or 37 wk
use betamethasomne 48 hr till birth
fetal lung maturity
contraindications
When are tocolytic medications used?
PTL
24-34wks
NOT FDA APPROVED
Tell me about magnesium sulfate?
piggy back never mainline
most common (lack of evidence)
antidone is calcium gluconate
How is brethine given?
SubQ
PRN
NO CAFFEINE
Tell me about nepfepine?
Calcium Channel Blocker
drops BP(dont give if under 100)
inhibits contractions
change positions slowly
What do you never give nepfepine with?
magnesium sulfate
erythromycin
(cardiac arrest)
