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MCN (Theory) > Unit 1: CARE OF AT-RISK/HIGH RISK AND SICK MOTHER AND CHILD > Flashcards

Unit 1: CARE OF AT-RISK/HIGH RISK AND SICK MOTHER AND CHILD Flashcards

1
Q

(Nutritional status) A mother’s is at risk when hematocrit value is less than ____

A

33%

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2
Q

Mother is at risk for pre-term labor if she is younger than _____ or older than ______

A

16

35

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3
Q

Mother is at risk for pre-term labor if her maternal weight is below ____

A

50 kg

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4
Q

High caffeine is ___ or more cups of coffee each day

A

3

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5
Q

To decrease pregnancy complications, a woman should get pregnant ___ years after menarche

A

6

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6
Q

A DFMC (Daily Fetal Movement Count) is aka

A

Kick counts

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7
Q

A test done after_____ gestation to identify potentially hypoxic fetuses

A

28 weeks

DFMC (Daily Fetal Movement Count)

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8
Q

In a DFMC (Daily Fetal Movement Count) if ____ movements can’t be felt within 1 hour, walk around but if still none, you should notify physician

A

10

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9
Q

A noninvasive test done that monitors the baby’s heartbeat when he is at rest and when he is moving

A

Non-stress test

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10
Q

Result of the NST (Non-stress Test) : 2 or more accelerations of 15 beats/min lasting 15 seconds or more a in 20 min period

A

Reactive

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11
Q

Result of the NST (Non-stress Test) : No fetal heart rate acceleration or accelerations less than 15 beats/min

A

Non reactive

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12
Q

Result of the NST (Non-stress Test) : Fetal heart rate pattern cannot be interpreted

A

Unsatisfactory

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13
Q

If NST(Non-stress Test) is reactive for _____weekly, the pregnancy is allowed to continue

A

2x

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14
Q

If the result of the NST (Non-stress Test) is unsatisfactory what would you do? (2)

A 
Repeat NST
Do CST (Contraction Stress Test)
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15
Q

A test done on the fetus that utilizes oxytocin given to the mother (IV) or through nipple massage to cause labor contractions and release oxytocin

A

Contraction Stress Test

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16
Q

During a Contraction Stress Test, what does it imply if the fetal heart rate decelerates after a contraction instead of speeding up?

A

The baby may have problems with the stress of normal labor

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17
Q

Should the mother eat before undergoing a Contraction Stress Test?

A

No (NPO for 4-8 hours)

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18
Q

What is the result if CST interpretation is: 3 contractions, 40-60 sec long within 10-min period, no late decelerations

A

Negative

Fetus may tolerate labor process if it occurs within 1 week

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19
Q

What is the result if CST interpretation is: Persistent/consistent late decelerations with more than 50% of contractions

A

Positive

Fetus is at risk

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20
Q

What is the result if CST interpretation is: Decelerations in less than 50% of contractions

A

Suspicious

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21
Q

What is the result if CST interpretation is: Inadequate pattern or poor tracing

A

Unsatisfactory

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22
Q

In abdominal ultrasound, should the bladder be empty or full?

A

Full

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23
Q

A test that provides excellent pictures of soft tissues

A

MRI

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24
Q

The amnion extracted during amniocentesis contains what?

A

Fetal cells

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25
Q

True anemia (1st and 3rd Trimester) is an Hgb of _____

A

<11g/dl

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26
Q

True anemia (2nd Trimester) is Hgb of ____

A

<10. 5 g/dl

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27
Q

True anemia (1st and 3rd Trimester) is Hct of ____

A

<33%

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28
Q

True anemia (2nd Trimester) is Hct of ____

A

<32%

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29
Q

Pseudoanemia in pregnancy happens when plasma volume increases by ____ but the RBC count increases by _____

A

50%

30%

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30
Q

The most common anemia in pregnancy

A

Iron-deficiency anemia

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31
Q

Iron deficiency anemia is Hgb of __

A

<12 mg/dl

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32
Q

Iron deficiency anemia is Hct of __

A

<33%

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33
Q

How many years should a mother become pregnant again to decrease risk of iron deficiency anemia?

A

at least 2 years

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34
Q

To prevent iron deficiency anemia a mother should take ___ of elemental iron supplements

A

27 mg

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35
Q

If the mother already has iron-deficiency anemia a dose of _____ elemental iron is given every day

A

120-200mg

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36
Q

Vitamin C supplies ____ which promotes iron absorption

A

ascorbic acid

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37
Q

If the mother cannot take iron by mouth what is prescribed?

A

IM or IV iron dextran

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38
Q

Folic Acid deficiency anemias is seen in __% to ___ %of pregnancies

A

1-5

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39
Q

It is necessary for the normal formation of RBCs in the mother as well as preventing neural tube defects in the fetus.

A

Folic Acid or Folacin

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40
Q

A condition where large and immature blood cells are formed

A

Folic Acid Deficiency Anemia

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41
Q

A condition where RBCs are enlarged

A

Megaloblastic Anemia

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42
Q

An anticonvulsant agent that interferes with folate absorption

A

Hydantoin

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43
Q

For expectant mothers, ___ of folic acid is supplemented

A

400g

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44
Q

For pregnant mothers ____ of folic acid is prescribed

A

600g

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45
Q

An endocrine disorder in which the pancreas cannot produce adequate insulin to regulate body glucose level.

A

Diabetes Mellitus

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46
Q

A condition of abnormal glucose metabolism that arises during pregnancy

A

Gestational Diabetes

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47
Q

4P’s for Assessing Diabetes Mellitus

A

Polyuria
Polydipsia
Polyphagia
Pound loss

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48
Q

What is OGTT?

A

Oral glucose tolerance test

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49
Q

Diabetes is diagnosed if the Fasting Blood Sugar is

A

Equal to or greater than 200mg/dl

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50
Q

A venous blood sample is taken for glucose determination 60 minutes later. If the serum glucose level at 1 hour is more than 140 mg/dl, the woman is scheduled for a 100 mg, 3 -hour fasting glucose tolerance test.

A

50 mg Oral Glucose Challenge

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51
Q

If two or more of the blood samples collected for this test are abnormal or the fasting value is above 95 mg/dl, a diagnosis for diabetes is made.

A

100 mg Glucose tolerance test

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52
Q

50 mg Oral Glucose Challenge -a venous blood sample is taken for glucose determination _____ minutes later. If the serum glucose level at ___ minutes is more than ____, the woman is scheduled for a _______

A

60
60
140 mg/dl
100 mg, 3 -hour fasting glucose tolerance test.

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53
Q

What is the process for an Oral Glucose Tolerance test?

A

8-12 hour fasting
Test for FBS
Glucose drink
3 blood samples every hour

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54
Q

What is the Normal Glucose level for pregnant women after fasting?

A

9 mg/dl

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55
Q

What is the Normal Glucose level for pregnant women 1 hour after taking a 100 mg glucose load?

A

180 mg/dl

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56
Q

What is the Normal Glucose level for pregnant women 2 hours after taking a 100 mg glucose load?

A

155 mg/dl

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57
Q

What is the Normal Glucose level for pregnant women 3 hours after taking a 100 mg glucose load?

A

140 mg/dl

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58
Q

How do you know that the pregnant glucose level is abnormal at 1-hour intervals?

A

If 2 values are exceeded

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59
Q

Why does increased glucose concentration in urine lead to UTI?

A

Because sugar in urine promotes bacterial growth

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60
Q

The usual regimen recommended for women with gestational diabetes? (calorie diet)

A

1800-2400 calorie diet divided into 3 meals and 3 snacks

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61
Q

A mother’s insulin requirement is highest during what trimester?

A

3rd

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62
Q

What type of insulin is chosen during pregnancy?

A

Humulin

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63
Q

Humulin is administered _____in the morning, ___ at dinner and administered____, ___ minutes before meals

A

2/3
1/3
SQ
30

64
Q

Insulin is administered in what route and and angle?

A

SQ

90 degree angle

65
Q

What does postprandial mean?

A

After a meal

66
Q

Insulin is adjusted to keep the FBS below_____

A

95-100 mg/dl

67
Q

Insulin is adjusted to keep the 2-hour post-prandial level below__

A

120 mg/dl

68
Q

How does stress affect your blood glucose level?

A

Stress increases blood glucose levels

69
Q

Why is human insulin preferred rather than a beef or pork insulin?

A

Because it has a lesser risk of provoking the antibody response

70
Q

It utilizes an automatic pump about the size of an mp3 player and implanted into the SQ tissue in the abdomen or thigh

A

Insulin Pump Therapy

Continuous SQ Insulin Infusion

71
Q

What is the best predictor of subsequent fetal macrosomia?

A

Blood glucose level 1 hour after beginning a meal

<120 mg/dl

72
Q

What does high insulin sensitivity mean?

A

High insulin sensitivity allows the cells of the body to use blood glucose more effectively

It increases during exercise

73
Q

What should prenatal vitamins contain to reduce the risk of gestational diabetes mellitus?

A

Folic Acid

74
Q

Why is diet/insulin therapy not needed for a woman with gestational diabetes 24 hours after giving birth?

A

They usually demonstrate normal glucose values in this timeframe

75
Q

A normal result in this test suggests that the woman’s vascular system is intact because the kidney function is normal

A

Creatinine clearance test

76
Q

A healthy fetus makes how many movements per hour?

A

10

77
Q

A rock type of methamphetamine that is smoked

A

Amphetamine

78
Q

Common name for Amphetamine

A

Ice

79
Q

Substances obtained from the hemp plant, cannabis

A

Marijuana and Hashish

80
Q

Why can’t women who takes marijuana or hashish breastfeed?

A

It reduces milk production

81
Q

Why do women usually use marijuana during early pregnancy?

A

To counteract nausea

82
Q

An animal tranquilizer that is frequently used as street drug in polydrug abuse

A

Phencyclidine (PCP)

83
Q

How does Phencyclidine (PCP) affect the body? (2)

A

Increase CO

Sense of euphoria

84
Q

A substance that has a potential for causing long-term hallucinations (flashback episodes)

A

Phencyclidine (PCP)

85
Q

A substance that tends to leave maternal circulation and concentrates in fetal cells, which can injure the fetus

A

Phencyclidine (PCP)

86
Q

A substance that can be abused and is used for the treatment of pain (Morphine or meperidine) (Demerol) and cough suppression.

A

Narcotic agonist

87
Q

What are the two effects of Narcotic agonists?

A

Analgesia

Euphoria

88
Q

Heroin abuse during pregnancy can result in:

severe _____ in the infant after birth

A

withdrawal symptoms

89
Q

Refers to the ”sniffing” or “huffing” of aerosol drugs

A

Inhalants

90
Q

Airplane glue
Cooking sprays
Computer keyboard cleaner

are abused as _____

A

Inhalants

91
Q

The effect of Inhalants in the body is similar to _____

A

Alcohol abuse

92
Q

If the baby has characteristics such as:

Small eye openings
Smooth Philtrum
Thin upper lip

it may be indicative of___

A

Fetal Alcohol Syndrome

93
Q

An inflammatory connective tissue disease which may develop in untreated group A B-hemolytic streptococcal infections.

A

Rheumatic Fever

94
Q

Results when recurrent inflammation from bouts of rheumatic fever causes scarring formation in the valves.

A

Rheumatic Disease

95
Q

Failure of the heart valve to open completely

A

Stenosis

96
Q

Failure of the valve to close completely or a combination of both thereby increasing the workload of the heart

A

Regurgitation

97
Q

Scarring due to Rheumatic fever results in: (2)

A

Stenosis

Regurgitation

98
Q

Classify the Functional Capacity Of a Patient With Cardiac Disease:

Asymptomatic.
No limitation of physical activity

A

Class 1

99
Q

Classify the Functional Capacity Of a Patient With Cardiac Disease:

-marked limitation of physical activity.
-comfortable at rest but
symptomatic during less than ordinary physical activity

A

Class 3

100
Q

Classify the Functional Capacity Of a Patient With Cardiac Disease:

  • slight limitation of physical activity
  • asymptomatic at rest
  • symptoms occur with ordinary physical activity
A

Class 2

101
Q

Classify the Functional Capacity Of a Patient With Cardiac Disease:

-inability to carry on any physical activity without discomfort
-discomfort increases with
any physical activity

A

Class 4

102
Q

A relatively rare condition of excessive vomiting during pregnancy

A

Hyperemesis Gravidarum

usually during the 1st 10 weeks of pregnancy

103
Q

3 Medications given for uncontrolled nausea and vomiting

A

Pyridoxine (B6) or with doxylamine (Unisom)
Promethazine (Phenergan)
Metoclopramide (Reglan)

104
Q

Refers to the premature dilatation of the cervix, usually in the 4th or 5th month. Associate w/2nd Trimester abortions

A

Incompetent cervix

105
Q

Why does an incompetent cervix open too early?

A

Due to the pressure exerted by the growing fetus

106
Q

An incompetent cervix is traditionally managed by a ____ operation

A

Shirodkar-Barter (Cerclage)

107
Q

Shirodkar-Barter (Cerclage) Operation is a modification of a ___ operatoin

A

Mcdonald

108
Q

Majority of spontaneous abortion are related to ___abnormalities

A

chromosomal

109
Q

Most miscarriages occur before the ___week of pregnancy

A

14th

110
Q

What type of Abortion?

  • embryo or fetus is jeopardized by unexplained bleeding, cramping, and backache.
  • Cervix is closed
  • bleeding may persist for days
  • maybe followed by partial or complete expulsion of the embryo or fetus, placenta, and membranes.
A

Threatened Abortion

111
Q

What type of Abortion?

  • bleeding and cramping increase
  • internal cervical os dilates
  • membranes may rupture
A

Imminent Abortion

112
Q

What type of Abortion?

-all products of conception are expelled.

A

Complete Abortion

113
Q

What type of Abortion?

-the fetus die in utero but was not expelled. Uterine growth ceases, breast changes regress and the woman may report a brownish vaginal discharge.

A

Missed Abortion

114
Q

What type of Abortion?

-(formerly called habitual abortion). Abortion occurs consecutively in three or more pregnancies.

A

Recurrent pregnancy loss

115
Q

What type of Abortion?

  • presence of infection. May occur with prolonged:
  • -unrecognized rupture of the membranes
  • -pregnancy with intra-uterine device (IUD) in utero
  • -attempts of unqualified individuals to terminate a pregnancy.
A

Septic Abortion

116
Q

(1st Trimester) Abortion Assessment:

Vaginal spotting, perhaps slight cramping

A

Threatened Miscarriage

117
Q

(1st Trimester) Abortion Assessment:

Vaginal spotting, cramping, cervical dilatation

A

Imminent miscarriage

118
Q

(1st Trimester) Abortion Assessment:

Vaginal spotting, perhaps slight cramping, no apparent loss of pregnancy

A

Missed miscarriage

119
Q

Abortion Assessment:

Vaginal spotting, cramping, cervical dilatation, but incomplete expulsion of uterine contents

A

Incomplete Miscarriage

120
Q

Abortion Assessment:

Vaginal spotting, cramping, cervical dilatation, andcomplete expulsion of uterine contents

A

Complete miscarriage

121
Q

Assessment:

Sudden unilateral lower abdominal quadrant pain,; minimal vaginal bleeding, possible signs of shock or hemorrhage

A

Ectopic (tubal pregnancy

122
Q

Assessment:

Overgrowth of uterus; highly positive human chorionic gonadotropin (hCG) test; no fetus present on sonogram; bleeding from vagina of old or fresh blood accompanied by cyst formation

A

Hydatidiform Mole (gestational trophoblastic disease)

123
Q

(2nd Trimester) Assessment:

Painless bleeding leading to expulsion of fetus

A

Premature Cervical Dilatation

124
Q

Retained trophoblast tissue can lead to ____

A

Choriocarcinoma

125
Q

At 1st trimester when the fetal contents are not expelled within 4-6 weeks what is done?

A

D&C

126
Q

At 2nd trimester when the fetal contents are not expelled within 4-6 weeks what is done?

A

Induction of Labor

127
Q

The placenta is implanted in the lower uterine segment rather than the upper portion of the uterus.

A

Placenta previa

128
Q

What type of Placenta Previa?

the internal os is completely covered

A

Total

129
Q

What type of Placenta Previa?

internal os is partially covered

A

Partial

130
Q

What type of Placenta Previa?

the edge of the internal os is covered

A

Marginal

131
Q

What type of Placenta Previa?

placenta is implanted in the lower uterine segment in close proximity but not covering the os.

A

Low lying

132
Q

The premature separation of a normally implanted placenta from the uterine wall.

A

Abruptio placenta

133
Q

What type of Abruptio placenta?

-placenta separates at it’s edges, the blood passes between the fetal membranes and the uterine wall, and the blood escapes vaginally (also called marginal sinus rupture)

A

Marginal

134
Q

What type of Abruptio placenta?

-the placenta separates centrally and the blood is trapped between placenta and the uterine wall. Entrapment of the blood results in concealed bleeding.

A

Central

135
Q

What type of Abruptio placenta?

-massive vaginal bleeding is seen in the presence of total separation.

A

Complete

136
Q

The rupture of the amniotic sac and leakage of amniotic fluid beginning at least 1 hour before the onset of labor at any gestational age.

A

Premature Rupture of membranes (PRoM)

137
Q

Premature Rupture of membranes (PRoM) is when membranes rupture before ____ weeks gestation

A

37

138
Q

Pregnancy in which implantation occurs outside the uterine cavity

A

Ectopic pregnancy

139
Q

A red flag for a ruptured ectopic pregnancy

A

Shoulder pain when lying down

140
Q

An unruptured ectopic pregnancy is usually treated with ______

A

methotrexate

141
Q

A folic acid antagonist chemotherapeutic agent that attacks and destroys fast growing cells, used for ectopic pregnancy

A

methotrexate

142
Q

An abortifacient, effective at causing sloughing of the tubal implantation site.

A

Mifepristone

143
Q

Therapy for ruptured ectopic pregnancy is ___to ligate the bleeding vessel and to remove or repair the damaged fallopian tube.

A

laparoscopy

144
Q

H mole or gestational trophoblastic disease may happen in women with blood type ____ who married men with blood type _____

A

A

O

145
Q

What type of Molar growth?

  • all trophoblastic villi swell and become cystic.
  • if an embryo is formed it dies early at 1-2 mm in size, with no fetal blood present at the villi.
A

Complete mole

146
Q

What type of Molar growth?

  • some of the villi form normally, however swollen and mishapen.
  • a macerated embryo of approximately 9 weeks gestation maybe present in the villi
A

Partial Mole

147
Q

H-mole management

After__months, if hCG level are still negative the woman is theoretically free of any malignancy developing.

After __months, the woman can have the 2nd pregnancy.

A

6

12

148
Q

The drug of choice for choriocarcinoma.

A

methotrexate

149
Q
  • the most common medical complication of pregnancy.

- a significant contributor to maternal and perinatal morbidity and mortality

A

Hypertension

150
Q

Pregnancy induced hypertension is manifested with a systole elevation of ____ and diastole elevation of _____ or a BP of ______ on 2 consecutive readings at least 6 hours apart

A

> 30 mm Hg
15 mm Hg
140/90 mm Hg

151
Q
  • onset of HPN without proteinuria after 20 weeks of pregnancy
  • development of mild hypertension during pregnancy in previously normotensive women without proteinuria or pathologic edema
A

Gestational HPN

152
Q

-development of proteinuria after 20 weeks of gestation in previously non-proteinuric woman without hypertension

A

Gestational Proteinuria

153
Q

-development of HPN and proteinuria in previously normotensive woman after 20 weeks of gestation or in an early postpartum period; in presence of trophoblastic disease it can develop before 20 weeks gestation

A

Preeclampsia

154
Q

HPN and /or proteinuria in pregnant women prior to 20 weeks gestation and persistent after 12 weeks postpartum.

A

Chronic Hypertension

155
Q

-development of preeclampsia or eclampsia in woman with woman with chronic hypertension prior to 20 weeks gestation.

A

Superimposed preeclampsia or eclampsia

MCN (Theory) (8 decks)

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