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Maternal Newborn 211 > Week 03 > Flashcards

Week 03 Flashcards

Prenatal Care

1
Q

What are the three stages of prenatal care?

A

Antepartum, Intrapartum, Postpartum

Antepartum is from the first day of LMP until labor, Intrapartum is labor and delivery, and Postpartum is 6 weeks after delivery.

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2
Q

Define ‘Term’ in the context of due date classification.

A

37+ weeks

This classification helps in understanding the timing of delivery.

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3
Q

What are the goals of preconception care?

A
  • Promote health and wellbeing
  • Identify and modify risk factors
  • Prevention and management

Examples include addressing smoking, hypothyroidism, and drug use.

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4
Q

List three risk factors that can affect pregnancy.

A
  • Medications
  • Alcohol
  • Smoking

Other risk factors include diabetes, obesity, and STIs.

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5
Q

What is the purpose of the initial prenatal visit?

A
  • Establish a relationship
  • Medical history and overall wellness
  • Identify and correct risk factors
  • Health assessment
  • Physical exam
  • Lab testing

This visit is crucial for a healthy pregnancy.

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6
Q

Name three prenatal labs typically conducted during the initial visit.

A
  • Urinalysis
  • CBC
  • Blood type

Additional tests may include rubella, HIV, and cervical smears.

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7
Q

What does the acronym A-B-C-D-E-F stand for in prenatal assessment?

A
  • A: Amniotic fluid leakage
  • B: Bleeding vaginally
  • C: Contractions
  • D: Dysuria
  • E: Edema
  • F: Fetal movement

This helps in monitoring the health of the pregnancy.

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8
Q

How often should follow-up prenatal visits occur until 28 weeks?

A

Every 4 weeks

Frequency changes after 28 weeks.

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9
Q

What is Naegele’s Rule used for?

A

Determining the estimated due date

It involves calculating from the first day of the last menstrual cycle.

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10
Q

What is the significance of measuring fundal height?

A

To assess fetal growth and development

At various weeks, the height corresponds to specific anatomical landmarks.

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11
Q

Define ‘Complete miscarriage’.

A

All products of conception are passed, no interventions needed

This is one type of spontaneous abortion.

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12
Q

What are the two types of surgical abortion?

A
  • Dilation and curettage (D&C)
  • Dilation and evacuation (D&E)

These methods are used depending on the gestational age.

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13
Q

What does the letter ‘G’ represent in the pregnancy classification system?

A

Gravida - number of times a patient has been pregnant

This is part of the GTPAL system used for pregnancy history.

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14
Q

True or False: Fetal Fibronectin (FFN) levels should be present before 35 weeks.

A

False

FFN is typically absent before 35 weeks.

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15
Q

What is the purpose of a Fetal Non-Stress Test (NST)?

A

To indicate fetal well-being and oxygenation

Reactive results are considered good.

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16
Q

What are common first trimester discomforts?

A
  • Urine frequency
  • Fatigue
  • Nausea/Vomiting
  • Breast tenderness
  • Constipation
  • Nasal stuffiness
  • Bleeding gums
  • Epistaxis
  • Cravings
  • Leukorrhea

These discomforts are often experienced by pregnant women.

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17
Q

What nutritional recommendations are made during pregnancy?

A
  • Increase calories by 300/day
  • Protein: 25 grams daily
  • Iron: 27 mg daily
  • Folic acid: 400 mcg daily
  • Fluids: 48-64 oz daily
  • Calcium: 1300 mg daily

Proper nutrition is vital for the health of both mother and baby.

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18
Q

What is pseudoanemia?

A

A condition where hematocrit is less than 32% and hemoglobin is less than 11 mg/dL

It often occurs during pregnancy due to increased blood volume.

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19
Q

What is the function of chorionic villus sampling (CVS)?

A

To test for chromosomal abnormalities and genetic disorders

It can be performed early in pregnancy.

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20
Q

What is the Fetal Biophysical Profile (BPP) used to assess?

A
  • Fetal heart rate (FHR)
  • Breathing
  • Movement
  • Muscle tone
  • Amniotic fluid levels

This test helps reduce the risk of stillbirth.

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21
Q

What is a key sign of impending labor related to fetal position?

A

Lightening - when the fetus drops into the pelvis

This usually occurs around week 39.

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22
Q

Fill in the blank: The average weight gain during pregnancy is ______ pounds.

A

25-35

Weight gain varies based on initial maternal weight.

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23
Q

antepartum

A

first day of LMP until labor begins

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24
Q

intrapartum

A

labor and delivery

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25
Q

postpartum

A

6 weeks following delivery

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26
Q

term

A

37+ weeks

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27
Q

early term

A

37-38 weeks and six days

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28
Q

full term

A

39-40 weeks and six days

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29
Q

late term

A

41-41 weeks and six days

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30
Q

post term

A

42+ weeks

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31
Q

goals of preconception

A
  • promote health and wellbeing
  • identify and modify risk factors
  • prevention and management
  • examples: smoking (IUGR), hypothyroidism (decreased milk production), special diets (supplements), street drugs (abruption)
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32
Q

risk factors in pregnancy

A

meds, alcohol, smoking, diabetes, folic acid, hep b, HIV, rubella, immunity, obesity, nutrition, STI’s, environment

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33
Q

initial prenatal visit

A
  • establish a relationship
  • medical history and overall wellness
  • identify risk factors and correct them
  • health assessment
  • physical exam
  • lab testing
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34
Q

prenatal labs

A

uranalysis, CBC, blood type, rubella, Hep B and C, HIV, RPR, VDRL, cervical smears, ultrasound, A1C, random glucose

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35
Q

prenatal assessment A-F

A

A: amniotic fluid leakage
B: bleeding vaginally
C: contractions
D: dysuria
E: edema
F: fetal movement

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36
Q

prenatal follow up visit every 4 weeks until

A

28 weeks

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37
Q

prenatal follow up visit every 2 weeks until

A

29-36 weeks

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38
Q

prenatal follow up visit weekly starting at

A

37 weeks until delivery

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39
Q

prenatal follow up visit 2 times a week

A

after due date

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40
Q

prenatal follow up visit biweekly for

A

high risk at 28 weeks

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41
Q

prenatal visit week 20

A

ultrasound

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42
Q

prenatal visit weeks 24-28

A

glucola

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43
Q

prenatal visit weeks 26-28

A

RhoGAM if mother is RH-

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44
Q

prenatal visit weeks 34-36

A

weight, bp, urine protein, urine glucose, ketones, fundal height, FHR

45
Q

Naegele’s Rule

A
  • determine first day of last period
  • from month, subtract 3
  • add 7 days
  • add 1 to year if needed
46
Q

McDonald’s rule

A

fundal height is measured from the level of the pelvic bone to the top of the uterus

47
Q

McDonald’s rule week 12

A

the uterus is above the pelvic bone

48
Q

McDonald’s rule week 20

A

the uterus is at the level of the umbilicus

49
Q

McDonald’s rule week 36

A

the uterus is at the level of the xiphoid process

50
Q

McDonald’s rule weeks 38-40

A

the uterus will go down by 2 cm

51
Q

complete abortion

A

all products of conception are passed, no interventions are needed

52
Q

incomplete abortion

A

partial, some POC remain, patients may need medications, D&C, or D&E

53
Q

inevitable abortion

A

no expulsion, but the cervix is changing, and the patient is bleeding, cannot be avoided

54
Q

threatened misscarriage

A

a patient may be bleeding, and the cervix may have changed, but the fetus is viable

55
Q

missed misscariage

A

no S/S found on ultrasound or no FHR on doppler, patient may need medications, D&C, or D&E

56
Q

medical (therapeutic) abortion

A

patients’ life Is in danger if pregnancy remains, or the fetus has anomalies that are not compatible with life, medications, D&C, or D&E will be done

57
Q

surgical abortion

58
Q

D&C

A

dilation and curettage

59
Q

D&E

A

dilation and evacuation

60
Q

medications to induce abortion

A

cytotec, methotrexate

61
Q

gravida

A

number of times a patient has been pregnant

62
Q

nulligravida

A

never been pregnant

63
Q

primigravida

A

experiencing first pregnancy

64
Q

multigravida

A

more than one pregnancy

65
Q

parity

A

number of pregnancies carried to viability

66
Q

nullipara

67
Q

primipara

68
Q

multipara

69
Q

abortion

A

spontaneous and induced below 19 weeks and 6 days

70
Q

warning signs in pregnancy

A

edema, headaches, visual changes, rapid weight gain, pain, signs of infection, vaginal bleeding, persistent vomiting, muscular irritability, decrease in fetal movement

71
Q

ultrasonography transvaginal

A

before 12 weeks

72
Q

ultrasonography transabdominal

A

after 12 weeks

73
Q

amniocentesis

A

amniotic fluid sample

74
Q

time period for a amniocentesis

A

they prefer to wait until after 14 weeks, but it can be done at any time

75
Q

amniocentesis early in pregnancy

A

11-14 weeks; genetic testing, higher risk of SAB

76
Q

amniocentesis mid pregnancy

A

15-20 weeks; chromosomal abnormalities, fetal wellbeing in mothers with RH- blood

77
Q

amniocentesis later in pregnancy

A

30+ weeks; fetal lung testing, diagnosis of fetal infection, paternity testing

78
Q

chorionic villus sampling (CVS)

A
  • sample of chorionic villi
  • can be done early in pregnancy
  • invasive procedure
  • testing for down syndrome, cystic fibrosis, sickle cell anemia
79
Q

chorionic villi

A
  • finger like projections
  • anchors the fetus to the uterus lining
  • will become the placenta
80
Q

percutaneous umbilicus blood sampling

A
  • PUBS
  • done after 18 weeks
  • cord access
  • remove blood
  • give medications
  • administer blood products
81
Q

alpha-fetoprotein (AFP)

A
  • glycoprotein produced by the fetal sac and fetal liver
  • testing should be done between weeks 16-18
  • high occurrence of false positives
82
Q

high alpha-fetoprotein

A

neuro tube defect

83
Q

low alpha-fetoprotein

A

fetal malformation, increased risk of miscarriage

84
Q

fetal fibronectin (FFN)

A
  • protein Needed to Keep the amniotic sac attached to the Uterus
  • there should be none before 35 weeks
  • when labor starts the amniotic sac begins to detach from the Uterus
  • levels begin to rise
  • test vaginal secretions
85
Q

positive fetal fibronectin

A

the amniotic sac is detaching and labor process has started

86
Q

negative fetal fibronectin

A

labor has not started

87
Q

fetal non-stress test (NST)

A
  • non-invasive screening
  • indicates fetal wellbeing and oxygenation
  • at least 28 weeks gestation
  • results are reactive or nonreactive
88
Q

reactive NST

89
Q

non-reactive NST

90
Q

contraction stress test (CST)

A
  • contractions are triggered
  • predicts how the fetus will handle labor
  • at least 32 weeks gestation
  • results are negative or positive
91
Q

negative CST

92
Q

positive CST

93
Q

biophysical profile

A
  • done to decrease the instance of stillbirth
  • if there is a decrease from one week to the next, they may need to schedule an induction or c-section
94
Q

what to observe during biophysical profile

A

FHR, breathing, movement, muscle tone, amniotic fluid levels

95
Q

biophysical profile ranges

A
  • normal: 8-10
  • equivocal: 6
  • abnormal: 4 or less
96
Q

first trimester discomforts

A

urine frequency, fatigue, N/V, breast tenderness, constipation, nasal stuffiness, bleeding gums, epistaxis, cravings, leukorrhea

97
Q

second trimester discomforts

A

backache, vasrcosities, hemorrhoids, flatulence, bloating

98
Q

third trimester discomforts

A

same as first plus dyspnea, heartburn, indigestion, dependent edema, Braxton hicks

99
Q

average weight gain

A

25-35 pounds

100
Q

underweight weight gain

A

28-40 pounds

101
Q

overweight weight gain

A

15-25 pounds

102
Q

obese weight gail

A

11-20 pounds

103
Q

calories intake during pregnancy

A

increase by 300 cal per day

104
Q

protein intake during pregnancy

A

25 grams daily

105
Q

iron intake during pregnancy

A

27 mg per day

106
Q

folic acid intake during pregnancy

A

400 mcg per day

107
Q

fluid intake during pregnancy

A

6-8 oz glasses per day

108
Q

calcium intake during pregnancy

A
  • 1300 mg per day with vitamin D
  • can only absorb 500 mg at a time

Maternal Newborn 211 (5 decks)

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