Week 2 Flashcards
What is normal weight gain during pregnancy?
25-35 pounds
If one is underweight, what weight gain is recommended?
28-40 pounds
If one is overweight, what weight gain is recommended?
15-25 pounds
If one is obese, what weight gain is recommended?
11-20 pounds
In the 1st and 2nd trimesters, who is mainly growing?
The mother
In the 3rd trimester, who is mainly growing?
The fetus
If a mother’s weight gain is too high–what are some ]health risks?
- High birth weight
2. Cephalopelvic disproportion
If a mother’s weight gain is too low–what are some health risks?
- Malnourishment
2. Low birth weight infant.
For a pregnant woman, what nutritional needs are increased?
- Calories
- Protein
- Iron
- Vitamin A and C
- Folate/Folic Acid
- 6-8 glasses of water/fluids daily
What are the daily recommended servings for pregnant women?
1/2 plate of fruits and vegetables
Healthy proteins
Low-fat dairy, plant oils
Water/milk
What four types of food should pregnant women avoid?
- Fish at top of food chain
- Raw or undercooked meat or fish
- Hot dogs/deli meat
- Unpasteurized cheeses
How often can pregnant women have fish?
No more than 2x per week
What is Pica?
Craving for non-food substances like clay, soil, laundry starch, ice, ashes, plaster, crayons, baking soda, cornstarch, soap, chalk)
What might Pica indicate?
Nutrient deficiencies and anemia
What does Gravidity mean? Gravida
The number of times a woman has been pregnant, including current pregnancy (twins count as one pregnancy)
What does Parity mean?
The number of pregnancies delivered past 20 weeks.
What does GTPAL method provide?
Details of obstetric history
GTPAL means?
Gravity Term Preterm Abortion Living
Abortion means what, in GPTAL?
Number of pregnancies ending before 20 weeks
What does TAB mean?
Therapeutic abortion
What does SAB mean?
Spontaneous abortion (miscarriage)
What does viability mean?
Ability to survive outside of the uterus
What does nulli mean?
Never
What does Postdate/postterm mean?
Pregnancy greater than 42 weeks
At the first prenatal visit, what would they do?
- Complete health history
2. Physical Assessment
Why do we gather so much information at the first prenatal visit about the patient?
To identify risk factors so we can intervene
What are 9 initial prenatal lab tests a pregnant woman is recommended to take?
CBC Blood type/Rh Urinalysis Rubella titer Hepatitis B HIV STI testing TB test Glucose (fasting, HbA1c, random)
How often do pregnant women have prenatal visits throughout the pregnancy?
1-28 weeks: q4 weeks
28-36 weeks: q2 weeks
37 weeks-birth: weekly
During a prenatal visit, what do we teach?
Physical changes and warning signs
What are 6 follow-up lab tests a pregnant woman might be recommended to take?
Repeat Hct/Hgb Antibody titer if Rh negative Group B strep screen Glucose screening 2nd trimester Alpha fetoprotein (AFP) Ultrasound--may be ordered at any time for variety of reasons
When is fetal movement counted?
Beginning at 28 weeks
What three factors affect fetal movement?
- Fetal sleep
- Time of day
- Maternal drug use
What is the typical kick count protocol?
10 movements/2 hours
When is a pregnant woman advised to call the provider regarding fetal movement?
If there is less than 10 movements in 2 hours
If the fetus has not moved all day
If there is noticeable change in quality/quantity of fetal activity
If the woman is Rh negative, what do they want to know?
If she has any antibodies to Rh positive blood.
What are two types of ultrasonography?
- Abdominal
2. Transvaginal
When is AFP screening test done on maternal blood?
16-18 weeks
What might low levels of AFP indicate?
Down syndrome: “Low is Down”
What might high levels of AFP indicate?
Neural tube defect, such as spina bifida
If AFP is abnormal, what might the Dr order?
- Repeat AFP
- High level ultrasound
- Amniocentesis
What is amniocentesis?
An ultrasound-guided amniotic fluid collection for analysis
What are four indications for amniocentesis?
- Assess for genetic defects 2nd trimester (recommended at age 35 and older)
- Assess fetal lung maturity in 3rd trimester
- Check for uterine infection
- Monitor severity of maternal Rh sensitization in Rh negative women
What will all Rh negative women receive after an amniocentesis?
RhoGAM
How common are complications from amniocentesis?
0.5%
What is a Non-Stress Test?
A noninvasive assessment of fetal well-being
When is a non-stress test valid?
After 28 weeks
What are three indications for a non-stress test?
Post-term
Diabetic woman
Decreased fetal movement
How does one do a non-stress test? NST
Apply fetal monitor ultrasound and evaluate the fetal heart rate in response to its own movement
What is the desired result for a NST?
At least 2 accelerations 15 bpm above baseline, lasting at least 15 seconds in a 20 minute period.
Normal baseline rate
If NST is nonreactive, what could this be the result of?
Fetal acidosis
Fetal sleep cycle
What is a biophysical profile? BPP
Real time ultrasound assessment of fetus
What is evaluated and scored during a BPP? Each gets a 2 or a 0
Non-Stress Test Fetal breathing movements Fetal body movements Fetal tone Amniotic fluid volume
What are the scores for BPP?
8-10= normal
6= Equivocal
4 or less=abnormal, will have further tests or delivery ASAP
What is the normal heartbeat range of a fetus?
120-160
