Week 2: Antepartum Testing & Procedures Flashcards
What is Free Cell DNA Diagnostic Procedure?
A laboratory method that that involves analyzing free DNA contained. Examines fetal DNA through the bloodstream. Starting at 9-10 weeks.
What is Cell Free DNA procedure used for?
Most sensitive and specific screening for the common fetal aneuploidies.
The only lab test to identify this.
What is an abdominal Ultrasound?
Consist of High-Frequency sound waves to visulize internal organs and tissue by producing a real time 3D image of the baby
What does the abdominal ultrasound indicate?
Confirming pregnancy and gestational age.
Assess fetal growth, position, and viability
Nursing actions for an abdominal Ultrasound.
Instruct the Mom to have a full bladder
Explain the procedure
Client in supine position.
What is a transvaginal Ultrasound?
a invasive procedure in which a probe inserted vaginally to allow more accurate evaluation
When is a transvaginal Ultrasound used?
Usually best for the the 1st trimester or for bigger BMI patients.
What is the big difference between an abdominal ultrasound and transvaginal ultrasound?
Transvaginal doesnt require a full bladder but abdominal does.
What is CVS? (Chorionic Villus sampling)
The assessment of a portion of the developing placenta (Chorionic villi), which is taken through a needle that comes through the abs or vaginal.
Done 10-13 weeks
What does CVS indicate?
Risk for giving birth to a neonate who has a genetic chromosomal abnormality.
What the risk of CVS?
0.22% risk of bleeding, infections or rupture.
What are the complications of CVS?
Spontaneous Abortion
Risk for fetal limb loss
Miscarriage
Nursing Actions for CVS procedure
Education for Pt
Assess fetal and mom post procedure. Check FHR in 30 mins
Report any abdominal pain, bleeding, and chills.
-Adminster RhoGAM to RH- women post procedure to prevent antibody formation
What is Amniocentesis?
The aspiration of amniotic fluid for analysis by inserting a needle with ultrasound.
Can be performed after 14 weeks
Why do we take the amniotic fluid during Amniocentesis?
We can measure Alpha-Fetoprotein to determine neural tube defects in the fetus and chromosomal disorders.
Nursing actions
Pre, intra, and post procedure for Amniocentesis
Pre:
- Explain and confirm consent.
- Empty Bladder
Intra
- Vital signs and FHR.
- Pt in supine position but wedge under R hip
- Tell client that there will be pressure but continue to breathe. Might cause a shift in contents in the stomach.
What are the interpretation for the Alpha-fetoprotein for Amniocentesis?
Too High- Neural tube defects like spina bifida
Too Low- chromosomal disorders or gestational trophoblastic disease
What are some complications for amniocentesis?
Hemorrhage
Leaking amniotic fluid
Fetal damage or death
Miscarriage or preterm labor
What is the VAS (Vibroacoustic)?
A screening tool that uses auditory stimulation to assess fetal well-being with Electronic fetal monitoring (EFM) when NST is non-reactive
What is the interpretation for VAS?
Baby needs to get a High HR above 15 beats for 15 secs in 20 mins
What is does the Amniotic Fluid Index mean? (AFI)
Measures the volume of amniotic Fluids with ultrasound. Fetal urine = amniotic fluid level
What does a low and high AFI mean?
less then 5- indicated oligohydranios
more then 24= polyhydramnios- malformation
What is BPP (Biophysical profile)
An overall assessment of fetal status along with the NST.
What are the 5 fetal assessment variables for BPP
NST reactive
Fetal Movement
Amniotic fluid
Breathing
Fetal tone
What is the interpretation for BPP?
8-10/10 is good
6/10= possible fetal asphyxia
4/10= nonressuring, further testing
