week 2 content Flashcards
which screening is a prenatal blood test done during 15-22 weeks pregnancy to assess the risk of certain birth defects in the developing baby.
It measures the levels of four substances in the mother’s blood: and helps identify an increased risk for:
down syndrome
Edwards syndrome
Neural tube defects - spina bifida
MSAFP “Quad screen”
which screening is used to assess the risk of certain chromosomal abnormalities in the developing baby such as:
down syndrome
patau syndrome
Edwards syndrome
problems with # of sex chromosomes
Noninvasive prenatal test (NIPT) or cell free DNA
after delivery does maternal insulin requirements i/d
why is breastfeeding encouraged in DM moms
decrease
glucose leaves body through breast milk
what prophylactic med do we give a mother who is Rh- carrying a Rh+ fetus?
what scenario would we give this med?
28 weeks T/F
before/after spontaneous or induced abortion of ectopic preg
before/after invasive procedure during preg
before/after maternal trauma
Rh immune globulin IM (Rhogam)
- at 28 weeks
- After spontaneous or induced abortion of ectopic preg
- After invasive procedure during preg
- After maternal trauma
the blood types of the mother and baby are incompatible is called ___________________
ABO incompatibility
no change vs increase intake during pregnancy?
- Thiamine
- Sodium
- Riboflavin
- Niacin
- Vitamin B
- Iodine
- Folic acid
increase
no change - sodium
increase
increase
increase
no change - iodine
increase - 400 mcg before, 1 mg during
which type of HTN
patient D:
25 weeks
yes proteinuria
sudden increase in well controlled chronic HTN
Patient has 2 readings of high BP at least 4 hours apart
Systolic 140+
Diastolic 90+
Think what gestation is patient?
Is proteinuria involved?
Chronic HTN w/ superimposed preeclampsia
Chronic HTN - Before 20 weeks, No
Gestation HTN - After 20 weeks, No
Preeclampsia - After 20 weeks, Yes
Chronic HTN w/ superimposed preeclampsia - After 20 weeks,
Sudden increase in well controlled chronic HTN, Yes
patient A is being screened for gestational DM with 1 hour GTT
does she need to fast?
her glucose came back at 150. Did she pass or fail?
- 1 hour GTT (glucose tolerance test)
- Don’t have to fast
- > 140 = failed
what should the nurse tell the mom that is 37 weeks that called c/o contractions/cramping?
think preterm or term, frequency and other associated signs
could be labor!
- Counsel to go to hospital when contractions are 5 mins apart, getting stronger every hour, or if water breaks
if contractions/cramping is:
- Associated with heavy vaginal bleeding (more than spotting/bloody show)
- Change in fetal movement
common discomforts - round ligament pain
cause -
when to be concerned -
teaching -
- Cause
Weight of uterus stretching round ligament - When to be concerned
If pain is moving (not transient) - Teaching
Warmth to abdomen
Slow changes from lying to sitting/standing
what should the nurse tell the mom that is 20 weeks that called c/o contractions/cramping?
think preterm or term, frequency, cause, and other associated signs
less then 37 weeks = preterm
preterm if contraction/cramping is:
- Rare/occasional
- Associated with cause like increased activity
- associated with Normal fetal movement, no vaginal bleeding/leaking of fluid
OK
preterm if contraction/cramping is:
- Regular (>4-6/hour)
- associated with no cause
- associated with Change in fetal movement, vaginal bleeding, or leaking of fluid
NOT OK
10 weeks gestation patient presents with
- Uni-lateral abdominal pain
- Dizzy
- Vaginal bleeding
what should the nurse suspect?
threatened abortion
ectopic pregnancy
molar pregnancy
ectopic pregnancy
Uni-lateral abdominal pain = big giveaway
iron deficiency vs sickle cell vs folic acid anemia?
Treatment – prevent crisis, IV fluids, O2, abx, folic acid, analgesics
Treatment – folic acid 400 mcg before pregnancy, 1 mg during pregnancy
Treatment – supplemental iron
sickle cell
folic acid
iron deficiency
which test measures
- fetal breathing movements
- gross body movements
- fetal tone
- amniotic fluid volume
BPP
how do we screen for gestational DM
1 hour glucose tolerance test
3 hour GTT
which stress test evaluates oxygenation and carbon dioxide exchange of the placenta
contraction stress test
what is the desired score on a contraction stress test - negative or positive?
- negative test = desired score, no late decelerations, no signs of fetal distress
- positive test = bad, late decelerations, signs of fetal distress, consider preparing for C/S
which technique assesses fetal well-being by using high frequency sound waves to deflect off tissues in the uterus to a transducer showing structures
- Non invasive, painless, non radiating
- No harmful effects
- 3D and 4D images
- Identify anomalies, neural tube deficits, skeletal malformations
Abdominal Ultrasound
common discomforts - SOA
cause -
when to be concerned -
teaching -
- Cause
- Pressure on diaphragm
- hormones
- When to be concerned
- Dyspnea not r/t activity
- Accompanied with chest pain, cough, heart palpitations
- Persistent despite position changes
- Teaching
- Good posture when sitting
- Prop up HOB
ABO incompatibility
Maternal serum antibodies against ___ and ___ are present
hemolysis of fetal RBC leads to hypobilirubinemia/hyperbilirubinemia
will an indirect/direct combs test be conducted?
would we expect mild/severe anemia to occur?
Maternal serum antibodies against A and B are present
hyperbilirubinemia
Cord blood – (direct combs test) – Done on cord/infant blood, Detects if maternal antibodies are adhered to infants RBC
Mild anemia may occur, severe anemia doesn’t generally occur
Gestational trophoblastic disease:
type - ___________________-
abnormal development occurs in the fertilized egg, not a viable pregnancy
Molar pregnancy (hydatidiform mole)
partial molar pregnancy vs complete molar pregnancy
(abnormal ovum + normal sperm)
(normal ovum + abnormal sperm)
- Complete mole – (abnormal ovum + normal sperm) ovum containing no genetic material is fertilized by normal sperm
- Partial mole – (normal ovum + abnormal sperm) normal ovum is fertilized by 2 sperm or sperm that hasn’t divided
when should mom seek care if she thinks fetus is moving less or not at all?
Go to HCP if <10 movements in 2 hours
advanced maternal age =
medical risks associated with AMA
i/d miscarriage
i/d GDM and GHTN
i/d placenta previa
i/d difficult labor
i/d c-section
i/d multiple births
i/d down syndrome
i/d infertility
35
increase in all