Week 2 Lecture

Question 1

What is included in the fetal assessment? (7)

Answer 1

1) Prenatal Screening
2) CVS/Amniocentesis
3) Ultrasounds
4) SFH for monitoring growth
5) Fetal health surveillance (electronic fetal monitoring, NST)
6) Fetal movement counting (min 6 movements in 2hrs)
7) Biophysical profile

Question 2

What are the major uses for ultrasounds?

Answer 2

1) Confirm pregnancy and viability
2) Determine the gestational age
3) Prenatal screening: NT, fetal anatomy, congenital anomalies
4) Assess level of amniotic fluid
5) Detect fetal growth
6) Determine fetal position
7) Detect placental previa or abruption

Question 3

True or false: ultrasounds are accurate early on, but after 20 weeks, it’s not as accurate.

Answer 3

True

Question 4

How should culture be integrated into discussions surrounding genetic counselling?

Answer 4

• Certain ethnicities are more at risk for certain complications.
• Consider shame/stigma, values and beliefs.
• Careful w/ how you bring up termination.

Question 5

CASE STUDY:

A client is 38 year old primigravida

• Planned pregnancy, healthy with no complications
• She is concerned that her age may have an effect on the fetus.

1) What implications does advance maternal age have on a developing fetus?
2) The client shares that even if the baby has a defect, she will continue with the pregnancy. She wonders if there would be an advantage to knowing before delivery. How would you respond?
3) The client is concerned that the prenatal testing might injury the fetus. What would you tell her about the possible complications of amniocentesis?

Answer 5

1) Genetic abnormalities (ex: Down’s syndrome)
2) Get test to prepare and educate yourself on the topic. Get prepared emotionally and plan of care
3) Reassure that the risk is <1%

Question 6

What are the common causes of bleeding in late pregnancy?

Answer 6

1) Placenta previa
2) Placenta abruption
3) Variations in insertion of the cord and placenta

Question 7

True or false: any bleeding in a woman past 20 weeks gestation requires immediate assessment to determine the cause.

Answer 7

True

Expedited assessment and diagnosis will reduce both fetal and maternal mobility and mortality.

Question 8

What are the hypertension disorders in pregnancy (HDP)? (3)

Answer 8

1) Pre-existing (chronic) hypertension
2) Gestational hypertension
3) Preeclampsia

Question 9

True or false: Approx. 5-10% of pregnancies are complicated by HDP

Answer 9

True

Question 10

What are the risk factors of HDP? (2)

Answer 10

1) Advanced maternal age

2) Family history of pre-eclampsia

Question 11

How is HDP diagnosed?

Answer 11

sBP of 140mmHg or greater and/or dBP of 90mmHg or greater, taken at two separate times and at least 15 mins apart