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HRM Final Exam > Westra Prenatal Care > Flashcards

Westra Prenatal Care Flashcards

1
Q

Pre-term delivery is defined as what?

A

Gestational age < 37 weeks

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2
Q

What is term pregnancy?

A

Gestational age 37 to 42 weeks

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3
Q

What is post-term pregnancy?

A

Gestational age > 42 weeks

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4
Q

How do you calculate estimated date of delivery using Naegele’s rule?

A

First day of LMP - 3 months + 7 days + one year

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5
Q

What does the G stand for in GP status?

A

Gravidity - how times (n) the patient has been pregnant including the current pregnancy

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6
Q

What does P stand for in GP status?

A

Parity - results of previous pregnancies

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7
Q

What does G(n)P(fpal) stand for?

A

Gravida - the number of times pregnant; P - pregnancy outcomes, f- full term births, p-preterm births, a-abortions (elected or spontaneous), l-living number of children

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8
Q

How do you state the status of a woman who has been pregnant 3 times, had 1 full term, 1 preterm and 1 spontaneous abortion? All born children are living.

A

G3P1112

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9
Q

How do you site the results of the previous pregnancies?

A

P (fpal) - full term, preterm, abortions, living

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10
Q

In drug classifications, what does category A mean?

A

Studies in humans, no risk

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11
Q

What is a category B drug classification?

A

Studies in animals, no risk

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12
Q

What does a category D drug classification mean?

A

Evidence of fetal risk, but benefit may outweigh risk

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13
Q

What does a category X drug classification mean?

A

Fetal risks clearly outweigh benefit

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14
Q

Prenatal vitamins are what type of category medication?

A

A

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15
Q

Sulfonamides are what type of category drug class?

A

B

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16
Q

Aminoglycosides are what kind of category drug class?

A

C

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17
Q

Tetracyclines are what type of category of drug class?

A

D

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18
Q

Cephalosporins are what type of drug class?

A

B

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19
Q

Fluoroquinolones are what type of drug class?

A

C

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20
Q

Trimethoprim is what type of category drug class?

A

C

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21
Q

Penicillins are what type of drug class?

A

B

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22
Q

Erythromycin is what type of category drug class?

A

B

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23
Q

Vancomycin is in what category of drug class?

A

C

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24
Q

Streptomycin is in what category of drug class?

A

D

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25
What is Chadwick's sign?
Purple coloration to cervix
26
What is Hegar's sign?
Softening of cervix
27
At what maternal age is genetic screening recommended?
>35 with singleton, >32 with twins
28
What can be measured for open neural tube defects?
Alpha fetoprotein
29
What is the quad screen? When is it done?
Maternal serum alpha fetoprotein, hCG, unconjugated estriol, pregnancy associated plasma protein-A, screenign 16-18 weeks gestation
30
What are the results of the quad screen in a fetus with a neural tube defect?
Increased maternal serum AFP; hCG and UE3 normal
31
What are the results of the quad screen in trisomy 18?
Decreased AFP, hCG, and UE3
32
What are the results of trisomy 21 in quad screening?
Decreased AFP and UE3; increased hCG and PAPP-A
33
What is the fetal fibronectin assay?
Large glycoprotein thought to act as adhesive of fetal membranes to decidua; better predictive value than cervical dilation or uterine activity in prediciting imminent delivery
34
In order to predict imminent delivery, especially in potential preterm labor, what test can be used?
Fetal fibronectin assay
35
If the fetal fibronectin assay is positive, what does this mean?
1/6-1/3 deliver in 14 days
36
If fetal fibronectin is negative, what does this mean?
1/125 deliver in 14 days
37
How does placenta previa present?
Painless bleeding; often after intercourse
38
How does placental abruption appear?
Painful contractions
39
If there is antepartum bleeding, what is the first step in treating the patient?
Evaluation first by ultrasound
40
When does gestational DM screening happen?
24-28 weeks
41
How is gestational DM screening done? What is a positive test result?
50 g on hour glucose challenge; if >130 mg/dL, this is a positive screening test - have to go onto the 3 hour screening test
42
What is the definition of preterm labor?
Cervical changes associated with uterine contraction prior to 37 weeks
43
In a nulliparous woman, what is considered preterm labor?
Uterine contractions with 2 cm dilation and 80% or greater effacement
44
What is the optimal treatment of HIV infection in pregnancy?
Initiation of HAART, offer C section, oral zidovudine to neonate
45
Should patients with HIV breastfeed?
No, neonate can acquire HIV from infected breast milk
46
What is the viral load goal in pregnancy?
To maintin less than 1000 RNA copies/mL
47
How is chlamydia treated?
Oral amoxicillin, erythromycin, azithromycin
48
When is screening for GBS done?
36-37 weeks
49
How is GBS + women treated during pregnancy?
IV penicillin G when in labor
50
What is the definition of antepartum bleeding?
Bleeding after 20 weeks
51
After US evaluation in antepartum bleeding, what is the next step?
Speculum exam - helps R/o PROM
52
A woman at 34 weeks gestation presents with BP of 160/110 and 4+ proteinuria, what are two important questions to ask?
HAs? Visual abnormalities?
53
In pregnancy, what antihypertensive meds are contraindicated?
ACE-inhibitors
54
What is gestational hypertension?
HTN w/o proteinuria at > 20 weeks gestation
55
What is preeclampsia?
BP > 140/90 occuring after 20 weeks gestation in a woman whose BP has previously been normal; proteinuria (300 mg)
56
What may reduce risk for preeclampsia?
Calcium supplementation, low dose ASA from 12-36 weeks
57
What are the BP findings in severe preeclampsia?
Systolic >160; diastolic >110
58
What is the treatment for preeclampsia?
Hydralazine or labetolol for the BP; magnesium sulfate to prevent seizures
59
What are the SEs of magnesium sulfate?
Pulmonary edema and hypreflexia
60
How is eclampsia treated?
Magnesium sulfate; delivery
61
What is HELLP syndrome?
Hemolysis, Elevated Liver enzymes, Low Platelet count
62
Is pregnant patient comes in complaining of continual abdominal pain, what labs should be ordered?
Liver enzymes
63
During an oxytocin stress test, evaluation of fetal heart tones should show what?
FHT should show variability without decelerations with contractions
64
Bishop's score is useful for what?
Whether induction will be successful or not
65
What is assessed in bishop's score for induction?
Position, consistency, effacement, dilation, fetal station
66
What is an "unfavorable" bishop score?
Five or less
67
What score would indicate that the cervix was ripe and induction would have a high probability of success?
A score of 8 or more
68
When does maternity blues begin? How long does it last?
Begins about day 3-4 postpartum; lasts less than a week
69
What is treatment for postpartum depression?
SSRI (can be used during pregnancy and breast feeding), counseling, and family support
70
What medication can be used as antidepressants during pregnancy?
TCAs, SSRIs (citalopram, fluoxetine, sertraline), buproprion (good for smoking cessation)
71
What is the onset for postpartum depression?
Onset within 4 weeks after childbirth
72
What can be used for postpartum depression screening?
Edinburgh postnatal depression scale, PHQ-9, beck depression inventory
73
When do you do quad screening?
16-18 weeks

HRM Final Exam (21 decks)

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