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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
Q

What is Chadwick’s sign?

A

Purple coloration to cervix

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26
Q

What is Hegar’s sign?

A

Softening of cervix

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27
Q

At what maternal age is genetic screening recommended?

A

> 35 with singleton, >32 with twins

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28
Q

What can be measured for open neural tube defects?

A

Alpha fetoprotein

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29
Q

What is the quad screen? When is it done?

A

Maternal serum alpha fetoprotein, hCG, unconjugated estriol, pregnancy associated plasma protein-A, screenign 16-18 weeks gestation

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30
Q

What are the results of the quad screen in a fetus with a neural tube defect?

A

Increased maternal serum AFP; hCG and UE3 normal

31
Q

What are the results of the quad screen in trisomy 18?

A

Decreased AFP, hCG, and UE3

32
Q

What are the results of trisomy 21 in quad screening?

A

Decreased AFP and UE3; increased hCG and PAPP-A

33
Q

What is the fetal fibronectin assay?

A

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
Q

In order to predict imminent delivery, especially in potential preterm labor, what test can be used?

A

Fetal fibronectin assay

35
Q

If the fetal fibronectin assay is positive, what does this mean?

A

1/6-1/3 deliver in 14 days

36
Q

If fetal fibronectin is negative, what does this mean?

A

1/125 deliver in 14 days

37
Q

How does placenta previa present?

A

Painless bleeding; often after intercourse

38
Q

How does placental abruption appear?

A

Painful contractions

39
Q

If there is antepartum bleeding, what is the first step in treating the patient?

A

Evaluation first by ultrasound

40
Q

When does gestational DM screening happen?

A

24-28 weeks

41
Q

How is gestational DM screening done? What is a positive test result?

A

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
Q

What is the definition of preterm labor?

A

Cervical changes associated with uterine contraction prior to 37 weeks

43
Q

In a nulliparous woman, what is considered preterm labor?

A

Uterine contractions with 2 cm dilation and 80% or greater effacement

44
Q

What is the optimal treatment of HIV infection in pregnancy?

A

Initiation of HAART, offer C section, oral zidovudine to neonate

45
Q

Should patients with HIV breastfeed?

A

No, neonate can acquire HIV from infected breast milk

46
Q

What is the viral load goal in pregnancy?

A

To maintin less than 1000 RNA copies/mL

47
Q

How is chlamydia treated?

A

Oral amoxicillin, erythromycin, azithromycin

48
Q

When is screening for GBS done?

A

36-37 weeks

49
Q

How is GBS + women treated during pregnancy?

A

IV penicillin G when in labor

50
Q

What is the definition of antepartum bleeding?

A

Bleeding after 20 weeks

51
Q

After US evaluation in antepartum bleeding, what is the next step?

A

Speculum exam - helps R/o PROM

52
Q

A woman at 34 weeks gestation presents with BP of 160/110 and 4+ proteinuria, what are two important questions to ask?

A

HAs? Visual abnormalities?

53
Q

In pregnancy, what antihypertensive meds are contraindicated?

A

ACE-inhibitors

54
Q

What is gestational hypertension?

A

HTN w/o proteinuria at > 20 weeks gestation

55
Q

What is preeclampsia?

A

BP > 140/90 occuring after 20 weeks gestation in a woman whose BP has previously been normal; proteinuria (300 mg)

56
Q

What may reduce risk for preeclampsia?

A

Calcium supplementation, low dose ASA from 12-36 weeks

57
Q

What are the BP findings in severe preeclampsia?

A

Systolic >160; diastolic >110

58
Q

What is the treatment for preeclampsia?

A

Hydralazine or labetolol for the BP; magnesium sulfate to prevent seizures

59
Q

What are the SEs of magnesium sulfate?

A

Pulmonary edema and hypreflexia

60
Q

How is eclampsia treated?

A

Magnesium sulfate; delivery

61
Q

What is HELLP syndrome?

A

Hemolysis, Elevated Liver enzymes, Low Platelet count

62
Q

Is pregnant patient comes in complaining of continual abdominal pain, what labs should be ordered?

A

Liver enzymes

63
Q

During an oxytocin stress test, evaluation of fetal heart tones should show what?

A

FHT should show variability without decelerations with contractions

64
Q

Bishop’s score is useful for what?

A

Whether induction will be successful or not

65
Q

What is assessed in bishop’s score for induction?

A

Position, consistency, effacement, dilation, fetal station

66
Q

What is an “unfavorable” bishop score?

A

Five or less

67
Q

What score would indicate that the cervix was ripe and induction would have a high probability of success?

A

A score of 8 or more

68
Q

When does maternity blues begin? How long does it last?

A

Begins about day 3-4 postpartum; lasts less than a week

69
Q

What is treatment for postpartum depression?

A

SSRI (can be used during pregnancy and breast feeding), counseling, and family support

70
Q

What medication can be used as antidepressants during pregnancy?

A

TCAs, SSRIs (citalopram, fluoxetine, sertraline), buproprion (good for smoking cessation)

71
Q

What is the onset for postpartum depression?

A

Onset within 4 weeks after childbirth

72
Q

What can be used for postpartum depression screening?

A

Edinburgh postnatal depression scale, PHQ-9, beck depression inventory

73
Q

When do you do quad screening?

A

16-18 weeks

HRM Final Exam (21 decks)

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