W2: Prenatal Concept/ Antepartum Care Flashcards

1
Q

Preconception care

A

identifying and modifying risk factors in individuals considering pregnanvy in order to improve their health

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2
Q

8 Components of Preconception Care

A

Folic Acid
Healthy Body Weight
Mental Health
Physical Activity
Smoking
Immunizations
Nutrition
Environmental Hazards

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3
Q

Folic Acid

A

reduces risk of neural tube defects

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4
Q

Healthy Body Weight

A

high/low BMI can negatively affect pregnancy

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5
Q

Mental Health

A

premature birth
birth weight
breastfeeding initiation
coginitive & emotional development

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6
Q

Physical Activity

A

decrease risk of chronic conditions
weight
mental health

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7
Q

Smoking

A

less negative effects on pregnancies
maternal health

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8
Q

Immunizations

A

adverse pregnancy outcomes
prevent infections from being transmitted to fetus
protection durign early infancy

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9
Q

Nutrition

A

overall health
optimize maternal & fetal health

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10
Q

Environmental Hazards

A

complex to verify but should be done

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11
Q

Conception and Implantation Phases

A

unfertilized oocyte
fertilized oocyte
two cell stage
four-cell stage
eight cell stage
morula
blastocyte
embryo hatches
vlastocyte rotates and impants into endometrium of uterus

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12
Q

6 functions of the placenta

A

respiratory - O2 and CO2
excretory - waste products
endocrine- functions as an endocrine - secretes 4 pregnancy hormones (human chorionic gonadotropin, estrogen, progesterone, human placental lactogen)
nutrition: mother- fetus
storage- carbs, protein, Ca, Fe for fetal needs
barrier- from harmful substances

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13
Q

CHEAP.TORCHES acronym

A

C:chickepox & shingles
H: hepatitis B, C, D, C, E
E: enterovirus + poliovirus
A: aids
P: parovirus B19 (5th disease)
T: toxoplasmosis
O: other -group B streptococcus listeria, candida
R: rubella
C: cytomegalovirus
H: herpes simplex virus
E: sexually transmitted- gonorrhea, chlamydia
S: syphilis

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14
Q

Antepartum:

A

prenatal period (conceptio - onset of labor)

AKA antenatal, prenatal

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15
Q

Intrapartum

A

period from onset of true labour - delivery of baby & placenta

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16
Q

post partum

A

6 week period: delivery of placenta - body returning to pre-pregnancy state

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17
Q

First trimester

A

1-14 weeks

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18
Q

Second trimester

A

14-28 weeks

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19
Q

Third trimester

A

28-40 weeks/delivery

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20
Q

Gravida

A

a person who is pregnant

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21
Q

Gravidity

A

pregnancy

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22
Q

nulligravida

A

a person who has never been pregnany and is not pregnant currently

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23
Q

primigravida

A

a person who is pregnant for the first time

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24
Q

multigravida

A

a person who has had 2+ pregnancies

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25
Q

parity

A

number of pregnancies where the fetus has reached 20 weeks gestation

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26
Q

nullipara

A

person who has not completed a pregnancy beyond 20 weeks

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27
Q

primipara

A

one pregnancy reaching 20 weeks

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28
Q

multipara

A

2+ pregnancies reaching 20 weeks

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29
Q

viability

A

capacity to live outside the uterus

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30
Q

Infants born at __ - ___ weeks of gestations infants are considered to be on the threshold of viability

A

22, 25

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31
Q

pre-term

A

20 - 36 + 6 w

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32
Q

late pre-term

A

34- 36+6 w

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33
Q

term

A

37 - 40 + 6w

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34
Q

early term

A

37 - 38 + 6w

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35
Q

full term

A

39 - 40 + 6w

36
Q

late term

A

41st w

37
Q

post-term

A

after 42w

38
Q

GTPAL Score: Amy is pregnant for the first time

A

1, 0, 0, 0, 0

39
Q

GTPAL Score: Amy carries her pregnancy to term, new born survies

A

1, 1, 0, 0, 0

40
Q

GTPAL Score: Amy is pregnant with second child

A

2, 1, 0, 0, 0

41
Q

GTPAL Score: Amy has a child, her current pregnany ends in a miscarriage at 10 weeks

A

2, 1, 0, 1, 1

42
Q

GTPAL Score: Amy has one child, she is pregnant for the third time and gives birth to twins at 36 weeks

A

3, 1, 2, 1, 3

43
Q

What does GTPAL Score stand for

A

gravidity
term
pre-term
Abortion
Living children

44
Q

earliest biochemical marker of pregnancy

A

human chorionic gonadotropin (hCG)

45
Q

Technology used for home pregnancy tests

A

ELISA, enzyme linked immunoabsorbent assay

46
Q

Presumptive Signs of Pregnancy

A

cessation of menses
nausea and vomiting
frequent urination
breast, chest tenderness
skin changes
quickening
fatigue

47
Q

Probable Signs of Pregnancy

A

enlargement of abdomen
braxton hicks (end of 1st tri)
skin changes (striae, increased pigment)
positive pregnancy test
hegar’s test
goodell’s sign
chadwick’s sign

48
Q

hegar’s sign

A

palpable softening of lower uterine segment @ 6 weeks

49
Q

goodell’s sign

A

softening of cervix @ 8 weeks

50
Q

chadwick’s sign

A

blue-violet hue form congestation on vulva, vagina, cervix, vaginal opening @ 6-8 weeks

51
Q

Positive Signs of Pregnancy

A

fetal heart heard
-4-8w w/ ultrasound
-10-12w w/ doppler
fetal movement (18-20w)
visualization of fetus (5-6w)

52
Q

Adaptations: Uterus

A

changes in size, shape, position
hegar’s sign
changes in contractility
goodell’s sign
changes r/t fetal presense (ballotement) - displacement of abdominal structures

53
Q

Adaptations: Vagina & Vulva

A

chadwick’s sign
leukorrhea

54
Q

Adaptations: Breasts

A

fullness, heavtt
heightened sensitivity (tingling, pain)
areaola more pigmented
mongomery tubercules
colostrum

55
Q

Adaptations: Cardiovascular System

A

slight change in diastolic pressure
-slight decrease mid-preg, return to normal by end
blood volume increases
hemoglobin level decreases
hematorcrit decreases
RBC mass increase
cardiac output increases
— all mainly due to increased fetal demand

56
Q

Adaptations: Respiratory System

A

oxygen consumption increases
changes from abdominal-thoracic breathing (diaphragm displaced)
increases vascularization in upper tract d/t estrogen
nasal & sinus stuffiness, nosebleeds, voice changes

57
Q

Adaptations: Renal System

A

increased GFR
increase frequenct & nocturemia (pressure on bladder)
dilation of ureters & renal pelvis increase pylonephiritis

58
Q

Adaptations: endocrine system

A

thyroid- enlarge, tt4 inc
adrenal- cortisol & aldosterone inc
pituitary- gland enlarges, prolactin inc
pancreas- glucose for growth
hyperglycemia & hyperinsulinemia after eating (insulin resistance)
potential for gestation diabetes

59
Q

Adaptations: GI system

A

morning sickness due to hCG
constipation
gas, discomfort
risk of gallstones
heartburn
hiatus hernia
mouth, gum soreness/bleeding
hemarroids

60
Q

Adaptations: Musculoskeletal System

A

lumbar lordosis as uterus enlarges & moves upwards & outwards
relaxation of motility of pelvic joints (waddle)
rectis abdominous, diastasis recti
umbilicus protrudes

61
Q

Adaptations: neurological system

A

lightheadedness, fainting
carpal tunnel
sensory changes in the legs
headaches
decrease attention, concentration, memory

62
Q

Adaptations: Integumantary system

A

chloasma
linea negra
striae gradrium (stretch marks)- reduced conenctive tissue strength d/t elevated steroid levels
thicker hair

63
Q

Determining date of delivery

A

nagele’s rule

add 7 days to 1st day of LMP
substract 3 months from that date

64
Q

fundal height

A

measures size of uterus from pubic symphysis to fundus
22-34w
mcdonald’s method: using a tape measure

65
Q

Quickening

A

awareness of fetal mocements by pregnant person
16-22 weeks

66
Q

hormones of pregnancy

A

HPL
HCG
Estrogen
Preogesterone
oxytocin
prolactin
relaxin

67
Q

HPL

A

metabolism regulation-free up glucose for fetus use
insulin resistance

68
Q

HCG

A

proliferation of uterus & causes cessation of menstruation

69
Q

estrogen

A

increases at end of pregnancy for labor
maintains, controls, stimulates the production of other pregnancy hormones
ensures developmnt of fetal organs
growtth & function of placenta
maternal breast tissue growth (lactation)

70
Q

progesterone

A

!! maintains pregnancy
growth of blood vessels
nutrients for erly embryo
thickening of endometrium for implantation
establish placenta
prevents uterus from contracting until labor
prevents lactation until PP
strengthen pelvic muscles for labor

71
Q

oxytocin

A

produced by hypothal. secreted py posterior pituitary
induced uterine contractions for labor
letdown reflex during lactation

72
Q

prolactin

A

produced by anterior pituitary
essential for milk production

73
Q

relaxin

A

produced by corpus luteum then placenta after 6-8 weeks
relaxes pelvic muscles/joint for birth

74
Q

An infant has a lpw birth weight when they weigh ___

A

2500g or less

75
Q

BMI Classification

A

<18.5 = underweight
18.5 - 24.9 = normal
25-29.9=overweight
>30= obese

76
Q

per week weight gain for each BMI category

A

underweight= 0.5
normal= 0.4
overweight= 0.3
obese= 0.2

77
Q

total weight gain range for each bmi category

A

underweight= 12.5-18
normal= 11.5-16
overweight= 7-11.5
obese= 5-9

78
Q

Foods to avoud during pregnancy

A

blue cheese
unpasteurized milk
raw/undercooked eyes
raw/undercooked meat
shark/sword fish (mercury)
limit intake of tuna & mackerel
limit coffee intake (lbw)
no alcohol
limit intake of liver (to much vit A)

79
Q

Common Discomforts during pregnancy

A

nausea/vomiting
heartburn
breast tenderness
vaginal d/c, bleeding
headaches
nosebleeds
gingivitis
abdominal pain/cramping
fatigue
constipation
urinary frequency
backpain
skin changes
pytalism
quickening
pica

80
Q

Prenatal Visit Frequency

A

1x per month until 28w
q2w 28-36w
1x week 37-40w

81
Q

Normal Fetal Heart Rate: Pregnancy

A

160-170 bpm (early)
110-160 bpm (late)

82
Q

Screening: 1st Trimester

A

PAP
CBC
HIV
urine culture
rubella titre
ABO & RH typing
STI
ultrasound NT, B-hCG, PAPP-A
- Aneuploidy= increased NT , inc B-hCG, reduced PAPP-A

83
Q

Screening: 2nd Trimester

A

quadruple screen: blood test
- alpha fetal proteins (AFP), h-CG, unconjugated estriol (UE), inhibin-A (placental hormone)
ultrasoung (getational age, growth, abnormalities, heart)

84
Q

Ultrasound

A

1st Trimester: assess gestational age, number of fetuses, assess for problems (ectopic, bleeding)
2nd/3rd: gestational age, level of amniotic fluid, location of placenta, identify presentation, cause of bleeding, fetal death

85
Q

amniocenthesis

A

part of amniotic fluid is taken to test for genetic disorders, congentical abnormalities

86
Q

Screening: 3rd trimester

A

gestational diabetes
group b streptococcus
fetal health (fetal movement counts, NST, CST, ultrasound)

87
Q

6 practices for culturally safe, humble, trauma-informed perinatal care

A

cultural safety + humility
self-determination
trust through relationship
respect
anti-indigenous reacism
strength & resilience based practice