ALL Flashcards
(105 cards)
1
Q
- Used to screen pregnant clients for gestational diabetes
A
- GLUCOSE TOLERANCE TEST (GTT)
2
Q
- GLUCOSE TOLERANCE TEST (GTT) how many weeks before screening
A
(24-29 weeks AOG)
3
Q
how many gram of oral glucose load in GTT
A
50g
4
Q
The venous plasma glucose is assessed how many hours
A
1 hour after glucose load
5
Q
if the findings of GTTS is ABNORMAL how many mg/dl
A
140 mg/dl
6
Q
a Client with abnormal GTT result should be re assessed with how many hours and grams of oral
A
3-hour 100g-oral
7
Q
Procedure in GTT
A
Client is told to eat a high-carbohydrate diet for 3 days before the test; then on the day of the test, the woman fasts for 8 hours (overnight) and a fasting serum glucose is obtained; following the fast, 100 g of oral glucose is administered and glucose levels are assessed at 1,2, and 3 hours.
8
Q
- Gestational diabetes is diagnosed if??
A
2 or more are abnormal
9
Q
- Results are borderline if
A
one value is abnormal
10
Q
Abnormal OGTT result in Fasting
A
greater than 105 mg/dl
11
Q
Abnormal OGTT result in 1 hour
A
greater than 190 mg/dl
12
Q
Abnormal OGTT result in 2hours
A
greater than 165 mg/dl
13
Q
Abnormal OGTT result in 3 hours
A
greater than 145 mg/dl
14
Q
to screen for maternal syphilis
A
VDRL
15
Q
WHAT IS ABBREVIATION OF VDRL
A
Venereal disease Research Laboratory
16
Q
testing for women high risk for HIV infection.
A
- Immunosorbent assay (ELISA)
17
Q
ELISA means
A
enzyme-linked immunosorbent assay.
18
Q
HIV If the result is positive, the diagnosis is confirmed
A
Western Blot test
19
Q
- Women with HIV are treated with
A
Zidovudine (AZT)
20
Q
Zidovudine (AZT) is used
A
with HIV are treated with Zidovudine (AZT) during pregnancy to decrease the risk of the fetus acquiring the infection.
21
Q
- HIV screening is recommended for women:
A
a. Who are IV drug users
b. With multiple sexual partners
c. With sexual partner who are HIV positive or who belong to the high-risk group (homosexuals, IV drug users, hemophiliacs)
d. Who received blood transfusions bet 1977-1985 when HIV testing for blood products is not yet routinely conducted.
22
Q
to determine the client’s level of immunity to certain infections that can cause serious consequences if acquired during pregnancy.
A
Antibody screen
23
Q
titer of 1:8 or less indicates?
A
Lack of immunity
24
Q
Test in Rubella antibody titer is for
A
- Hemagglutination-inhibition test – titer of 1:8 or less indicates lack of immunity
25
what to instruct to a woman; what to avoid?
children with rubella infection and who have just received rubella vaccine.
26
Rubella If with no immunity, advice women to be vaccinated
6 weeks after delivery
27
Titer more than 1:8 indicates
IMMUNITY
28
DM universal Screening performed on all pregnant women at
28 weeks gestation
29
DM universal screening is done?
as early as first clinic visit if woman is high risk.
30
Risk factors of DM universal
* Age >25 years
* Family history of diabetes
* Glycosuria
* History of unexplained pregnancy loses
* Previous fetal or neonatal death
* Previous infant with congenital anomalies
* LGA infants or term infant more than 4,000 grams
* Polyhydramnios
31
7. Maternal serum Alpha-fetoprotein (AFP) Performed at
14-16 weeks gestation
32
Maternal serum alpha-fetoprotein * Elevated AFP indicates
neural tube defect, fetal nephrosis, omphalocele
33
7. Maternal serum Alpha-fetoprotein (AFP) * Decreased maternal levels of AFP may indicate
Trisomy 21
34
Maternal serum Alpha-fetoprotein (AFP)
Abnormal levels of AFP may indicate a need for a
triple-screen test, ultrasound, or assessment of AFP levels in amniotic fluid.
35
7. Maternal serum Alpha-fetoprotein (AFP) TEst for Down syndrome, trisomy 18 and neural defects
4. Triple-screen test
36
- Screening test for cervical cancer
Pap smear
37
1st Pap test is done within
3 years after a woman’s first sexual contact or at the age of 18 whichever comes first.
38
- All woman who are sexually active should have a pap test every year during the
first 3 yrs. from the 1st coitus.
39
- If these 1st examinations all revealed a “no pathologic finding” results, succeeding pap test can done every
3-5 years. However, all women should have routine pelvic examination every year
40
If non-pregnant client, pap test
performed around ovulation and never on menstruation
41
Instruction in Pap smear
: no coitus, douche, and vaginal medications 24 hours before pap test
- Client is placed in lithotomy position. Only sterile water is used as lubricant. No chemical lubricant such as KY jelly is used.
42
What are the 3 specimen collected in Pap smear
1. Endocervix
2. Endocervical – most common site of malignancy
3. Vaginal pool specimen – from posterior fornix
43
Most common site of malignancy
Endocervical
44
From posterior fornix
Vaginal Pool specimen
45
Results in Pap smear
1. Class 1 – normal findings
2. Class II – normal with atypical cells present. The atypical cells are often caused by inflammatory conditions such as infection
3. Class III – suggestive of malignancy with benign and possibly malignant cells.
4. Class IV - Probably malignant, with signs of malignancy present
5. Class V - definitely malignant cells are present
46
- Protein may normally be found in the urine during pregnancy at a level of trace to +1 using the
Dipstick method
47
Increased protein may indicate? in Urinalysis
PIH or the Pregnancy Induced Hypertension
48
- WBCs or nitrites can indicate a possible
UTI which can place the client at risk for preterm labor.
49
Urinalysis ketones indicates
diabetes and hyperglycemia.
50
indicative of UTI
- Greater than 10,000 bacteria/ml
51
severe form of diabetes milletus is
Diabetic ketoacidosis
52
- a series of tests done on peripheral blood that provide information on the hematologic system as well other body systems.
CBC
53
CBC IS DONE DURING
28-32 weeks TO DETERMINE ANEMIA
54
NORMAL VALUES OF HEMOGLOBIN (Hgb)
12-16 g/dl; >11 g/dl (pregnancy)
55
NORMAL VALUES OF HEMATOCRIT
(Hct) – 37-47%; >33% (pregnancy)
56
normal values of WBC
5,000-10,000 mm3; 5,000-15,000 mm3 (pregnancy)
57
normal values of Platelet count
150,000-400,000 mm3; none until 3-5 days after delivery (pregnancy)
58
: to determine the client’s blood group and Rh status so that the fetus at risk for developing erythroblastosis fetalis or hyperbilirubinemia in the neonatal period may be identified
BLOOD TYPE AND RH FACTOR
59
- if multigravida is Rh (-), she should next undergo to determine?
Coomb’s test to determine presence of antibodies.
60
Blood type and Rh factor - If not sensitized, should receive
RhoGAM at 28 weeks gestation and within 72 hours after delivery to prevent sensitization
61
Non-invasive procedure that utilizes high frequency sound waves to visualize the products of conception.
Ultrasound
62
To determine sex how many weeks
14-16 weeks
63
requires full bladder, advice to drink 1 quart water 2 hours before ultrasound and assist to lie flat on back.
Abdominal Ultrasound
64
does not require full bladder and useful for early confirmation of pregnancy.
Transvaginal Ultrasound
65
- Use to assess fetal well-being and maturity.
Amniocentesis
66
small amount of amniotic fluid to determine genetic anomalies
Amniocentesis
67
prenatal diagnosis of genetic disorders or congenital anomalies, assessment of pulmonary maturity, and diagnosis of fetal hemolytic disease.
2. Amniocentesis
68
used to asses fetal lung maturity; normal: 2:1
* Lecithin to sphingomyelin (LS) ratio
69
– phospholipid found in pulmonary surfactant – indicator of lung maturity.
Phosphatidylglycerol (PG)
70
as well as the gender of the fetus can be determined from cells cultured for karyotype.
* Genetic and chromosomal aberrations
71
either increased or decreased can indicate anatomic abnormalities
* Alpha-fetoprotein levels
72
status and severity of hemolytic anemia can be assessed by measuring bilirubin pigment in the amniotic fluid.
RH isoimmunization
73
- a transcervical or transabdominal insertion of a needle into the fetal portion of the placenta
Chorionic Villus Sampling
74
how many grams of chorionic villi for examination
5-8 grams
75
CVS is performed at
8-12 weeks gestation under ultrasound guidance to ensure that the fetus is unharmed.
76
indication of CVS
women who are >35 years old; who have had frequent spontaneous abortion, who have had fetuses with chromosomal abnormalities or other defects
77
* To determine some genetic aberrations
CVS
78
- involves performing a trans abdominal insertion of a needle under ultrasound guidance to withdraw 1-4 ml fetal blood sample from a fetal umbilical vessel for examination.
PUBS
79
how many ml in PUBS
1-4 ml fetal blood sample
80
- this test assesses fetal well-being based on the reaction of FHR to fetal movement.
NONSTRESS TEST (NST)
81
how to say in nonstress test is a reactive/normal
– the fetal heart rate should accelerate during fetal movement, by 15 beats for at least 15 secs., twice in a 20-minute period. A reactive NST indicates intrauterine survival for 1 week.
82
how to say in nonstress test is a Nonreactive/Abnormal
No acceleration is observed or acceleration is below than what is expected.
83
- noninvasive method of assessing the general well-being of the fetus and the fetal environment.
BIOPHYSICAL PROFILE
84
what are the 5 parameters evaluated in BPP
1. fetal breathing movements
2. fetal movement
3. fetal tone
4. amniotic fluid index
5. Reactive FHT from Nonstress test
85
scores and total in BPP
- Score of 2 is given if findings for a criterion is normal
- Score of 0 – abnormal
- Total score of 8-10 – normal
- Total score of 4-6 – possibly abnormal
- Total score of less than 4 – indicate need for delivery
86
At least 1 episode of breathing movement lasting at least 60 secs in a 30-min assessment period
Fetal breathing movements score 2
87
At least 3 episodes of fetal movement in a 30-min assessment period
Fetal body movement score 2
88
Fetal body movements
2 or fewer fetal movements
score 0
89
At least 1 episode of extension and return to flexion during the assessment period
fetal muscle tone score 2
90
Slow extension with return to only partial flexion
Fetal muscl tone score 0
91
2 or more movement-associated heart rate increases of at least 15 bpm above baseline and 15 secs in duration in 20-min assessment period
Fetal heart rate activity score 2
92
Fewer than 2 movement-associated heart rates
FHT score 0
93
At least 1 pocket of amniotic fluid measuring 1 cm in two perpendicular planes
Amniotic Fluid Volume score 2
94
Either fluid is absent in most areas of the uterine cavity of the largest pocket measures 1 cm or less in the vertical axia
Amniotic fluid volume score 0
95
calculated by adding the largest vertical pockets of amniotic fluid in the four quadrants of the gravid uterus.
7. Amniotic Fluid Index (AFI)
96
Normal AFI is
10-24 cm
97
fetal movement count considered normal
at least 3 movements in one hour
98
– used to measure uteroplacental function or the feto-placental respiratory reserve by observing the response of fetal heart rate to uterine contractions induced by oxytocin administration or nipple stimulation.
9. Contraction Stress Test
99
Interpretation of CST Positive
Positive
Findings
There is persistent late deceleration or late deceleration with more than half the contractions
Actions
Fetus is no longer receiving adequate oxygen and needs to be delivered
100
Interpretation of CST Negative
Findings
There is no late deceleration Safe for the fetus to remain in the utero for the next 7 days
Actions
Safe for the fetus to remain in the utero for the next 7 days
101
Interpretation of CST Suspicious
Findings
Inconstant late deceleration pattern. Late deceleration occurring with less than half the uterine contraction
ACtions
TEst must be repeated
102
Interpretation of CST Hyperstimulation
Findings
Uterine contractions occur more often than every 2 minutes or lasting longer than 90 seconds or there is a presence of hypertonicity of the uterus
Actions
the test must be repeated
103
Interpretation of CST Unsatisfactory
Findings
Quality of the records is not sufficient to be sure that no late decelerations are present
ACtions
The test must be repeated
104
waveform with a gradual decrease and return to baseline with time from onset of the deceleration to the lowest point of the deceleration (nadir) >30 seconds.
Early Deceleration
105
waveform with a gradual decrease and return to baseline with time from onset of the deceleration to the lowest point of the deceleration (nadir) >30 seconds
Late deceleration
