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NURS 320 - Final > Antepartum > Flashcards

Antepartum Flashcards

(90 cards)

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1
Q

When does gestation start?

A

First day of LMP

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2
Q

When is the first trimester?

A

1 - 13 weeks

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3
Q

When is the second trimester?

A

14 - 26 weeks

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4
Q

When is the third trimester?

A

27 - 42 weeks

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5
Q

______ is a formula used to estimate the estimated date of delivery (EDD)

A

Nagele’s rule

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6
Q

Describe Nagele’s rule

A

First day of LMP - 3 months + 7 days

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7
Q

When can fundal height be measured?

A

10 - 12 weeks

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8
Q

What is the primary tool used for assessing fetal heartbeat during the first trimester?

A

Doppler

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9
Q

Describe Goodell’s sign

A

Softening of the cervix

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10
Q

Describe Chadwick’s sign

A

Blue / purple cervix

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11
Q

Describe Hegar’s sign

A

Softening of the uterine isthmus

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12
Q

What are the expected findings related to fundal height?

A

Number of cm correlates with number of weeks gestation (may fluctuate by 2 - 3 cm)

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13
Q

What method is used to measure fundal height?

A

MacDonald’s method

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14
Q

Describe MacDonald’s method

A

Place 0 cm on the symphysis pubis and extend over the curve of the abdomen to the top of the uterus

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15
Q

When measuring fundal height, the woman should ______

A

Void prior to measurement

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16
Q

What method is used to determine the orientation of the fetus through abdominal palpation?

A

Leopold Maneuver

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17
Q

Describe the Leopold Maneuver

A

1st - determines fetal direction (vertical or transverse)

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18
Q

Describe the Leopold Maneuver

A

2nd - determines position of fetal back and small parts

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19
Q

Describe the Leopold Maneuver

A

3rd - palpates presenting part to determine degree of engagement

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20
Q

Describe the Leopold Maneuver

A

4th - determines fetal occipital prominence

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21
Q

Women with normal BMI and one fetus are expected to gain ______ during pregnancy

A

25 - 35 lbs

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22
Q

Hemoglobin of ______ indicates anemia

A

< 11

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23
Q

Rubella ratio of ______ indicates immunity

A

1:10

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24
Q

What signs are considered dangerous during pregnancy? (4)

A
  • Blurred vision
  • Facial swelling
  • Vaginal bleeding
  • Decreased fetal movements
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25
"Eating for two" suggests an additional ______ calories per day
300
26
What is the recommended daily intake of folic acid during pregnancy?
400 mcg
27
Amniocentisis allows for evaluation of ______ in preterm labor
Fetal lung maturity
28
Presence of how much fluid is considered polyhydramnios?
> 2000 cc
29
Presence of how much fluid is considered oligohydramnios?
< 400 cc
30
Describe the composition of the umbilical cord
- 2 umbilical arteries - 1 umbilical vein
31
The umbilical arteries carry ______ blood
Deoxygenated
32
The umbilical vein carries ______ blood
Oxygenated
33
Placental function is dependent on ______
Maternal BP
34
How can optimal circulation be achieved during pregnancy?
Lying on the left side
35
Describe chorioamnionitis (2)
- Infection of the membranes (chorion and amnion) - Prostaglandins interfere with placental perfusion
36
What is placenta previa?
The placenta covers the cervical os
37
What is the primary manifestation of placenta previa?
PAINLESS, frank (bright red) blood
38
What is abruptio placentae?
The placenta prematurely separates from the uterine wall
39
Abruptio placentae is a ______
Life threatening condition
40
What are the manifestations of placental abruption? (2)
- Dark red / occult bleeding - Board-like, rigid abdomen
41
What are the major concerns associated with placental abruption? (4)
- DIC - Hemorrhage - Hypovolemic shock - Fetal prematurity
42
What are the risk factors of placental abruption? (2)
- Smoking / cocaine (vasoconstriction) - Hypertension
43
Describe the management of abruptio placentae
If fetus is immature / no active bleeding --> bedrest
44
Upon admission to L&D for placental abruption, it is most important to ______
Evaluate bleeding
45
If a patient is bleeding vaginally for any reason ...
DO NOT perform cervical / vaginal assessments
46
Placenta previa / aprubtio placentae require immediate ______
C-section
47
Describe Rh sensitization (2)
- Rh- mother carries an Rh+ baby - Mother develops antibodies against Rh+
48
Describe the management when antibodies against Rh+ are formed
Rhogam injection at 28 weeks - may repeat within 72 hours after delivery
49
Describe the management of hypertension during pregnancy (5)
- labetolol - Limit sodium - Fetal monitoring - BP monitoring - Bedrest
50
Describe gestational hypertension
Transient BP ≥ 140 / 90 during pregnancy
51
Describe preeclampsia (2)
- BP ≥ 140 / 90 after 20 weeks gestation - Proteinuria / edema (toxemia)
52
Describe eclampsia
Seizure occurrence secondary to preeclampsia
53
What is the only cure for preeclampsia?
Birth of the fetus and removal of the placenta
54
What BP is associated with mild preeclampsia?
BP ≥ 140 / 90
55
What assessment findings are present in mild preeclampsia?
Proteinuria ≥ 1+
56
What BP is associated with severe preeclampsia?
BP ≥ 160 / 110
57
What assessment findings are present in severe preeclampsia? (2)
- Proteinuria ≥ 2+ - Oliguria ≤ 30 ml / hr
58
Where is pain associated with preeclampsia located?
RUQ
59
What is the primary risk associated with severe preeclampsia?
Placental abruption
60
Describe the characteristics of HELLP syndrome (3)
- Hemolysis - Elevated liver enzymes - Low platelets
61
Describe hemolysis in HELLP syndrome
Low hematocrit
62
HELLP syndrome is associated with what condition?
Severe preeclampsia
63
When do most women present with manifestations of HELLP?
< 36 weeks
64
What are the manifestations of HELLP syndrome? (3)
- RUQ pain - Severe edema - Nausea / vomiting
65
What intervention must take place in the case of HELLP syndrome?
Immediate delivery
66
Describe the functions of magnesium sulfate (MgSO4) in pregnancy (3)
- Uterine relaxation - Seizure prevention - Decreased BP
67
What is the antidote / reversal agent for magnesium sulfate?
Calcium gluconate
68
How long should magnesium sulfate (MgSO4) be continued after birth to prevent seizures?
24 hours
69
What are the signs of magnesium sulfate toxicity? (4)
- Respiratory depression (RR < 12) - Decreased urinary output (< 30 mL / hr) - Decreased reflexes - Clonus
70
When is a blood glucose screen conducted?
24 - 28 weeks
71
Describe the process of glucose testing in pregnancy (4)
- 1 hour 50 gram test - If ≥ 130 - 140 .. - 3 hour 100 gram test - 2 abnormal tests - indicates gestational diabetes
72
For gestational diabetes, it is recommended to have an intake of ______ kcal / kg
30 - 35
73
What test determines diabetic control over the past 4 - 12 weeks?
Hgb A1C
74
If a type I diabetic mother has vascular involvement (such as preeclampsia), the baby may be ______ due to poor perfusion to the placenta
Small for gestational age
75
What are the types of tocoyltics used to stop preterm labor? (4)
- MgSO4 - Terbutaline (SQ) - Indomethacin - Nifidepine
76
What are the indications that it is too late to stop preterm labor? (2)
- Fetal distress - > 6 cm dilated
77
What is the therapeutic level of magnesium?
4 - 8 mg / dL
78
What occurs when magnesium levels are ≥ 9?
Reflexes disappear
79
What occurs when magnesium levels are ≥ 15?
Respiratory depression
80
What is the purpose of betamethasone (Celestone)?
Aids in feel lung development / prevents respiratory distress
81
______ is recommended for all women experiencing preterm labor
betamethasone (Celestone)
82
Birth should be delayed for at least ______ after the first round of betamethasone (Celestone) treatment
24 hours
83
Carriers of GBS are often ______
Asymptomatic
84
What is the primary concern associated with GBS?
Neonatal sepsis
85
When does screening for GBS occur?
35 - 37 weeks (vaginal / rectal swab)
86
What is the primary nursing intervention for a GBS + mother?
Prophylactic antibiotics at onset of labor / ROM
87
How often are prophylactic antibiotics given for GBS?
Q 4 hours
88
Describe the frequency of Terbutaline injections
3 injections 15 minutes apart
89
What is precipitous labor?
Birth within < 3 hours
90
What are the risks associated with precipitous labor? (2)
- Facial bruising on newborn - Vaginal lacerations

NURS 320 - Final (19 decks)

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