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antepartum 2 Flashcards

(65 cards)

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1
Q

n/v

A

increased hcg
only concerned if dehyd and weight loss
crackers/toast before sitting up, small and freq, no crease or spicy or trigger, carbonated good, antiemetic, meds if necessary

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2
Q

urinary freq

A

P on bladder and hormones
q2 hr during day, avoid night time drinking, completely empty

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3
Q

fatigue

A

hormone and life
nap

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4
Q

breast tenderness

A

hormones
supportive bra

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5
Q

vaginal discharge

A

leukorrhea - no odor,
natural - lubricate and prevent infection
daily bathing, cotton, dont douche

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6
Q

nasal stuffy

A

estrogen
cool air vapor, NS nasal spray

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7
Q

heart burn

A

uterus push on stomach, sphincter relax, progesterone
combo, non Na antacid, no spicy, dont lay down after eating, avoid trigger

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8
Q

ankle edema

A

decreased venous return
concern if high BP, wont resolve with rest, generalized
avoid prolonged sit or stand, keep feet and legs elevated, exercise, hydrate

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9
Q

varicose veins

A

exercise, avoid sit or stand

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10
Q

flatulence

A

P
reg bowel habit

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11
Q

hemorrhoids

A

avoid C, gently self reduce, topical ointment, warm soak, sitz bath

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12
Q

constipation

A

hormones (progesterone)
concern if abd pain (contractions)
increase fluid, no roughage, daily exercise, reg bowel habits, laxative, fiber

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13
Q

backache

A

baby weight, lordosis
pelvic title, posture, avoid fatigue, good body mechanics when lifting, no heels
concern if reg intervals or UTI

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14
Q

leg cramps

A

unknown cause
massage, warm soak, stretch, dorsiflex

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15
Q

faint

A

sit and lower head btw knees, avoid standing in 1 place too long

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16
Q

SOB

A

P of uterus on diaphragm
posture, prop up in bed
concern if at rest, doesnt go away, with pain, cough, heart palpitations

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17
Q

difficulty sleeping

A

avoid caffeine, max comfort in bed

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18
Q

round ligament pain

A

weight of uterus stretching round ligaments
warmth to abd, slow change of position
concern if not transient

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19
Q

carpal tunnel

A

avoid repetitive hand movements, may disappear after delivery, Sx

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20
Q

fetal movement counts

A

16-22 wk, same time daily, 1 hr after meal, side lying, call if <10/2hr, eat/drink, quiet room

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21
Q

breast

A

supportive bra, clean, no soap on nipples, breast shield for inverted

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22
Q

clothes

A

no high heels or restrictive

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23
Q

cleanliness

A

bathe daily
avoid hyperthermia 1T (hot tub)

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24
Q

employment

A

work till labor, env hazards

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25
travel
no restriction unless complication car = stop q2 hr and walk for 10 min, seat belt - shoulder and hips
26
exercise
nothing new, +300 kcal/day, dont overheat, walking great! contraindications: ROM, htn, competent cervix, bleeding, preterm labor or hx of placenta previa after 26th week benefits: self image, energy, sleep, relieve tension, control weight gain, bowel function, help with recovery PP kegels!
27
sexual activity
1T: fatigue, n/v 2T: fewer discomforts, vascular congestion increase libido 3T: fatigue, SOB, decreased mobility fathers feelings: previous relationship, acceptance, change in appearance, pain
28
dental
regular, brush after n/v, avoid x ray
29
immunization
no live (mmr), flu and Tdap good, U2D before if possible
30
meds
highest risk 1T -> organs, nothing 100% safe pregnancy (dev), lactation, reproductive potential
31
tobacco
lbw babies, preterm, prom, fetal demise, placental previa, abruptive placenta, sids
32
OH
FAS = growth retardation, facial anomalies, retardation increased risk of miscarriage, IUFD, lbw
33
caffeine
no clear evidence, limit to 200 mg/day, hypersensitive
34
marijuana
low research, strength and composition unreliable, other drugs
35
cocaine
maternal MI, cardiac arrhythmias, ruptured aorta, seizure, stroke abruptio placenta, PROM, lbw, sids, heart defect, limb defect cord sampling -> detect use, best method urine sampling (- in 24-48 hr, metabolize rapidly)
36
advanced maternal age
35+ high risk, well educated, $ secure miscarriage, high r/o GDM, GHTN, placenta previa, hard labor; c/s multiple births, down (screen, amniocentesis), infertile (meds) E levels, deal with child when older, peer group
37
adolescent - socioeconomic
poverty, AA and H, low edu and community involvement
38
adolescent - behavior
multiple partners, low contraceptive use, low knowledge, invulnerability
39
adolescent - psychosocial
fam, slef esteem, abuse, punish parents, escape, attention, love
40
adolescent - phys
preterm and lbw, preeclampsia-eclampsia, Fe anemia, CPD, OH and drug use, STI
41
adolescent - interventions
prenatal: assess and counsel nutrition, assess for high risk, test and educate STD, edu about substance, promote fam adap, prenatal edu labor: sustained presence, educate choices, help support people postpartum: contraception, resources, parenting
42
nutrition
increase folic acid, Fe, Ca
43
weight distribution
fetus, placenta, amniotic fluid = 11 lbs uterus = 2lbs blood volume = 4 lbs breast = 31 lbs maternal storage = 5-10 lbs gain: 1-5 in 1T; 1lb/week after
44
obesity
abortion, gestational DM, preeclampdia, labor induction, c/s, anomalies
45
fluid
rxns, lubricate, transport, temp (8-10, 8 oz (4-6 = h2o))
46
pica
cravings (non nutritive) - Fe anemia clay, soil, powdered laundry starch, soap, baking powder i guess they are allowed to have some - dont interfere with nutrition and not harmful
47
ultra sound
sound waves, abd = invasive, can be done at any time benefits: tons non radiating, neural tube defects, skeletal malformations, anomalies
48
nuchal testing
screen, NOT diagnostic, done with US 11 -14 wk -> trisomy disorders, >3mm back on fetal neck = at risk non invasive, 70-80% downs
49
transV US
clearer, predict preterm (short cerv or funnel (cone shaped)) need empty bladder
50
doppler blood flow
unbilical velocimetry blood flow changes (mom and baby) elevations >95% = abn 2T and 3T
51
non stress test
fetal and contraction monitor acceleration of fetal HR with movement or contractions = adequate o2 and CNS intact <32 wk = 2 FHR, 10 beats above, 10 sec >32 wk = 2 FHR, 15 beats above, 15 seconds nonreactive = BPP
52
fetal accoustic stim
sound and vibrate to stimulate infant, show accelerations
53
BPP
fetal breathing movement, gross body movement, fetal tone, amniotic fluid volume (/8), non stress test (/10) 2 = normal for each category
54
contraction stress test
eval O2 and CO2 exchange with placenta bad = late decels - = good + = bad, maybe prep for c/s equivocal = uncertain, continue to monitor
55
amniotic fluid analysis
diagnostic, genetic abn, invasive, 15-20 wk or 3T amniocentesis -> lung maturity with L/S (2:1 = mature)
56
chorionic villus sampling
10-13 week, invasive diagnostic = chrom abn risk = ROM, bleed, intrauterine infection, possible limb reduction and birth defects with early CVS
57
US benefits
early identification of pregnancy, FRB and breathing, multigestational, estimate BW, nuchal translucency in 1T, check heart structures, length of nasal bone, check AFI, location of placenta, detection of fetal death, fetal position and presentation, help with amniocentesis, chorionic villus sampling
58
danger zone - fetal movement
one of most reliable indicators of fetal wellbeing 16-20 wk once it starts, it shouldnt stop, feeling will change
59
danger zone - contract/cramp
preterm: ok if - rare/occasional, know cause, normal FM and no bleeding or leaking; not ok if - regular, no cause, change in FM, bleeding or leaking term: hopefully labor! hx if 5 min apart and getting stronger or if water breaks; not ok if - heavy bleeding, change in FM
60
danger zone - leaking fluid
preterm: identify source - leukorrhea and urine ok; not ok - foul odor, change in color, itchy/irritate, amniotic fluid term: source = same; not ok if UTI s/s; amniotic fluid is ok but go to hospital (bacteria)
61
danger zone - bleeding
preterm: cause, amount, FM, spotting = activity, sex, exam, if cant identify not okay, more than spotting is not ok term: cause, amount, FM, spotting = same, with contractions = ok, persistent with no cause = not ok
62
genetic screening - carrier
maternal and/or paternal serum or buccal swab can be done anytime before or during
63
other danger s of pregnancy
abd pain, fever, persistent v, dysuria, dizzy, blurred vision, spots before eyes, persistent HA, edema (generalized), muscular irritability or convulsions, epigastric pain, oliguria
64
genetic screening - MSAFP
quad screening maternal serum, 15-22 wk measures 4 substances screen for down, edwards, and NTD, not diagnostic
65
genetic screening - NIPT
maternal serum, done anytime after 10 wk screen for down, pataue, edward, and problems with # of sex chromosomes not diagnostic

ob - 332 (15 decks)

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