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NUR 359: OB > Antepartum > Flashcards

Antepartum Flashcards

1
Q

what groups are considered at risk

A

homeless
single
uninsured
no access to prenatal care

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2
Q

when is a preg considered high risk

A

when the life of the mother or fetus is jeopardized

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3
Q

how long is mom considered high risk for

A

up to 30 days after delivery

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4
Q

maternal complications usually resolve by when?

A

within 1 month after birth

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5
Q

when is a neonate considered high risk?

A

when the neonate does not meet cultural, societal, or familial norms/expectations

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6
Q

what are the leading causes of maternal mortality

A

preg induced HTN
PE
hemorrhage

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7
Q

what factors are r/t maternal death

A 
younger than 20
older than 35
lack of prenatal care
low edu
unmarried
non-white
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8
Q

what is the leading cause of neonate death

A

congenital anomaly

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9
Q

other causes of neonate death

A 
short gest
low birth wt
SIDS
resp distress
effects of maternal complications
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10
Q

what are genetic risk factors

A

heritable factors that originate within the mother or fetus

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11
Q

name demographic risks

A

geo location
socio-eco status
racial disparity
occupational hazards

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12
Q

what are behavioral risk factors

A

behaviors that arise from the mother and/or family and place the fetus at incr risk

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13
Q

name behavioral risks

A

sub abuse

poor maternal nutrition

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14
Q

risk factors are…

A

inter-related and cumulative

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15
Q

how can mom help monitor fetal well being?

A

daily fetal mvmt count

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16
Q

indications for US

A 
-FHR activity
gest age
fetal growth
fetal anatomy
placental position and fx
adjunct to other invasive tests
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17
Q

how do we use the US to determine fetal well being?

A

amnio fluid vol
doppler blood flow analysis
biophysical profile

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18
Q

what is the nurses role during prenatal testing/procedures

A
  • education

- support

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19
Q

what are fetal mvmts and tone

A

the way the baby moves

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20
Q

indications for MRI

A

-fetal structure
- placenta:
position
density
presence of gest tropho disease
- quant if amnio fluid
- maternal structures:
uterus
cervix
adnexa
pelvis
fibroids
- biochemical status of tissues and organs
-soft tissue anomalies
- metab anomalies
- fx anomalies

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21
Q

is the mom exposed to radiation during an MRI

A

no

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22
Q

are MRI’s and US considered invasive procedures

A

no

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23
Q

what is amniocentesis

A

assessment of the babys chromosomes

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24
Q

amniocentesis is guided via

A

US

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25
when is an amnio done
on or after week 14
26
maternal risks a/w amniocentesis
``` hemorrhage infec labor abruptio placenta damage to intestines or bladder amnio fluid embolism ```
27
what % is the risk a/w amniocentesis
<1%
28
recommendations for mom after amniocentesis
- rest for the remainder of the day - no bending, reaching, climbing stairs - restrict taking care of other children- if possible
29
what should a mom report after an amniocentesis
dull back pain
30
fetal risks a/w amniocentesis
``` death hemorrhage infec (amniotitis) injury from needle miscarriage pre term labor amnio leakage ```
31
indications for amniocentesis
hx of genetic disorders fetal maturity fetal hemolytic disease ante/intra partal meconium
32
what is lactophinomylin ratio
lung maturity
33
what is karyotyping
terminating a preg bc the baby is an undesired sex
34
percutaneous umbilical blood sampling is aka
cordocentesis
35
what is PUBS
insertion of a needle into umbilical vessel under US guidance
36
benefit of PUBS
direct access to fetal circulation
37
when can a PUBS be done
2nd and 3rd trimester only
38
is a PUBs done often
no- very rarely
39
risks a/w PUBS
infec premature ROM cord prolapse
40
what is chorionic villus sampling (CVS)
- removal of small tissue specimen from fetal portion of placenta
41
where does chorionic villi originate
zygote
42
what does chorionic villi tissue reflect?
genetic makeup of fetus
43
when can a CVS be done
bx 10-12 wks gest
44
benefits of CVS
- earlier dx | - rapid results
45
risks a/w CVS
miscarriage | bleeding
46
indication for AFP
screening: NTD's abdominal wall defects
47
who is AFP testing recommended for
all pregnant women
48
how is AFP collected
maternal serum
49
AFP is produced by
the fetal liver
50
when is AFP tested?
16-18 wks gest
51
AFP blood tests are combined with
US results
52
how are the results from an AFP presented?
- a percentage risk of having a baby with down syndrome
53
it is possible to receive what kind of results from an AFP
false positive
54
what else is looked at in conjunction with AFP?
estriol and HCG
55
if a baby has down syndrome, describe the rship bx afp/estriol/hcg levels
- AFP and estriol will be low | - HCG will be high
56
what is a coombs test used for
- determine RH incompatibility and its severity | - determines other AB's for incompatibilty w/ moms Ag's
57
if mom and fetus are Rh incompatible, what will be admin to mom after birth
Rhogam
58
indications for electronic fetal monitoring
- assess fetal response to hypoxia and asphyxia - fetal well being - cxns - cns of the baby
59
variability of fhr demonstrates
fetal well being cxns cns of the baby
60
what is a NST done for
fetal activity determination
61
how is a NST performed?
mom lays down 2 belts mom relaxes vibroacoustic stimulation
62
when is a NST indicated
- 2x per week after week 28 if mom has: DM HTN previous stillborn
63
interpretaion of NST results
2 or more accelerations of 15 bpms lasting over 15 secs over 20 mins demonstrates moderate variability
64
vibroacoutic stimulation
5-10 mins getting baseline get a variability w/ HR scare baby
65
what is the protocol if there is no activity after vibroacoustic stimulation
mom will be sent for more testing- biophysical
66
how long will HCP allow baby to be non-reactive before sending mom for a biophysical
40 mins
67
when is a contraction stress test (CST) indicated
when a baby fails NST
68
what are the 2 different CST's
- nipple stim CST | - oxytocin stim CST
69
how is a CST performed?
- monitor for 20 mins - get a baseline - give 20 units - wait a few mins - give 10 units - assess baby to cxns - wait another 20 mins - assess baby again
70
interpretation of CST
-if baby reacts, test is (-)
71
benefit of CST
- provides a warning of fetal compromise earlier than an NST
72
name biophysical assessment techniques
fetal mvmt counts US MRI
73
name the biochemical monitoring techniques
amnio PUBS CVS maternal serum AFP
74
what interpretations suggest fetal well being
reactive NST and (-) CST

NUR 359: OB (15 decks)

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