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NUR 359: OB > Antepartum > Flashcards

Flashcards in Antepartum Deck (74):
1

what groups are considered at risk

homeless
single
uninsured
no access to prenatal care

2

when is a preg considered high risk

when the life of the mother or fetus is jeopardized

3

how long is mom considered high risk for

up to 30 days after delivery

4

maternal complications usually resolve by when?

within 1 month after birth

5

when is a neonate considered high risk?

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

6

what are the leading causes of maternal mortality

preg induced HTN
PE
hemorrhage

7

what factors are r/t maternal death

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

8

what is the leading cause of neonate death

congenital anomaly

9

other causes of neonate death

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

10

what are genetic risk factors

heritable factors that originate within the mother or fetus

11

name demographic risks

geo location
socio-eco status
racial disparity
occupational hazards

12

what are behavioral risk factors

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

13

name behavioral risks

sub abuse
poor maternal nutrition

14

risk factors are...

inter-related and cumulative

15

how can mom help monitor fetal well being?

daily fetal mvmt count

16

indications for US

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

17

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

amnio fluid vol
doppler blood flow analysis
biophysical profile

18

what is the nurses role during prenatal testing/procedures

-education
-support

19

what are fetal mvmts and tone

the way the baby moves

20

indications for MRI

-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

21

is the mom exposed to radiation during an MRI

no

22

are MRI's and US considered invasive procedures

no

23

what is amniocentesis

assessment of the babys chromosomes

24

amniocentesis is guided via

US

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