Exam 2 Prenatal Care Flashcards Preview

Q4 Women's Health > Exam 2 Prenatal Care > Flashcards

Flashcards in Exam 2 Prenatal Care Deck (46):
1

Reasons for prenatal care? (5)

1) Early, accurate estimate of gestational age
2) Identify at-risk pts
3) Eval/follow health of mom/baby
4) Anticipate/intervene problems
5) Pt education

2

Preconception exam should include?

General physical (check for cavities)

3

Preconception exam should always include what lab?

When indicated? (10)

HIV

Rubella/Varicella titer
Hep B/C
Gonorr/Chlam cx
TB
RPR
CBC
Fasting blood sugar
Hgb A1C
Cystic fibrosis carrier
Tay Sachs

4

Preconception care should include what immunizations? (6)

MMR (NOT if already pregnant/must wait 1 mo post)
Varicella
Hep B
Flu
Tdap
+/- pneumococcal

5

Preconception folic acid dose?

0.4 -0.8 mg/day
4 mg if neural tube defect hx

6

Prenatal care 1st visit should occur when?

By week 10 (1st trimester)

7

Prenatal care 1st visit history should include? (7)

Full hx including:
STD, PID, Abn paps
Planned vs unintended preggo
Domestic violence
Tobacco/alcohol/drugs
Inheritable dzs
Barriers to care

8

Prenatal care 1st visit Obstetric Hx includes?

G: # of pregnancies
P: TPAL
T = Full term
P = Preterm (<37wks)
A = Abortions (spont, induced, ectopic)
L = Living

9

Prenatal care: Estimated Date of Confinement (Delivery) is calculated how?

(LMP + 7 days) - 3 months

10

Early Term is?

37 0/7 - 38 6/7 weeks

11

Full Term is?

39 0/7 - 40 6/7 weeks

12

Late Term is?

41 0/7 - 41 6/7 weeks

13

Postterm is?

42 0/7 weeks on

14

Prenatal care 1st visit Physical Exam should include? (2)

General
Pelvic

15

Prenatal care 1st visit Pelvic Exam should include? (4)

Uterine size/shape/adnexa (parts joining it)
Chadwick's Sign
Hegar's Sign
Specimen collection

16

Chadwick's Sign is?

Blue coloring of vagina/cervix from ↑ blood flow
Indicates pregnancy

17

Hegar's Sign is?

Softening of isthmus (where cervix meets uterus)

18

What specimens should be collected during 1st visit pelvic? (2)

pap
gonor/chlam

19

Prenatal care 1st visit labs should include? (11)

hCG (ALWAYS!)
Blood type/Rh
Anitbody screen
Rubella/Varicella titers
Syphilis
Hep B
HIV
CBC
UA w/ C&S
TSH
Cystic Fibrosis if pt wants it

20

Prenatal care 1st visit additional lab for at-riskers? (5)

TB
Hep C
Trichomonas
HSV
Hgb A1C

21

Prenatal care 1st visit US done how?

Why?

Cardiac motion visible how soon?

Transvag US

Confirm estimated delivery date (IMPORTANT!)

5 - 6 weeks

22

1st trimester is?

2nd trimester is?

3rd trimester is?

1 to end of wk 12

13 to end of week 26

27 on

23

Prenatal F/U care schedule?

1st 28 wks = Q 4 wks

28-36 wks = Q 2wks

36 wks = Q 1wk

24

Quickening is?

1st fetal movements:
@ 18-20 wks w/ 1st preg
@ 16-18 wks w/ add'l pregs

25

Prenatal F/U visits should include? (5)

Hx
BP
Fetal Heart Tones
Fundal height
Extremities

26

Fetal Heart Tones measured how?

When?

Normal bpm?

Doppler

wks 10 - 12

120-160 bpm

27

Fundal Height at 12 weeks?

20 weeks?

After 20 weeks?

Drops when?

12 wks = pubic symphysis

20 wks = umbilicus

1 cm additional height for each week after 20

Drops @ 36-38 weeks

28

Prenatal Care 3rd Tri should include? (2)

Leopold's Maneuvers
Cervical exam

29

Leopold Maneuvers are?

Method of feeling for baby's position during 3rd trimester

30

Cervical Exam during 3rd Tri assesses what? (4)

Effacement (thinning/shortening)
Dilation
Station
Presenting parts

31

Station is?

Measured how?

"Engaged" means?

Position of baby's head in relation to ischial spines of pelvis

Measured -5 to +5

Measurement of 0
Head entered vaginal canal w/i pelvic bones

32

Prenatal Care Routine Screening labs? (6)

Urine protein/sugar EVERY time
Down's @ 1st tri
Gestational DM @ 24-28 wks
CBC for anemia @ 3rd tri
Repeat Rh @ 3rd tri
Group B strep (vag/rectum) @ 35-37 wks

33

If Rh screen is negative, next step?

Rh IG @ 28-30 wks

34

Aneuploidy screening is for?

Neural tube
Down
Tri 18

35

Aneuploidy screening done when/how? (3)

1st tri

Sonogram for nucal translucency w/ blood markers

Maternal Quad Screen for markers AFP, uE3, hCG, inhibin A

36

Cell Free DNA testing is? (5)

Optional for:
35+ yo
Fetal US = ↑ aneuploidy risk
Hx of trisomy
+ test for aneu
Robertsonian translocation

37

US schedule/purpose? (3)

1st tri: dating, location, eval bleeding/pain

2nd tri (18-20wks): growth, anatomy, placenta, P gender

3rd tri: growth, presentation, bleeding, Biophys Profile

38

Biophysical Profile includes? (5)

Non-Stress Test
Fetal Breathing Movements
Fetal Movement
Fetal Tone
Amniotic fluid vol

39

Appropriate Weight Gain by BMI:

<18.5?

18.5 - 24.9?

25 - 29.9?

30+?

<18.5 = underweight
gain 28-40 lbs

18.5 - 24.9 = normal
gain 25-35 lbs

25 - 29.9 = overweight
gain 15-25 lbs

30+ = obese
gain 11-20 lbs

40

Fetal Wellbeing Tests? (4)

Fetal mvmt/Kick counts
Non-stress Test
Contraction Stress Test
Biophys Profile

41

Compound presentation causes risk of what?

Anterior tear of vulva
(Posterior tears are more common)

42

Parts of pelvis:

Inlet landmarks?

Midpelvis landmarks?

Outlet landmarks?

Inlet = Symphysis (top), Sacral promontory (post), pectinate lines (lateral)

Midpelvis = Mid symphysis (top), Midpoint of sacral curve (post), Ischial spines (lateral)

Outlet = Inferior symphysis (anterior), tip of sacrum (post), Ischial tuberosities (lateral)

43

Passage shape best for pregnancy/delivery?

Gynecoid

44

Acceptable meds for HTN in pregnancy?

NOT ACE inhib! (-prils)

Methyldopa
β-block
CCB

45

Acceptable ABX for pregnancy?

NOT TCN (Doxy) during preg and breast feeding!

Topical Erythro, Clinda
Systemic Azythro, Amox

46

Acceptable meds for Bipolar in pregnancy?

NOT
Valproate
Carbamazepine
Lithium
Lamotrigine

Anti-depressants
Anti-psychs (not during 3rd tri)