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

Exam 2 Prenatal Care Flashcards

(46 cards)

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1
Q

Reasons for prenatal care? (5)

A

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

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2
Q

Preconception exam should include?

A

General physical (check for cavities)

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3
Q

Preconception exam should always include what lab?

When indicated? (10)

A

HIV

Rubella/Varicella titer
Hep B/C
Gonorr/Chlam cx
TB
RPR
CBC
Fasting blood sugar
Hgb A1C
Cystic fibrosis carrier
Tay Sachs
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4
Q

Preconception care should include what immunizations? (6)

A 
MMR (NOT if already pregnant/must wait 1 mo post)
Varicella
Hep B
Flu
Tdap
\+/- pneumococcal
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5
Q

Preconception folic acid dose?

A

0.4 -0.8 mg/day

4 mg if neural tube defect hx

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6
Q

Prenatal care 1st visit should occur when?

A

By week 10 (1st trimester)

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7
Q

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

A 
Full hx including:
STD, PID, Abn paps
Planned vs unintended preggo
Domestic violence
Tobacco/alcohol/drugs
Inheritable dzs
Barriers to care
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8
Q

Prenatal care 1st visit Obstetric Hx includes?

A 
G: # of pregnancies
P: TPAL
T = Full term
P = Preterm (<37wks)
A = Abortions (spont, induced, ectopic)
L = Living
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9
Q

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

A

(LMP + 7 days) - 3 months

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10
Q

Early Term is?

A

37 0/7 - 38 6/7 weeks

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11
Q

Full Term is?

A

39 0/7 - 40 6/7 weeks

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12
Q

Late Term is?

A

41 0/7 - 41 6/7 weeks

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13
Q

Postterm is?

A

42 0/7 weeks on

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14
Q

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

A

General

Pelvic

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15
Q

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

A

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

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16
Q

Chadwick’s Sign is?

A

Blue coloring of vagina/cervix from ↑ blood flow

Indicates pregnancy

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17
Q

Hegar’s Sign is?

A

Softening of isthmus (where cervix meets uterus)

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18
Q

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

A

pap

gonor/chlam

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19
Q

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

Study These Flashcards
A 
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
Q

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

Study These Flashcards
A 
TB
Hep C
Trichomonas
HSV
Hgb A1C
21
Q

Prenatal care 1st visit US done how?

Why?

Cardiac motion visible how soon?

Study These Flashcards
A

Transvag US

Confirm estimated delivery date (IMPORTANT!)

5 - 6 weeks

22
Q

1st trimester is?

2nd trimester is?

3rd trimester is?

Study These Flashcards
A

1 to end of wk 12

13 to end of week 26

27 on

23
Q

Prenatal F/U care schedule?

Study These Flashcards
A

1st 28 wks = Q 4 wks

28-36 wks = Q 2wks

36 wks = Q 1wk

24
Q

Quickening is?

Study These Flashcards
A

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)

Q4 Women's Health (20 decks)

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