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Flashcards in Exam 3 Deck (111)
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1

How to diagnose pregnancy

Missed period
Nausea/vomiting
Fatigue
Frequent Urination
Breast Tenderness
Positive urine or serum pregnancy test (HCG)
Morning Sickness

2

Standard laboratory urine pregnancy tests become positive approximately _____ following the first day of the LMP (around the time of the missed period)

3.5--4 weeks

3

1st prenatal visit components

General Medical History
OB history
Calculate EDD/EDC
Full physical exam
Pelvic Exam, STD screen

4

CDC recommends all women should be tested for ___

ACOG recommends test high risk women (high risk entails __)

chlamydia

1+ sexual partner,

5

how to document GTPAL
(most accurate way)

G (gravida) = # of times pregnant
T (term) = # of full-term deliveries 37 weeks or after (36 weeks and 6 days is still preterm)
P (preterm) = # of preterm deliveries betwn 20-37 weeks
A (abortions) = # of ‘abortions’ prior to 20 weeks (SAB or TAB or ectopic)
L (living) = # of living children

6

how to document GP

G (gravida) P (parity)

Refers to # of pregnancies (G) and # of deliveries (P) of a fetus greater than 20 weeks gestation whether alive or stillborn

E.g. If just delivered: G2P1-->2 (2 pregnancies,1 delivery now 2)

7

TAB
SAB

terminated pregnancy/abortion
spontaneous abortion

8

What is the GTPAL of a woman with 2 pregnancies, 1 full term infant, 1 spontaneous abortion, and 1 living child?

G2T1P0A1L1

9

All prenatal care is based on the ____

EDD

10

how to determine EDD

-a pregnancy calculator wheel based on LMP
-use Naegele’s Rule: LMP + 7 days minus 3 months
**Naegele’s Rules assumes a normal 28 day cycle

11

What is the EDD of a woman whose LMP was 8/8/13?

LMP + 7 days - 3 months

May 15, 2014

12

does pregnancy warrant an earlier PAP to be done?

no

13

PE for prenatal visit consists of

BP
weight and height --> BMI
Cardiac
Thyroid
Breast Exam
Pelvic exam

14

Fetal heart tones at ____ with an acoustic fetoscope (dop-tone/Doppler)

Fetal heart tones at ____ (Doppler)

18-20 weeks

12 weeks

15

fetal movement at ___ weeks

16-20 weeks

16

uterine softening and enlargment at ___ weeks

6+ weeks

17

Chadwick's sign? and when does it happen

vaginal pallor/bluish

*at 6-8 weeks

18

Hegar/Goodell sign? and when does it happen

Cervical softening


*at 6-8 weeks

19

at 20 weeks where should the uterus be at

umbilicus

20

what labs do you get done at the 1st prenatal vistis

Confirmation Lab: B-HCG

Labs:
CBC (hemoglobin, hematocrit, MCV)
Blood group
Rh +/-
Antibodies (to Rh)
Serology for syphilis
Gonorrhea/Chlamydia
Rubella immunity
(if mom is not immune could worry about TORCH infections)
HIV
Hepatitis B antigen testing
Urinalysis, urine culture for bacteriuria

21

Rh + =
Rh - =

Rh + = has antigen
Rh - = lack antigen

22

Cramping on one side at ___ weeks worry about ectopic pregnancy

5 weeks

23

purpose of 1st trimester us

Confirm Diagnosis (cardiac activity)
Estimate Gestational Age (measure crown rump length)
Evaluate uterine anomalies

24

when do you do a transvaginal US and Abdominal US

Transvaginal at 7-9 weeks

Abdominal at 9+ weeks

*have to wait 7 weeks before you get an US

25

cardiac activity starts around

6.5 weeks

26

how many pregnancies are aborted in 1st trimester

1:5

27

schdule of visits for prenatal care

Assess every 4 weeks until 32 weeks
Assess every 2 weeks between 32-36 weeks
Assess weekly after 36 weeks

28

questions to ask at every visit

Vaginal bleeding, N/V, dysuria, vaginal discharge, overall feeling and fetal movements (after 20 weeks)

29

exam and labs done at ALL visits

BP
Weight
Edema
Urine glucose/protein

30

LE edema is common due to

inferior vena cava syndrome