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Flashcards in Exam #4 Deck (182)
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1

What supplementations should a pregnant patient be taking daily?

- Folic acid (4 mg/day)
- Calcium
- Iron

2

At ________ weeks, an U/S can detect fetal age up to +/- 7 days

6-11 weeks

3

At ________ weeks, an U/S can detect fetal age up to +/- 10 days

12-20 weeks

4

At ________ weeks, an U/S can detect fetal age up to +/- 14-20 days

20+ weeks

5

Important maternal history dz to look out for (6):

1. DM
2. HTN
3. CVD
4. Renal dz
5. Pulmonary dz
6. Autoimmune

6

Important family history dz to look out for (6):

1. DM
2. HTN
3. CVD
4. Anemia
5. CA
6. Blood clotting d/o

7

Labs for the Initial PN visit

Blood type
Anemia
Syphilis (Rapid Plasma Reagin / VDRL)
Kidney Dz (UA)
Cervical Dysplasia (Pap Smear)
Chlamydia
DM (glucose)
Hep B/Hep C/HIV

8

When should a pregnant patient be screened early for gestational DM?

Fam hx of DM
High BMI (Obesity > 30)

Should be screened early, and then again at 28 wks

9

TORCH Titer

Toxoplasmosis
Rubella
CMV / HSV / HIV / EBV
Syphilis
Hepatitis B
Parvovirus B19

10

Category X Medications

Warfarin
Chemo (antineoplastic agents)
Retinoids
DES (diethylstilbestrol)

11

Category C Medications

SSRIs

12

Craniofacial findings for Fetal Alcohol Spectrum D/O

Small Eye Openings
Smooth philtrum
Thin upper lip

13

Risky seizure medications during pregnancy

Phenytoin
Valproic Acid
Carbamazepine
Phenobarbital

14

What can happen to the fetus/mother if the mother has a seizure during pregnancy?

Trauma from fall
Hypoxia
Decreased heart rate
Premature labor, miscarriage

15

Live attenuated immunizations, such as Rubella, MMR, and Varicella, must be given during which time frame?

>3 months before/after pregnancy

16

Which immunizations can be given during pregnancy?

Recombinant Immunizations
Influenza
Gardasil
Hep B
Tetanus

17

What can cause a blueberry muffin baby?

Rubella
Toxoplasmosis
Syphilis
Hep B
CMV
EBV

18

Fetal heart can be heard around _____ weeks
Normal rate?

12 weeks
120-160

19

Symptoms of pregnancy

N/V
HA
Acne
Varicose Veins
Hemorrhoids
Leg Cramps
Heartburn
Backache

20

When does N/V of pregnancy start? How long can it continue to?

Starts around 4-6 weeks
Usually resolves by 16 weeks

21

Tx for N/V of pregnancy

Rest
BRAT diet
Sea bands
Ginger
Several small meals
Carbohydrate snacks before bedtime

22

Signs/Symptoms of hyperemesis gravidarum

Persistent vomiting / inability to tolerate PO
Weight loss > 5% of pre-pregnancy weight
Dehydration (ketones, orthostasis)
Electrolyte abnormalities

23

Tx of hyperemesis gravidarum

1. IV hydration
2. Antiemetics (Phenergan, Zofran)
3. GI motility drugs (Reglan)
4. Goal is toleration of po liquids

24

If a patient with hyperemesis gravidarum is admitted, what should be done?

U/S to rule out multiple gestations, molar pregnancy
Thyroid panel to r/o Graves

25

Urinary frequency of pregnancy improves after _____ weeks when the uterus rises in the abdomen, but worsens again in the third trimester. Tx includes:

12 weeks
Kegel exercises, frequent urination
Make sure to watch for sx of UTI

26

Management of heartburn in pregnant patient

Avoid lying flat
Sleep with more pillows, lay on right side
Small frequent meals, avoid late night snacks
Antacids

27

Management of varicosities in pregnant patient

Elevate feet, pump leg muscles

28

Management of constipation in pregnant patient

Fruits and vegetables, drink lots of water
Exercise and walking
Stool softeners, laxatives prn

29

Patients > 35 years old are at increased risk for:

Trisomy 18, 13, and 21

30

Risk of Trisomy 21:
_______ at age 35
_______ at age 39
_______ at age 45
_______ at age 49

1/800
1/300
1/80
1/20