healthy pregnancy

Question 1

at how many days of gestation has the heart developed 4 chambers and you can hear a heart beat?

Answer 1

day 49 (7 weeks)

Question 2

at how many weeks do arms/legs begin to bud and brain is differentiated?

Answer 2

weeks 4-5

Question 3

at 9 weeks…

Answer 3

all organs and structures are present

Question 4

at 12 weeks…

Answer 4

genitals are differentiated, produce urine, reflexes, and brain development

Question 5

at 14 weeks…

Answer 5

greater muscle and skeletal development

Question 6

at 20 weeks…

Answer 6

nails and lanugo

Question 7

often find out the gender at…

Answer 7

20 weeks

Question 8

at 25 weeks…

Answer 8

covered in vernix (cream cheese coating), opens and closes eyes, immature lungs that would allow for (some) gas exchange, maturing neuro system

Question 9

in which trimester do the lungs become more mature?

Answer 9

third

Question 10

what is amniotic fluid and what is it’s purpose?

Answer 10

it’s baby’s urine

purpose: protect umbilical cord and its’ vessels (decompression agent), thermoregulation

Question 11

what makes up the umbilical cord?

Answer 11

it’s made up of 2 arteries and 1 vein (AVA) which are covered in wardens jelly (protects vessels from being compressed)

Question 12

what is the purpose of the umbilical cord?

Answer 12

carries fetal blood to and from the placenta

Question 13

what’s the purpose of the placenta?

Answer 13

provides oxygen and nutrition for fetus, accepts waste from fetal blood, and produces hormones

Question 14

goodell’s sign

Answer 14

softening of the cervix

Question 15

chadwick’s sign

Answer 15

bluish coloring of cervix

Question 16

cardiac maternal changes r/t pregnancy

Answer 16

• pulse increases
• blood volume increases by 40-45%
• plasma volume increases by 50%

Question 17

vena caval syndrome

Answer 17

the pregnancy places pressure on the vena cava when supine, so we want to put them on left lying to relieve pressure

Question 18

what can vena caval syndrome cause?

Answer 18

• can lead to decreased blood flow to the heart
• can lead to HTN

Question 19

what is the expected weight gain for a normal weight woman?

Answer 19

25-35 lbs

Question 20

what is the expected weight gain for an underweight woman?

Answer 20

28-40 lbs

Question 21

what is the expected weight gain for an overweight woman?

Answer 21

15-25 lbs

Question 22

when is hCG released in pregnancy?

Answer 22

early

Question 23

hPL pregnancy hormone

Answer 23

antagonist of insulin, more free-floating glucose so the fetus can develop

Question 24

estrogen pregnancy hormone

Answer 24

stimulates uterine development, prepares breast for nursing and lactation

Question 25

progesterone pregnancy hormone

Answer 25

greatest role in maintaining pregnancy, small role in helping develop lobes of breast for lactation

Question 26

relaxin pregnancy hormone

Answer 26

helps inhibit uterine activity, diminishes strength of contractions, also aides in softening of the cervix in prep for birth

Question 27

naegele’s rule

Answer 27

(first day of LMP) - (3 months) + (7days) = EDD

Question 28

presumptive changes

Answer 28

subjective

ex: tender breasts, fatigue, N/V

Question 29

probable changes

Answer 29

objective

ex: positive home pregnancy test (only means she’s probably pregnant), period late

Question 30

positive changes

Answer 30

diagnostic

ex: things that indicate she’s definitely pregnant; seeing fetus on US, or time of delivery

Question 31

TPAL

Answer 31

T: term pregnancies (38 wks or >)
P: preterm (20-37 wks 6 days)
A: abortions (< 20 wks)
L: living

Question 32

initial prenatal labs

Answer 32

• pap (if needed; if out of date or in time for annual exam)
• STDs (gonorrhea, chlamydia)
• H/H
• blood type (Rh factor)
• hep B (immune?)
• rubella (immune?)
• HIV/AIDS

Question 33

nuchal translucency

Answer 33

tests for potential genetic issues

• US and serum tested
• performed at 11-13 weeks along

Question 34

quad screen

Answer 34

test for potential NTD (neural tube defects), potential for multiples, or genetic issues

• performed at 16 weeks along, give option to mom

Question 35

components of quad screen

Answer 35

1. AFP (alpha feta protein); looks at possibility of NTD like spina bifida or anencephaly
2. hCG
3. inhibin A
4. estriol

3&4 look for possibility of potential genetic problems

Question 36

at what point do expected mothers need to take their 1hr glucose tolerance test?

Answer 36

24-28 weeks

Question 37

when is a 3hr GTT indicated for expected mom?

Answer 37

if 1hr value is > 130-140 mg/dL

Question 38

what can we expect if a patient comes in GBS positive?

Answer 38

we must treat in L&D with PCN/ampicillin

Question 39

what is GBS and how can it be harmful?

Answer 39

it’s bacteria normal flora in women that can cause meningitis or septicemia in neonate if exposed

Question 40

how can we assess fetal development?

Answer 40

• fetal heartbeat
• ultrasound (US)
• quickening

Question 41

at what point can we asses fetal heartbeat and how do we do it?

Answer 41

as early as 8 weeks or so

transvaginal US, if looking for cardiac movement

later on –> external monitor, or doppler

Question 42

using abdominal ultrasound to assess fetal development:

Answer 42

• can do critical measurements
• view organ structures
• at 20 weeks = anatomy US

Question 43

quickening is…

Answer 43

fetal movement felt by mom (at 20 weeks)

Question 44

couvade

Answer 44

father going through pregnancy symptoms