maternal exam 1 sammy rak Flashcards
(189 cards)
1
Q
combined oral contraceptives are made of
A
estrogen and progesterone
2
Q
the state of pregnancy is called
A
gravidity
3
Q
woman who has never been pregnant is called
A
nulligravida
4
Q
woman who is pregnant for the first time is called
A
primigravida (primero gravida)
5
Q
woman who has tow or more pregnncies
A
multigravida
6
Q
number of pregnancies that reached viability is called
A
parity
7
Q
when is a fetus viable
A
22-25 weeks
8
Q
woman who has never completed a pregnancy with a viable fetus
A
nullipara
9
Q
completed 1 pregnancy with fetus that reached viability
A
primipara
10
Q
completed more than one pregnanct with viability
A
multipara
11
Q
pregnancy has reached 20 weeks of gestations but did not reach 37 wks of gestationn
A
preterm
12
Q
reached between 34-36 weeks and 6 days
A
late preterm
13
Q
reached 37 weeks and 38 weeks 6 days
A
early term
14
Q
reached 39 wks and 40 wks 6 days
A
full term
15
Q
reached 41 wks-41 wks 6 days
A
late term
16
Q
reached 42 wks and beyond
A
past term
17
Q
capacity to live outside the uterus aftr 22-25 wks is called
A
viability
18
Q
GTPAL stands for
A
gravida
term
preterm
abortions
living children
19
Q
The T in GTPAL stands for what and how many weeks should it be
A
term (39 wks- 40 wks 6 days)
20
Q
how soon can hcg be detected
A
7-8 days
21
Q
what hormone do pregnancy tests test for
A
hcg
22
Q
what does hcg preserve
A
the corpus luteum
23
Q
what does the corpus luteum produce
A
progesterone
24
Q
what does progesterone do for pregnancy
A
maintains it by growing endometrium lining inside uterus and maintain placenta until it matures
25
how long does hcg increase in pregnant woman
60-90 days
26
what happens if hcg continues to increase after 90 days
hydatidiform molar pregnancy
27
what is a hydatidiform molar pregnancy
placenta tissue swells but no fetus is formed so hcg levels continue to rise
28
what causes hcg to lower after 90 days
placenta forms and takes over
29
hydatidiform molar pregnancy is also known as
trophoblastic disease
30
linea negra is what kind of pregnancy sign
presumptive
31
uterine growth is what kind of pregnancy sign
probable
32
what is ballotement
test where uterus is pushed to see if fetus moves and returns again
33
what kind of sign is ballotement
probable
34
uterus changes during pregnancy
size
shape
position
contractibility
35
what is needed for breast fullness and heaviness
supportive bra
36
what position should you not put a pregnant pt in
supine
37
what happens if a pregnant pt is put in supine position
cardiac output is reduced by 30% and pressure is put on vena cava
38
what position takes postion off of vena cava
left side lying
39
hypotension from supine position is called
supine hypotensive syndrome
40
what kind of murmur is common in pregnancy and what causes it
systolic murmur from increased blood flow
41
increasing clotting factors put pregnant women at risk for what
clots
42
varicose veins in rectum are called
hemmorhoids
43
changes in resp system from pregnancy
increased nasal congestion
increased oxygen consumption
respiratory alkalosis
44
renal system changes during pregnancy
urinary frequency
increased GFR (glomerular filtration rate)
stress incontinence (pee when laughing etc)
45
what trimesters will urinary frequency occur
1st and 3rd
46
skin changes from pregnancy
chloasma
linea negra
striae gravidarum
angiomas
palmar erythema
diaphoreses
47
what is know as the mask of pregnancy
chloasma
48
spider veins are also known as
angiomas
49
muskuloskeletal changes in pregnancy
ligament and joint softeninf
lordosis
decreased calcium
decreased potassium
50
what causes ligament and joint softening during pregnancy
relaxin
51
what causes change in center of gravity in pregnancy
lordosis
52
what causes calf muscle pain in pregnancy
decreased calcium
53
neuro changes during pregnancy
depression
54
endocrine changes during pregnancy
thyroid enlargement
increased thyroid actvity
mild hyperthyroid state
lower serum glucose
lower maternal serum glucose levels
diastasis
55
what is diastasis
abs stretch and separate from pregnancy
56
when does blood glucose levels lower in pregnancy
early in pregnacy
57
what cause increase in glucose levels during pregnacy
baby growing
58
gi changes during pregnancy
nausea/vomiting
increased appetite
PICA
bleeding gums
decreased peristalsis
59
what is PICA
eating non edible things (why the hell u PICA that up?)
60
what causes bleeding gums in pregnancy
increased estrogen
61
what causes decreased peristalsis in pregnancy
progesterone
62
how much weigh gain is expected during pregnancy
25-35 lbs
63
calorie increase of how much for pregnant pt
330 calories/day
64
minimum protein per day for pregnant pt
60 g
65
what should be given daily to prevent neural tube defects to women of child bearing age
folic acid
66
iron education for pregnant pt
increase iron (ferrous sulfate)
67
pregnant teen education about nutrition
protein
carbs
calcium
iron
68
labs to draw at initial visit
cbc
blood type
rh status
hcg
rubella titre
hep b
VDRL/RPR
urine culture and screen
urinalysis
pap smear
GC
chlamydia
group b strep
69
why is rubella titre obtained
to see if pt is immunized or has hx of rubella
70
can u give rubella vaccine to preg pt
no
71
what do VDRL and RPR test for
syphyllis
72
what happens if baby catches group b strep
encephalitis
meningitis
brain issues
73
until what month will preg pt have monthly visits
7 th month
74
after 7th month how frequent will visits be
bi weekly
75
after 8th month how frequent will visits be
weekly until delivery
76
what is PIH
pregnancy induced hypertension
77
what are signs of PIH
faical/hand edema
78
what do alpha feto protein tests screen for
genetic problems
79
what happens if placenta is too low in womb
placenta previa
80
what should pt do before amniocentisis
empty bladder
81
when should oral GTT (glucose screen) be done
24-28 weeks
82
when should GBS (group B strep) be done
36 weeks
83
what is a normal fetal heart rate during a non stress test
110-160 bpm
84
accelerated fetal heart rates during non stress test are
short term rises of atleast 15 bpms for atleast 15 seconds must happen atleast 2x
85
what are the 2 possible non stress test results
non reactive
reactive
86
no fetal reaction or no short term rise in bpm is what result for non stress test
non reactive
87
how long is fetal hr monitored during non stress test
15 mins
88
how to stimulate contractions for contraction stress test
natural ocytocin nipple stimulation challenge
low dose of pitocin iv (oxytocin)
89
how many contraction should be monitored during contraction stress test? what happens after each contraction?
3 and HR slows down after each one
90
what is hr dropping at peak called and is it a good or bad thing (contraction stress test)
early deceleration and its good
91
what is hr dropping after peak called and is it a good or bad thing (contraction stress test)
late deceleration and its bad (insufficient nutrition supply from placenta)
92
is a negative contraction stress test good or bad
good (no late deceleration)
93
is a postive contraction stress test good or bad
bad (persistent late deceleration)
94
situations where rhogam will be given
pregnancy
eptopic pregnancy
abortion
miscarriage
amniocentisis
placental abruption
95
placenta previa risk factors
hx of c section
hx of placenta precia
multiple gestations
uterine abnormalities
advanced maternal age
96
s/s of plaenta previa
painless
bright red vag bleeding
soft non tender uterus/abdomen
97
how to diagnose placenta previa
ultrasound
98
interventions for placenta previa
peripad count
bed rest
vaginal rest
monitor for shock
monitor fetal hr
administer betamethasone (around 25 wks)
prepare for c section
99
what does l/s measure
amount of surfacant in lungs
100
normal l/s ratio
2:1
101
what does abnormal l/s ratio mean
lungs not mature enough
102
#1 cause of abruptio placentae
HTN
103
2 or more BP readings over 140/90 indicates
gestational HTN
104
gestational HTN risk factors
smoking
cocaine
abdominal trauma
105
s/s of abrupio placentae
sharp sudden abdominal pain w or w/o bleeding
abdominal distention
board like abdomen
uerine contractions
shock
106
how to diagnose abruptio placentae
ultrasound
107
should u perform vaginal exam for abruptio placentae
no can cause more bleeding
108
abruptio placentae interventions
assess fhr and movement
prep for possible c section
type and screen
cbc
anticoagulants
iv access
109
name the insulin antagonists
human placental lactogen
progesterone
cortisool
prolactin
110
what do insulin antagonists cause
elevated blood glucose lvls and lipolysis
111
what causes gestational diabeted
inadequate insulin production and decreased sensitivity to available insulin causes elevated blood glucose
112
does gestational dm affect the size of the baby
yes can cause a bigger baby
113
gestational dm increases the risk of what after pregnancy
dm
114
what is macrosomia
larger than average fetus
115
weight to be considered macrosomial
9 lbs 4 oz or more
116
what is cephalopelvic disproportion
baby head too big to fit through pelvis
117
what are congenital anomalies
defects that u are born with ("born this way" lady gaga)
118
whatdoes delayed lung maturity cause
resp distress
119
too much insulin in mother and babys blood is that causes low surfacant in baby lungs is called
hyperinsulemia
120
when does hyperinsulemia start
towards end of pregnancy when mother uses insulin
121
oral hyperglycemic used for pregnant pts
glyburide
122
what does glyburide do?
decreases serum glucose lvls
123
what preg complication can cause frequent yeast infections in preg women
gestational dm
124
when would a oral flucose test be performed
24 weeks
125
HbA1C lvl higher than 10% indicates what
congenital anomalies
126
how is regular insulin given
through iv
127
what should you monitor when giving regular insulin
potassium lvls
128
gestational dm effects on fetus
-macrosomia
-congenital anomalies
-delayed lung maturity
-neonatal hypoglycemia after delivery
-neonatal hyperbilirubinemia
129
how to dx gestational htn
2 or more BP readings above 140/90 w or w/o proteinuria & edema
130
when does gestational htn usually appear
20 wks or later
131
gestational htn risk factors
-primigravida w age extremes (younger than 18 or older than 40)
-chronic medical conditions
-multiple fetuses
-family hx
-protein deficiency
132
facial/hand edema is a sign of what kind of preeclampsia
mild preeclampsia & eclampsia
133
generalized pitting edema is a sign of what kind of preeclampsia
severe preeclampsia & eclampsia
134
seizures are a sign of what kind of eclampsia
eclampsia
135
weight gain is a sign of what kind of preeclampsia
mild preeclampsia & eclampsia
136
+30 systolic BP reading from baseline is a sign of what kind of eclampsia
mild preeclampsia and eclampsia
137
HTN 160/100 or higher is a sign of what kind of eclampsia
severe preeclampsia and eclampsia
138
altered mental status is a sign of what kind of eclampsia
eclampsia
139
+15 diastolic over baseline BP reading is a sign of what kind of eclampsia
mild preeclampsia and eclampsia
140
increased proteinuria of 5g/24 hrs is a sign of what kind of eclampsia
severe eclampsia and eclampsia
141
HELLPS stands for
hemolysis of blood cells
elevated
liver enzyme
low
platelets
syndrome
142
HELLPS is a sign of what kind of eclampsia
eclampsia
143
what should you monitor in pt w/ HELLPS
deep tendon reflexes
144
proteinuria more than 1g/24hrs is a sign of what kind of eclampsia
mild preeclampsia and eclampsia
145
headache is a sign of what kind of eclampsia
sever eclampsia and eclampsia
146
visual disturbances is a sign of what kind of eclampsia
severe preeclampsia and eclampsia
147
low urine output is a sign of what kind of eclampsia
severe eclampsia and eclampsia
148
hyperreflexia is a sign of what kind of eclampsia
severe eclampsia and eclampsia
149
what kind of environment should eclampsia pt be plaed in
low stimuli environment
150
what to monitor in eclampsia pt
strict I&O
edema
deep tendon reflexes (DTR)
BP
vitals
baseline weights
151
what kind of protein diet should eclampsia pt follow
high protein
152
what kind of sodium diet should eclampsia pt follow
low sodium
153
how long should eclampsia pt be on seizure precautions
up to 72 hrs post delivery
154
what is the cure for eclampsia
delivering baby
155
what does magnesium sulfate (MgSO4) do?
lowers BP
anticonvulsant (reduces deep tendon reflexes)
156
antidote for magnesium sulfate
calcium gluconate
157
how does magnesium sulfate affect resp rate
lowers resp rate
158
how does magnesium sulfate affect heart rate
increases it
159
how does magnesium sulfate affect serum glucose
increases It
160
what should you monitor when giving magnesium sulfate to pt
BP
deep tendon reflexes
resp rate
heart rate
serum glucose
161
should you palpate abdomen when you notice abd distention
no
162
how much weight should an pt w underweight BMI gain
1 lb/week
163
a BMI of 18.5 indicates
underweight
164
a BMI of 26.5 indicates
overweight
165
how much weight should a pt w a BMI of 26.5 gain
15-25 lbs
166
a BMI of 30 and above indicates
obese
167
how much weight should a pt w a BMI of 30 gain
11-20 lbs
168
what does nageles rule find
estimated due date
169
what does folic acid supplements prevent
neural tube defects
170
what should be done w diaphragm (contraceptive) after birth
it should be refitted
171
how is magnesium sulfate given
iv or im
172
how much mg of calcium should pt take daily
1000
173
suggested zinc nutritional intake
12 mg/day
174
suggested folic acid intake during pregnancy
600 mg
175
suggested folic acid intake during lactation
500 mg
176
suggested iron daily intake in women over 19 y/o
9 mg/day
177
should you increase iron in pt who is breast feeding
no
178
product of protein breakdown is called
phenylalanine
179
phenylketonuria (PKU) dietary education
avoid protein rich foods
180
can a PKU pt eat beans?
no
181
can PKU pt eat cheese?
no
182
can PKU pt eat aspartame
no
183
how long can pt not ejaculate before semen analysis
2-5 days before test
184
can body temp be used to see if a woman is ovulating
yes
185
ambivalence is
having mixed feelings
186
what does alpha feto-protein test look fpr
predicts genitic defects
187
0-13 weeks is what trimester
1st trimester
188
27-40 weeks is what trimester
3rd trimester
189
14-26 weeks is what trimester
2nd trimester
