OB Exam 1 Flashcards
(194 cards)
1
Q
What is the goal to genetic testing?
A
Identify risk
2
Q
Your client wants to know how to tell if she is ovulating. Select all that apply:
A. Cervical mucus is thick, sticky, and opaque white
B. Basal body temp drops slightly, then spikes 1/2 a degree
C.menstural period is just starting, spotting
D.positive test for spike in LH
E. Levels of progesterone are decreasing
A
B,D
3
Q
How long is an egg fertile for after ovulation?
A
12-24 hours
4
Q
Where does fertilization occur?
A
Outer 1/3 of fallopian tube
5
Q
how long does it take a zygote to travel to the uterus?
A
3-4 days
6
Q
Morula
A
“Solid ball of cells”, gives rise to blastocyst= embryoblast(embryo) and trophoblast (placenta)
7
Q
when does blastocyst implant into endometrium?
A
6-10 days after conception, usually into fundus
8
Q
How long does the sperm remain viable in female reproductive tract?
A
At least 2-3 days
(possibly 3-5 days)
9
Q
Which is counted as the first day of the menstrual cycle?
A. First day of bleeding during menses
B. Day of ovulation
C. Last day of bleeding during menses
D. Day before the menstrual bleeding starts
A
The first day of bleeding during menses
10
Q
How long after intercourse could she get pregnant?
A
Sperm can reach site of fertilization in 5 minutes; conception likely up to a week after intercourse (sperm viable 3-5 days in female tract) and implantation (pregnancy) 2-3 weeks after
11
Q
How long after ovulation could she get pregnant?
A
five days before ovulation, the day of ovulation, and one day after ovulation (sperm can live 3-5 days, ova fertile for 24 hours)
12
Q
What is included in genetic counseling?
A
Information, education, and support
13
Q
How many pregnancy genetic tests are there?
A
4
14
Q
What is the first (earliest) genetic test that can be done in pregnancy?
A
CVS (chorionic villus sampling)
15
Q
When can a CVS be done?
A
10-13 weeks
16
Q
What is a CVS?
A
Chorionic villus sampling: tissue sample of the placenta
Indicated: risk for giving brith to neonate with genetic chromosomal abnormality (cannot determine spina bidifida or anencephaly)
Full bladder necessary for testing
17
Q
What are the four pregnancy genetic tests?
A
Chorionic villus sampling, amniocentesis, alpha-fetoprotein, and level 2 ultrasound/targeted ultrasound
18
Q
What is an amniocentesis?
A
Sample of amniotic fluid, empty bladder needed (avoid puncture)
19
Q
When is an amniocentesis done?
A
15-20 weeks
20
Q
What is an AFP test?
A
Alpha-fetoprotein test of maternal blood
21
Q
When is an alpha-fetoprotein test done?
A
15-18 weeks
22
Q
When is a level 2 ultrasound (targeted ultrasound) done?
A
After 18 weeks
23
Q
What is a level 2/targeted ultrasound?
A
Complete scan of fetal anatomy
24
Q
What area is more likely to be damaged during childbirth?
A
Perineum
25
What is the pear shaped organ?
Uterus
26
Organ made of hollow smooth muscle with constant rhythmic contractions, lined with cells responsive to hormones
Uterus
27
What is a gynecoid pelvis?
Perfect shape and angle that is most optimum condition for vaginal delivery
28
Presumptive signs of pregnancy
Amenorrhea, fatigue, N/V, urinary frequency, breast changes, quickening(Could be gas), uterine enlargement
29
What is quickening?
The mother feels the movement of the baby
30
Probable signs of pregnancy
Abd enlargement, Hegar’s sign, Chadwick’s sign, Goodell’s sign, Braxton Hicks contractions, positive pregnancy test, fetal outline felt by examiner(could be tumor, anatomy)
31
Confirmation of pregnancy: positive indicators
Auscultation FHR, fetal movements felt by examiner, visualization of embryo/fetus by ultrasound
32
Risk for CVS
Spontaneous abortion, risk for fetal limb loss (greatest risk=prior to 9 weeks), miscarriage, chorioamnionitis and rupture of membranes
33
Risk for amniocentesis
Amniotic fluid emboli, maternal/fetal hemorrhage,maternal/fetal infection ,inadvertent fetal damage/anomalies involving limbs, fetal death, inadvertent maternal intestinal/bladder damage,miscarriage/preterm labor,premature rupture of membranes,leakage of amniotic fluid
34
key points for amniocentesis
Empty bladder prior to procedure
Baseline vitals and FHR prior to
Monitor vs, FHR, uterine contractions throughout and 30 min following
Client rest for 30 min
Administer Rho(D) immune globulin to client if they are Rh-Negative
35
Risk for AFP test
Low AFP= Down syndrome
High AFP= neural tube defects
36
Placenta previa vs placental abruption
Placenta implants in lower segment of uterus covering cervical opening vs premature separation of placenta from uterus
37
Presentation for placenta previa
Painless, bright red vaginal bleeding during 2nd and 3rd trimester; higher than expected fundal height; fetus may be breech, oblique, or transverse
38
Risk factors for placenta previa
Previous previa, uterine scarring, advanced maternal age (>35), multi fetal pregnancy, multiple gestations, smoking
39
Presentation for placental abruption
Partial or complete detachment of placenta after 20 weeks; sudden onset of intense localized uterine pain, dark red vaginal bleeding, “board-like” with palpation, contractions with hypertonicity, fetal distress
40
Risk factors for abruptio placentae
Maternal HTN, trauma (MVA=biggest), cocaine(substance abuse), history of abruption, smoking, PROM(premature rupture of membranes), Multifetal pregnancy
41
Tx plans for placenta previa
Assess bleeding, leakage, or contractions; fundal height; NO vaginal exams; prepare to give IVF, blood products, betamethasone, prepare for c section, bed rest, nothing inserted into vagina
42
Tx plans for placental abruption
Palpate uterus for tenderness, serial monitoring for fundal height, FHR monitoring, emotional support, Delivery is only management for abruption
43
Ectopic pregnancy
Abnormal implantation of ovum outside of uterine cavity; second most frequent cause of bleeding in early pregnancy
44
expected findings for ectopic pregnancy
Unilateral stabbing pain, tenderness in lower quadrant, scant dark red or brown vaginal spotting
If ruptured, bleeding is red
45
Tx for ectopic pregnancy-ruptured
Methotrexate (dissolves pregnancy) and laparoscopic salpingectomy
46
Tx for ectopic pregnancy-non ruptured
Methotrexate and salpingostomy to salvage fallopian tube
47
Hegar’s sign
softening and compressibility of lower uterus
48
Chadwick’s sign
Deepened violet-bluish color of cervix and vaginal mucosa
49
Goodell’s sign
Softening of cervical tip
50
Non-stress test
Monitors FHR in response to fetal movement; client pushes button when she feels fetal movement
Reactive vs non reactive
51
Positive non-stress test
Reactive= two or more accelerations within a 20 min period
52
Negative nonstress test
Non reactive= fewer than two accelerations in 40 min period
53
Contraction stress test
Nipple stimulated and oxytocin stimulated
(Contractions must be started)
Analysis of FHR response to contractions, determines how fetus will tolerate labor stress
54
What should be avoided with contraction stress test?
Hyperstimulation of uterus (contraction longer than 90 seconds or five or more contractions in 10 min)
55
When is oxytocin stimulated contraction stress test used?
If nipple stimulation doesnt work. More difficult to stop… can lead to preterm labor
56
Contraindications for oxytocin-stimulated contraction stress test
Placenta previa, vasa previa, preterm labor, multiple gestations,previous classic incision from c section, reduced cervical competence(insufficiency)
57
Quad marker screening
Blood test to provide info about likelihood of fetal birth defects- DOES NOT DX
Can be used instead of maternal AFP blood level, yields more reliable results
58
What does quad marker screening test for?
Human chorionic gonadotropin (hCG), alpha-fetoprotein (AFP), estriol, inhibin A
59
Low levels of AFP indicate
Risk for Down syndrome
60
high levels of AFP indicate
Risk for Neural tube defects
61
Higher than expected levels of hCG and inhibin A indicate…
Risk for Down syndrome
62
lower levels than expected for estriol can indicate…
Risk for Down syndrome
63
Positive and negative contraction stress test
reactive and nonreactive
64
When is a BPP ordered?
Non reactive stress test, suspected oligohydramnios or polyhydramnios, suspected fetal hypoxemia or hypoxia
65
What is a BPP?
Biophysical profile ; uses ultrasound to visualize physical and physiological characteristics of fetus, observes for fetal response to stimuli, combo of FHR and fetal ultrasound monitoring
66
What is the BPP assessing?
FHR, fetal breathing, body movements, fetal tone (flexed?), amount of amniotic fluid
67
BPP scoring
8-10=normal, low risk of chronic fetal asphyxia
4-6= abnormal, suspect chronic fetal asphyxia
Less than 4= strongly suspect chronic fetal asphyxia—>possible delivery
each category=0-2
68
If quad marker screening tool shows abnormalities…
Diagnostic tools (depending on gestation) needed for Dx (amino or CVS)
69
Maternal alpha-fetoprotein results
High levels indicate neural tube defect/open abdominal defect
Low levels can indicate Down syndrome
ONLY A SCREENING TOOL
70
Stages of fetal development
Two stages: embryonic and fetal
71
embryonic stage
Day 15-8 weeks gestation
Most critical time in development of organ systems
Most vulnerable to malformations caused by environmental teratogens
72
what stage is the most critical time in development of organ systems?
Embryonic: All organ systems are present by end of 8 weeks
73
What stage is most vulnerable to malformations caused by environmental teratogens?
Embryonic
74
During embryonic stage, the amniotic fluid…
Cushions against impact to maternal abdomen
Maintains stable temp
Allows symmetric development(neutral position for fetus to develop properly, defies gravity)
Prevents membranes from adhering to fetal parts
Allows room and buoyancy for fetal movement
75
Hormones produced by placenta
Chorionic gonadotropin
Prolactin
Estrogen
Progesterone
Relaxin
76
When is quickening felt?
Subsequent=18-19 weeks
First-time moms= 20-22 weeks
77
Monozygotic twins
“Identical”
1ovum/1sperm->2 babies
78
Dizygotic twins
“Fraternal”
2 ova/2 sperm->2 babies
79
Risks for monozygotic twins
TTTS (twin to twin transfusion syndrome), sFGR (selective fetal growth restriction), low birth weight, preterm birth, umbilical issues (tangled/compressed), oligo/polyhydramnios, heart defects, brain defects, neural tube defects, postpartum hemorrhage (large placenta/(s) )
80
Risks for dizygotic twins
least amount of risk associated
umbilical cord issues (tangled/compressed), fetal growth restriction (limited room), low birth weight, preterm birth, placenta issues (placenta previa, abruptio placentae,etc)
81
When is the fertile period for the menstrual cycle?
12-14 days before new menstrual cycle; five days leading up to ovulation, day of ovulation, and day after ovulation (abt 7 day window)
82
Describe the menstrual cycle
Three phases: menstrual, proliferative, and secretory ; two cycles: ovarian and endometrial ; average of 28 days
83
whole body effects of ovulation
Temp drops before ovulation, then spikes 1/2 degree after ovulation
Cervical mucus changes from thick to thin-> clear and stretches like egg white
84
spinnbarkeit
Sign of ovulation: cervical mucus changes from thick, sticky, and white to thin, clear, and stretches like egg white
85
How long does it take for an egg to implant?
6-10 days after conception
86
How do hormones impact menstrual cycle and how they change
regulate menstrual cycle
GnRH released and triggers release of
FSH(inc size and number of follicle cells) and LH(inc antral fluid to burst follicle to ovulate) to stimulate ovarian follicle to ovulate and release estrogen(rebuilding endometrium) and progesterone(maintaining uterine lining for implanting)
if no implanting-> levels of estrogen and progesterone drop-> menstruate, prostaglandins cause contractions of myometrium to release the endometrial lining
87
Estrogen function-menstrual cycle
Maturing of egg follicle
88
Progesterone function- menstrual cycle
Thickens endometrium to ready for zygote
89
Progesterone function- after implantation (pregnancy)
Relaxes uterus to maintain the pregnancy
90
Prostaglandins function-menstrual cycle
Help release of egg in ovulation
91
Prostaglandins function- pregnancy
Increases labor contractions and opening of cervix for birth
92
what hormone(s) decrease to trigger the shedding of the endometrium?
Estrogen and progesterone
93
What happens when estrogen drops (before progesterone begins)
Ovulation
94
Placenta functions
1. Transfers oxygen and nutrients to fetus
2. Removes waste products and CO2 into maternal blood
3. Makes hormones
4. Transfers antibodies from mother to fetus
95
Placenta….
Prevents direct contact between fetal and maternal blood (placental barrier)
96
What roles does placenta play
Transfers oxygen and nutrients, removes waste, makes hormones, transfers antibodies form mother to fetus and serves as a direct contact barrier between fetal and maternal blood
97
hormones produced by placenta
Chorionic gonadotropin, prolactin, estrogen, progesterone, relaxin
98
Progesterone promotes growth…
Of the lobes, lobules, and alveoli in the lungs
99
During pregnancy… renal filtration is… and urinary production…
Increased filtration, urine production amount is the same
100
Describe umbilical cord
Two arteries, one vein-> vessels surrounded by Wharton’s jelly
“AVA”
Lifeline
101
Cholasma
Inc of pigmentation on the face (pregnancy mask) Lightens and goes away
102
Linea Nigra
Dark line of pigmentation form umbilicus to pubic area, lightens and goes away
103
Striae gravidarum
Stretch marks, dont go away, but lighten
104
Umbilical arteries…
Carry deoxygenated blood away from the fetus to placenta (mother)
105
Umbilical vein…
Brings oxygenated blood from mother to fetus “main vein”
106
describe embryo at 5 weeks
Marked C-shaped body and rudimentary tail
107
Describe embryo at 7 weeks
Head is rounded and nearly erect. Eyes shifted forward and closer together, eyelids begin to form
108
describe embryo at 8 weeks
Every organ system present, HR detectable by Doppler, eyes ears nose and mouth recognizable
109
At about 20 weeks gestation…
Quickening, primitive breathing movements (alveoli filled with fluid), vernix caseosa, lanugo
110
The more premature… the …. Vernix caseosa is present
MORE
111
The further along the baby is developed… the… lanugo is present
Less
112
fetal stage
9 weeks-pregnancy ends
Amniotic fluid first from diffusion from maternal blood then fetus’ urine, volume inc weekly to about a quart
113
What is amniotic fluid
First from diffusion from maternal blood then fetus’ urine
Regulates temp, cushions, allows movement, allows symmetrical development, barrier to infection
114
Amniotic fluid function
Regulates temperature, cushions, allows movement, barrier to infection
115
What hormone is produced during pregnancy
Human chorionic gonadotropin (hCG)
116
Danger signs during middle pregnancy-report!
Facial edema, blurred vision, seeing floaters, edema in hands, severe headaches, epigastric pain-> HTN condition or preeclampsia (middle of pregnancy)
117
Danger signs during pregancy-beginning-report!
Burning during urination
Severe vomiting
Diarrhea
Fever/chills
Abd cramping, vaginal bleeding(early vs late means diff things)
Gush of fluid from vagina(27 weeks)
118
Naegele’s rule
Take LMP date (beginning) and subtract 3 months and add 7 days and one year (if applicable)= due date
119
How to calculate GTPAL
G= how many pregnancies(total)
T=term deliveries (after 37 weeks)
P=preterm(before 37 weeks)
A=abortion
L=living children
120
Supine hypotension
Weight of baby and uterus compresses on IVC and SVC and causes hypotension
121
Relaxin effects musculoskeletal system
Causes pelvic joints to relax and gait to change
122
How is supine hypotension alleviated?
Have mother lay on her left side(best side bc vena cava runs on right side=optimal blood flow but right works too)
123
Progression of HTN
GHTN—>preeclampsia->severe preeclampsia-> eclampsia
124
Gestational HTN
Begins after 20 weeks
140/90 or greater (about twice, 4-6 hrs apart within a week)
NO proteinuria
BP return to baseline postpartum
125
Preeclampsia
Gestational HTN with proteinuria > or = to 1+. Report transient headaches might occur with episodes of irritability . Edema can be present
BP higher than 140/90
Tx= bed rest and increase circulation to kidneys and uterus
126
Severe preeclampsia
BP=160/110 or greater, proteinuria greater than 3+, oliguria, creatinine higher than 1.1
-headaches, blurred vision, hyperreflexia(clonus), extensive peripheral edema, epigastric pain, RUQ pain(enlarged liver, inc ALT and AST), thrombocytopenia
127
Eclampsia
Severe preeclampsia with onset of seizures and/or coma. Preceded by headache, severe epigastric pain, hyperreflexia, hemoconcentrations (possible warning manifestations of convulsions)
After 20 weeks, up to 6 weeks postpartum
128
HELLP syndrome
Variant of GHTN=hematologic conditions coexist with severe preeclampsia and hepatic dysfunction. Dx by laboratory not clinically
129
Components of HELLP syndrome
H: hemolysis->anemia and jaundice
EL:elevated liver enzymes (ALT,AST, epigastric pain, N/V)
LP: low platelets (thrombocytopenia, abornmal bleeding and clotting time, bleeding gums, Petechiae, possible DIC)
130
Difference between polyhydramnios and oligohydramnios
Oligo=low fluid
Poly=too much fluid
131
Hyperemesis gravidarium
Continuous and excessive vomiting causing weight loss, dehydration, electrolyte imbalances, and malnutrition; high hCG levels
132
assessment for hyperemesis gravidarum
S/s dehydration, fluid/electrolyte imbalance
Weight loss
133
Tx for hyperemesis gravidarium
-LR
-vitamin B6 (pyridoxine) and other supplements as needed
-antiemetic (metoclopramide)
NPO diet
Nausea medicine-ondansetron
Gradually reintroduce food
134
What are the different types of abortions?
Spontaneous vs. elective
135
spontaneous abortion
Natural causes that end pregnancy
First trimester- before 20 weeks
136
types of spontaneous abortions
Threatened, inevitable, incomplete, complete, missed, septic, and recurrent
137
Threatened abortion
Possible mild cramps, slight spotting, no tissue passed and cervical opening closed; pregnancy still safe
138
mild to moderate cramps, moderate bleeding, May or may not have tissue passed and dilated cervical opening; case of “when” it happens
Inevitable spontaneous abortion
139
severe cramps, heavy/profuse bleeding, tissue is passed, dilated with tissue in cervical canal or passage of tissue; some tissue remains
Incomplete spontaneous abortion
140
Complete spontaneous abortion
Mild cramps, minimal bleeding, tissue passed, and no cervical opening (closed after tissue passed)
141
Missed spontaneous abortion
No cramps, minimal to no bleeding(spotting), retention of tissue (none passed), closed cervical opening; usually feel no changes, typically found in US with no FHR; no signs of distress
142
Various cramp intensities, possible malodorous discharge, various amounts of tissue passed, cervical opening usually dilated
Septic spontaneous abortion
143
Recurrent spontaneous abortion
Cramps and bleeding varies, tissue has passed, cervix usually dilated
144
Tx for each abortion
-Ultrasound=priority(is placenta intact?)-?fetus viable?
-Cervical exam (if threatened->avoid!)
-D&C or D&E
-Prostaglandins (stimulate labor to let body take care of it naturally i.e. missed spontaneous abortion)
145
nursing care for spontaneous abortions
-Perform pregnancy test
-Observe color and amt of bleeding (count pads)
-Maintain client on bed rest (esp if threatened abortion)
-avoid vaginal exams
-determine how much tissue passed and save for examination (genetic issue?)
-assist with termination of pregnancy(if missed/incomplete)
-client education and support
146
Education for clients-spontaneous abortion
-Notify provider if heavy,bright red vaginal bleeding, elevated temp, foul-smelling vaginal discharge
-small amt of discharge normal for 1-2 weeks
-take prescribed abx
-refrain from bath tubs, sexual intercourse, placing anything into vagina for 2 weeks
-discuss grief and loss with provider before attempting another pregnancy
147
Risk factors for spontaneous abortions
Chromosome abnormalities
Maternal illness
Advanced maternal age
Premature dilation
Chronic maternal infections
Maternal malnutrition
Trauma (MVA, DV)
Substance use
148
What is gestational diabetes
Impaired glucose tolerance, first recognized or begins during pregnancy; pregnancy hormones—>insulin insensitivity
Two classes: A1-no meds and A2-meds
149
How is GDM diagnosed?
1 hr Oral glucose test(blood taken 1 hr after 50 g oral glucose) if elevated(>130-140), then a 3 hour glucose tolerance test administered(fasting, 100g oral glucose, sugar taken before and after glucose); if two or more out of the four BGL are elevated, Dx of GDM
150
GDM and the fetus
Macrosomia(big baby), birth trauma(shoulder dislocation), electrolyte imbalance, hypoglycemia (dec sugar after cord cut after birth from moms sugar, risk at 24-48 hr)
151
How is GDM treated?
Manage sugar with insulin and lifestyle changes
152
Magnesium sulfate
anticonvulsant used to prevent seizures for eclampsia pts
153
What is magnesium sulfate used for
Anticonvulsant, prophylaxis/tx to depress CNS and prevent seizures (eclampsia and severe eclampsia)
154
Magnesium sulfate toxicity
BURP
BP dec
Urine output dec
RR <12
Patella reflex absent
155
What do you monitor for a pt on magnesium sulfate?
VS, I&O, headache, visual disturbances, contractions, FHR and activity
156
What are signs of magnesium sulfate toxicity
Absence of deep tendon reflexes
Urine output <30mL/hr
RR <12/min
Dec LOC
Cardiac dysrhythmias
Hot flashes
Double vision
Slurred speech
157
Magnesium sulfate antidote
Calcium Gluconate
D/C infusion, administer antidote
158
Cerclage
Stitch in cervix to keep it closed until time for delivery
159
What is cerclage used for
Tx for cervical insufficiency(besides progesterone if she’s low)(no signs of labor, but feels pressure and cervix opens, preterm delivery due to weakness)
160
What s/s do pt need to report with cerclage
S/s infection, abnormal discharge, foul odor, pain, contractions, “pressure” pink-stained discharge or bleeding, rupture of membranes
161
How does pregnancy affect BP?
inc cardiac output, blood volume, HR, heart muscle enlargens for circulation for two; begins around/after 20 weeks
162
What pregnancy category medications are safe?(BP)
Methyldopa (antihypertensive)
Nifedipine (CCB and antihypertensive)
Hydralazine (vasodilator)
Labetalol (BB)
163
what medications are not safe for pregnant HTN pts?
ACEs and ARBs!
(-pril and -sartan)
164
How do we advise pts about BP meds?
do not take anything ending in -pril or -sartan; do not take antihypertensive if BP systolic 100 or below
Take BP and HR before BB- hold if les than 60 or systolic 100
Orthostatic hypotension- move positions slowly
Report SOB with BB
165
What are neural tube defects?
severe birth defects that affect the brain, spinal cord, or spine (Spina Bifida, anencephaly, encephaloceles, chiari malformation)
166
Spina bifida
spinal column doesn't close completely, which can cause nerve damage and paralysis of the legs
167
Chiari malformation
Brain tissue extends into the spinal canal
168
Anencephaly
Most of the brain and skull don't develop, and babies are usually stillborn or die shortly after birth
169
Encephaloleces
Portions of the brain and meninges protrude due to defects in the cranium
170
How can neural tube defects be prevented?
tale 400 mcg folic acid daily, avoid hot temperatures while pregnant (saunas hot tubs etc), control diabetes, avoid opioids, avoid anticonvulsants and other medications that may cause them
171
What is fundal height?
Measured in cm from symphasis pubis to top of uterus. Cm should match weeks in pregnancy ex: 36cm=36 weeks; helps gauge how baby is growing
172
How is Fundal height measured, and how do we know it is on track?
Fingers above and below umbilical cord, tape measure from pubis symphasis to fundus
173
What is urinary frequency during pregnancy?
The uterus sits behind bladder, first trimester it pushes on the bladder
174
When does urinary frequency during pregnancy get better or end?
When uterus gets big enough to rise above the bladder
175
What is a fetal demise?
When a baby dies in the womb after 20 weeks, or stillborn
176
How is fetal demise diagnosed?
Death of a baby after 20 weeks (before=miscarriage)
-vaginal bleeding, a uterus that is smaller than expected, or a lack of fetal movement, no FHR, non reactive stress test
177
Which physiological change is common in the cardiovascular system during pregnancy?
-inc lung capacity
-inc cardiac output
-dec blood volume
-dec HR
-inc iron absorption
Inc cardiac output
178
Which sign refers to the deepened violet-bluish color of the cervix and vaginal mucosa during pregnancy?
-Braxton hicks contractions
-Hegar’s sign
-Goodell’s sign
-Chadwick’s sign
Chadwick’s sign
179
Which of the following is a presumptive sign of pregnancy?
-Hegar’s sign
-Quickening
-fetal heart sounds
-visualization of the embryo
Quickening
180
What is a common discomfort of pregnancy related to the musculoskeletal system?
-heartburn
-leg cramps
-round ligament pain
-N/V
-headache
Round ligament pain
181
What’s physiological change occurs in the uterus during pregnancy?
-dec in uterine weight
-thickening of the uterine wall
-inc in uterine muscle tone
-reduced uterine blood flow
Thickening of the uterine wall
182
What is an indicator of potential preeclampsia during pregnancy?
-mild back ache
-facial edema and severe headaches
-constipation
-round ligament pain
Facial edema and severe headaches
183
What does BPP assess?
-fetal heart rate
-maternal blood pressure
-fetal breathing, body movements, tone
-maternal weight gain
Fetal breathing, body movements, tone
184
What is the main benefit of conducting a nonstress test (NST)?
-determines the gestational age of fetus
-assesses the response of fetal heart rate to fetal movements
-it measures the amount of amniotic fluid
-it evaluates the size of the uterus
It assesses the response of fetal heart rate to fetal movements
185
Which of the following is NOT a contraindication for an oxytocin-stimulated contraction stress test?
-placenta previa
-multiple gestations
-previous vaginal birth
-reduced cervical competence
Previous vaginal birth
186
In a contraction stress test, which condition should be avoided?
-hyperstimulation of the uterus
-fetal movement
-maternal position changes
-continuous FHR monitoring
Hyperstimulation of the uterus
187
At what gestational age is chorionic villus sampling (CVS) ideally performed?
10-13 weeks
188
In a quad marker screening, which combination of results suggests an increased risk for Down syndrome?
Low AFP, high hCG, high inhibin A, low estriol
189
What is the second most frequent cause of bleeding in early pregnancy?
Ectopic pregnancy
190
Which medication is used for medical management of an unruptured ectopic pregnancy?
Methotrexate
191
What is the primary characteristic of bleeding associated with placenta previa?
Painless and bright red blood
192
Which of the following is NOT a risk actor for placenta previa?
-previous previa
-advanced maternal age (>35)
-first pregnancy
-multiple gestations
First pregnancy
193
Which statement about abruptio placentae is correct?
-it typically occurs before 20 weeks gestation
-it is characterized by painless vaginal bleeding
-the uterus may feel “board-like) on palpation
-vaginal examinations are recommended for diagnosis
The uterus may feel “board-like” on palpation
194
What is the only definitive management for abruptio placentae?
Delivery
