OB Exam 1 Flashcards
(70 cards)
1
Q
Gravidity
A
Number of pregnancies
2
Q
Parity
A
Number of pregnancies reaching 20 weeks
3
Q
Preterm and late preterm
A
20 weeks 0 days to 37 weeks 0 days
34 weeks 0 days to 38 weeks 6 days
4
Q
Early Term
A
37 weeks to 38 weeks 6 days
5
Q
Full term
A
39 weeks to 40 weeks 6 days
6
Q
Late term
A
41 weeks 0 days to 41 weeks 6 days
7
Q
Post Term
A
Beyond 42 weeks gestation
8
Q
What is the earliest biomarker for pregnancy
A
Human chorionic gonadrotropin (hCG)
9
Q
What can higher levels of hCG be associated with?
A
Abnormal gestation such as down syndrome or multiple gestation
10
Q
What can lower levels of hCG be associated with?
A
Indicate an impending miscarriage or ectopic pregnancy
11
Q
When can you first palpate the fundus?
A
12-14 weeks above the symphysis pubis
12
Q
When does the fundus rise to the umbilicus
A
20 weeks
13
Q
What is lightening?
A
When the fetus begins to descend into the pelvis between 38-40 weeks
14
Q
Hegar’s Sign
A
Softening and compressibility of lower uterine segment around week 6
15
Q
When do braxton hicks begin to happen?
A
After 4 months
16
Q
Goodell sign
A
Softening of uterine tip
17
Q
Increased friability
A
tissue is damaged easily
18
Q
Ballottement
A
passive movement of unengaged fetus
19
Q
Quickening
A
First recognition of fetal movements
20
Q
Chadwick sign
A
Blue-violet vaginal mucosa and cervix from increased vascularity
21
Q
Leukorrhea
A
White or greyish discharge
22
Q
What increases the risk for yeast growth?
A
Higher glycogen levels
23
Q
Stretch marks
A
Striae gravidarum
24
Q
What causes supine hypotension?
A
Compression of vena cava when lying flat on back
25
What causes dependent edema, varicose veins, and hemorrhoids?
Compression of iliac veins and inferior vena cava by uterus
26
When do WBC increase?
During the second trimester and through delivery
27
What does increased vascularity cause in the mother?
Congestion, epistaxis, and changes to voice
28
What causes the increased susceptibility to UTIs?
Urine held in pelvis and ureters, slowed urine flow
29
Melisma
Mask of pregnancy: Blotchy brownish hyperpigmentation of skin over cheeks, nose, and forehead
30
Linea nigra
Line extending from symphis pubis to top of fundus
31
Angiomatas
Vascular spiders. Result from increased blood flow to skin
32
Palmar erythema
Pinkish red well defined blotches over palmar surfaces
33
Viability
Capacity to live outside the uterus. There is no clear limits of gestational age or weight. Threshold 22-25 weeks
34
Presumptive signs of pregnancy
```
Period absent (amenorrhea)
Really tired (fatigue)
Enlarged breast
Sore breast
Urination increases
Movement perceived (Quickening)
Emesis/nausea
```
35
Probable signs of pregnancy
Positive pregnancy test
Return of fetus when uterus pushed with fingers (Ballottement)
Outline of fetus palpated
Braxton Hick's Contractions
A softening of the cervix tip (Goodell sign)
Bluish color of vulva/vagina/cervix (Chadwick sign)
Lower uterine segment soft (Hegar sign)
Enlarged uterus
36
Positive signs of pregnancy
Fetal heart tones
Delivery of a baby
Ultrasound of a baby
37
Physiologic anemia of pregnancy
Result of hemodilution (plasma increase > RBC increase) = low H&H count
38
PEP/PUPP
Pruritis. Itchy, uncomfortable rash that will last all 40 weeks
39
Changes in abdominal muscles
Diactasis recti
40
What results due to edema of peripheral nerves?
Carpal tunnel
41
PICA
nonfood cravings
42
Pyrosis
Heartburn as a result of decreased tone and motility of smooth muscles
43
Maternal morality
Number of deaths per 100,000 live births. This is preventable with improved access and prenatal care services
44
Maternal morbidity
High-risk pregnancy, acute renal failure, sepsis, and stroke
45
Importance of prenatal period
Preparing for birth, influencing health of family, and health promotion interventions
46
How long is pregnancy and how many trimesters?
9 months, 280 days, 3 trimesters each 13 weeks
47
Stages of maternal adaptation
```
Accepting the pregnancy
Identifying with the mother role
Reordering personal relationships
Establishing a relationship with the fetus
Phase 1: I am pregnant
Phase 2: I am going to have a baby
Phase 3: I am going to be a mother
Preparing for birth
```
48
Paternal adaptation
Accepting the pregnancy
Announcement phase- few hours to few weeks where father accepts biologic fact of pregnancy
Moratorium phase- adjusting to the reality of pregnancy
Focusing phase- last trimester, active involvement in pregnancy, building relationship with child
Identifying with the father role
Reordering personal relationships
Establishing a relationship with the fetus
Preparing for the birth
49
Goal of prenatal care
Promote health and well-being of pregnant woman
50
Reasons prenatal care are inaccessible
```
Poverty, lack of health insurance
Lack of culturally sensitive care and communication barriers
Lack of transportation
Inconvenient clinic hours
Personal and cultural beliefs
```
51
Prenatal interview
Reason for seeking care, current pregnancy, OB history (G's & P's and STI history), Medications being taken, nutritional history, history of drug and herbal preparation use, family history, social, experimental, and occupational history, mental health screening, intimate partner violence (Often begins during pregnancy)
52
Lab test
H&H (anemia and baseline)
Blood type (Rh incompatibility or ABO incompatibility)
Rubella titer
Chlamydia (done first visit)
GBS (done at 35 to 37 weeks)
RPR/VDRL (first visit; screening for syphilis)
HIV
Hep B surface antigen
1hr and 3hr glucose testing
Urine (trace albumin and protein is expected but increased levels could indicate preeclampsia, glucose indicates gestational diabetes)
53
Weight gain
2 to 4 lbs in first trimester
1lb per week
Total of 25 to 35 lbs during entire pregnancy
54
Frist trimester education
Discomfort usually subsides after 13 weeks; plan rest periods; can still travel but ensure frequent movement to prevent DVT
55
Second trimester education
Dental hygiene need to be maintained due to gum hypertrophy
56
Third trimester education
Attending birth classes, return of urinary frequency; positioning with pillow, expect round ligament pain
57
Teenagers prenatal care
Don't get access to prenatal care, more likely to smoke, increased risk for newborn including preterm birth, chorioamnionitis, and inadequate weight gain
58
+35 years prenatal care
Increased risk for preexisting conditions such as diabetes and HTN
Increased risk for miscarriage, cesarean section, and pregnancy related mortality
59
Multifetal pregnancies prenatal care
Increased risk for adverse outcomes, premature birth, more frequent visits, changes to weight gain and nutritional needs, and increased stressors such as finances, space and workload
60
Folic acid needs
400 mcg during prenatal period
| 600 mcg during pregnancy
61
Why is nutrition important during pregnancy
Development of placenta, increased blood volume and metabolic rate, and increased energy needs
62
Proteins needed during pregnancy
25 g/day for 71 g total
63
Iron needs during pregnancy
27 mg/day total
64
Foods to avoid
Raw lunch meats, raw eggs, and fish high in mercury
65
How to prevent nausea/vomiting and heartburn
Small meals that are low in fat, eat crackers in morning before getting out of bed, avoid spicy foods, don't take iron on an empty stomach, and small glasses of water
66
Risk if mom is underweight
Preterm labor, low birth weight infants, IUGR (intrauterine growth restrictions)
67
Risk if mom is overweight
Preeclampsia, gestation DM, macrosomia, cepholopelvis disproportion, wounds, postpartum hemorrhage, miscarriages, congenital/growth abnormalities
68
Classifications of BMI
Underweight: <18.5
Normal: 18.5 to 24.9
Overweight : 25 to 29.9
Obese: >30
69
What increases absorption of iron
Vitamin C (citrus fruits, tomatoes, strawberries)
70
What decreases absorption of iron
Bran, tea, coffee, milk, oxalate (in spinach) and egg yolk
