practice exam 2023 Flashcards
(34 cards)
list risk factors for GDM
BMI >30, previous LGA, previous/family hx GDM, PCOS, multiple, Aboriginal and Torres Strait Islander, Asian, Indian, Pacific Islander, mat age >40
outline the BGL levels after OGTT that lead to diagnosis of GDM (fasting, 1 hour, 2 hours)
fasting: 5.1-6.9
1 hour: >10
2 hours: 8.5-11
what is the target BGL range in GDM
4-7mmol/L
what is the end product of fat metabolism?
ketogenesis
when is glucagon secreted?
in response to drop in BGL
list fetal/neonatal problems assoc with GDM
LGA, IUGR, prematurity, birth trauma, hypoglycaemia, RDS, stillbirth
list maternal risks from GDM
PET, IOL, instrumental birth, CS, HTN, preterm, polyhydramnios, PPH, infection, birth trauma
list CV changes that occur in pregnancy
increase in plasma vol, O2 consumption, HR, heart size, SV, CO, reduced Hb
what is the definition of HTN in pregnancy
sBP of 140 or >, and/or dBP 90 or >
list the organ systems involved in PET and a clinical symptom of each
renal: proteinuria
neuro: headaches
hepatic: sudden increase transaminases w or w/out RUQ pain
pulmonary: pulmonary oedema
haematological: haemolysis
uteroplacental: FGR
what is first line treatment of acute HTN in pregnancy?
hydralazine 20-30mg
what is the loading dose of mag sulf?
4g IV over 20mns via controlled infusion device
what are key clinical indications of mag sulf overdose?
muscle weakness, loss of reflexes, vomiting, flushing
list fetal/neonatal complications related to obesity in pregnancy
LGA, stillbirth, hypoglycaemia, fetal anomalies, preterm, jaundice, RDS
list maternal complications related to obesity in pregnancy
miscarriage, stillbirth, GDM, HTive disorders, depression, anxiety, prolonged pregnancy, CS, IOL
how often should pregnant women be weighed?
every appt
what is the appropriate weight gain for a woman with BMI >30?
5-9kg
name the steps and examples for the 5As framework
asses: assess for behavioural health risks and factors
advise: give specific, personalised, clear behavioural change advice
agree: collaboratively select goals and methods
assist: assist pt to achieve goals through skills, confidence and support
arrange: arrange follow up contacts for ongoing assistance and support
identify maternal risks assoc with post-dates pregnancy
IOL, instrumental birth, increased risk PPH, CS, perineal tears, stress and anx
list methods used for managing post-dates pregnancy
membrane sweep, IOL, CS, expectant management, fetal monitoring, cervical ripening
list reasons for woman to contact/present to hospital when post-dates
ROM, PV bleeding, DFM, contractions
list physical manifestations of tocophobia
SOB, tachycardia, need to remove self from situation
identify aspects of midwife role in helping reduce/manage stress in antenatal period
support and prepare partner/family to support mother and baby, facilitate connections to community social support
define trauma
deeply disturbing or distressing experience, physical, psychological, mental, spiritual, cultural or social