Pregnancy

Question 1

Chadwick sign

Answer 1

bluish color cervix, vagina, vulva due to increase in blood and lymph flow (wk 8-12)

Question 2

Goodell sign

Answer 2

softening of cervix due to increase in vascularity (wk 4-6)

Question 3

“bloody show”

Answer 3

loss of thick mucus plug obstructing cervical canal

Question 4

result of isthmus softening and compressibility

Answer 4

uterine ante flexion during first 3mo - fundus presses on bladder

Question 5

obstetric history

Answer 5

G-gravity (#pregnancies)
T-term
P-preterm
A-abort.
L-living
complications

Question 6

Piskacek sign

Answer 6

lateral bulge or soft prominence of uterine cornu (wk 8-12)

Question 7

fundal height measurement

Answer 7

upper part of pubic symphysis to superior fundus in centimeters

Question 8

factors affecting accuracy of fundal height measurement

Answer 8

• obesity
• amount of amniotic
• myomata
• mult. gestation
• fetal size
• fetal position

Question 9

Hegar sign

Answer 9

softening of the uterine isthmus (wk 6-8)

Question 10

McDonald sign

Answer 10

fundus flexes easily on the cervix (wk 7-8)

Question 11

Braun von Fernwald sign

Answer 11

fullness and softening of the fundus near the site of implantation (wk 7-8)

Question 12

effacement

Answer 12

thinning of the cervix

• precedes cervical dilation in primipara
• occurs w/ dilation in the multipara

Question 13

cervical risk for preterm labor

Answer 13

shortening of the cervix less than 29mm

Question 14

fetal heart rate heard

Answer 14

dopper: 11-12 weeks
fetoscope: 19-20 weeks

Question 15

fetal movement

Answer 15

• Cardiff count-to-10
• weeks 16-20
• 10/h - 10/12h
• mon. wks 34-36
• <10 in 12h = emergency
• 3 or less in 2h for 2d in left lateral position = ER

Question 16

Leopold maneuvers

Answer 16

assess fetal position:
1-fetal pole:
id fetal part at fundus/lie
2-umbilical pole:
id fetal back with pressure
3-Pawlicks Grip:
id head/butt over symphysis pubis
4-Pelvic Grip:
outline fetal head while facing woman (flexed/extended)

Question 17

documentation abdominal palpation

Answer 17

Presenting part-vertex/breech
Lie- longitudinal, transverse, oblique
Fetal head- flexed or extended

Question 18

station

Answer 18

relationship of presenting part to ischial spines of mother’s pelvis
(below lines (+), above lines (-)

Question 19

uterine contractions beginning as early as third month

Answer 19

Braxton Hicks contractions

Question 20

when to evaluate Braxton Hicks contractions,

what to document

Answer 20

more than 4-6 contractions per hour before 37 weeks,

strength, duration, freq.

Question 21

N/V treatments

Answer 21

• B6 and Unisom 1st line

- Zofran (small risk of heart defects and cleft palate in early pregnancy)

Question 22

hyper pigmentation during pregnancy

Answer 22

• linea nigra
• periareolar skin
• chloasma (mask)
• striae

Question 23

pregnancy test

Answer 23

• beta-human chorionic gonadotropin (beta-Hcg) 4-7d after missed period
• US as early as 5w

Question 24

pregnant woman hx

Answer 24

-LMP
-prior: vag vs. csection, complications, size
-medical:
>gyn- pap, cysts, STIs
>cardiovascular
>asthma, bleeding, seizure,
-surgical: ab, pelvic
-fx: MR, diabetes, chromos.
-sx: alc., drugs, diet, DVS

Question 25

terms: nulliparous primaparous multiparous

Answer 25

- no delivery - first delivery - previous delivered

Question 26

calculating gestational age (EDD)

Answer 26

first day LMP | + 1yr - 3mo + 7d

Question 27

avg. duration of pregnancy

Answer 27

280d or 40w

Question 28

trimesters

Answer 28

3 months each: 1: 1st day LMP - end 13w 2: 14w - end 28w 3: 28w - delivery

Question 29

fundal ht expected pattern

Answer 29

``` 1cm increase per week: 12w: just above pub sym 14-16: mid pub and umbil 20-22: umbilicus 22-38: 1cm/w 38-40: 2-3cm below xiph ```

Question 30

PROM

Answer 30

premature rupture of membranes: | if preterm, M&M risk

Question 31

when to check for gestational diabetes

Answer 31

weeks 24-28

Question 32

gestational diabetes tests

Answer 32

-initial glucose challenge after 1h, <130-140 normal -glucose tolerance test fast, blood level, drink, check every 3h, 2+ high = gestational diabetes