Prenatal Flashcards
(229 cards)
1
Q
How long after ovulation can a ovum be fertilized?
A
24 hours after?
2
Q
Average time for sperm to fertilize a ovum?
A
48 to 72 hours
3
Q
What are the forms of contraception?
A
Barrier, Natural family planning, Hormonal, intrauterine, surgical?
4
Q
How many different forms for contraception are there?
A
5
5
Q
What are the 7 natural family planning methods?
A
Abstinence, Coitus interruptus, calendar rhythm, standard days, Basal body temperature, cervical mucus ovulation detection, 2-day method.
6
Q
Abstinence
A
Withholding from sex
safest form needs high self- control.
No risks to this natural form.
7
Q
Coitus interruptus
A
Withdrawal
Choice of natural family planning
one of least effective methods
No protection for STI
can have pre ejaculation risk for pregnancy.
8
Q
Calander Rhythm method
A
Must be in tune to the bodies cycle. abstain during the fertile period.
must record at least 6 cycles
fertile period shortest cycle length minus 18
plus, longest cycle length minus 11 days.
9
Q
Example of Calander rhythm
A
shortest 26
longest 29
(26-18) - (29-11) 8th day through the 18th day avoid this time.
10
Q
What does ACHES stand for with oral hormonal contraceptives?
A
Abdominal pain, Chest pain, Headache, eye vision, shortness of breath. Risk of blood clot.
11
Q
How long does it take to become fertile again after stopping injectable progesteron?
A
12- 18 months to start ovulation again.
12
Q
Standard day method
A
Natural method using a app or bead necklace.
Do not use if cycles are long or short can be unreliable.
Less effective while IUD breastfeeding.
13
Q
Basal Body temp
A
BBT natural method.
Core temp raises while ovulating. 3 days before and after a shift.
not reliable to be a cause to many variables.
14
Q
Cervical mucus ovulation
A
Billings method. Using the spinnbarkeit sign during ovulation thin, slippery lasts 4 days after the last day.
15
Q
How many barrier methods are there?
A
6 kinds
16
Q
Male condom
A
Educate how to properly put them on
protects against STI’s except skin-to-skin infections.
17
Q
What are the STI’s that are not protected from most forms of barriers?
A
HSV (1,2) HPV, syphilis.
18
Q
Female condom
A
More protection against skin to skin infections
Avoid using males condoms with
19
Q
What type of lube should you use with condoms?
A
Water based to avoid breaking.
20
Q
Spremicide
A
Barrier device. Chemical that kills sperm.
Makes the environment too acidic.
21
Q
Diaphragm
A
Barrier method
Use with spermicide
replace every 2 years
rule of 6 insert 6 hours before leave in for 6 hours after not to exceed 24 hours.
Needs a prescription
22
Q
Cervical cap
A
Barrier Method
comes in 3 sizes
6 hours before for 6 hours after up to 48 hours.
22
Q
Cervical cap
A
Barrier Method
comes in 3 sizes
6 hours before for 6 hours after up to 48 hours.
needs fitting
23
Q
Contraceptive sponge
A
Barrier method
polyurethane sponge with spemicide
moisten with water leave for 6 hours
one size fits all
24
How many forms of Hormonal methods are there?
8
25
COC contraceptive
Hormonal method
Combined oral contraceptive
26
What is combined for a COC?
Estrogen and progestin
Suppress ovulation thickening the uterine wall.
27
What are some other reasons to use COC?
Acne, dysmenorrhea, menorrhagia, ovarian cancer,
28
What do you do if you missed one pill?
Take as soon as you remember. Dont double
if missed more than 2-3 use other protection method and pick back up.
29
What is the disadvantages for COC?
Estrogen cancers, HTN, blood clotting disorders, stokes, emboli, migraines.
30
What does ACHES stand for in problems in COC's?
A: Abdominal pain
C: Chest pain
H: Headache migraine
E: Eye visual disturbances
S: Shortness of breath
31
What should you do if you experience a symptom of ACHES??
See provider right away could be a blood clot stop medication.
32
Progestin only pill
Hormonal method
safe when breastfeeding
fewer SE compared to COC
33
Problems with progestin only pill?
Less effective suppressing ovulation,
Breast cancer, irregular bleeding.
34
Transdermal contraceptive patch
Hormonal method
Replace weekly for 3 weeks then one week off.
Better adherence than the pill form COC
No liver metabolism
Same side effects with ACHES
35
Injectable progestin
Hormonal method
Every 11-13 weeks (IM/SC first 5 days)
36
Problems with the hormonal method injectable progestin?
Decrease bone mineral density, Weight gain, depression.
Once stopping can take 12 to 18 months to return to fertile.
37
Contraceptive ring
Hormonal method
Take out every 3 weeks replace within 7 days
Lower dose since the route.
38
Intrauterine devices
Insert long term option.
Can be hormonal or copper
up to 10 years
immediate effect post birth or SA within 48hours.
Can be expelled
T- shaped
39
Transcervical sterilization
device placed into the fallopian tubes stopping ovum movement down.
40
How many ways of surgical methods are used?
3 methods
tube tie, implant, vasectomy.
41
How long does the implanted progestin last?
3 years
42
Where is the rod for implanted progestin usually placed?
upper arm
43
What is bilateral tubal ligation doing?
Blocking the fallopian tubes permanent cannot be undone.
44
Vasectomy what is it doing?
Surgical obstructing the vas deferens.
Best practice is to wait a few days post with a couple dry ejaculations to clear the lines fully.
45
Emergency contraceptive
Copper IUD
Morning after pill within 72 hours. Take with antiemetic since nausea, abdominal pain.
46
What are the three forms of tubual ligation?
Banded - not cutting band a loop
tied - cut and tie off
cauterized- burn cut through fallopian tubes.
47
How long should you leave a diaphragm in after intercourse?
6 hours
47
How long should you leave a diaphragm in after intercourse?
6 hours
48
What symptom should the nurse tell the patient in regard to COC?
Reduced menstrual flow
breast tenderness
Shortness of breath
Nausea?
Shortness of breath for the high risk of blood clots and chance of a PE.
49
Since IUD can sometimes get dislodged what do you need to tell patient after each period?
Check to make sure the strings of the IUD are still in place.
50
What are some common adverse effects of implantable progestins?
Irregular bleeding
weight gain
nausea
depression
51
What should you also be taking when on an injectable method?
Calcium and vitamin D to restore bone density.
52
What is the vitamin that all women of child bearing age should take?
Folic acid
53
What is folic acid used for and when can you lower it down?
It is used to prevent neural tube defects (spina bifida)
Take supplement before through the first trimester.
54
What is the recommended dose for folic acid before and during pregnancy?
0.4mg before to 0.6mg during.
If history 3-5mg a day. before and during.
55
At what age does the risk for infertility increase in women?
Over 35 infertility and risks for adverse effects can happen.
56
LMP
Last menstrual period
57
How long is the typical menstrual cycle?
28 days
58
What are the phases of a cycle?
Follicular phase
ovulatory phase
Luteal phase
59
Menstrual cycle is also referred to as?
Period
Ovarian cycle- producing a mature egg/ ova
60
What process creates a mature egg?
Oogenesis
61
What phase in the period is first and how long does it last?
Follicular phase day 1 to day 12-14.
62
What are the main hormones during follicular phase?
Luteinzing Hormone (LH)
Follicle- stimulating hormone (FSH)
63
What are LH and FSH doing during follicular phase?
They are maturing the graafian follicle that creates estrogen.
64
Second phase of the period is?
Ovulatory phase
Release of oocyte (ovulation)
65
What happens to hormones during the second phase ovulatory phase?
Peak estrogen
LH hormone surges 12-36hrs before ovulation.
estrogen starts to decrease
progestin increases.
66
Last phase of the period?
Luteal phase
after ovulation lasting about 14 days.
67
Empty graafian follicle forms what?
Corpus luteum
68
what does the corpus luteum produce? Empty and with a pregnancy?
empty- low estrogen, progesterone
+- progesterone and more estrogen till placenta can produce its own.
69
What happens to the corpus luteum if no fertilization?
degenerates and sheds progesterone drops causing the menstruation.
70
Spermatogenesis
formation of mature sperm gametes.
71
Hormones that play a role in spermatogenesis.
FSH, LH, Testosterone.
72
During spermatogenesis what are the hormones doing?
Follicular stimulating hormone- stimulates production.
Luteinzing hormone (LH) - stimulates testosterone production.
Testosterone- promotes mature sperm.
73
What is usually the first step in determining infertility and why?
Semen analysis cheap non invasive.
74
In infertile couples what's the average of it being on the males?
40% of infertile couples are due to males.
75
How long after an egg be fertilized after ovulation?
24 hours
76
How long can sperm fertilize an egg for?
48-72 hours
77
How long do you have to try to conceive to be considered infertile?
Attempting for 12 months under the age of 35 or 6 months trying over the age of 35.
78
What are some reasons that someone might be infertile?
Exposure to teratogenic substances.
STI's (untreated chlamydia)
Endocrine disorders
Decreased sperm population (heat, drugs, illness)
79
Can mumps make a male infertile?
Yes if post adolescence
80
Ectopic pregnancy
Ovum implants into the fallopian tube
81
What is the risk of a ectopic pregnancy?
If the tube is not ruptured can increase the risk for another wrong implantation.
82
What hormones are tested during a fertility test?
Prolactin, progesterone, thyroid, FSH, LH
83
How to treat infertility issues non medical?
Relieve stress life style modifications, diet, exercise, drug stoppage, avoiding high temps.
84
What medical therapies are used to treat infertility?
Metformin to support ovulation.
medications to stimulate ovary production. (clomiphene citrate)
85
If all methods are not working what should you consider?
Stopping trying a different route for parenthood, genetic counseling.
86
What are the types of assisted reproductive technologies?
intrauterine insemination- placed sprem into uterus at time of ovulation.
In vitro fertilization- embryo transfer (IVF-ET) - collect both gametes fertilize in lab then transplant to uterus.
Gamete intrafallopian transfer - both gametes in a catheter laproscopically placed into fallopian tube.
Donor oocyte- Donated egg fertilized in lab then placed in uterus.
Donor embryo- Donated embryo is transferred no genetic material from either parent.
Gestational carrier- contract to carry the IVF embryo carrier has no genetics.
Surrogate mother sperm is transferred who will then carry child. surrogate is genetic parent.
Therapeutic donor insemination- donor sperm is transferred to fertilize egg.
Adoption
87
What are some of the ethical issues that come up with assisted reproductive tech procedures?
Surplus of embryos that are needed ( too few or leading to too many)
At what point does life truly start? ( fertilization, implantation, heartbeat, embryo to zygote cellular multiplication.
Who has the right to embryo ownership?
The cost for access.
Would you ever tell the child.
At what point is enough, enough needing to be stopped.
Is this selective process ethical not just genetically but on a broader eugenic level of designer babies.
88
During same sex couples there is some of teh same conversations with a few different ones which are?
who will carry the baby?
How will you decide the gametes for the baby?
88
During same sex couples there is some of teh same conversations with a few different ones which are?
who will carry the baby?
How will you decide the gametes for the baby?
88
During same sex couples there is some of teh same conversations with a few different ones which are?
who will carry the baby?
How will you decide the gametes for the baby?
89
While checking for infertility if a genetic disease is found either showing or a carrier genetic counselor will be brought in.
Example would be sickle cell anemia
Von Willebrand- genetic bleeding disorder.
Cystic fibrosis
90
What would you maybe think infertility after 18 months?
*Occupational hazard with teratogenic (chemicals, radiation, pesticides)
*Atypical secondary sexual characteristics -irregular menstrual history (endocrine disorder)
*Infections - untreated STI, (childhood infections in males' mumps)
91
If you had a ectopic implantation and only had unilateral removal can you still get another fallopian tube implantation?
Yes the risk is increased. Only way to stop it again is if you have a bilateral removal of both fallopian tubes making you sterile.
92
What kind of testing is done with genetic testing in family planning?
Carrier testing
preimplantation testing
prenatal testing Early detection (trisomy 21, hemophilia, Tay- Sachs)
Newborn testing (PKU)
93
If a patient has a fish allergy they should avoid or be taught about which testing for fertality?
hysterosalpingography
Dye used causes reaction.
94
Primary genetic diseases that are looked for in family testing?
Sickle cell anemia
Cystic fibrosis
Tay- Sachs disease
phenylketonuria
Huntington's
Hemophilia
Duchenne's muscular dystrophy
95
Sickle cell anemia
Recessive
Most common in African ancestry
Forms a sickle shape in hemoglobin disrupting the capacity of oxygen carrying.
96
Cystic Fibrosis
Recessive
most common of European ancestry
Produce thicker mucus in respiratory and pancreas in greater number leading to clogs and respiratory infections/ problems.
97
Tay- Sachs disease
Recessive
Most common from Jewish ancestry.
Destroys neurons and nervous system resulting in death within first 2 years.
98
Phenylketonuria
PKU
Recessive
Lack of an enzyme that is used to metabolize amino acid phenylalanine.
Diet change and enzyme addition works.
Can lead to mental and physical retardation.
99
Huntington's disease
Dominant
uncontrollable muscle contractions 30-50 years old followed by loss of memory.
100
Hemophilia
X- linked
Lack of factor 8 clotting factor.
Can be controlled with replacement factor 8 from donor blood.
101
Duchenne's muscular dystrophy
X- linked
replacement of muscle with adipose and scar tissue.
progressive loss of muscle till cardiac muscles are affected around age 20 leading to death.
102
Teratogen
Alcohol
Increased risk fetal alcohol syndrome.
No amount during pregnancy is ok.
Can lead to microcephaly, mental retardation, cardiac defects, low birth weight, unusual facial structure.
Short nose, underdeveloped jaw,
flat mid face,
small head, thin upper lip, small eye openings.
103
Teratogens
ACE inhibitors
increased risk for renal tubular dysplasia which can lead to renal failure. Fetal or neonatal death is a possibility as well as intrauterine growth restriction.
104
Carbamazepine
anticonvulsant
increased risk for neural tube defects, cleft lip/ palate, intrauterine growth restriction.
105
Teratogens
Cocaine
increased risk for heart, limb face, GI, GU defects , placenta abnormalities.
106
Teratogen
Warfarin
increased risk for spontaneous abortion.
Fetal or newborn hemorrhage, CNS abnormalities.
107
Teratogens
Cytomegalovirus (CMV)
Infection part of TORCH
Form of herpes.
Increased risk for hydrocephaly, microcephaly, mental retardation.
Hearing loss.
108
Teratogens
Herpes Varicella (Chicken pox)
Infection part of TORCH
O- other
increased risk for hypoplasia hands/feet.
Visual deficits (blindness, cataracts)
mental retardation.
109
Teratogen
Rubella
Infection TORCH
R
increased risk for heart defects. deafness, blindness, fetal termination, mental retardation.
110
Teratogen
Syphilis
Infection
increased risk for skin bone or teeth defects. fetal termination.
Untreated leads to blindness.
111
Teratogens
Toxoplasmosis
Infection TORCH
T
cat litter
blindness, mental retardation, fetal termination.
parasitic infection.
112
Teratogen
Zika
Infection
impaired growth
blindness, hearing defects, microcephaly.
113
Each year what is the amount that are unintended?
about half of all
114
6/10 unintended
3/10 of all end in abortion
True.
115
What is the timeline of the first trimester?
First day of the LMP through 14 completed week.
116
Second Trimester timeframe
15 weeks through 28 completed weeks.
117
Third trimester timeline
29 weeks through 40 weeks.
118
progress of pregnancy
fertilization formation zygote in fallopian tube
cell division forming blastocyst, to uterus for implantation day 5/6
embryo until 8 weeks gestation
fetus 9 weeks on
119
When does the placenta form?
fully functional 8-10 weeks
120
Functions of the placenta
Nutrients and gas exchange
Hormone production (progesterone, estrogen, hCG, hPL.
121
What does estrogen help with?
Enlargement of breasts and uterus.
122
Progesterone helps with what during pregnancy?
implantation and decreases contractability of uterus.
123
What does Human chorionic gonadotropin hCG do?
Helps stimulate corpus luteum until the placenta can produce own hormones.
124
What does hPL Human placental lactogen help with?
Growth of the fetus as well as stimulating breasts for lactation.
125
How many layers are there in embryonic membranes.
two layers an inner and a outer layer.
126
Function of the Embryonic membranes?
maintain a sterile environment preventing bacteria from entering the fluid.
127
Inner embryonic membrane
amniotic
128
Outer embryonic membrane
chorionic
129
How many arteries and veins are there in the umbilical cord?
2 arteries and one vein
the vein is oxygenated
130
What are the variations of amniotic fluid volume?
500-600ml during terms
peak at 34 weeks 800-1000ml.
131
polyhydramnios
excess amniotic fluid 1500-2000ml
132
oligohydramnios
decreased amounts of amniotic fluid <500ml or decrease by 50%.
133
order of growth of the body parts.
CNS-3 weeks
eyes, heart, leg- 4- 5 weeks
palate, ear- 7-8 weeks
134
What are the three signs of pregnancy?
Presumptive
Probable
Positive
135
Presumptive signs
Changes that happen that make you think you might be pregnant.
136
What are presumptive signs?
Amenorrhea- without menses
Fatigue
Nausea and vomiting
Urinary frequency
Breast changes- darkened areole, enlarged
Quickening- feeling of fluttering movement from fetus felt around 18 weeks gestation
Uterine enlargement
137
Probable signs
Changes that make a provider suspect pregnancy main changes in uterine.
138
What are some probable signs.
Abdominal enlargement- related to size shape and position of uterus (could be tumor or pregnancy)
139
What are the probable signs?
Abdominal enlargement
Hegar's sign: softening of lower uterus.
Chadwick's sign: violet bluish color cervix
Goodell's sign: softening of cervical tip
Ballottement: rebound of unengaged fetus.
Braxton Hicks contractions: False contractions that are painless, irregular and relieved by walking.
Positive pregnancy test: drugs or time/ hydration can give false positive or negative.
Fetal outline: felt by examiner.
140
Positive signs
Signs only explained by a pregnancy .
141
What are the positive signs?
Fetal heart sounds
Visualization of fetus by ultrasound
Fetal movement : palpated by experienced examiner.
142
When should you take a urine pregnancy test?
First thing in the morning with the first void.
143
What are you looking for in pregnancy tests?
hCG human chorionic gonadotropin
144
when can you read hCG and at what point is it at its peak?
7-8 days before next menses
peak at 60-70 days declines around 100-130 days.
145
How can you estimate the delivery date?
Ultrasound
measurment of fundal height
using Nagele's rule calculate from last menstrual period.
146
Using Nagele's rule how do you calculate EDD?
LMP -3 months add 7 days and add 1 year.
147
Gravida/ para meanings
gravida is number of pregnancies
para is the number of pregnancies that reach over 20 weeks.
148
GTPAL meanings
G total number of pregnancies
T number of term births
P number of preterm births
A number of abortions
L Number of children currently living
149
what are some physiological changes that happen in the reproductive system?
Breasts enlarge and get tender.
150
What are cardiovascular and respiratory changes?
CO up 40%
plasma volume up 40-50%
decreased blood pressure
o2 consumption up 15-20%
151
changes in endocrine and immune
WBC increases.
increased pigmentation linea nigra
more need for glucose
152
HIV/ AIDS CD4 numbers?
>500 for intercourse
< 1000 vaginal delivery
153
Chlamydia
gray- white discharge
bacteria most common sti
premature rupture of membranes
Do not take doxycycline while pregnant
154
Gonorrhea
Bacteria
yellow- green discharge
bleeding
untreated leads to infertility
neonate sepsis
always treat for chlamydia as well
155
Trichomoniasis
parasite
yellow- green frothy odorous discharge
Avoid alcohol gives N/V disulfiram like symptoms.
metronidazole not during 1st trimester
156
Syphilis
Bacterial infection
3 stages
painless lesion
flu like symptoms, rash on hands, feet.
damage to internal organs, neuro, blindness
stillborn
reportable disease
157
HSV Herpes simplex Virus
Viral
non curable
risk for active lesions
HSV1/2
HSV1 oral can go south
HSV2 genital
158
HPV
non curable
genital warts
can grow and obstruct vaginal canula
159
Bacterial vaginosis
bacteria infection not STI
thin, white or gray discharge with fish like odor
160
Nulli
none
161
Primi
first
162
multi
2 or more
163
What is the goal for prenatal care?
To collect data (family history, medication, weight nutrition status)
self care education for mother for certain discomforts
promoting safe pregnancy outcomes
fostering positive feelings
164
True or false since the start of prenatal care mortality has gone up?
False it has gone down since this care has started.
165
True or false is it common to experience a feeling of dread and ambivalence?
True this is common and totally normal during the first trimester.
Life is totally changing.
166
Days when talking about trimesters not just week.
14 weeks 6 days
how ever many days till the next week.
167
How often should you have a prenatal visit during pregnancy?
every 4 weeks during first.
every 4 weeks during second
every 2 weeks during third after the 36th week it is weekly.
168
When is the initial visit? What is done during that visit?
Within the first 12 weeks.
History gathering starting to think of birthing plan with supports. EDD,
Lab tests to determine blood type, rh status.
testing for STI or TORCH is done at this time along with CBC and nutritional intake with starting weight.
169
what is Rh incompatibility?
This is a protein that is on the blood.
If mother doesn't have it the baby still can creating an antibody if blood is mixed A-, vs A+.
Looking at the protein on the cell not the type.
170
How many times should the mom be tested for Rh?
Initial
follow up later
before birth
171
What needs to happen if the mother is Rh-?
They will need to take immunoglobulin for Rho
172
True or false women are more likely to stop or leave a dangerous situation more when pregnant?
True. 1/4 have experienced IPV
more common in unintentional pregnancies
Will be more willing to listen and leave a violent situation.
173
What is GBS and when is it tested?
Group B strep.
Most have this on skin needing to be tested 35-37 weeks
174
What is checked each additional visit?
Wt, BP, birth plan, fundal height (pubic bone to top of uterus)
Education for self care.
Monitor FHR
175
What would you do to check the position of the fetus?
Leopold maneuvers
Top
Side
Bottom side
176
What are some common tests during pregnancy?
Pap smear- sti infections
CBC - anemia watch growth of additional cells
GBS - vaginal anal swab for group b strep.
Rh - looking for antibodies for proteins on Rbc
Anatomy us. - looks for growth and development
1hr gtt - hour test checking for diabetes.
Rubella titer
Maternal serum (alpha fetoprotein)
177
At what weeks do you get certain tests?
Anatomy US - 20 weeks
Maternal serum - 15-20 weeks
1hr gtt- 24-28 weeks
GBS - 36-38 weeks
Rh- initial and 24-28 weeks
Pap- initial and if expected
CBC- each visit
178
What immunization should a pregnant woman get?
Tdap- 27-36 weeks
179
What can the anatomy us be used to check for?
Checks for all fingers and toes.
Possibly of cleft lip/ palate.
Can check nuchal region for Down syndrome
Gender
180
What can alpha fetoprotein be used for?
Checks for high risk chromosomal disorders.
181
When does the fetus start to move
Around 20 weeks
182
Does everyone get the 3 hr GTT?
No only if they were positive and elevated for the 1 hr
183
Main things for each trimesters
1st comfort labs and lifestyle with adaptation to change
2nd posture birth plan possible complications
3rd birth prep
184
What are the benefits for breastfeeding?
Mom: helps loose weight that was gained
Lower rates of HTN, DM2
Lower rates of breast and ovarian cancer
Releases oxytocin contracting uterus decreasing bleeding post birth.
Baby: high in fat sugar minerals
Easier to digest less GI problems
Has antibodies to protect from diarrhea, ear infections
Lower risk of SIDS (sudden infant death syndrome)
If preterm helps against many issues
185
How many extra calories do you you need for each phase?
340cal/day 2nd tri
452cal/day 3rd tri
450-500cal/day while breastfeeding
186
What is rich in folic acid?
Dried peas
Beans
Leafy vegetables
Seeds
Fortified oj/ cereals
187
Why do they need an increase in iron?
Because of the increase in RBC to avoid anemia
188
What is the recommended folic acid intake?
400mcg/0.4mg if of child bearing age
600mcg/0.6mg once pregnant
If high risk 3-5mg
189
How much weight is healthy to gain?
Total 25-35 lbs
1-2 kg 1st tri
0.5kg weekly 2nd tri on
190
What helps iron to be absorbed
Vit C
191
What is the limit for caffeine?
200mg a day
192
Why don’t you exceed the caffeine limit?
Spontaneous abortion
Intra uterine growth restriction
193
How to help against nausea and vomiting?
Small meals
Toast or crackers before getting out of bed
Avoid greasy, spicy, gas forming foods
194
How to help against breast tenderness?
Wear a properly fitted supportive bra
195
How to help against urinary frequency?
Decrease fluids before going to bed.
Kegal exercise to help with stress incontinence (cough or sneeze)
196
How to help against UTI?
Urinate as soon as possible don’t hold
Urinate after intercourse
Wipe front to back
197
What to do for fatigue?
Encourage resting and naps
198
How to help against heartburn?
Don’t lie down right after eating
Keep something in the stomach
Don’t eat too much or too little
199
How to help constipation?
Encourage fiber fluids and exercise
200
How to help hemorrhoids?
Sitz bath with ointment helps
201
How to help backache?
Pelvic tilt exercises help
Proper body mechanics when moving and lifting
202
How to help SOB?
Use good body positions
Use extra pillows while sleeping.
203
How to help against leg cramps?
Use a warm pad while leg extended at rest will help
204
How to help against varicose veins?
Compression socks
Avoid too tight of clothing.
205
What to do for gingivitis and epistaxis?
Soft bristle brush
Humidifier
206
What to do for Braxton Hicks contractions?
If Braxton hicks they should go down during movement.
207
What to do for supine hypotension?
Side lying position or having knees slightly bent.
208
What are issues that can be seen in patients?
Bleeding
Extreme vomiting
Burning while urinating
Cramping while first tri
209
What are the 3 kinds of ultrasound?
External abdominal
Transvaginal
Doppler
210
Advantages of transvaginal ultrasound?
Don’t need to have a full bladder
Useful for obese patients
211
External abdominal ultrasound requirements
Needs to have a full bladder
212
Abdominal ultrasound risks?
No know. Risks to mother or baby
213
BPP
Biophysical profile
Can determine if there is a risk to the fetus do to low perfusion.
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What are the two parts combined for a BPP
Fetal heart rate monitoring and fetal ultrasound.
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BPP responds to what?
Stimuli other than stress
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What are the 5 categories in a BPP?
FHR
Fetal breathing movements
Gross body movements
Fetal tone
Qualitative amniotic fluid volume.
Total of 10 points.
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Non stress test
Watches for fetal movement at the same time of watching FHR
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What happens if there is not enough movement during the NST
A stress test will need to be done if there is not to increases in heart rate in 20 mins
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Two types of contraction stress tests?
Nipple stimulated
Oxytocin stimulated
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What are some tests that are taken using samples to asses fetal well being?
amniocentesis
percutaneous umbilical sampling
villus sampling
MSAFP
Quad marker screening
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What is amniocentesis?
It is a test aspirating amniotic fluid for birth defects
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What is umbilical sampling?
A blood test that takes from umbilical cord
Used for fetal blood sampling
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Chorionic villus sampling
1st trimester alternative to amniocentesis
From the placenta instead of amniotic sac
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MSAFP
Maternal serum alpha-fetoprotein
Standard testing for screening for neural tube defects
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What does the quad marker test for?
Alpha-fetoprotein, hCG, inhibin A, estriol
