Prenatal Flashcards
Other Definitions/ Concepts (125 cards)
1
Q
Polyhydraminos
A
Excess amniotic fluid, AFI greater than 24
2
Q
Poly is associated with
A
-multiple gestation
-RH incompatibility
-maternal diabetes
-hydrocephaly
- anencephaly
- Spina bifida
3
Q
Oligohydraminos
A
Reduced amniotic fluid, AFI less than 5
4
Q
Oligohydraminos is associated with
A
SGA, IUGR, Postdatism
5
Q
Oligohydraminos increased risk for:
A
- fetal mortality due to IUGR
- postmaturity syndrome
- congenital anomalies
- cord compression
- fetal distress in labor
6
Q
Herbs contraindicated during pg
A
- blue cohosh
- goldenseal
-cotton root bark - Edhedra
-Pennyroyal - Birthroot
7
Q
Greatest risk for breech
A
CPD or cephalopelvic disproportion
8
Q
Risks associated with breech
A
CPD (fetal hypoxia) and cord prolapse
9
Q
Predisposing factors for breech presentation
A
Previous breech
Prematurity
Multiple gestation
Multiparity with lax uterine tone
Polu, oligo
Placenta previa
Large fibroids low in uterus
Hydrocephaly
10
Q
Preterm
A
born before 34 weeks
11
Q
Greatest risk for preterm babies
A
neonatal mortality
12
Q
Risk factors for preterm
A
Parent born premature, short cervix, Poor: nutrition, hydration, BMI, weight gain, Substance use, multiples, PROM, Chorioamnities, UTI, Chlamydia, Periodontal infections
13
Q
Newborn fetal lungs are almost always mature by
A
34 weeks
14
Q
Bleeding in 1st tri
A
placenta, miscarriage, ectopic preg (with pain)
15
Q
Bleeding in 2nd tri
A
placenta abruption/ previa, fetal demise
16
Q
Bleeding in 3rd tri
A
Placenta abruption/ previa, uterine rupture. Never do a vaginal exam
17
Q
DIC or Disseminated intravascular coagulation is
A
a disorder from retained products of conception
18
Q
DIC risk increases with
A
longer the mother has been pg and the longer the fetus has been retained
19
Q
Ectopic pg is associated with
A
vaginal spotting (brown or red) or bleeding, abdominal pain
20
Q
Ectopic pg increased risk with
A
uterine scaring, STIs, infection
21
Q
Rupture of ectopic pg is high around?
A
8-10 weeks
22
Q
Hydatidiform mole associated with
A
Light brown bleeding lasting weeks or months, Large for dates, Woody or doughy uterus, High HCG levels
23
Q
Placenta abruption
A
premature separation of placenta
24
Q
Concealed placenta abruption
A
central portion separates/bleeding is not evident, acute abdominal pain
25
Placenta abruption is associated with
hypertension, physical trauma, cord entanglement, unknown (often)
26
Marginal placenta abruption
edges separated cause bleeding
27
Complete placenta abruption
total separation of the placenta
28
If you suspect a placenta abruption you should
administer oxygen, treat for shock and transport immediately
29
Placenta previa is
Placenta implanted low in the uterus
30
A sign of placenta previa
Painless bleeding in 3rd tri
31
What types of placenta previa
Complete, partial, marginal, low lying
32
Placenta previa is associated with
uterine surgeries, uterine scaring, endometritis, previous pregnancy, multiparity, short interval pgs
33
GDM risk factors
family hx, marked obesity, age over 35, previous delivery of baby more than 9 pounds
34
With GDM babies might have
respiratory issues (production of surfactant in the lungs can be interrupted by increased levels of insulin), hypoglycemia, and hypocalcemia
35
GDM has increased risk of
pre-e, poly, pph
36
What to avoid with High BP
Avoid mustard, black pepper, ginger, nutmeg
37
What foods could help with BP
Watermelon, cucumber, parsley, onion, garlic, salting food to taste
38
Helpful herbs for BP
hops, skullcap, passionflower, hawthorn, chamomile
39
What supplements, etc is helpful with BP
acupuncture , magnesium, calcium, and potassium are helpful
40
Early signs of pre-e
Hemoconcentration, hypertension, generalized edema, sudden and excessive wt gain, protein in urine
41
What are signs of worsening pre-e
Severe headache, epigastric pain, visual disturbances, decreased output of urine, extreme nervous irritability, decrease in fetal movement signs
42
BV s/s
Fishy odor, thin gray, or white discharge in vagina, positive whiff test, clue cells
43
If untreated BV can lead to
chorioamnionitis, PROM, preterm labor, PP endometriosis, Higher risk getting a STI
44
What treats with BV
Metronidazole (Ok if BF) or clindamycin
45
Yeast symptoms
Itching, burning, irritation, redness, swelling, increased discharge
46
Follicular phase
Day 1-5 menstrual, low estrogen and progesterone, produce an ovum for fertilization
47
Ovulation
Day 14 proliferative, high estrogen and growing levels of progesterone. FSH and LH peak
48
Luteal phase
Day 15-26 secretory. Implantation phase. Progesterone dominant
49
Obstetrical conjugate
From sacral promontory to inner pubic bone
Actual inlet diameter baby negotiates
50
Diagonal Conjugate
From sacral promontory to outside of vagina
51
Interspinous diameter
Distance between ischial spines measures by spreading pointer and middle fingers apart to reach each ischial spine
52
Intertuberous diameter
Outlet dimension measured by placing fist near introitus
53
TORCH
Toxoplasmosis, Other, Rubella, Cytomegalovirus, Herpes
54
Fetal Postmaturity Syndrome
Maternal malnutrition and dehydration after 42 weeks lead to decreased blood volume and oligohydramnios
55
Preterm Labor
Hydration, fish oil, excellent diet, decrease stress, increase PNV to every 2 wks at 24 wga
56
Ultrasound examination shows a woman has a partial placenta previa. The midwife should:
Refer the client for a higher level of care
57
What should be included in a client's 'social hx'?
-Substance abuse
-Diet and exercise
- support and safety
58
Urinalysis can help screen for
Food insecurity (or hunger)
59
Which of the following would you need the client/pt to agree to in order to share a photo or image of them or their family?
Authorization to release protected health information
60
Most UTIs are caused by
bacteria from the digestive system that travel from the rectum to the urethra
61
A client entering care reports a BMI of 34. What is the recommended total weight gain for this client during pg?
11-20 lbs
62
The midwife is performing a physical exam on a client. She notes +2 deep tendon reflexes on the chart. what might this indicate?
The midwife was able to elicit deep tendon reflexes in 2 areas that were assessed
63
Why is it important to take a social hx' of a new pg ct?
A client with low SES may need additional support in pp
64
when taking a family medical hx', which of the following is the most important to the client's health in pg
Hypothyroidism in sibling
65
A 41 year old client is seen for her first prenatal visit at 10 weeks gestational age. She expressed concern that her fetus may have Down syndrome. What is the most appropriate initial Down syndrome screening to offer in the first trimester?
US and Pregnancy-associated plasma protein-A (PAPP-A) and human chorionic gonadotropin (HCG) testing
66
What is the LEAST reliable way to diagnose gestational diabetes?
Fetoscope
67
You have a mother who has a breech presentation at 32 weeks, you suggest
Laying on an ironing board inversion for 15 minutes twice per day
68
What is the most common cause of a false positive Alphafetoprotein test?
Underestimated fetal age
69
CT with vulvar varicosity what should your recommendations be?
Educate her on the anatomical reasons and normalcy in pg. Suggest support hoses with a perineal pad and foods rich in vitamins A, C, E, and B complex
70
Epistaxis
Nosebleeds
71
you receive an ultrasound report for a client that was measuring 36 cm at 31 weeks and had trace proteinuria. The report shows that there is a single intrauterine pg in the cephalic presentation with an average ultrasound age of 32 weeks and 1 day. All fetal structures are present and WNL. The placenta is posterior and grade 1. The amniotic fluid index is 21.5 cm. Fetal movement is seen. Fetal heart rate 148 beats per minute. what is your dx based on these results?
Polyhydraminos
72
Which is not considered a fat?
Polysaccharide
73
Which person is a better candidate for a vaginal birth after c-section?
a woman with one prior C-section for a breech presentation, double, layer closure (low transverse)
74
ABO incompatibility usually occurs when the mom has which of the following blood types?
O
75
You see a new client who is 9 wga. when discussing prior contraception use, she states that she had an IUD. Which of the following is the most important question to ask as follow-up?
Was the IUD removed before conception
76
If your client states she has noticed pruritis on her extremities but there eis not a rash present, which condition should you monitor for?
Intrahepatic Cholestasis of Pregnancy
77
Testing for Intrahepatic Cholestasis of pregnancy
-liver enzyme check
-liver panel
-ALT Alanine amniotransferase
78
When is it most common for a multiple to feel first kicks
16-18 weeks
79
Which is the following would be the most severe reason to deny a home birth to a client?
Type I Diabetes + Extreme obesity
80
Your CT is 12 wga. She reports having a hx' of PID and is currently experiencing severe abdominal pain and bleeding. Which condition should you suspect?
Tubal Pg
81
Someone with hyperthyroidsim would exhibit which symptoms?
Anxiety, fatigue, intolerance to heat, weight loss
82
Someone with hypothyroidsim would exhibit which symptoms?
Depression, fatigue, weight gain, intolerance to cold
83
At 10 weeks the uterus is the size of what?
large orange
84
When performing pelvimetry, you are assessing the depth of the sacral curve, you notice that you are able to feel the entire curve. This would indicate that your client might have which pelvis type?
Platypelloid
85
To assess the size of the pelvic inlet during pelvimetry, you would measure which valve?
Obstetrical conjugate
86
A client who is 14 wga complains of brown bleeding that has persisted for weeks and feeling incredibly nauseous. You bring her in for assessment and find her uterus to be measuring 19 cm and hard to the touch. you suspect which condition?
Molar pg
87
Fetal condition you would suspect if a client has oligohydraminos
Absent kidneys
88
A pp client states having sore nipples and her baby has diaper rash. what natural treatments would you recommend for both conditions
Applying breast milk to the nipples and exposing them to air (vitamin e); aloe vera on baby's bottom (zinc oxide)
89
A client had a BP of 144/90 at her initial visit. At her next visit 4 weeks later her BP was 142/94. Which type of hypertension does this client have
Essential hypertension
90
Your client is 32 wga. at her visit her BP was 140/94 and she had no proteinuria or visual disturbances. what would you suspect this client has?
Gestational hypertension
91
What values are taken with when assessing a score for a BPP
fetal breathing movements, fetal tone, amniotic fluid index, fhr
92
When doing a physical exam, you want to elicit Homan's sign to check for?
Blood clots
93
Why would you check for Clonus at an interview visits?
neurological issues
94
Acidophilus is a natural treatment for
candidiasis
95
You have made an appointment for an initial exam with a new client who is 9 wga. one week before the schedules appointment, your client calls and tells you she had some brown spotting yesterday and today the blood is bright red. she also complains of abdominal cramping similar to menstrual cramps. you recommend that she come to the clinic for a cervical exam as you suspect she is experiencing
inevitable abortion
96
If the NIPT is positive, what is the next step
CVS
97
Mean corpuscular volume
average size of rbcs
98
to text for hyperreflexia, you will perform which maneuver
clonus
99
what landmarks is used for pelvimetry
sacral promontory
100
when is a AFP done
15-20 weeks
101
NT ultrasound is done
10-14 weeks
102
Mother typically feels first kick around
20 wga
103
Which of the following women is MOST likely to have a contraindication to home birth?
A woman with a history of cigarette use in the past year
104
A woman with an LMP of 01/20/2017 is in for a routine prenatal visit on May 10. 2017. Her fundal height is measuring at her umbilicus. What is the midwife's assessment?
She is measuring large for dates
105
When performing a physical exam, a woman does not have a patellar reflex. Which of the following could this indicate?
Neurological issues
106
Which of the following pelvimetry measurements can be obtained using the ischial spines?
Transverse diameter
107
A woman in your practice has a BP of 140/89 taken after 5 minutes in the office. She states that she feels "anxious" about her BP. what is the appropriate response?
You documented the first result, lay her on the left side and then take it again after she calms down
108
A woman states in her GYN history that she had a cone biopsy procedure five years ago, which was normal. Which of the normal following interventions should you prepare her for during pg and labor
scar tissue on her cervix that may respond to EPO
109
Which of the following measurements do you measure from the external position?
Bi-tuberous diamater
110
A pg CT at 28 wga complains of backache, especially at night. The midwife teaches which of the following exercises to relieve the discomfort?
Pelvic rocking
111
A client at 28 wga complains of back pain. the client's urinalysis reveals normal findings. Which of the following instructions from the midwife would be the least effective at alleviating the client's back pain
walk with the pelvis tilted backward
112
A client comes to the clinic for her first prenatal examination. the midwife determines that the client is in her 12th week of pregnancy. which of the following does the midwife NOT expect to find at this time?
Ballotment
113
What is a major cause of glucosuria in pg
the decreased reabsorption of glucose by the kidneys
114
What is the least reliable way to diagnose gestational diabetes
urinalysis test strips
115
if a woman has had heavy bleeding for the 3 cycles prior to conception, which of the following is she at increased risk for in pg
anemia
116
At which of the following times would it be appropriate to administer prophylactic Rhogam?
28 weeks after a negative antibody screen
117
when you are doing a speculum exam, you see a smooth, shiny, round globe on the cervix, this is most likely
cervical polyp
118
when you are doing a speculum exam you notice a raised bump of cauliflower texture. what is your assessment?
HPV condalamata
119
what is the most important information from a vaginal exam to dx preterm labor
cervical dilation
120
What is the best predictor of pre-e
high HCT/HGB at the 28 week visit
121
You have a mother who has a breech presentation at 32 weeks, you suggest
laying on an ironing board inversion for 15 minutes twice per day
122
which is true about preterm labor
approximately 50% of time it happens without risk factors
123
All of the following are normal sexual changes in pg except
vaginal dryness in the 3rd trimester
124
Which of the following is the most common reason for elevated systolic BP in pregnancy?
Stress
125
