Quiz Biz Flashcards
(33 cards)
What are three tools used for mental health status in pregnancy and pp?
History taking: At intake - Personal and family history;
Antenatal Psychosocial Health Assessment (ALPHA)
Edinborough Postnatal Depression Tool. 27-32 weeks, at any time, and in the postpartum
List the names of complimentary treatments that there is evidence to support in the treatment of the nausea and vomiting in pregnancy.
Vit B6
Accupuncture/ Accupressure
Ginger
Mindfullness
3 ways to determine EDD?
Ultrasound (dating)
Known date of conception (IVF, or insemination, etc)
Naegel’s Rule
List the diagnostic and screening options that should be offered to all persons for routine prenatal care in the FIRST trimester (8).
CBC - To screen for aneamia, bleeding disorders, and other abnormalities - to treat or refer
Urinalysis and specimen for C&S - screen for abnormalities, and urinary tract infection. - to treat or refer.
*
Chlamydia and gonorrhea Nucleic Acid Amplification Test (urine, cervical or vaginal self-collection if avail.) - screen for STI’s that can be treated.
- HBsAg, STS/RPR, Rubella titre - to treat, refer, or advise for management.
HIV as optional and recommended - to treat person and decrease transmission rates to newborn
- Blood ABO Group, Rh factor, and antibody screen - screening for Rh status
First trimester US for dating between 8 - 13 weeks. Confirm dates,
Prenatal Genetic Screening - to offer choices around pregnancy management or termination.
Reccomended dose of folic acid?
400 micrograms
Uterine blood flow what percentage of cardiac output?
20%
Glomerular filtration rate in pregnancy?
Increases
Gut motility in pregnancy?
Decreases
Water reabsorbtion in pregnancy?
Increases
Kidney size in preganancy ?
Increases
What is station?
The relationship of the leading edge of the presenting part from the plane of the ischial spines.
Define fetal heart rate accelerations by intermittent auscultation defined at term?
An audible increase in the fetal heart rate from the baseline rate.
Order of PA of pregnant ab later in preg?
inspection, palpation, auscultation, no percussion
Acrocyanosis in the 12 hour old infant is?
Normal
Erythema toxicum neonatorum is?
A benign rash
Ideal collection time of newborn screen?
24-48 hours
What are mechanisms of newborn heat loss?
Convection. This is the loss of heat from the newborn’s skin to the surrounding air. Newborns lose a lot of heat by convection when exposed to cold air or draughts.
Conduction. This is the loss of heat when the newborn lies on a cold surface. Newborns lose heat by conduction when placed naked on a cold table, weighing scale or are wrapped in a cold blanket or towel.
Evaporation. This is the loss of heat from a newborn’s wet skin to the surrounding air. Newborns lose heat by evaporation after delivery or after a bath. Even a newborn in a wet nappy can lose heat by evaporation.
Radiation. This is the loss of heat from a newborn’s skin to distant cold objects, such as a cold window or wall etc.
Is a soft systolic murmer normal on a nb?
Yes
What can you do to facilitate nb transition?
- dry newborn and toss wet towels aside
- place newborn directly skin to skin with parent
- cover newborn with a warm, dry blanket
- gently stimulate the newborn’s back or feet
Fetal heart adaptations (5)?
2 Umbilical arteries take deoxygenated blood to the Placenta. at the villi level where gas and nutrients/ waste are exchanged
1 Umbilical Vein takes oxygen right blood back to the fetus
diverted through the **Ductus Venosus **
to the Inferior Vena Cava
into the right atrium -
some of which is diverted through Foramen Ovale
and the rest of the O2 rich blood makes it into the right ventricle, then pulmonary artery, and is shunted through ductus arteriosis to aorta. ,
The aorta circulates it through the body, to the umbilical arteries.
Cap refill of nb measured where and how long?
Chest or forehead
For 45 seconds refil in less than 3 seconds
10 events of with first breath/loss of placenta?
First breath fills alveoli - pushes out lung fluid and increased PO2
Rising PO2 dilates pulmonary vessels
Dilated pulmonary vessels lead to decrease pulmonary vascular resistance (PVR)
Decrease PVR lowers pressure on right side of heart (R.A.)
Meanwhile loss of placenta
increases systemic vascular resistance (SVR)
Removes the placental prostaglandins and prostacyclin
The increase in SVR raises the pressure in the Left Atrium, pushing the Foramen Ovale flap against the septum, closing the foramen ovale and stopping the right to left shunt.
The higher PO2 and the falling PGE2 cause constriction of the ductus arteriosis over 2-3 days.
No more blood enters the body from the placenta, and the drop of PGE2 also causes constriction of the ductus venosus which is not longer needed.
With the shift from lung bypass, the left side of the heart becomes hypertrophied
The deoxygenated blood now enters the right atrium, then right ventricle, through the pulmonary artery to the lungs, returning fully saturated with oxygen via the pulmonary vein, to the left atrium, to the left ventricle and then out to the body via the Aorta.
What must be maintained in the healthy nb (4)?
1) Temperature
2) Heart rate
3) Respirations
4) Perfusion
What is latent phase of third stage?
after birth of baby myometrium continues to contract and retract, causing it to thicken
