- often unexplained - increased estrogen, progesterone, and hCG - elevated body temp - psychologic response to pregnancy - physical adaptations

Test 1 Blueprint (3) Flashcards by Rachel Mason

What causes morning sickness?

often unknown
hormonal changes, possibly hCG
emotions

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What causes fatigue?

often unexplained
increased estrogen, progesterone, and hCG
elevated body temp
psychologic response to pregnancy
physical adaptations

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What causes urinary frequency?

1) vascular enlargement and altered bladder function from hormones
2) pressure on bladder from enlarged uterus

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What causes pyrosis (heartburn)?

progesterone slows GI tract motility and digestion, reverse peristalsis, relaxes cardiac sphincter, enlarged uterus presses upward on stomach

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What causes hemorrhoids and varicosities?

hereditary

pressure from enlarged uterus, gravity, and bearing down

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What causes backache?

lumbar lordosis, change in center of gravity, relaxation of symphyseal and sacroiliac joints from hormones (relaxin)

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What causes insomnia?

fetal movements
muscle cramping
urinary frequency
SOB

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What causes leg cramps?

Compression of nerves to lower extremities b/c of enlarging uterus
Too little calcium, too much phosphorus
Fatigue, poor peripheral circulation, pointing toes
Drinking too much milk

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What causes supine hypotensive syndrome?

uterus pressing on vena cava when woman supine, decreasing perfusion to uterus and placenta, baby can become hypoxic

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Other pregnancy discomforts:

vaginal discharge
skin changes
nasal stuffiness

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What signs/symptoms should be reported to doctor immediately?

UTI
PIH
Preeclampsia

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What can result from frequent UTI’s?

preterm labor

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What do UTI’s include?

asymptomatic bacteriuria
cystitis
pyelonephritis

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Asymptomatic bacteriuria is diagnosed when:

10,000 organisms/mL

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All women screened for asymptomatic bacteriuria when?

first prenatal visit

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What problems are associated with asymptomatic bacteriuria?

preterm labor

low birth weight

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What is a bladder infection called?

cystitis

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S/S of cystitis:

dysuria
urgency/frequency
lower abdominal/suprapubic pain
Pathogens in urine
hematuria

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What is a kidney infection called?

pyelonephritis

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What is the leading cause of septic shock during pregnancy?

pyelonephritis

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Complications of pyelonephritis?

anemia
septicemia
transient renal dysfunction
pulmonary insufficiency

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What can pyelonephritis cause?

fetal death
intrauterine growth restriction
preterm labor

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S/S of pyelonephritis?

abrupt fever
shaking
chills
aching of lumbar area/costovertebral angels tender 
anorexia
N/V

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Pregnancy induced hypertension (PIH) is a precursor to ____.

preeclampsia

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PIH can lead to:

- preeclampsia - stroke - acute kidney injury - heart failure - placental abruption - death

Fetal risks associated with PIH:

IUGR death preterm labor

S/S of PIH:

visual disturbances periorbital edema fluid volume deficit

Who is more at risk for preeclampsia?

pregnant women with PIH

What occurs with the liver in preeclampsia?

HIGH liver enzymes

What med is given to women with PIH or preeclampsia?

Magnesium sulfate

What is the purpose of mag sulfate?

prevent seizures

HELLP syndrome is:

H: hemolysis EL: elevated liver enzymes LP: low platelets

What are the 5 cardinal signs of preeclampsia?

1) proteinuria 2) edema 3) HTN 4) HA, dizziness 5) blurred vision

Signs of ECCLAMPSIA:

``` persistent HA blurred vision severe epigastric pain (RUQ) altered mental status seizures ```

Amniotic fluid is slightly ____ (pH).

alkaline

What color does amniotic fluid turn litmus (nitrazine) paper?

blue

What is ballottement? What type of pregnancy sign is it?

gentle tapping on cervix, fetus bounces away then back | PROBABLE sign

What is the first recognition of fetal movements called? When does it occur?

quickening | 16-20 wks (14-16 wks for multips)

What is a concern when the membranes rupture?

umbilical cord prolapse | cuts off baby's blood and oxygen

What is the purpose of the mucus plug?

prevent bacteria from entering the uterus

Why is measuring fundal height important?

assesses fetal well being and determines age

When the fundal height is stable or decreased, this could indicate...

intrauterine growth restriction (IUGR)

Excessive increase in fundal height could indicate...

polyhydramnios | multifetal gestation

What lab values are important to know in pregnancy:

``` Hct Hgb Rh Rubella RPR and VDRL (syphilis) 1 hr and 3 hr glucose tolerance Urinalysis ```

What lab values indicate anemia?

Hgb less than 10 g/dL | Hct less than 30%

What does ABO typing test for? Rh typing?

``` ABO = blood type (A,B,AB,O) Rh = antigen (-,+) ```

If the rubella titer is negative it will read as ____. What does this mean?

lower than 1:10 dil | means susceptible to rubella

When can a pregnant woman get the rubella vaccine?

Never! Wait until postpartum.

If canker sore is present, test for syphilis with which tests?

RPR or VDRL

When must the mother be treated to avoid spreading syphilis to the fetus?

by 18-20 weeks

All women take which glucose tolerance test? When?

1 hour | 24-28 wks gestation

Who must take a 3 hr glucose tolerance test?

At risk pts | If failed 1 hr

Glycosuria is ___ in the urine.

sugar

What causes glycosuria?

decreased renal threshhold

What may glycosuria indicate?

diabetes

What can proteinuria be a sign of?

infection or preeclampsia

Proteinuria is seen with a value of:

2+ to 4+ on dipstick

Ketonuria may result from insufficient ____ intake or ____.

food | vomiting

WBCs in urine may indicate ____.

infection

What are Braxton Hicks contractions?

irregular uterine contractions no cervical change - increases blood flow to uterus - strengthens muscles for birth process

Education for Braxton Hicks contractions:

drink water to help with BP and amount of amniotic fluid

BMI: underweight | mom needs to gain:

- gain in entire 1st Tri: 2.2-4.4 lb - gain in 2nd, 3rd Tri: 1-1.3 lbs/wk - total during pregnancy: 28-40 lbs

BMI: normal | mom needs to gain:

- gain in entire 1st Tri: 2.2-4.4 lbs - gain in 2nd, 3rd Tri: 0.8-1 lb/wk - total during pregnancy: 25-35 lb

BMI: overweight | mom needs to gain:

- gain in entire 1st Tri: 1.1-4.4 lbs - gain in 2nd, 3rd Tri: 0.5-0.7 lbs/wk - total during pregnancy: 15-25 lb

BMI: obese | mom needs to gain:

- gain in 1st Tri: 1.1-4.4 lbs - gain in 2nd, 3rd Tri: 0.4-0.6 lb/wk - total during pregnancy: 11-20 lb

How to determine EDC using Naegles Rule:

subtract 3 months from FIRST DAY OF LAST PERIOD | add 7 days

Agents that cause birth defects are called:

teratogens

During the first 2 weeks of development the embryo is not usually susceptible to ____.

teratogens

Teratogens in 3-8 weeks can result in:

major congenital anomalies

Teratogens in 9-38 weeks can result in:

functional defects and minor anomalies

Severity of exposure to teratogens related to:

1) timing of exposure 2) different susceptibility or organ system 3) strength of teratogen

What areas are the most vulnerable to malformation upon teratogen exposure?

developing areas with rapid cell division

Caffeine can cause:

heart dysrhythmias

Drug use can cause:

birth defects SROM vaginal bleeding

How far before pregancy should rubella vaccine be given?

at least 3 months prior

Why should pregnant women avoid changing the litter box?

risk of toxoplasmosis

How should a pregnant woman lay to increase venous flow?

on her side

How may a pregnant woman have pseudoanemia?

increase in vascular anemia --> increase in RBCs --> hemodilution --> Hgb & Hct levels decrease --> pseudoanemia of pregnancy

Education for diaphragm use:

- insert into vagina up to 6 hours before sex - use with spermicidal jelly/cream - leave in place 6-8 hours after sex - increases risk of UTI - may need new size if weight fluctuates - does not prevent STD - must be washed with mild soap and water, dried, kept away from heat

What nutritional concerns with vegetarian pregnant woman?

- risk for B12 deficiency; need supplement - sources of B12: milk, eggs, meat (liver) - Deficient B12 may result in neurologic deficits: maternal-infant megaloblastic anemia; infant-neuron-development delays

Fetus viable at ___ weeks, ___ g.

20 wks | 500 grams

Test 1 Blueprint (3) Flashcards

(81 cards)