Test 1 Blueprint (3) Flashcards Preview

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Flashcards in Test 1 Blueprint (3) Deck (81):
1

What causes morning sickness?

- often unknown
- hormonal changes, possibly hCG
- emotions

2

What causes fatigue?

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

3

What causes urinary frequency?

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

4

What causes pyrosis (heartburn)?

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

5

What causes hemorrhoids and varicosities?

hereditary
pressure from enlarged uterus, gravity, and bearing down

6

What causes backache?

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

7

What causes insomnia?

fetal movements
muscle cramping
urinary frequency
SOB

8

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

9

What causes supine hypotensive syndrome?

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

10

Other pregnancy discomforts:

vaginal discharge
skin changes
nasal stuffiness

11

What signs/symptoms should be reported to doctor immediately?

UTI
PIH
Preeclampsia

12

What can result from frequent UTI's?

preterm labor

13

What do UTI's include?

- asymptomatic bacteriuria
- cystitis
- pyelonephritis

14

Asymptomatic bacteriuria is diagnosed when:

10,000 organisms/mL

15

All women screened for asymptomatic bacteriuria when?

first prenatal visit

16

What problems are associated with asymptomatic bacteriuria?

preterm labor
low birth weight

17

What is a bladder infection called?

cystitis

18

S/S of cystitis:

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

19

What is a kidney infection called?

pyelonephritis

20

What is the leading cause of septic shock during pregnancy?

pyelonephritis

21

Complications of pyelonephritis?

anemia
septicemia
transient renal dysfunction
pulmonary insufficiency

22

What can pyelonephritis cause?

fetal death
intrauterine growth restriction
preterm labor

23

S/S of pyelonephritis?

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

24

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

preeclampsia

25

PIH can lead to:

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

26

Fetal risks associated with PIH:

IUGR
death
preterm labor

27

S/S of PIH:

visual disturbances
periorbital edema
fluid volume deficit

28

Who is more at risk for preeclampsia?

pregnant women with PIH

29

What occurs with the liver in preeclampsia?

HIGH liver enzymes

30

What med is given to women with PIH or preeclampsia?

Magnesium sulfate

31

What is the purpose of mag sulfate?

prevent seizures

32

HELLP syndrome is:

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

33

What are the 5 cardinal signs of preeclampsia?

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

34

Signs of ECCLAMPSIA:

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

35

Amniotic fluid is slightly ____ (pH).

alkaline

36

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

blue

37

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

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

38

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

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

39

What is a concern when the membranes rupture?

umbilical cord prolapse
cuts off baby's blood and oxygen

40

What is the purpose of the mucus plug?

prevent bacteria from entering the uterus

41

Why is measuring fundal height important?

assesses fetal well being and determines age

42

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

intrauterine growth restriction (IUGR)

43

Excessive increase in fundal height could indicate...

polyhydramnios
multifetal gestation

44

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

45

What lab values indicate anemia?

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

46

What does ABO typing test for? Rh typing?

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

47

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

lower than 1:10 dil
means susceptible to rubella

48

When can a pregnant woman get the rubella vaccine?

Never! Wait until postpartum.

49

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

RPR or VDRL

50

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

by 18-20 weeks

51

All women take which glucose tolerance test? When?

1 hour
24-28 wks gestation

52

Who must take a 3 hr glucose tolerance test?

At risk pts
If failed 1 hr

53

Glycosuria is ___ in the urine.

sugar

54

What causes glycosuria?

decreased renal threshhold

55

What may glycosuria indicate?

diabetes

56

What can proteinuria be a sign of?

infection or preeclampsia

57

Proteinuria is seen with a value of:

2+ to 4+ on dipstick

58

Ketonuria may result from insufficient ____ intake or ____.

food
vomiting

59

WBCs in urine may indicate ____.

infection

60

What are Braxton Hicks contractions?

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

61

Education for Braxton Hicks contractions:

drink water to help with BP and amount of amniotic fluid

62

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

63

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

64

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

65

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

66

How to determine EDC using Naegles Rule:

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

67

Agents that cause birth defects are called:

teratogens

68

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

teratogens

69

Teratogens in 3-8 weeks can result in:

major congenital anomalies

70

Teratogens in 9-38 weeks can result in:

functional defects and minor anomalies

71

Severity of exposure to teratogens related to:

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

72

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

developing areas with rapid cell division

73

Caffeine can cause:

heart dysrhythmias

74

Drug use can cause:

birth defects
SROM
vaginal bleeding

75

How far before pregancy should rubella vaccine be given?

at least 3 months prior

76

Why should pregnant women avoid changing the litter box?

risk of toxoplasmosis

77

How should a pregnant woman lay to increase venous flow?

on her side

78

How may a pregnant woman have pseudoanemia?

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

79

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

80

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

81

Fetus viable at ___ weeks, ___ g.

20 wks
500 grams