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NURS 372 - maternity > Week 1: Antenatal Assessment and Care > Flashcards

Week 1: Antenatal Assessment and Care Flashcards

(85 cards)

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1
Q

What are some health promotions for preconception care

A
  • nutrition and healthy diet (folic acid intake)
  • optimum wt
  • exercise
  • avoidance of tobacco, alc, recreational drugs
  • risk-reducing sexual practices
  • infertility
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2
Q

What to ask about med history for preconception care

A

immune status
family history
illness
use of meds: use micromedex and look in the preg/lactation area

reproductive history:
contraceptive
obstetrical

Strong family history of a genetic history - discuss consult to a genetic tester

Discuss previous pregnancies, therapeutic abortions, time in between pregnancies

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3
Q

when does folic acid need to be taken and why

A

taken 3 months prior to conception to support pregnancy

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4
Q

when can you get a infertility consult
1) within 6 months
2) within a year

A

1) age 32+
2) younger

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5
Q

what is RNAO

A

Screening for abuse

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5
Q

what is vasovagal

A

blood pooling (can happen when a pregnant person stands for long hours, for ex at work)

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6
Q

1) why is folic acid so important for pregnancy
2) what is the dose for low risk
3) what is it for higher risk

A

1)
Folic acid supplementation during preconception and pregnancy helps prevent neural tube defects
Decreases incidence of facial cleft palate, neural tube defects, congenital heart diseases, and limb differences

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7
Q

describe conception as well as the 3 steps

A
  • union of single egg and sperm
  • process including gamete formation, ovulation, result of an embryo, and implantation

1) fertilization occurs in uterine tube within 24 hrs of ovulation
2) transport the early embryo down uterine tube into uterus
3) implantation when blastocyst embed into endometrium

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8
Q

what does a zygote contain?

A

46 chromosomes; 23 from the mature ovum and 23 from sperm

(22 pairs of autosomes and one pair of sex chromosomes from ovum and sperm)

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9
Q

what do chorionic villi do

A

obtain o2 and nutrients from maternal bloodstream and dispose of carbon dioxide in maternal blood.

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9
Q

Look @ lecture 1 diagram i dont have the time for this shit

A
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10
Q

what is the earliest biochemical marker of pregnancy?

A

human chorionic gonadotropin (hCG)

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11
Q

what is hCG

A
  • hormone produced by cells in the placenta during pregnancy
  • supports maintenance of corpus luteum in ovary, producing progesterone during early stages of preg
  • essential for maintaining uterine lining + early development of embryo
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12
Q

what is the most popular test for pregnancy

A

enzyme-linked immunosorbent assay (ELISA)

(basis for most over-the-counter preg tests)

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13
Q

how far along are most clients when they find out they r pregnant

A

4-7 weeks (1-2 months)

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14
Q

how accurate are OTC preg test

A

90%

if too early it may not pick up

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15
Q

how long is pregnancy

A

9 months
40 weeks
280 days

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16
Q

how is length of preg calculated

A

from the 1st day of the last menstrual period (LMP), conception occurs approximately 2 weeks after 1st day of LPM

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17
Q

most clients give birth within how many days of their due date?

A

14 days before to 14 days after

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18
Q

what is Nagele’s rule

A

(assumes 28 day cycle and pregnancy occurred on day 14)

  • first day of last menstrual period (LMP), minus 3 months, add 7 days, plus 1 yr
    OR
  • add 7 days to LMP and count forward 9 months

most clients give birth 7 days before or after EDB

inconsistent cycle can affect this calculation, and as fetus grows there is more variable

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19
Q

how accurate are ultrasounds at dating early preg

A

it is accurate dating the gestational age during early preg

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20
Q

what is classified as the 1st trimester

A

weeks 1-13

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21
Q

whats classified as the 2nd trimester

A

weeks 14-26

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22
Q

whats classified as the 3rd trimester

A

weeks 27 through term

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23
what are some presumptive signs of preg
subjective felt by client breast changes (3-4 wk) amenorrhea (4 wk) nausea/vomiting (4-14 wk) urinary frequency (6-12 wk) fatigue 12 wk quickening (fluttering related to fetal movement) 16-20 wk
24
probable signs of preg
objective by examiner +'ve preg test goodell sign 5-6wk chadwick sign 6-8wk hegar sign ballottement
25
what is goodell sign
softening of cervical tip due to increased vascularity, hyperplasia, and hypertrophy
26
what is chadwick sign
violet bluish colour of the vaginal mucosa and cervix
27
hegar sign
softening and compressibility of lower uterine segments
28
ballottement
technique of palpitating a floating structure by bouncing it gently and feeling it rebound
29
positive signs of preg
shows presence of fetus visualization of fetus fetal heart tones by stethoscope, doppler, ultrasound fetal movements at 19-22wks fetal movements visible during late stages of preg
30
what are therapeutic abortions and when do they occur
intentional interruption of preg b4 20 wks
31
describe first trimester abortions
- surgical (aspiration) abortion - methotrexate and misoprostol - mifepristone and misoprostol
32
describe 2nd trimester abortions
- dilation and evacuation (D+E) - medical induction (prostaglandins, hypertonic and uterotonic agents) - emotional considerations
33
what is gravidity
pregnancy
34
what is gravida
client who is pregnant
35
what is primigravida
pregnant for the 1st time
36
what is multigravida
client who has had 2 or more pregnancies
37
what is nulligravida
client who has never been pregnant
38
what is parity
of pregnancies which the fetus or fetuses have reached 20 weeks gestation - whether fetus is born alive or is stillborn after viability is reached does not affect parity
39
what is primipara
completed 1 pregnancy to 20 weeks or more
40
what is multipara
clients who has completed 2 or more pregnancies to 20 weeks or more
41
what is nullipara
clients who has not completed a pregnancy with fetus/fetuses to 20 weeks or more
42
what is preterm
pregnancy beyond 20 weeks gestation but delivered prior to completion of 36 weeks
43
what is term
pregnancy from the beginning of week 37- end of 40
44
what is early term
pregnancy between 37-38 weeks
45
what is full term
pregnancy 39-40 weeks
46
what is late term
pregnancy in the 41 week
47
what is post term
pregnancy after 42 weeks
48
what is viability
capacity to live outside of the uterus 22-25 weeks
49
what is abortus
total # of spontaneous or therapeutic abortions occurring prior to 20+0 weeks spontaneous
50
simon is preg for the 3rd time. 1st preg resulted in a spontaneous abortin @ 9 weeks. they delivered their second preg at 39 weeks. what is their GTPAL 5 number.
G3T1P0A1L1
51
what is the GP 2 Digit System
only uses G (gravidity): total # of pregnancies P (para): indicates # of pregnancies that have completed 20 weeks gestation and beyond regardless of outcome
52
where is the placenta supposed to embed, and what would be considered abnormal
Placenta embeds in top back part of uterus (abnormal is at the bottom)
53
what is the abdominal cavity filled with in preg
amniotic fluid
54
what does the amnion layer blend with
the umbilical cord
55
what does the chorion layer blend with
with the placenta
56
during implantation how many fetal membranes surrounding the embryo begin to form
2
57
what is the chorion
- it is the membrane covering the fetal size of the placenta - contains major umbilical blood vessels branching out over the surface of the placenta
58
how does the chorion develop
from the trophoblast and contains the chorionic villi on the surface
59
what is the amnion
- inner cell membrane - developing embryo draws amnion around itself to form a fluid-filled sac - becomes the covering of the umbilical cord and covers the chorion on the fetal surface of the placenta
60
what does the amnion develop from
blastocyst
61
what is the amniotic cavity first filled with
fluid derived by maternal blood by diffusion
62
what is amniotic fluid
fluid secreted by the respiratory and GI tract of the fetus that then enters the amniotic cavity
63
how much amniotic fluid is regular by term, does it increase or decrease throughout pregnancy
amount increases throughout pregnancy, 700-1000 mL by term
64
what is oligohydramnios and what is this associated with
means having less than 300 mL and is associated with fetal renal abnormalities
65
what is polyhydramnios and what is this associated with
having more than 2000 mL and is associated with GI and other malformations
66
what are the 6 functions of amniotic fluid
- constant body temp - source of oral fluid and reposition for waste - cushions the fetus from trauma - allows freedom of movement for MSK development - barrier to infection - allows lung development
67
what does amniotic fluid contain
albumin, urea, uric acid, creatinine, lecithin, sphingomyelin, bilirubin, fructose, fat, leukocytes, protein, epithelial cells, enzymes, and lanugo hair
68
how many arteries/veins for the umbilical cord and what are each of their purposes
- 2 arteries carry blood from the embryo/fetus to chorionic villi - 1 vein returns blood to the embryo/fetus
69
what percent of umbilical cords contain only 2 vessels, what can this impact
around 1% and may be associated w congenital malformation
70
what is wharton's jelly
a connective tissue that prevents compression of the blood vessels to ensure nourishment to the embryo/fetus
70
at term how long is the umbilical cord
cord is 2 cm thick, 30-90 cm in length
71
where is the umbilical cord normally attached
centrally to the placenta
72
when is maternal-placental-embryonic circulation established
by day 17 when the embryo's heart begins beating
73
when is the structure of the placenta complete
complete by week 12, grows wider until week 20 then continues to get thicker
74
what is the placenta
is an endocrine gland that produces four hormones to maintain the pregnancy and support the embryo/fetus
75
what 4 hormones does the placenta produce
1. Human chorionic gonadotropin (hCG) 2. Human chorionic somatomammotropin or human placental lactogen (hPL) 3. Progesterone 4. Estrogen
76
what is usually the traditional prenatal care frequency
- initial visit usually in the 1st trimester - monthly visits until 28 weeks - visits every 2 weeks until 36 weeks - weekly visits until birth
77
what are some factors that may prevent clients in poverty to care
- may not have access - lack of culturally sensitive care - communication interferes w care - birth outcomes less positive, higher rates complications
78
what is the purpose of prenatal care
- to identify existing risk factors - health promotion emphasis on preventive care/self care
79
what does an initial pregnancy visit include (6-8 weeks)
- reason for seeking care - current preg - obstetric and gynecologic history - medical history - nutrition history - history of drug use and herbal preparations
80
what is true about perinatal nurses? a) provide care for only high risk mothers and infants b) work with families from preconception throughout childbearing yrs c) provide care for families w children up to 18 yrs d) provide care for only low risk families from conception to birth
a
81
true/false clients at low risk should take 0.4 mg of folic acid while pregnant
true
82
B-hCG begins are early as day of implantation and can be detected as early as _____ days after conception
7-10

NURS 372 - maternity (13 decks)

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