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Antepartal Care
| Question | Answer |
|---|---|
| Amennorrhea, nausea, vomitting, breast/skin changes, cervical color changes & quickening are signs of? | Presumptive indications |
| Abdominal enlargement, Goodell's sign, ballottement, Braxton Hicks contractions, palpation of fetal outline & positive pregnancy test are signs of? | Probable indications |
| Define Hegar's sign | softening of isthmus of uterine cervix, occurs early in pregnancy |
| Define Goodell's sign | softening of the cervix |
| Define ballottement | fetal head movement on exam |
| Define Braxton Hicks contractions | irregular contractions or false labor |
| When is doppler used in ausculation of the FH sounds? | 10-12 weeks |
| When is the fetoscope used in ausculation of the FH sounds? | 18-20 weeks |
| When is the embryo seen using ultrasound? | 5-6 weeks |
| When is the embryo seen using transvaginal technique? | 10 days |
| Define gravida | total # of pregnancy including the one in progress |
| Define para | birth given at least 20 weeks |
| Define term births | 38 weeks or later |
| Define preterm births | before 38 weeks |
| What are some complications in pregnancy history that may affect labor? | HTN, DM, infx or bleeding |
| What is Nagel's rule? | Last normal menstrual period minus 3 months plus 7 days |
| What are some complications in medical history that may affect labor? | Age, blood diseases, hepatitis, std, tb, gbs, anemia |
| Capacity of uterus? | 5000 ml |
| Weight of uterus during pregnancy? | 2.2 lb or 1000gm |
| How many weeks when uterus is in abdominal cavity or above symphysis pubis | 12 weeks |
| How many weeks when uterus is midway symphisis & umbilicus | 16 weeks |
| How many weeks when uterus is in xiphoid process | 36 weeks |
| How many weeks when uterus is lightening? | 40 weeks |
| When is uterine contractility (Braxton Hicks) infrequent? | 1st & 2nd trimester |
| When is uterine contractility (Braxton Hicks) more frequent & cause discomfort? | 3rd trimester |
| What happens to the uterine blood flow? | increases dramatically |
| What happens to the myometrial artery? | enter intervillous space |
| What is the reason for the myometrial artery entering the intervillous space? | exchange of O2 & CO2 from ; provide nutrients & eliminate wastes to venous system |
| What is the fx of mucus secretions? and where is the location? What is the name of the ends of the mucus? | protection from bacteria and protects baby from infx; canal of the cervix; internal & external OS |
| Define Chadwick's sign | bluish color of the vagina & labia |
| What causes bluish color? | increase level of estrogen |
| Vagina & Vulva changes - what causes the thick, white discharge? | increase glycogen=increase sloughing |
| Vagina & Vulva changes - describe acidity | discharge acidic (pH 3.5-6.0) due to increase lactic acid |
| Vagina & Vulva changes - what happens to bacteria? | bacterial growth decreases but increase in yeast infx |
| Vagina & Vulva changes - increased edema & vascularity causes? | orgasmic experience |
| Changes in ovaries - after conception, what is secreted and how many weeks? | progestrone the first 6-7 weeks |
| What does progesterone do within the uterus? | suppresses contraction of uterus & prevent tissue rejection of the fetus |
| After 7 weeks, what happens to the progesterone? | The placenta will secrete it the rest of the pregnancy. |
| Main fx of progesterone? | relaxes everything |
| What happens to the ovulation when pregnant? | It stops because of high estrogen and progesterone levels which inhibits FSH & LH |
| When does quickening occur? | 16 and 20 weeks gestation |
| When does backache develop? | 2nd trimester |
| When does dyspnea develop? | 3rd trimester |
| When does fatigue develop? | 1st trimester |
| Normal weight gain for a pregnant woman? | 25-35 lb |
| When (# weeks) does leg cramping occur? | 22 |
| What causes leg cramps? | low Ca+ and or high Phosphorus |
| High levels of progesterone decrease contractility of the smooth musculature throughout the body resulting in an increase in? | Pulse Rate and Temperature |
| When (# weeks) is vaginal and rectal cultures done? Purpose? | 36 weeks, GBS (group B streptococcal) |
| At what position of the fetus is when urinary frequency happens? | descent of the fetus into the pelvis or once lightening occurs |
| Anemia is a normal finding at how many weeks of gestation? | 36 weeks |
| What promotes growth of lobes, lobules and alveoli? | progesterone |
| What stimulates mammary ductal tissue? | estrogen |
| When (timeframe) is heart pushed upward and left? | 3rd trimester |
| When (# weeks) is systolic murmur heard? What sound is normal? | after 12-20 weeks until 2 weeks PP; 3rd sound due to rapid filling of diastole |
| When (# weeks) does total blood volume increase by 45%? | 6-8 weeks of pregnancy |
| When (# weeks) does plasma volume increase? How many mL? | 32 weeks; 4700-5200 mL |
| Reason for plasma volume increase as it relates to protection? but risk in? | protects from hemorrhage but increase risk of thrombus formation |
| Reason for plasma volume increase as it relates to other body growth? | meet demands of increase uterine and breast tissues |
| What physiological changes causes plasma volume to increase? | due to vasodilation from estrogen, progesterone & prostaglandins |
| Reason for plasma volume increase as it relates to respiratory and health? | necessary to provide nutrients & O2 |
| What is the reason for more blood volume as it relates to the fetus? | more blood must circulate through the mom's kidneys to remove waste from mom & fetus |
| RBC mass increase to how many mL or %? | 250-450mL (20-30%) |
| HCT decreases causing? | physiologic anemia |
| Normal range for Hgb and Hct | Hgb <10.5g/dl Hct <33% |
| When (# weeks) does cardiac output increase and by what %? | 20-24 weeks (5-6 months), increase by 40% |
| What happens to the stroke volume and HR when CO increases? | both increases, HR increases 15-20 bpm |
| What happens to the peripheral vascular resistance (PVR) when CO increases? | PVR dialates or decreases |
| What changes happen to the respiratory at 10 weeks r/t O2, breathing, TV, & pH? | O2 consumption inc. 20%, breathes deeper, tv inc., pH inc. more alkaline |
| What does progesterone do to the airway, CO2, ventilation? | decreases airway resistance, inc sensitivity to CO2, inc. minute ventilation |
| What does estrogen do to the respiration as it r/t upper respiratory tract & congestion | inc vascularity of URT, inc. congestion & stuffiness |
| What does progesterone do to the GI tract? | relaxes GI tract muscles, slows emptying of stomach & sm. intestine |
| What does progesterone do to the colon as it r/t constipation? | dec. motility leading to constipation & making hemorrhoids worst |
| What happens to the liver & uterus at 3rd semester? | uteres lift diaphragm 4cm, prevents full lung expansion, |
| What semester has most frequency & urgency to urinate? | 1st |
| Because kidney is working so hard, what declines? | plasma creatine & urea |
| Define creatine | creatinine is broken down by the body to make energy |
| What semester does waddling gait begin? | 2nd |
| What semester stores extra Ca in bones? | 1st |
| What semester does the fetus begin using Ca? | 3rd |
| Abdomen separation is? | Diastasis Recti |
| What hormone prepares breasts for lactation? | prolactin |
| What hormone enlarges gland & BMR at 1st trmester? | thyroid gland |
| What hormone dec. but able to meet fetal demands for Ca & Phos? | parathyroid glands - regulates Ca & Phos |
| What does Ca & Phos do? | inc, absorption offrom GI |
| What happens to the pancreas at 1st trimester? | insulin production inc. due to glucose levels |
| What happens to the insulin at 3rd trimester? | inc. 30% |
| What happens if there is too much resistance to insulin at 3rd trimester? | hperglycemial |
| Fx of aldosterone? | overcome Na wasting & maintain Na level with large blood volume |
| Define chorion | outer layer of the placenta |
| When does heart develop? | 5-8 weeks |
| When is fetal stage? | `9-12 weeks |
| When does fetus begin to move and what oocurs with the fetus? | 13-16 weeks; makes urine & mec |
| When can you hear FHT? | 17-28 weeks |
| When is surfactant produced? | 20 weeks |
| When does vernix & laguno occur? | 21-24 weeks |
| Least amount of weeks that a fetus can survive? | 29-32 |
| How many grams by 33-36 weeks? | 2-2.5g |
| What week 2 plus lbs, first viable? | 28 |
| What week 2mm tubular heart | 2 |
| What week resembles a human being? | 8 |
| What week lung maturity? | 36 |
| What week 1 plus lbs, lanugo, quickening | 20 |
| When does increased vaginal discharge occur? | 1st |
| When does dyspnea, constipation, hemorrhoids occur? | 2 & 3 |
| When does heartburn occur? | 2 & 3 |
| When does nasal stuffiness and epistaxis occur? why? | 2 & 3; due to blood excess |
| When does faintness occur? is it dangerous or discomfort? cause? | 2 & 3; discomforts; low BG |
| What are danger signs r/t head? | severe headache, dizziness, blurred vision, double vision, elevate temperature |
| What are danger signs r/t extremities? | edema of hands, face, legs & fee |
| What are danger signs r/t abdominal? | abdominal pain; persistent vomiting, |
| What are leg cramps r/t? | xchange of electrolytes |
| What are danger signs r/t urinary system? | oliguria, dysuria |
| What are danger signs r/t preclamsia? | muscular irritability, convulsions |
| What are danger signs r/t digestive system? | epigastric pain |
| What are possible causes of danger signs r/t placenta | placenta previa, abruptio |
| What are possible causes of danger signs r/t BP? | preeclampsia or PIH, pregnancy induced hypertension, eclampsia |
| What are possible causes of danger r/t kidney? | UTI, pylonephritis (back pain that goes up) |
| What are possible causes of danger r/t fetus? | SROM, premature labor |
| What type of spontaneous abortion when vaginal or spot bleeding occurs? | threatened |
| What type of spontaneous abortion when membranes rupture and cervix dilates? | inevitable |
| What type of spontaneous abortion when some products of conception have been expelled but some remain? | incomplete abortion |
| What type of abortion when products of conception die and no spontaneous bleeding or evacuation occurs? | Missed abortion |
| What may need to be done for a missed abortion? | may need dilation & curettage |
| What type of abortion when all products of conception & tissue is passed | complete abortion or miscarriage |
| What are s/s of ectopic pregnancy? | pain, bleeding, low BP, shock |
| When is ultrasound best done? determines? | 14-16 weeks; size and dates |
| When is the placenta assessed during pregnancy and why? | later in pregnancy to detect location if she's bleeding |
| What does modes B in ultrasound show? | brightness shows density |
| What does modes M in ultrasound show? | movement, can see fetus swallowing, hear valves closing |
| What does CST - Contraction Stress Test measure? aka? | ultrasound for FHR and toco for uterine contractions, late decels with contractions; Oxytocin Challenge Test |
| When is daily movement log test performed? | after 20 weeks |
| What test is performed for Rh disease or pH? | cordocentesis |
| What test is performed for high risk pregnancy or genetic? | chorionic villus sampling |
| Total weight gain in pregnancy? | 25-35 lbs |
| How much weight gained 1st trimester? Then 2nd & 3rd? | 2-3 lbs; 1lb/wk |
| Intrauterine Growth Restriction is associated with? | preeclampsia |
| What is an example of a prenatal high risk factor? | multiparity >3 |
| Which semester is uncertainty & ambivalence? | 1st |
| What occurs psychologically at 2nd trimester | fetus as primary focus, body image, changes in sexuality |
| What occurs psychologically at 3rd trimester | Vulnerability, increasing dependence, preparation for birth |
| s/s of recent cocaine use r/t skin, blood, respiratio | diaphoresis & cellulitis (red patches-dirty needles being used), high BP, irregular respirations |
| s/s of recent cocaine use r/t uterus and fetus | sudden onset of severely painful contractions, fetal tachycardia, |
| Anxiety, depression, panic attacks, sleeplessness, anorexia is defined as? |
Created by:
jjcarmelbeach
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