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parent/child: final
| Question | Answer |
|---|---|
| Molar pregnancy (Hydatidiform Mole) | A benign proliferative growth of the placental trophoblast; cause is unknown; s/s: dark red (prune juice) or bright red vaginal discharge; diagnostics: ultrasound will show grapelike bunches & high hCG levels; treatment: D&C; no pregnancy for 1 year |
| Ectopic pregnancy | Implantation outside of uterus; s/s: abdominal pain, delayed menses, abnormal vaginal bleeding; diagnostics: ultrasound (hCG >1500 but no activity & progesterone <5); treatment: removal of fetus/embryo, methotrexate, or fallopian removal (salpingectomy) |
| Diet | 1st trimester: 2 - 4 lbs; normal: 25 - 35, underweight: 28 - 40 lbs, overweight: 15 - 25 lbs, obese: 11 - 20 lbs; folic acid to prevent neural tube defects (400 - 600 mcg/day), iron (30 mg/day), caffeine (< 200 mg); breastfeeding: increase fluids & cals |
| Biophysical profile (BPP) | Normal score: 8 - 10; consists of amniotic fluid index, fetal breathing movements, fetal movements, & fetal tone; *modified: combines nonstress test with measurement of amniotic fluid* |
| Amniocentesis | After 14 weeks; to check for any birth defects |
| Fetal Lung Maturity | Determines L/S ratio (2:1); dexamethasone to accelerate if necessary (give shot to mom) |
| Oxytocin test | Evaluates fetal tolerance to uterine contractions; done by nipple stimulation or administration of oxytocin; negative is normal (no late decelerations) |
| Nonstress test | Determines fetal activity; may need to stimulate baby by drinking orange juice or vibroacoustic stimulation; reactive is normal (2 accelerations in 20 min, each lasting at least 15 sec & peaking at least 15 beats/min above baseline |
| Placenta previa | Placenta is implanted in the lower uterine segment; complete, marginal, low-lying; risk factors: c-section, age, multiparity, prior suction, smoking; s/s: painless bright red bleeding; diagnostic: ultrasound; treatment: hysterectomy, bed rest, & no exams |
| Abruptio placentae | Detachment of normally implanted placenta from the uterus; risk factors: hypertension, cocaine, abdominal trauma, smoking, hx, premature ROM; s/s: pain, dark red bleeding, hypovolemia, board-like abdomen; ultrasound or after birth; monitor or birth asap |
| Estimated date of birth calculation (Naegele’s Rule) | Last menstrual period - 3 months + 7 days (Remember to adjust year accordingly) |
| Gestational diabetes | Risks/complications: macrosomia, shoulder dystocia, baby born hypoglycemic; 1 hour & 3 hour glucose testing (1 hour positive if > 130 - 140 -> 3 hour positive -> diet & exercise still positive -> glyburide or metformin) |
| Pre-eclampsia | Hypertension & proteinuria develop after 20 wks; s/s: headaches, blurred/double vision, mental confusion; assessment: edema, DTRs, clonus; diagnostics: proteinuria (> 300 mg); treatment: hold birth till 34 wks, environment, meds: mag, BP, & steroids |
| HELLP syndrome | |
| Variant of preeclampsia that involves hepatic dysfunction; H - hemolysis EL - elevated liver enzymes, LP - low platelet counts; risks: maternal death, pulm edema, renal failure, DIC, placental abruption, liver hemorrhage or failure, ARDS, sepsis, stroke | |
| Preterm labor | 20 wks 0 days - 36 wks 6 days; causes: infection, chronic hypertension, diabetes, preeclampsia; predictors: cervical length (unlikely if > 30 mm) & fetal fibronectin test (unlikely if negative); diagnosis: reg contractions & at least 2 cm dilated |
| Rh isoimmunization | Rh incompatibility: when mom is Rh - & baby is Rh +; IM Rhogam injection given at 28 wks gestation & within 72 hrs after birth |
| Hydramnios | Polyhydramnios increased amniotic fluid (AFI) > 24 - 25; subjective criteria: fundal height large for gestational age & a fetus that cannot be easily palpated or is ballotable; drain amniotic fluid |
| Signs labor is to begin | Lightening or dropping; persistent low backache, profuse vaginal mucus, bloody show, return of urinary frequency, ruptures membranes, weight loss of 1 - 3.5 lbs, & nesting (surge of energy) |
| GTPAL | G: gravidity (# or pregnancies, including current one) T: term (# of births 37 wks, 1 day - 40 wks 6 days P: preterm (# of births end 20 wks 0 days - 37 weeks 0 days) A: abortion (# of babies lost before 20 wks) L: # of living children |
| Labor induction | The chemical or mechanical initiation of uterine contractions; |
| Cardinal movements | Engagement -> descent -> flexion -> internal rotation -> extension -> restitution (external rotation) -> expulsion |
| Station & presentation of the fetus | Station: a measure of the degree of descent; engagement corresponds to 0; presentation: cephalic (occiput) is good, breech is bad (frank, complete, footling); ROA & LOA (baby’s back is facing mom’s stomach) - ideal, ROP & LOP - back to back |
| Stages of labor | 1) Onset of reg contractions -> full dilation (latent or active) 2) Dilation -> birth (latent or active) 3) Birth of fetus -> placenta delivery 4) Delivery of placenta -> first 2 hrs after birth |
| FHT patterns during labor | Baseline FHR: 110 - 160; variability: absent, minimal, moderate (6 - 25 bpm), marked, sinusoidal pattern; tachy: > 160 & brady: < 110; VEAL CHOP; accelerations: reassuring; early decelerations are normal; late, variable, & prolonged decelerations are bad |
| Shoulder dystocia | A condition in which the head is born, but the anterior shoulder cannot pass under the pubic arch; interventions: McRoberts maneuver, suprapubic pressure, Gaskin maneuver, DO NOT APPLY FUNDAL PRESSURE |
| Assessment of labor progress | True vs. false labor; 3 stages (see study guide) |
| Treatment of discomfort | Nonpharmacologic; pharmacologic: sedatives to relieve anxiety & induce sleep, analgesia for pain relief & anesthesia to abolish pain perception by interrupting nerve signals to brain |
Created by:
tatianalopez03
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