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107 Ch. 9
Asses for Risk Factors
| Question | Answer |
|---|---|
| What is puerperium | 4-6 wks after childbirth |
| Three leading causes of maternal death over last 50 yrs. In US? | hypertensive disorders, infection, hemorrhage US: gestational hypertension, pulmonary embolism, hemorrhage |
| What are factors related to maternal death | age, lack of prenatal care, low educational attainment, unmarried status, nonwhite race (Af Am) |
| what is leading cause of death in neonatal period? | congenital anomalies |
| Factors to consider when determining risk factors for perinatal care | resources available locally to treat, facilities for transport, best match for pt needs |
| What are three categories of risk now for childbearing | genetic: herited effect dev or fx demographic: geo., economic, edu., age, ethnic, racial behavorial: subst. abuse, no prenatal, nutrition, dental, psycho |
| What test is best for early fetal assessment | DFMC: daily fetal movement count (kick counts) 10 mvmts in 12 hrs |
| what is polyhydraminos and what are signs | increased AFV, >8cm, floating fetus signs: diabetes,multiple gest, congenital abnorms, Rh/ABO Assoc w/ NTD, neural tube defects |
| What is oligohydraminos | Decreased AFV, <2cm, crowding fetus signs: Potter's syndrome(renal), rupture of membranes, intrauterine growth restricition, fetal death |
| when is transvaginal ultrasonography used | 1st trimester detect ectopic preg, monitor dev embryo, abnormalities, gestational age useful in obese pts |
| what are three levels of ultrasonography? | standard- most freq limited- fetal position/heart specialized- abnormal fetus |
| four ways to get fetal age | 1. gestational sac dimensions(8wks) 2. measure crown/rump length(5-10wks) 3.biparietal measure, BPD (12 wks) 4.femur length(12wks) |
| What are 7 conditions for ultrasound to assess fetal growth | 1.poor maternal wt gain 2.prev preg w/ intrauterine growth restriction(IUGR) 3.infections, 4.drugs, 5.diabetes, 6. hypertension, 7. multifetal preg, 8. other med complications |
| what does fetal nuchal translucency(TNT) test for | measure of fluid in nape of neck bn 10-14 wks to id abnormals <2.5mm fluid = abnormal |
| when is the placenta clearly defined | by 14-16 wks. Calcium deposits concern for posttern pregs |
| Total AFV, amniotic fluid volume is measure as AFI amniotic fluid index. What is norm and abnorm | 5-19sm = normal >20cm = polyhydramnios <5cm = oligohydramnios |
| What is the Doppler effect | sound wave of blood flow |
| what is BPP, biophysical profile and what is norm, abnorm | physical exam of fetus, i.e.VS, CNS is fx, so fetus is not hypoxic norm 8-10 suspicious 6 abnorm <6 |
| What is main role of nurses | counseling and educating women about procedure |
| Coombs' Test tests maternal blood for antibodies for Rh compatibility and rubella | titer of 1:8 and rising, shows significant incompatibility and alarm |
| What does the AFP alpha fetal protein usually test for | NTD's, neural tube defects. 85% of NTD's and open abd wall defects found. In fetal liver, 14-34 wks. Levels low w/ Down syndrome(hCG high) |
| What adv. does MRI have over CT scanning | no ionizing radiation is used |
| what are some biochemical assessments | amniocentesis, PUBS(percutaneous umbilical blood sampling), CVS(chorionic villus sampling), maternal sampling |
| what is purposed for amniocentesis | genetic disorders/congenital anomalies, assess lung maturity, dx fetal hemolytic disease |
| what are two complications of amniocentesis | mom= hemorrhage, infection, labor, hurt organs, fluid embolism Fetal= death, hemorrhage, infection, needle stick, miscarriage, leakage |
| what is common to administer after amniocentesis | immune globulin D(RhoGAM) to woman who is Rh neg |
| What is shake test with amniocentesis | bubbles present after shaking fluid indicates surfactant(hold alveoli up) |
| What does the PUBS test determine | fetal hemolytic disease Get sample 1-2cm from cord insertion into placenta |
| What is meconium | baby's first poop seen late in labor is bad sign |
| What is gathered in the chorionic villus sampling test | test for genetic studies, get small tissue specimen from fetal portion of placenta(shiny shultz) |
| What is goal of testing in 3rd trimester | determine intrauterine env. and if supportive to fetus. Decr of placental fx leads to IUGR, poor fetal nutrition |
| Fetal monitoring is best for testing what in a fetus. What are happens to compensate for this | hypoxia or asphyxia redistribute blood flow to vital organs, decr O2 consumption, anaerobic glylysis Can survive for 30 min. |
| what is most widely used technique for antepartum evaluate of fetus | NST, non stress test, noninvasive, tests FM in relation to incr FHR, give mom OJ to raise glucose abnorm: no accel in FHR/FM in 40min. |
| what is fetal acoustic stimulation test | Test FHR with laryngeal stimulator, norm is accel. HR |
| what is contraction stress test | 2 types: nipple stimulated contraction test, oxytocin stimulated contraction test Positive results: late decelerations, not good provides warning of fetal compromise earlier than NST, but more expensive. |
Created by:
palmerag
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