Term
| First thing to do in an initial antepartal exam. |
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Definition
| Have woman provide clean urine specimen. |
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Term
|
Definition
| Birth occurring <20 wks or 500 g. |
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Term
|
Definition
| Pregnancy of any duration including current. |
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Term
|
Definition
| Birth >20 wks regardless of alive or dead. |
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Term
| Fetus born dead after 20 wks. |
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Definition
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Term
|
Definition
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|
Term
| Common skin changes in pregnancy |
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Definition
| Spider nevi, linea nigra, striae gravidarum, melasma. |
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Term
| What can happen to the nose in pregnancy? |
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Definition
|
|
Term
| What can happen to the mouth in pregnancy? |
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Definition
|
|
Term
| What can happen to the thyroid during pregnancy? When? |
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Definition
|
|
Term
| When is breast increase noted? |
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Definition
|
|
Term
| What sensation is noted in the first and third trimesters? |
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Definition
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|
Term
| When may colostrum be present? |
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Definition
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Term
| Normal <3 changes in pregnancy |
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Definition
| Palpitations, short systolic murmurs. |
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Term
| Separation of abdominal muscles. |
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Definition
| Diastasis of the rectus muscle. |
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|
Term
| Tapping sharply on uterus - if baby floats up and comes back down. |
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Definition
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Term
|
Definition
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|
Term
| Softening of isthmus of uterus |
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Definition
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|
Term
|
Definition
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|
Term
| Danger signs of pregnancy |
|
Definition
Gush of fluid
Vaginal bleeding
Abdominal or epigastric pain
Fever
Persisten vomiting
Oliguria
Dysuria
Absence of fetal movment
Muscle irritability or convulsions
Dizziness, blurred vision, spots in eyes
Edema |
|
|
Term
| How often do women need prenatal exams? |
|
Definition
Every 4 wks until 28 wks.
Every 2 wks until 36 wks.
Every wk until delivery. |
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Term
| When is GBBS testing done? |
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Definition
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Term
| Fundus location at 10-12 wks |
|
Definition
| Slightly above symphysis pubis |
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Term
|
Definition
| Halfway between symphisis and umbilicus |
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Term
| Fundus location at 20-22 wks |
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Definition
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|
Term
|
Definition
| 3 finger breadths above umbilicus |
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Term
| Fundus location at 36 wks |
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Definition
| Just below ensiform cartilage |
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|
Term
| When is gestational age most accurate with fundal height? |
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Definition
|
|
Term
| High risk factors for pregnancies |
|
Definition
>4 pregnancies
Baby weighing >8.5 lbs
Height <5 ft
Low socioeconomic status
<16 yrs >35 yrs. |
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|
Term
| What do gravida and para associate with: births or pregnancies? |
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Definition
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|
Term
| When is the doppler able to amplify fetal heart sounds so that they can be heard? |
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Definition
|
|
Term
| Which factors decrease the reliability of fundal height for gestational age? |
|
Definition
Uterine fibroids
Obesity
Hydramnios |
|
|
Term
| What complication is a pregnant woman <16 years old most likely to develop? |
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Definition
|
|
Term
| When are tub baths contraindicated for pregnant women? |
|
Definition
Vaginal Bleeding
Ruptured Membranes |
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|
Term
| What super relaxing places should pregnant women not go? |
|
Definition
Hot tub & sauna
Hyperthermia=teratogenic |
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|
Term
| How late in pregnancy can women fly safely if they have no complications? |
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Definition
|
|
Term
| What DVT precautions should pregnant women especially take when flying? |
|
Definition
| Wear support hose & drink plenty of fluids |
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|
Term
| What stretch stretches the inner thighs and glutes? |
|
Definition
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|
Term
| What do pregnant women need to keep their heart rate below during exercise? |
|
Definition
|
|
Term
| What stretch is good for the lower back and spine? |
|
Definition
|
|
Term
| What age groups have the highest risk of preterm births and low birth weights? |
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Fetus' head too large for pelvis |
|
Definition
| Cephalopelvic disproportion |
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|
Term
| Why is the US the leader in adolescent pregnancy? |
|
Definition
| Failure of contraceptive education and availability |
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|
Term
| How long is the lag time between initiation of sexual activity and use of contraception? |
|
Definition
|
|
Term
| Are there more adolescent pregnancies in MO in ages 15-17 or 18-19? |
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Definition
|
|
Term
| Describe the typical partner of the pregnant adolescent. |
|
Definition
| 1-3 years their senior, usually in a relationship. |
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|
Term
| Weight gain/rate for normal BMI |
|
Definition
25-35 lbs
3.5-5.0 lbs 1st trimester + 1lb/wk after |
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|
Term
| Mineral that promotes cellular metabolism & smooth muscle relaxation. |
|
Definition
|
|
Term
| Mineral promotes growth of fetus & sufficient lactation |
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Definition
|
|
Term
| System Omega 3 has most effect on |
|
Definition
|
|
Term
| Hormone that plays a role in immune function |
|
Definition
|
|
Term
| Amt of sun exposure needed per week to get enough Vitamin D |
|
Definition
| 5-30 minutes arms & legs exposed 2x/wk |
|
|
Term
| Months that it is impossible to get enough Vit D from the sun in Missouri |
|
Definition
|
|
Term
| What is the largest way in which high fructose corn syrup has contributed to lifestyle diseases? |
|
Definition
| Cheaper than sugar -> bigger portions |
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|
Term
| How much should cals increase for 2nd/3rd trimester & lactation from normal diet? |
|
Definition
|
|
Term
| Non-pregnant protein requirements are 14 grams. What are they in pregnant women? |
|
Definition
|
|
Term
| How much does BMR inc. in pregnancy? |
|
Definition
|
|
Term
| Most vegans need additional supplements of what? |
|
Definition
|
|
Term
| How long after menarche do women reach their full height? |
|
Definition
|
|
Term
| Can you have sex after an abortion? |
|
Definition
| No - maintain bed rest and hospitalization if persistent bleeding. |
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|
Term
| What conditions is Methotrexate used for? |
|
Definition
| Abortion, Ectopic Pregnancy & Gestational trophoblastic disease |
|
|
Term
| Cervix is not dilated & placenta still attached to uterine wall, but some bleeding occurs. |
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Definition
|
|
Term
| Placenta has separated from uterine wall, cervix has dilated and the amt of bleeding has increased |
|
Definition
|
|
Term
| Embryo or fetus has passed out of the uterus, but the placenta remains |
|
Definition
|
|
Term
| Most commons site for ectopic pregnancy |
|
Definition
| Ampulla of fallopian tube |
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|
Term
| If HcG levels are stable, what may be happening? |
|
Definition
| Ectopic pregnancy - normally levels double frequently. |
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|
Term
| What is the classic symptom of ectopic pregnancy? |
|
Definition
| Sharp, unilateral pain & lower abdominal pain |
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|
Term
| If women do not desire to become pregnant in the future, what are options for ectopic pregnancies? |
|
Definition
| Salpingostomy/Salpingectomy |
|
|
Term
| Med that stops cell division and causes tissue to die |
|
Definition
|
|
Term
| Pathologic proliferation of trophoblastic cells including molar pregnancy |
|
Definition
| Gestational Trophoblastic Disease |
|
|
Term
| What are the chromosomes in gestational trophoblastic disease usually like? |
|
Definition
|
|
Term
| Signs of gestational trophoblastic disease |
|
Definition
Uterine enlargement > gestational age
Bleeding
Hyperemesis gravidarum and early pre-ecclampsia (12 wks) |
|
|
Term
| How long must women who have had gestational trophoblastic disease wait to conceive? |
|
Definition
| 1 year - with monitoring of HcG levels. |
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|
Term
| A woman who has had repeated second trimester abortions may have what? |
|
Definition
|
|
Term
| Procedure where cervix is tightened with purse-string suture until at term. |
|
Definition
|
|
Term
| Main causes of bleeding during second half of pregnancy. |
|
Definition
Abruptio placentae
Placenta previa |
|
|
Term
| What normal nursing action must you not take in patients with placenta previa? |
|
Definition
|
|
Term
| What is diagnostic for hyperemesis gravidarum? |
|
Definition
Intractable vomiting
5% wt. loss |
|
|
Term
| What meds can be used to control vomiting in hyperemesis gravidarum? |
|
Definition
|
|
Term
| What % of preterm births does PPROM occur in? |
|
Definition
|
|
Term
| Methods to prevent infection in PPROM |
|
Definition
Sterile speculum to detect amniotic fluid
Limit digital exams |
|
|
Term
| How many hrs after PROM does risk for infection ^? |
|
Definition
| 18 hrs - 80% women are in labor within 12 |
|
|
Term
| Uterine contraction frequency Dx for labor |
|
Definition
|
|
Term
| How much does the cervix have to be dilated and effaced for it to be considered labor? |
|
Definition
| >1cm w/documented change, 80% effaced |
|
|
Term
| If cervix >4cm long, what does this indicate? |
|
Definition
| Risk for preterm labor is low |
|
|
Term
| If cervico-vaginal fibronectin is detected, what does this mean? |
|
Definition
| Likely to go into labor soon |
|
|
Term
|
Definition
| Terbutaline, Ritodrine (B agonists), MgS04, Indomethacin, Nifedipine (Ca channel blocker) |
|
|
Term
| When does preeclampsia-eclampsia begin? |
|
Definition
|
|
Term
|
Definition
| Vasoconstriction of the spiral arteries |
|
|
Term
| Maternal complications preeclampsia-eclampsia |
|
Definition
Neuromuscular irritability
Headache & hyperreflexia
Seizures, RF, abruptio placentae
DIC, ruptured liver & pulmonary embolism
HELLP syndrome (Hemolysis, elevated liver enzymes, low platelet count) |
|
|
Term
| Fetal-Neonatal risks eclampsia |
|
Definition
| Small gestational age, Preterm, Mg toxicity |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| Grand mal convulsion that can occur antepartum through postpartum |
|
Definition
|
|
Term
Proteinuria 5g in 24 hr urine
Dipstick urine protein 3+ to 4+
Visual/cerebral disturbances |
|
Definition
|
|
Term
1+ proteinuria
Elevated liver enzymes
Edema |
|
Definition
|
|
Term
| Loss of DTRs & Resp depression in preeclampsia |
|
Definition
|
|
Term
Marked fetal edema (hydrops fetalis)
CHF, Marked jaundice |
|
Definition
| Erythroblastosis fetalis (due to Rh & hemolytic syndrome) |
|
|
Term
| Indirect coombs test is done on ______ at ______. |
|
Definition
| Mother, initially, 28 wks & postpartum |
|
|
Term
| Direct coombs test is done on _____ at _______. |
|
Definition
|
|
Term
| What does ABO incompatibility cause and how is it treated? |
|
Definition
| Hyperbilirubinemia (due to hemolysis) -- phototherapy |
|
|
Term
| This causes birth defects and is transmitted by eating raw/undercooked meat and contact with cat feces. |
|
Definition
|
|
Term
| Toxoplasmosis after 1st trimester can be treated with ________. |
|
Definition
|
|
Term
| Virus for which we have a herd immunity but can cause severe birth defects if acquired during pregnancy. |
|
Definition
|
|
Term
| Herpes virus transmitted trans-placentally & with direct cervical contact. Leading cause of deafness. |
|
Definition
|
|
Term
| Neonatal herpes transmission is greatest when? |
|
Definition
| If acquired near time of birth or if active lesion |
|
|
Term
|
Definition
|
|
Term
| If mother has active herpes lesion what is the best course of action for birth? |
|
Definition
| C-section within 4 hrs SROM. |
|
|
Term
|
Definition
|
|
Term
| What kind of bacteria is GBS? |
|
Definition
|
|
Term
| This bacteria is potentially transmissible to infants via breastfeeding. |
|
Definition
|
|
Term
| Why is erythromycin put in eyes/conjunctiva of newborns? |
|
Definition
| Prevent conjunctiva from gonorrhea/chlamydia infection. |
|
|
Term
| Does infection correlate with spontaneous abortions and preterm birth? |
|
Definition
|
|
Term
| If a woman has low CD4 counts (HIV) what is likely to happen during pregnancy? |
|
Definition
| May develop AIDS and opportunistic infection |
|
|
Term
| What is the current fetal transmission rate w/tx for HIV? |
|
Definition
|
|
Term
| What is the therapy to prevent transmission of HIV from mom to baby? |
|
Definition
| C/S at 38 wks, Oral ZDV daily during pregnancy, IV during labor until birth, Oral ZDV for infant for 6 wks. |
|
|
Term
| Leading cause of preventable mental retardation in US. |
|
Definition
|
|
Term
| In diabetes, _______ crosses the placenta but ______ doesn't. |
|
Definition
|
|
Term
| Insulin needs are ____ in the first trimester and postpartum. |
|
Definition
|
|
Term
| When should diabetics become pregnant? |
|
Definition
| When they have excellent glycemic control. |
|
|
Term
| 1 hr (50g) & 3hr (100g) glucose challenge test normal result |
|
Definition
|
|
Term
| Folic acid deficiency anemia |
|
Definition
|
|
Term
| Hg level that affects fetus |
|
Definition
|
|
Term
| Major risk for sickle cell pregnant women. |
|
Definition
| Increased susceptibility to infection |
|
|
Term
| Mild anemia condition r/t hgb chain |
|
Definition
|
|
Term
| US needs full bladder and relatively thin woman |
|
Definition
|
|
Term
|
Definition
Confirm multiple pregnancy, placental location, assess amniotic fluid volume, confirm viability
Guide for amnio & chorio |
|
|
Term
| _____ is visible on US at 8 wks |
|
Definition
|
|
Term
| ________ is measured between 7-12 wks |
|
Definition
|
|
Term
| After 12 weeks ______ is measured on US |
|
Definition
| Biparietal diameter and femur length |
|
|
Term
| When is chorionic villi sampling done? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| When can placental previa be diagnosed? |
|
Definition
|
|
Term
| When can placenta be clearly seen on US? |
|
Definition
|
|
Term
| What does the quad screen test for? |
|
Definition
| Downs, Trisomy 18, Neural tube defects |
|
|
Term
| The quad screen is _______ but not _________. |
|
Definition
|
|
Term
| At 10-12 wks, nuchal translucency, free b subunit HcG and Papp-A can be tested. If these results are normal, what does this indicate? |
|
Definition
Low chance of loss <20 wks.
Low risk of downs and trisomy 18 |
|
|
Term
| Negative fetal fibronectin indicates what? |
|
Definition
| Labor is unlikely to occur in next two weeks. |
|
|
Term
| How often should a woman perform Fetal movement counts after 28 wks? |
|
Definition
|
|
Term
| How many fetal movements in 1 hr are considered reassuring? |
|
Definition
|
|
Term
| NST: Baby is reactive if what? |
|
Definition
| Two accelerations at 15 bpm above baseline within 20 minutes when mom feels baby move. |
|
|
Term
| Negative contraction stress test is what? |
|
Definition
| No late decelerations w/min 3 UCs in 10 min period. |
|
|
Term
| When are velocity waveforms (doppler blood flow studies) typically used? |
|
Definition
| Twin pregnancies where worried one may be getting more blood than the other. |
|
|
Term
| This type of IUGR is more serious. |
|
Definition
|
|
Term
| L/S ratio at 30-32 wks is _____ at 35 wks is _____. |
|
Definition
|
|
