Term
| Gestional Trophoblastic Disease |
|
Definition
Hydatiform mole - anomaly of placenta
Increase risk cancer
Ultrasound - grape like cluster |
|
|
Term
| Causes of Placenta Previa |
|
Definition
| Nothing. Cause is unknown |
|
|
Term
Placenta Previa
1. Definition
2. Signs and Symptoms |
|
Definition
1. Placenta is located abnormally. low. Placenta is where the fertilized ovum implanted inside the uterus.
2. Painless
May have spotting, bright red bleeding
Uterus is soft,
There is No Fetal Distress
If functioning and ok, FHR and FHT is ok. |
|
|
Term
|
Definition
1. Total
2. Partial
3. Marginal
4. Low-Lying
5. Marginal/Low-Lying |
|
|
Term
|
Definition
Placenta completely covers Internal Cervical Os
This will not move and will be a C-Section |
|
|
Term
|
Definition
Placenta partially covers Internal Cervical Os
Could move up during pregnancy and allow a vaginal birth |
|
|
Term
Marginal Placenta Previa
or
Low-Lying Placenta Previa
These terms are used interchangeably |
|
Definition
Edge of Placenta is at the Margin (Edge) of the Cervical Os
Placenta is implanted in the lower uterine segment (ISTHMUS) but does not reach the cervical os.
Could move up during pregnancy and allow a vaginal birth |
|
|
Term
Placenta Previa
Ultra Sound at 8 weeks it is recognized.
Ultrasound at 20 weeks - see low lying placenta
What happens next? |
|
Definition
| Continue with Ultrasounds on visits to see if there is a change |
|
|
Term
| Placentia Previa Assessment |
|
Definition
Ultrasound is the ONLY WAY we know of this.
Episodic Painless Vaginal Bleeding after 20t6h week of pregnancy without contractions.
Each successive bleeding episode heavier than the last.
Profuse Hemorrhage
US shows location of placenta. |
|
|
Term
| When is a non stress test done |
|
Definition
If there is complications such as
Diabetes
HTN
decreased fetal movement
to relieve her of concerns |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
| 20 minutes wasn't long enough on US to see if anything is wrong is called? |
|
Definition
|
|
Term
| A Normal NST (Non Stress Test) |
|
Definition
| She presses the button 3 times in 20 minutes with 3 accelerations - no added stress. It is own accelerations. |
|
|
Term
|
Definition
|
|
Term
| What happens with a Non Reactive Stress Test |
|
Definition
| Longer Tests, move her, give her some caffeine, clap hands to try to increase babies heart rate |
|
|
Term
|
Definition
| Artificial Rupture of Membrane |
|
|
Term
|
Definition
| Spontaneous Rupture of Membrane |
|
|
Term
| What makes up a pelvic exam? |
|
Definition
Station
Ephasement
Dilation |
|
|
Term
What does this mean?
G4, P4 |
|
Definition
Gravida 4 = 4 pregnancies
Para 4 = 4 babies after 20 weeks |
|
|
Term
|
Definition
| Assessment of what fetus can withstand with the stress of uterine contraction. Create the contractions and look at how the placenta and cord are functioning. It looks at oxygen supply, which is how variability is known |
|
|
Term
|
Definition
| Premature Rupture of Membrane |
|
|
Term
|
Definition
history of uterine surgery
Any uterine scar
Leap |
|
|
Term
| Placenta Previa is what in a contraction stress test |
|
Definition
|
|
Term
| Results of a Contraction Stress Test |
|
Definition
Negative CST
Positive CST
No Satisfactory Results |
|
|
Term
| How do you get the contractions to a CST? |
|
Definition
stimulate nipples
give Oxytocin
Oxytocin Challenge Test |
|
|
Term
| What does stimulating the nipples do? |
|
Definition
| Release Oxytocin - it causes cramping during contractions |
|
|
Term
| Normal Uterine Resting Tone Baseline |
|
Definition
|
|
Term
|
Definition
Bad
shows decelerations during contractions. |
|
|
Term
How is Petossin given?
What does it do? |
|
Definition
IV - slow rate. 0.5 ml until you get contractions going.
It automatically creates contractions |
|
|
Term
|
Definition
| Ultrasound - high frequency sound waves at body tissues sent by a transducer showing different densities that give an image on screen |
|
|
Term
| 2 reasons for Antepartum Fetal Assessment |
|
Definition
1. Detect Fetal Anomalies
2. Evaluate condition of fetus |
|
|
Term
| What does a doppler US show |
|
Definition
| abnormals of diastolic flow complicated by HTN or fetal growth restriction |
|
|
Term
Alpha Fetoprotein Screening
If abnormal what does it indicate |
|
Definition
measured in MSAFP and amniotic fluid
serious fetal anomalies |
|
|
Term
| Elevated MSAFP in Alpha Fetoprotein Screen |
|
Definition
| open NTD (neural tube defects) or body wall defects |
|
|
Term
| Decreased MSAFP in Alpha Fetoprotein Screen |
|
Definition
| Chromosome Anomalies such as Down Syndrome |
|
|
Term
| When is an Alph Fetoprotein done? |
|
Definition
| 16 to 18 weeks. Must have an accurate maternal weight. |
|
|
Term
| Multiple Marker Screening |
|
Definition
| shows hCG and unconjugated estriol screens for abnormalties |
|
|
Term
Triple Screen
When is it done? |
|
Definition
MSAFP, hCG and Unconjugated estriol
16 to 18 weeks |
|
|
Term
| If MSAFP are low and hCG are high is it positive or negative |
|
Definition
|
|
Term
|
Definition
| MSAFP, hCG, unconjugated estriol, inhibit A |
|
|
Term
Chronic Villi Sampling what and when
detects? |
|
Definition
sample of chorionic villi tissue
10 to 12 weeks
chromosomal, metabolic, genetic make up, DNA abnormalties |
|
|
Term
Amniocentesis detects
When is it done |
|
Definition
chromosomal abnormalties
15 to 20 weeks |
|
|
Term
| Lecithin/Sphingomyeline should be a what ratio to indicate fetal lung maturity |
|
Definition
|
|
Term
|
Definition
Percutaneous Umbilical Blood Sampling aka cordocentesis - aspiration of fetal blood
RH disease |
|
|
Term
|
Definition
| Ultrasound and FKC - fetal kick counts |
|
|
Term
When is an amniocentesis done?
What does it do? |
|
Definition
Anytime during pregnancy. It tests amnio fluid.
determines sex and lung maturity |
|
|
Term
| What is fernidine Nitrozine |
|
Definition
| Looks for spontaneous rupture of Membrane. |
|
|
Term
BPP what is it and does what
When is it done?
What is Good? |
|
Definition
Biophysical Profile - assess fetal status - it is usually a NST and US
when possible complications in pregancy
8/10 or 10/10 |
|
|
Term
What is a Modified BPP
what is good? |
|
Definition
|
|
Term
| What is Hyperemesis in pregnancy usually related to? |
|
Definition
|
|
Term
| What is usually used for Hyperemesis |
|
Definition
Zofran (its expensive)
Can use:
Phenergren at night
Reglan |
|
|
Term
| What are types of Abortions and explain each |
|
Definition
Threatened - have blood spotting, possible
Imminent - Placenta not attached, moderate vaginal bleeding, dialated
Incomplete - Premature dialation, fetal membranes visible through cervix parts left inside usually need a D & C |
|
|
Term
| What do you do if someone is having an abortion? |
|
Definition
Save Peineal Pads
Bed Rest
No sex
check for shock
If Emminent - Rhogram is -RH, |
|
|
Term
|
Definition
| Sews up Cervix and removes about 36 weeks |
|
|
Term
Ectopic Pregancy
What conditions increase risk? |
|
Definition
implantation of a fertilized ovum in an area outside the uterus cavity
Signs: One sided pain and missed period, frank/occult bleeding, hypovolemic shock
scarred tubes, STDs, tubule ligation, hx of previous ectopic, Multiple abortions |
|
|
Term
|
Definition
| partial removal of fallopian tube |
|
|
Term
| What is drug is given to cause an abortion? |
|
Definition
| Metheltrexate - it is a cancer drugs - IM injection |
|
|
Term
|
Definition
| benign anomaly of placenta - changes chorionic villi to mass clear vesicles - US shows grapelike cluster - US No FHT, vag bleeding, FH greater for EDD, elevated hCG, PIH |
|
|
Term
|
Definition
| multi babies or Hydatidiform Mole |
|
|
Term
|
Definition
NTS - FHR Activity
US - Fetal Breathing Movements
Fetal Body Movements
Fetal Muscle Tones
Amniotic Fluid Volume
It is zero Points or 2 for each (there is No One point given) cannot be 9, 7, etc. |
|
|
Term
|
Definition
| Uncontrolled vomiting during pregancy usually causes weight lose during first trimester. Mostly hospitalized b/c dehydration can cause contractions and/or cramping. Cause is unknown - think it is b/c of allergy to fetal proteins |
|
|
Term
| N/I for Hyperemesis Gravidarum |
|
Definition
| V/S, FHT if less than 12 weeks monitor by Doppler, daily wts, calorie counts, popsicles, ice chips. Anything in small quantities. |
|
|
Term
| Medications for Hyperemesis Gravidarum |
|
Definition
Zofran
Phenergran
Reglan
Benadryle
If r/t Gastric Reflux
Zantac
Nexium
Pepsin |
|
|
Term
|
Definition
Premature dilation of Cervix
Usually from STDs, surgery to cervix or uterus. If continue to miscarry dr will perform shirodkar Barter procedure to surgical stitch. It is outpatient. Removes at 36 wks. |
|
|
Term
| Ectopic Pregancy is cured by |
|
Definition
Surgical Removal.
Removes half of fallopian tube. Chance of pregancy every other month |
|
|
Term
| Hydatidiform Mole increases |
|
Definition
| chances of cancer in future |
|
|
Term
|
Definition
| abnormally implanted over the internal cervical os |
|
|
Term
| Risk fx for Placenta Previa |
|
Definition
| Multiparity, AMA, Prior CS, Smoking, Recent AB, Large Placenta |
|
|
Term
|
Definition
Painless
Possible spotting to heavy bleed
Uterus is SOFT, nontender, relaxed, with normal tone
No Fetal Distress, |
|
|
Term
|
Definition
Total - completely over internal os - C-Section eminenet
Partial - partially covers internal os
Marginal/Low-Lying (watch may move for vag bith) |
|
|
Term
| How is Placenta Previa determined? What would happen? |
|
Definition
| first visit US reveals, watch to see if it moves. at 20 weeks watch. It is a condition that would allow more US. |
|
|
Term
|
Definition
| NO vag exams, bed rest, uterine rest - no sex, v/s, labs - need CBC, clotting studies fibrinogen; nutrition and emotional support |
|
|
Term
|
Definition
pulls away from uterine wall
Unknown but fxs to increase risks: HTN, drugs, smoking, cocoaine abuse, abdominal trauma |
|
|
Term
| Types of Placentae Previa |
|
Definition
|
|
Term
| S & S of Abruptio Placentae |
|
Definition
SEVERE pain
uterus is HARD, rigid, board-like, tender
May/May not bleed - usually just spot
heavy bleeding may be concealed,
Decelerations,
Decreased Variability |
|
|
Term
| During Abruptio Placentae the FHM - Fundal Height Measurement will be |
|
Definition
| Increased because of blood accumulation. |
|
|
Term
| Abruptio Placentae what happens? |
|
Definition
Palpate Uterine Fundus; Monitor fetal Heart Rate; No Vaginal Exams; Prepare for Stat C-Section = 4 minutes
IV; Foley, Shave |
|
|
Term
| N/I for Abruptio Placentae |
|
Definition
V/S, continous monitoring, Continuous EFM, Measure abd girth, Review Labs, IV, Oxygen
Assess for Bleeding, Uterine Activity, Abdominal Pain |
|
|
Term
Disseminated Intravascular Coagulation (DIC)
S/S |
|
Definition
what happens in pregnancy when person doesn't clot well.
bleed at IV site, bruising, nose bleeds, *D-DIMER, Uterus firm, check for lacerations, check Platelet counts, have packed blood cells - RBC ready |
|
|
Term
|
Definition
T - Toxoplasmosis - in cat liter
O - Other Infections
R - Rubella - they will do a titer
C - Cytomegalovirus - wash hands
H - Herpes 1 or 2 - Active Case = CS |
|
|
Term
| How is a Herpes baby delivered |
|
Definition
| If herpes is controlled (Valtrex at 36 weeks continuously to suppress virus) and there are no active lesions - vaginally. |
|
|
Term
| Group B Strep what is it? When is test done |
|
Definition
bacterial infection found in women. Very common. Not STD - tell them that. Does not cause Symptoms
Done at 35/37 weeks |
|
|
Term
| STDs of Pregnancy Complications |
|
Definition
Herpies type 1 and 2
Syphillis
Gonorrhea
Chlamydia
Trichomoniasis
HPV
HIV |
|
|
Term
| What STds can be treated and goes away unless re-exposed. |
|
Definition
| Syphillis, Gonorrhea, Chlamydia, and Trichomoniasis |
|
|
Term
|
Definition
| Guardisil - for women NOT pregnant |
|
|
Term
Signs and Symptoms of and how do you treat?
1. Candidiasis - Yeast
2. Bacterial Vaginosis |
|
Definition
1. cottage cheese like discharge - treated with Diflucan
2. Irritation, raw feeling with white discharge. Swap under a microscope Treated with Flagyl. |
|
|
Term
If UTI are untreated they can cause
S/S of UTI |
|
Definition
Preterm Labor, pyelonephritis.
dark urine, smells, particles in it, if suspected they do a urinalysis to make sure and culture to see what kills it |
|
|
Term
|
Definition
| 1st visit and at 28 weeks |
|
|
Term
| What Hmg level would an Iron Supplement |
|
Definition
|
|
Term
| What are the different types of Anemia |
|
Definition
Iron deficiency - most common
Megaloblastic - Folic Acid Deficit
Hemoglobinopathies - sickle cell & thalassemia |
|
|
Term
S/S of Iron Deficiency Anemia
How is it determined? |
|
Definition
weakness, fatigue, pale with dark circles, elevated hr
CBC is only way to know |
|
|
Term
| N/I of Iron Deficiency Anemia |
|
Definition
Monitor H/H for a couple of weeks
Administer Iron Supplements (take with Vit C)
* 3 weeks on/3 wks off
Monitor for Constipation - No Colace first! |
|
|
Term
|
Definition
| Mom is Rh negative and baby Rh positive, autosomal recessive trait, can be unrelated to pregnancy like through blood trasfusions, during L/B blood can mix |
|
|
Term
|
Definition
| At 28 weeks and after delivery usually within 48 hrs |
|
|
Term
| What is the screen for Antibody (Rh negative blood)? When is it given? |
|
Definition
Indirect Coombs on mom
Direct Coombs on Baby |
|
|
Term
| ABO Incompatibility is when |
|
Definition
Mother type O
Baby is A, B, or ABN
can have problems of frequent miscarriage, but this is Rare. |
|
|
Term
|
Definition
| Pregnancy Induced Hypertension |
|
|
Term
| What is the difference of Preeclampsia and Eclampsia |
|
Definition
Preeclampsis no seizures
Eclampsia - seizures |
|
|
Term
| When is PIH usually diagnosed |
|
Definition
| The 3rd trimester around 28 wks |
|
|
Term
| What tests does HTN include |
|
Definition
|
|
Term
| How is Hypertension diagnosed |
|
Definition
| 2 visits back to back with elevated b/p |
|
|
Term
|
Definition
| headache, blurred vision, spots in visiton, don't feel right |
|
|
Term
|
Definition
140/90 or elevation of 30/15 over baseline
Proteinuria trace to 1+
Pretibial Edema
Wt gain of 2 to 2.5 lbs week |
|
|
Term
| S/S of Severe Preeclampsia |
|
Definition
160/110
Proteinuria 3+ to 4+ or more than 5 in 24 hourse; sudden wt gain with facial edema, pitting pretibial edema, CNS irritation |
|
|
Term
| What are the baseline PIH Labs |
|
Definition
Liver enzyme - ALT and AST
CBC - reduced RBC and Platelets and increased Hgb |
|
|
Term
|
Definition
| CNS, Vision, Urination (problems), reflexes, Epigastric Pain |
|
|
Term
|
Definition
| Delivery - may take up to six weeks afterwards |
|
|
Term
|
Definition
| Left lateral position, monitor B/P and Wt, neuro status, DTRs, Fluids PO or IV, I/Os, elevated protein is indicated |
|
|
Term
What drug is given for Preeclampsia
What is its class? |
|
Definition
Magnesium Sulfate
ANTICONVULSANT - it is NOT an antihypertensive |
|
|
Term
MAGNESIUM SULFATE
Anticonvulsant
usually started slow then increased to (maximum) 2 g hour, usually on post pardum, 1 nurse to 1 patient, Drug is potent |
|
Definition
| Therapeutic Level is 4 to 8 mg/d>, given IVPB 4 to 6 g in 100ml over 15 to 20 minutes at 2g per hour. WATCH B/P CLOSELY, give 24 hrs after birth |
|
|
Term
| What side effects would cause Magnesium Sulfate to be discontinued? |
|
Definition
decreased respiration of 10 or less per min
low b/p
decreased reflexes
less than 30 ml/hr urinary output |
|
|
Term
| Side effects of Magnesium Sulfate |
|
Definition
| Vassodilation, flush, hot flash, headaches, blurred vision, nasal congestion, NAUSEA, VOMITING, DECREASED RESPIRATIONS, Reduced HR |
|
|
Term
| What are the babies side effects of Magnesium Sulfate? |
|
Definition
| decreased calcium, increased mag, decreased respirations. |
|
|
Term
| What is the drug of choice for HTN in pregancy? |
|
Definition
|
|
Term
| What are S/S of Chronic HTN |
|
Definition
| headaches, visual changes, inc b/p, delayed fetal growth, oligohydramios - not enough amniotic fluid, will have repeated US |
|
|
Term
| The Antihypertensive medications from most prescribed to least |
|
Definition
Aldomet (cat B
Apresoline (hydralazine)
Labetalol - BB
Procardia |
|
|
Term
|
Definition
| dyspnea, fatigue, peripheral edema, anginal type poain, palpitations, tachycardia, pulmonary edema, S/S respiratory infections |
|
|
Term
|
Definition
| V/S, FHR, Activity and Rest, nutrition, fluid, resp infection watch, may have holter monitor |
|
|
Term
| How does insulin requirements change in diabetes throughout pregnancy |
|
Definition
less in first trimester
increased in 2/3 |
|
|
Term
When is a glucose screen?
what is the limits |
|
Definition
28 wks
equal to or more than 140 = diet and exercise. if over 200 = insulin |
|
|
Term
| Gestational Diabetes is usually diagnosed when? What does this increase the risk for |
|
Definition
|
|
Term
|
Definition
| Non Fasting Glucose challenge at 28 wks |
|
|
Term
|
Definition
| Fasting Glucose Challenge |
|
|
Term
| GCT over 140 requires monitoring how often |
|
Definition
| every 4 hours - bring results into the doctor |
|
|
Term
|
Definition
| AMA, Smoking, Premature Baby, Increased UTI and yeast infections |
|
|
Term
| What is increased in baby with HTN |
|
Definition
|
|
Term
| What is the calorie recommendation per day if diabetic |
|
Definition
30 cal/kg/day
if obese 25 cal/kg/day
3 to 6 small meals a day and decrease carbs |
|
|
Term
| Premature labor is what (timewise)? |
|
Definition
|
|
Term
| A Term Pregnancy is (time) |
|
Definition
|
|
Term
| How is Premature labor determined? |
|
Definition
The contractions are regular (every 10 minutes and lasting at least 30 sec)
Cervix is dialated 2 cm or more
Ephasement is 80% or more |
|
|
Term
|
Definition
Positve Fetal Fibronectin -
22 to 34 weeks to be accurate |
|
|
Term
| Preterm labor is not stopped when? |
|
Definition
greater than 4 cm dilation and is in active labor
baby has complications
baby died
membrane is ruptured |
|
|
Term
| Risk fx for Premature Labor |
|
Definition
| African American, Unmarried, low ed, inadequate prenatal, poor hygiene, diabetes, incompetent cervix, overdistention, multifetal, PROM, |
|
|
Term
| What are the 2 tests for PROM |
|
Definition
Nitrizine paper
Ferning - sample under microscope |
|
|
Term
| What is assessed in Premature labor? |
|
Definition
| increased bloody discharge, leaking amniotic fluid, increased back pain, leaking amniotic fluid, palpable fetal contractions, diarrhea, sense of feeling bad |
|
|
Term
|
Definition
| Maintain bedrest, education because activity will increase pelvic pressure, no sex, no pelvic stimulation, increase hydration by IV/PO |
|
|
Term
| What IV is given in pregnancy? |
|
Definition
|
|
Term
Tocolytics do what?
Brethine is an example |
|
Definition
| decrease uterine contractions |
|
|
Term
| What medications are given for Preterm labor? |
|
Definition
Tocolytics - Brethine
Ca Channel Block
Prostaglandin Synthitase Inhibitors |
|
|
Term
| If in Preterm labor what do you do? |
|
Definition
|
|
Term
|
Definition
|
|
Term
What are the steroids given for Preterm Labor
What does it do? |
|
Definition
Betamethazone or Dextamethazone
increase baby's lung maturity/capacity |
|
|
Term
|
Definition
|
|
Term
| dosage for Dextamethazone |
|
Definition
|
|
Term
| What are the tocolytic agents prescribed during Preterm Labor |
|
Definition
Brethin - terbutaline
Beta-Adrenergic - not FDA approved - what is given most (Asthma med) - keeps uterine from contracting. PO
Yutopar - ritodrine - FDA approved not normally given - keeps uterine from contraction |
|
|
Term
| Anticonvulsants prescribed for preterm labor? |
|
Definition
| Mag Sulfate - Anticonvulsant - brings b/p down. Stops Contractions. |
|
|
Term
| If given Mag Sulfate for Pre=Eclampsia but want to have contractions what does doctor give? |
|
Definition
|
|
Term
|
Definition
| causes contractions and increased blood pressure |
|
|
