1
Q
which screening is a prenatal blood test done during 15-22 weeks pregnancy to assess the risk of certain birth defects in the developing baby.
It measures the levels of four substances in the mother’s blood: and helps identify an increased risk for:
down syndrome
Edwards syndrome
Neural tube defects - spina bifida
A
MSAFP “Quad screen”
2
Q
which screening is used to assess the risk of certain chromosomal abnormalities in the developing baby such as:
down syndrome
patau syndrome
Edwards syndrome
problems with # of sex chromosomes
A
Noninvasive prenatal test (NIPT) or cell free DNA
3
Q
after delivery does maternal insulin requirements i/d
why is breastfeeding encouraged in DM moms
A
decrease
glucose leaves body through breast milk
4
Q
what prophylactic med do we give a mother who is Rh- carrying a Rh+ fetus?
what scenario would we give this med?
28 weeks T/F
before/after spontaneous or induced abortion of ectopic preg
before/after invasive procedure during preg
before/after maternal trauma
A
Rh immune globulin IM (Rhogam)
- at 28 weeks
- After spontaneous or induced abortion of ectopic preg
- After invasive procedure during preg
- After maternal trauma
5
Q
the blood types of the mother and baby are incompatible is called ___________________
A
ABO incompatibility
6
Q
no change vs increase intake during pregnancy?
- Thiamine
- Sodium
- Riboflavin
- Niacin
- Vitamin B
- Iodine
- Folic acid
A
increase
no change - sodium
increase
increase
increase
no change - iodine
increase - 400 mcg before, 1 mg during
7
Q
which type of HTN
patient D:
25 weeks
yes proteinuria
sudden increase in well controlled chronic HTN
Patient has 2 readings of high BP at least 4 hours apart
Systolic 140+
Diastolic 90+
Think what gestation is patient?
Is proteinuria involved?
A
Chronic HTN w/ superimposed preeclampsia
Chronic HTN - Before 20 weeks, No
Gestation HTN - After 20 weeks, No
Preeclampsia - After 20 weeks, Yes
Chronic HTN w/ superimposed preeclampsia - After 20 weeks,
Sudden increase in well controlled chronic HTN, Yes
8
Q
patient A is being screened for gestational DM with 1 hour GTT
does she need to fast?
her glucose came back at 150. Did she pass or fail?
A
- 1 hour GTT (glucose tolerance test)
- Don’t have to fast
- > 140 = failed
9
Q
what should the nurse tell the mom that is 37 weeks that called c/o contractions/cramping?
think preterm or term, frequency and other associated signs
A
could be labor!
- Counsel to go to hospital when contractions are 5 mins apart, getting stronger every hour, or if water breaks
if contractions/cramping is:
- Associated with heavy vaginal bleeding (more than spotting/bloody show)
- Change in fetal movement
10
Q
common discomforts - round ligament pain
cause -
when to be concerned -
teaching -
A
- Cause
Weight of uterus stretching round ligament - When to be concerned
If pain is moving (not transient) - Teaching
Warmth to abdomen
Slow changes from lying to sitting/standing
11
Q
what should the nurse tell the mom that is 20 weeks that called c/o contractions/cramping?
think preterm or term, frequency, cause, and other associated signs
A
less then 37 weeks = preterm
preterm if contraction/cramping is:
- Rare/occasional
- Associated with cause like increased activity
- associated with Normal fetal movement, no vaginal bleeding/leaking of fluid
OK
preterm if contraction/cramping is:
- Regular (>4-6/hour)
- associated with no cause
- associated with Change in fetal movement, vaginal bleeding, or leaking of fluid
NOT OK
12
Q
10 weeks gestation patient presents with
- Uni-lateral abdominal pain
- Dizzy
- Vaginal bleeding
what should the nurse suspect?
threatened abortion
ectopic pregnancy
molar pregnancy
A
ectopic pregnancy
Uni-lateral abdominal pain = big giveaway
13
Q
iron deficiency vs sickle cell vs folic acid anemia?
Treatment – prevent crisis, IV fluids, O2, abx, folic acid, analgesics
Treatment – folic acid 400 mcg before pregnancy, 1 mg during pregnancy
Treatment – supplemental iron
A
sickle cell
folic acid
iron deficiency
14
Q
which test measures
- fetal breathing movements
- gross body movements
- fetal tone
- amniotic fluid volume
A
BPP
15
Q
how do we screen for gestational DM
A
1 hour glucose tolerance test
3 hour GTT
16
Q
which stress test evaluates oxygenation and carbon dioxide exchange of the placenta
A
contraction stress test
17
Q
what is the desired score on a contraction stress test - negative or positive?
A
- negative test = desired score, no late decelerations, no signs of fetal distress
- positive test = bad, late decelerations, signs of fetal distress, consider preparing for C/S
18
Q
which technique assesses fetal well-being by using high frequency sound waves to deflect off tissues in the uterus to a transducer showing structures
- Non invasive, painless, non radiating
- No harmful effects
- 3D and 4D images
- Identify anomalies, neural tube deficits, skeletal malformations
A
Abdominal Ultrasound
19
Q
common discomforts - SOA
cause -
when to be concerned -
teaching -
A
- Cause
- Pressure on diaphragm
- hormones
- When to be concerned
- Dyspnea not r/t activity
- Accompanied with chest pain, cough, heart palpitations
- Persistent despite position changes
- Teaching
- Good posture when sitting
- Prop up HOB
20
Q
ABO incompatibility
Maternal serum antibodies against ___ and ___ are present
hemolysis of fetal RBC leads to hypobilirubinemia/hyperbilirubinemia
will an indirect/direct combs test be conducted?
would we expect mild/severe anemia to occur?
A
Maternal serum antibodies against A and B are present
hyperbilirubinemia
Cord blood – (direct combs test) – Done on cord/infant blood, Detects if maternal antibodies are adhered to infants RBC
Mild anemia may occur, severe anemia doesn’t generally occur
21
Q
Gestational trophoblastic disease:
type - ___________________-
abnormal development occurs in the fertilized egg, not a viable pregnancy
A
Molar pregnancy (hydatidiform mole)
22
Q
partial molar pregnancy vs complete molar pregnancy
(abnormal ovum + normal sperm)
(normal ovum + abnormal sperm)
A
- Complete mole – (abnormal ovum + normal sperm) ovum containing no genetic material is fertilized by normal sperm
- Partial mole – (normal ovum + abnormal sperm) normal ovum is fertilized by 2 sperm or sperm that hasn’t divided
23
Q
when should mom seek care if she thinks fetus is moving less or not at all?
A
Go to HCP if <10 movements in 2 hours
24
Q
advanced maternal age =
medical risks associated with AMA
i/d miscarriage
i/d GDM and GHTN
i/d placenta previa
i/d difficult labor
i/d c-section
i/d multiple births
i/d down syndrome
i/d infertility
A
35
increase in all
25
which type of genetic test identifies individuals who carry a gene mutation for a specific genetic condition.
These individuals typically don't experience any symptoms of the condition themselves.
However, they can pass the mutated gene on to their biological children.
carrier screening
26
common discomforts - ankle edema
cause -
when to be concerned -
teaching -
- Cause
- Decreased venous return
- When to be concerned
- Generalized edema
- Sudden weight gain
- Headaches
- Visual changes
- Teaching
- Avoid prolonged sitting or standing
- Keep feet and legs elevated
- Compression socks
- Avoid constrictive clothes, esp around waist
- Exercise
- fluids
27
what should the nurse tell the mom that is 38 weeks that called c/o vaginal bleeding?
think preterm or term and amount, cause
Term (37 weeks or more)
- If cause can be identified (activity, sex, exam) = OK
- spotting with contractions = OK, labor!
- If cause can’t be identified = may evaluate for labor/problems
- persistent bleeding, no known cause = NOT OK, go to hospital
28
patient A - has high BMI, hx of DM and HTN
Is she high risk or low risk? when should she be screened for DM?
patient B - has normal BMI, no hx of DM or HTN
is she high risk or low risk? when should she be screened for DM?
patient A
High risk – screen as early as possible
patient B
Low risk – screen 24-28 weeks
29
diagnostic vs screening test?
Noninvasive prenatal test (NIPT) or cell free DNA
MSAFP “Quad screen”
carrier screening
all screening tests, not diagnostic
30
what should the nurse tell the mom that is 37 weeks that called c/o leaking fluid?
think preterm or term and type of fluid
Term (37 weeks or more)
- Leukorrhea – clear/white liquid, no/mild odor = normal, not labor
- Urine – teach practice Kegels = normal, not labor
- Amniotic fluid = go to hospital, labor!
Consider amount – spotting ok, large amount like having to wear a pad to catch the fluid = too much fluid needs further investigation
31
# which one?
- Partial/Complete mole – (abnormal ovum + normal sperm) ovum containing no genetic material is fertilized by normal sperm
- Partial/Complete mole – (normal ovum + abnormal sperm) normal ovum is fertilized by 2 sperm or sperm that hasn’t divided
- Complete mole – (abnormal ovum + normal sperm) ovum containing no genetic material is fertilized by normal sperm
- Partial mole – (normal ovum + abnormal sperm) normal ovum is fertilized by 2 sperm or sperm that hasn’t divided
32
types of abortion:
Miscarriage – lose of fetus before/after 20 weeks
Stillbirth – loss of fetus before/after 20 weeks
Miscarriage – lose of fetus before 20 weeks
Stillbirth – loss of fetus after 20 weeks
33
Fertilized egg in improper location - ______________
Treatment – methotrexate IM
- Avoid sun
- Report severe pain and heavy bleed
s/s
- Uni-lateral abdominal pain
- Dizzy
- Vaginal bleeding
ectopic pregnancy
34
__________ ____________ disease
group of rare tumors that develop in the uterus after conception.
Proliferation of trophoblastic cells
type - molar pregnancy
Gestational trophoblastic disease
35
which is more severe
ABO incompatibility or Rh incompatibility
Rh incompatibility
36
Patient A took 3 hour GTT.
does she have to fast?
BS 1: 160
BS 2: 130
BS 3: 145
BS 4: 130
did she pass or fail?
- Have to fast
- Test BS 4 times, if elevated 2+ times = failed
37
big 4 dangerous things to ask mom about
fetal movement/kick count
contraction/cramping
leaking
bleeding
38
what test produces sound/vibration to stimulate fetus
which should cause accelerations in FHR should show on fetal monitor
fetal acoustic stimulation and vibroacoustic stimulation test
39
which scenario are we concerned could to Rh incompatibility?
1st pregnancy mother who is Rh- carrying a Rh+ fetus
2nd pregnancy mother who is Rh- carrying a Rh+ fetus
Why?
2nd pregnancy mother who is Rh- carrying a Rh+ fetus
1st pregnancy she wouldn't have developed antibodies already so we can prevent it.
2nd pregnancy she has probably already developed Rh antibodies from a previous pregnancy so Rhogam won't be effective in preventing complications in the current pregnancy.
40
which test Shows fetus ability to respond to its environment by acceleration of FHR with movement
- Monitors are placed on belly which show:
- accelerations of fetal HR with movement or contractions
- adequate oxygenation and intact CNS
non stress test
41
in pregnant patients with heart disease watch for signs of cardiac decompensation:
- cough T/F
- dyspnea T/F
- edema T/F
- murmur T/F
- palpations T/F
- rales T/F
- weight loss T/F
all true
except
weight gain, not weight loss
42
in pregnant patients with heart disease assess factors that increase stress on heart:
- rest T/F
- anemia T/F
- infection T/F
- stress T/F
- lack of support T/F
- home and career demands T/F
rest - false, rest is encouraged
all true
43
which test Determines how much fetus Rh+ blood is in maternal circulation to calculate the amount of Rhogam needed
- Kleihauer-betke test
44
common discomforts - heartburn
cause -
when to be concerned -
teaching -
- Cause
- Pressure on stomach
- Hormones – progesterone
not concerned - just teaching
- Teaching
- Non sodium antacids
- Avoid lying down after eating
- Avoid trigger foods
- Small frequent meals
- Don’t smoke
- Prescription meds
45
no change vs increase intake during pregnancy?
- Calories
- Fat
- Carbohydrates
- Protein
- Calcium
increase
no change - fat
increase
increase
increase
46
what type of abortion?
Incomplete/complete abortion – loss of fetus, remnants of pregnancy is left in uterus
Incomplete/complete abortion – loss of fetus, no remnants of pregnancy is left in uterus
Incomplete abortion – miscarriage has occurred, remnants of pregnancy is left in uterus
Complete abortion – miscarriage has occurred, no remnants of pregnancy is left in uterus
47
which type of HTN
patient C:
25 weeks
yes proteinuria
Patient has 2 readings of high BP at least 4 hours apart
Systolic 140+
Diastolic 90+
Think what gestation is patient?
Is proteinuria involved?
Preeclampsia
Chronic HTN - Before 20 weeks, No
Gestation HTN - After 20 weeks, No
Preeclampsia - After 20 weeks, Yes
Chronic HTN w/ superimposed preeclampsia - After 20 weeks,
Sudden increase in well controlled chronic HTN, Yes
48
After birth where mom is Rh- and fetus Rh+ do we do a indirect/direct combs test?
why? Detects if maternal ___________ are adhered to infants ____________
is the test conducted on the mother or fetus?
direct combs test
Detects if maternal antibodies are adhered to infants RBC
Done on cord/infant blood
49
abortion question - think gestation, cervix, placenta
Patient A is 16 weeks gestation, cervix is closed , unexplained bleeding. what type of abortion?
Threatened
Immanent
incomplete
complete
Miscarriage – lose of fetus before 20 weeks
Threatened abortion – cervix is closed, potential for miscarriage
50
Gestational diabetes – insufficient ___________ production due to pregnancy
insulin
51
which diagnostic test determines fetal chromosomal abnormalities
invasive
10-13 weeks
Risks
- ROM – water break
- Bleeding
- Intrauterine infection
- Possible limb reduction
- Birth defects
involves obtaining a sample of _____ from the placenta
chronic villus sampling
52
common discomforts - backache
cause -
when to be concerned -
teaching -
- Cause
- Lordosis – from growing abdomen
- Hormones – progesterone – relaxing pelvic joints
- When to be concerned
- Pain is coming and going at regular intervals = contractions
- Accompanied with s/s of UTI or kidney infection
- Teaching
- Pelvic tilt exercise
- Good posture
- Avoid fatigue
- Good body mechanics when lifting
- Avoid high heels
53
common discomforts - constipation
cause -
when to be concerned -
teaching -
- Cause
- Hormones – progesterone – decreases peristalsis and gastric emptying
- Increased iron
- Decreased motility
- When to be concerned
- Abdominal pain
- Contractions
- Teaching
- Fluids
- Fiber
- Exercise
- Regular bowel habits
- Laxative or stool softener
54
are these risk associated with adolescent or obese patients?
- Spontaneous abortion
- GDM
- Preeclampsia
- Labor induction
- C/S
- Fetal anomalies
- Obese child
obese
55
how much caffeine intake should mom have
- Caffeine intake < 200 mg/day
56
common discomforts -n/v or morning sickness
cause -
when to be concerned -
teaching -
- Cause
- Increased HCG levels
- 1st trimester
- When to be concerned
- Persistent
- Can’t keep food/fluid down
- Weight loss
- Teaching
- Avoid empty stomach – eat crackers, dry toast before rising
- Small frequent meals
- Avoid greasy, spicy foods
- Drink carbonated beverages
- meds
57
which type of HTN
patient A:
15 weeks
no proteinuria
Patient has 2 readings of high BP at least 4 hours apart
Systolic 140+
Diastolic 90+
Think what gestation is patient?
Is proteinuria involved?
chronic HTN
Chronic HTN - Before 20 weeks, No
Gestation HTN - After 20 weeks, No
Preeclampsia - After 20 weeks, Yes
Chronic HTN w/ superimposed preeclampsia - After 20 weeks,
Sudden increase in well controlled chronic HTN, Yes
58
medication poses the greatest risk to the fetus is in ____ trimester because ___
- Greatest risk = 1st trimester while organs are developing
59
which diagnostic test determines fetal chromosomal abnormalities
invasive
when done at 15-20 weeks – genetic testing
when done at 3rd trimester – determine fetal lung maturity
- L/S ration – mature = 2:1
involves obtaining ___________
amniotic fluid test
60
are genetic screening tests used to diagnose things or identify risks for things?
Not diagnostic
screening = identifies risk
based on risk, mom can opt for a diagnostic test = CVS and amniocentesis
61
ABO incompatibility occurs when
mom is type ______
fetus is type __, ___, or ____
- Mom is type O
- Fetus is Type A, B, or AB
62
what is the next step if non stress test was nonreactive?
perform BPP
63
in pregnant patients with heart disease the recommended diet is:
- H/L iron
- H/L protein
- H/L sodium
- Adequate calories
- High iron
- High protein
- Low sodium
- Adequate calories
64
which test measures the fluid-filled space at the back of a developing baby's neck
- Screens for:
down syndrome
Edwards syndrome
patau syndrome
- Can be done at 11 – 14 weeks
- Fetus with measurement of _____ mm or greater are at risk
- Non-invasive
Nuchal translucency testing
3 mm
65
in pregnant patients with heart disease:
left/right side lying is best -
during labor - short and moderate/intense pushes with periods of rest in between pushes
epidural recommended/not recommended - why?
- Side lying – left side best
- Pushing
- Shorter
- Moderate pushes
- Rest between pushes
- Epidurals recommended – helps decreases cardiac output and O2 demand
66
Patient A failed 1 hour GTT. whats next?
3 hour GTT
67
After birth where mom is Rh- and fetus Rh+ we do a cord blood – (direct combs test) to the infant to detect if maternal antibodies are adhered to infants RBC.
what does a negative test result = blood has/hasn't mixed
what does a positive test result = blood has/hasn't mixed
If test was negative = give/don't give _________
If test was positive = give/don't give ____________
- Negative = blood hasn’t mixed
- Positive = blood has mixed
If test was negative = blood hasn't mixed yet so we Give Rhogam to prevent sensitization
If test was positive = don’t give Rhogam bc its too late blood has already mixed and mom has already made antibodies against fetal blood, instead monitor infant for hemolytic disease
68
common discomforts - urinary frequency
cause -
when to be concerned -
teaching -
- Cause
- Pressure on bladder
- Hormones
- When to be concerned
- Accompanied with s/s of UTI
- Teaching
- Void every 2 hours during the day
- Empty bladder completely
- Limit intake before bed
69
gestational DM
newborn at risk for hypoglycemia or hyperglycemia after delivery?
hypoglycemia
70
no change vs increase intake during pregnancy?
- Zinc
- Magnesium
- Iron
- Vitamin E and K
- Vitamin D,E,C
increase
increase
increase
no change - E and K
increase
71
if there are no late decelerations on a contraction stress test, is this a good thing or bad things, what will the score be?
what does a late deceleration indicate?
good thing!
negative test
late deceleration = decrease in FHR during contraction = poor placenta perfusion
72
what should the nurse teach the mom the best way to feel fetal movement
- Eat and drink something
- Go to quiet room
- Side lying position
- Hands on abdomen
- Pattern - Check same time of day 1 hour after meals
73
what type of abortion?
abortion question - think gestation, cervix, placenta
18 weeks, cervix is open, placenta is detaching
Miscarriage – lose of fetus before 20 weeks
Immanent abortion – cervix is open, placenta is detaching, miscarriage is likely
74
if you suspect low BS in a pregnant women with DM what should you do first
check BS
75
_____ stress test: Measures the baby's heart rate response to movement or activity. A healthy baby's heart rate should normally increase with movement.
_____ stress test: Evaluates how the baby tolerates stress, such as contractions during labor. Contractions can temporarily reduce blood flow to the baby.
non stress test
contraction stress test
76
which scenario(s) are we concerned could lead to ABO incompatibility?
1st pregnancy mother who is Type O carrying a Type AB fetus
2nd pregnancy mother who is Type O carrying a Type A fetus
3rd pregnancy mother who is Type B carrying a Type O fetus
- Mom is type O
- Fetus is Type A, B, or AB
can be an issue in 1st, 2nd, 3rd, etc. pregnancy as long as mom is type O and fetus is Type A, B, or AB.
77
associated with DM, anemia, HIV, or heart disease?
Prophylactic ZDV
c/s
bottle feed, don’t breast feed
HIV
78
Rh- mother carrying a Rh+ fetus (Rh Alloimmunization or sensitization)
fetus is at risk for:
- anemia T/F
- fetal edema T/F
- DM T/F
- congestive heart failure T/F
- jaundice T/F
- neurological damage T/F
- severe hemolytic syndrome T/F
all true expect DM
fetal risk
- anemia and fetal edema
- congestive heart failure
- jaundice
- neurological damage
- severe hemolytic syndrome
79
Preeclampsia can lead to
____________
___________
Preeclampsia can lead to
- eclampsia (seizures)
- HELLP syndrome
80
calorie and fluid requirements for pregnant woman?
150-300 calories/day in 2nd and 3rd trimester
8-10 cups of fluid
4-6 cups should be water
81
2 diagnostic tests?
CVS and amniocentesis
82
which technique that assesses fetal well-being can be used to:
date pregnancy if mom doesn't know the date of her last period
predict preterm birth
measure cervical length
measure funneling
Transvaginal ultrasound
83
what should the nurse tell the mom that is 20 weeks that called c/o leaking fluid?
think preterm or term and type of fluid, amount
Preterm (less then 37 weeks)
- Leukorrhea – clear/white liquid, no/mild odor = spotting, normal
- Urine – teach practice Kegels = spotting, normal
- Amniotic fluid = go to hospital
Consider amount – spotting ok, large amount like having to wear a pad to catch the fluid = too much fluid needs further investigation
84
gestational DM
- 1st trimester – i/d need for insulin
- Late 1st trimester – i/d need for insulin
- maternal Glucose can/can't cross fetal membrane
- maternal insulin can/can't cross fetal membrane
- Fetus makes own Insulin - T/F
decrease
increase
can
cant
True
85
which technique assesses fetal well-being by using Uses a sterile probe inserted into vagina to show images of structures
Closer to structure = clearer images
Uses
- Pregnancy dating
- Predictor of preterm births - measures cervical length and Funneling (cone shaped)
Transvaginal ultrasound
86
what screening test would we do for a mother who is Rh- carrying a Rh+ fetus - indirect/direct combs test
why?
is the test conducted on the mother or fetus?
when is it done (2)
at birth
at prenatal visit
at 28 weeks
at 20 weeks
antibody screening test (indirect combs test)
purpose is to see if mom Rh- has made antibodies against fetus Rh+
done on mother who is Rh-
done at prenatal visit and 28 weeks
87
which type of HTN
patient B:
25 weeks
no proteinuria
Patient has 2 readings of high BP at least 4 hours apart
Systolic 140+
Diastolic 90+
Think what gestation is patient?
Is proteinuria involved?
Gestation HTN
Chronic HTN - Before 20 weeks, No
Gestation HTN - After 20 weeks, No
Preeclampsia - After 20 weeks, Yes
Chronic HTN w/ superimposed preeclampsia - After 20 weeks,
Sudden increase in well controlled chronic HTN, Yes
88
are these risk associated with adolescent or obese patients?
- Preterm birth
- LBW
- Iron deficiency anemia
- Cephalopelvic disproportion CPD – small pelvic
- Drug alcohol use
- STI
- Preelclampsia and eclampsia
adolescent
89
common discomforts - leg cramps
cause -
when to be concerned -
teaching -
- Cause
- Unsure
- Nerve pressure
- Circulation
- Electrolyte imbalance
- When to be concerned - not concerned, just teaching
- Teaching
- Massage
- Warm soaks
- Stretching exercises
- Dorsiflex foot
90
Rh- mother carrying a Rh+ fetus is called ____________
If blood is mixed = ____________ are produced and they attack fetal ______
this triggers the rapid production of erythroblasts - the precursors to red blood cells
hyperbilirubinemia – excess of bilirubin in blood, from breakdown of ______, leads to _________ noticed on the fetus skin
Rh Alloimmunization (sensitization)
If blood is mixed = maternal antibodies are produced and they attack the fetal RBC
this triggers the rapid production of erythroblasts - the precursors to red blood cells
hyperbilirubinemia – excess of bilirubin in blood, from breakdown of RBC, leads to jaundice
91
what should the nurse tell the mom that is 20 weeks that called c/o vaginal bleeding?
think preterm or term and amount, cause
preterm
Spotting
- If cause can be identified (activity, sex, exam) = OK
- If cause can’t be identified = NOT OK, seek care
More than spotting = NOT OK, go to hospital
92
indicated vs contraindicated
1. exercise while pregnant
2. exercise after water breaks
3. exercise if you have BP issues
4. exercise if you have an incompetent cervix
5. avoid exercising in hot humid weather
6. continue exercising with vaginal bleeding
7. exercise with history of preterm labor
8. exercise after 26 weeks with placenta previa
1. I
2. C
3. C
4. C
5. I
6. C
7. C
8. C
93
Recurrent miscarriage – ______ or more consecutive losses
Recurrent miscarriage – 3 or more consecutive losses
94
reactive vs nonreactive?
if there are no accelerations observed in a non stress test, what would the results be?
if there is 1 acceleration on a non stress test, what would the results be?
nonreactive
nonreactive
- nonreactive test = accelerations are not present or don’t meet above criteria. Fetus is at risk or sleeping = perform BPP
95
Hyperemesis gravidarum
Excessive ____________ during pregnancy that impacts ____________ and ________________
Hyperemesis gravidarum
Excessive vomiting during pregnancy that impacts hydration and nutrition
96
if BPP is abnormal, what do we do next
non stress test
97
which is the desired result of a non stress test - reactive or nonreactive?
reactive
98
s/s Molar pregnancy (hydatidiform mole)
- bright red vaginal bleed / dark brown vaginal bleed - which one
- Anemia - T/F
- Hydropic vesicles – grape like - T/F
- Uterus larger/smaller then expected for gestational age - which one
- Absence of fetal heart beat - T/F
- Low/elevated HcG - which one
- Low/elevated MSAFP - which one
- Vomit - T/F
- preeclampsia - T/F
- Dark brown vaginal bleed
- Anemia
- Hydropic vesicles – grape like
- Uterine enlargements – larger then expected for gestational age
- Absence of fetal heart beat
- Elevated HcG – higher than expected for gestation
- Low MSAFP
- Vomit
- preeclampsia
99
which technique uses ultrasound technology to assess the blood flow through the umbilical cord and measure blood flow changes in maternal and fetal circulation
- Noninvasive
- Signal is directed off the RBC moving within the vessels and creates a wave form picture
- Highest velocity peaks are systolic
- Lowest velocity peaks are diastolic
- Elevations >95th percentile for gestational age = abnormal
Doppler blood flow studies (umbilical velocimetry)
100
non stress test results
- reactive test (< 32 weeks) = in a ___ minute window, ___ or more accelerations, ___ bpm above baseline, lasting at least __ secs
- reactive test (32 weeks or more) = in a ___ minute window, ___ or more accelerations, ___ bpm above baseline, lasting at least ___ secs
- reactive test (< 32 weeks) = in a 20-minute window, 2 or more accelerations, 10 bpm above baseline, lasting at least 10 secs
- reactive test (32 weeks or more) = in a 20-minute window, 2 or more accelerations, 15 bpm above baseline, lasting at least 15 secs
101
most reliable way to detect drug use - cord sampling vs urine screen
- Cord sampling – most reliable way to detect drug use
- Urine screen – only in system 24-48 hours
sav 332
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