1
Q
how long does the menstrual cycle take
A
26-35 days
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2
Q
when is an egg released before menstruation occurs
A
14 days
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3
Q
the shedding of the outer 2/3 of the endometrium with bleeding is called?
A
menstruation
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4
Q
how many phases of menstrual cycle are there?
A
4
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5
Q
site of oxygen, nutrient and waste exchange between the fetal and maternal blood supplies
A
placenta
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6
Q
when is a placenta fully developed
A
14 weeks
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7
Q
what is pinocytosis
A
large bacteria passing through the placental barrier
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8
Q
what is human chorionic gonadotropin (HCG)?
A
hormone that triggers body to make estrogen and progesterone
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9
Q
what is the original source of steroid hormones
A
estrogen and progesterone
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10
Q
what are the 3 categories of signs of pregnancy
A
presumptive
probable
positive
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11
Q
amenorrhea is considered what kind of sign of pregnancy
A
presumptive
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12
Q
a pregnancy test is considered what kind of sign of pregnancy
A
probable
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13
Q
auscultation of fetal heart beat is considered what kind of sign of pregnancy
A
positive
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14
Q
nausea/vomiting is considered what kind of sign of pregnancy
A
presumptive
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15
Q
a pregnancy test tests for the presence of what? (reason why athlete steroid users test pregnant)
A
HCG
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16
Q
What is Hegars sign?
A
softening of uterine isthmus
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17
Q
Hegars sign is considered what kind of sign of pregnancy
A
probable
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18
Q
ultrasound imaging of fetal heart motion by week 7 is considered what kind of sign of pregnancy?
A
positive
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19
Q
breast sensitivity and increased size is considered what kind of sign of pregnancy
A
presumptive
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20
Q
what is goodell’s sign
A
cervical softening
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21
Q
goodell’s sign is considered what kind of sign of pregnancy
A
probable
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22
Q
ultrasound confirmation of gestational sac by week 6 is considered what kind of sign of pregnancy
A
positive
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23
Q
fatigue is considered what kind of sign of pregnancy
A
presumptive
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24
Q
palpating fetal contours is considered what kind of sign of pregnancy
A
probable
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25
Q
fetal movements palpated by the provider by week 20 is considered what kind of sign of pregnancy
A
positive
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26
Q
abdominal enlargement is considered what kind of sign of pregnancy
A
presumptive
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27
Q
tightening in your abdomen that come and go are called?
A
braxton hicks contractions
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28
Q
braxton hicks contractions is considered what kind of sign of pregnancy
A
probable
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29
Q
bluish discoloration of the cervix, vagin*, and vulva is called
A
chadwicks sign
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30
Q
chadwicks sign is considered what kind of sign of pregnancy
A
presumptive
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31
Q
skin pigmentation changes is considered what kind of sign of pregnancy
A
presumptive
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32
Q
the “before birth” period of pregnancy is called
A
the antepartum period
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33
Q
what does the prefix “ante-“ mean
A
before
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34
Q
when does a woman enter the antepartum period
A
after fertilization (once u nut in her u upped the ante)
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35
Q
changes in uterus during antepartum period
A
gets bigger from fetus enlargement and steroid secretion
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36
Q
changes in cervix during antepartum period
A
chadwicks sign
goodells sign
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37
Q
changes in vagin* during antepartum period
A
smooth muscle hypertrophy causes vagin*l vault length to increase (puss* vault get big)
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38
Q
changes in breasts during antepartum period
A
increased sensitivity
nipple/areola pigmentation
mammary gland growth
colostrum expressed from nipples at termination of pregnancy
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39
Q
white yellow fluid that comes out at termination of pregnancy
A
colostrum
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40
Q
changes in cardiovascular system during antepartum period
A
increased blood volume
physiological anemia
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41
Q
what causes increased blood volume during the antepartum period
A
increased metabolic demands
sodium and water retention
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42
Q
what causes physiological anemia during the antepartum period
A
dilution of red blood cells in increased plasma volume
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43
Q
changes in respiratory system during antepartum period
A
diaphragm pushed up
increased oxygen demand
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44
Q
why is the diaphragm pushed up during the antepartum period
A
enlarged fetus
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45
Q
changes in basal metabolic rate during antepartum period
A
increased to meet increased demands for energy and oxygen during pregnancy
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46
Q
when will basal metabolic range return to normal
A
days after delivery
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47
Q
changes in renal system during antepartum period
A
urinary frequency
increased glomerular filtration rate
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48
Q
why is there urinary frequency during antepartum
A
fetal pressure on bladder
49
Q
what is nagelle’s rule and what is it used for
A
to determine estimated delivery date
50
Q
how to calculate estimated delivery date
A
1st day of LMP + 7 days - 3 months + 1 year
51
Q
what labs to obtain after performing physical of preg pt
A
rubella
blood type
Rh factor
HIV status
Hepatitis B screen
52
Q
how to obtain HIV status
A
toxoplasma
53
Q
what tests to perform for pregnant pt
A
TB
gonorrhea
chlamydia
pap smear
urinalysis
urine culture
54
Q
what to assess at later prenatal visits
A
blood pressure
fundal height
fetal heartbeat
pt’s sensation of fetal movement and contractions
signs of infection
gestational diabetes
55
Q
what type of diabetes should be checked for at prenatal visits
A
gestational diabetes
56
Q
how many bpm should a fetal heartbeat be
A
120-160 bpm (metro & sizzle bpm)
57
Q
when should one-hour glucose tolerance test be done
A
24-28 weeks
58
Q
when should maternal serum and fetoprotein be done
A
15-18 week s
59
Q
is a woman with a positive Rh factor a concern in pregancy?
A
no
60
Q
is both parents are positive for Rh factor is that a concern>
A
no
61
Q
if mother is Rh negative and father is Rh positive is that a concern?
A
yes may be incompatible (positive guys cant fw negative girls)
62
Q
why is a rh negative mother and rh postive father a concern
A
may affect future pregnancies (positive guys should only have make a negative girl their bm once)
63
Q
how will rh factor entering mothers circulatory system a concern for future pregnancies?
A
body builds antibodies against rh factor which will attack any future fetal RBC in future pregnancies and cause fatal anemia
64
Q
what prevents development of Rh antibodies in Rh incompatibility and when is it given?
A
RhoGAM (Rh immune globulin) given in 28th week of pregnancy
65
Q
what should be discussed for the post partum period
A
birth control options
Psychosocial support
66
Q
diagnostic test used to diagnose potential geneteic problems in fetus, fetal hemolytic disease and estimate fetal lung maturity,
A
amniocentesis
67
Q
needle inserted through abdomen and uterus into amniotic sac to withdraw amniotic fluid for evaluation is called
A
amniocentesis
68
Q
who is amniocentesis indicated for
A
women over 35
familial hx of diseases
pt/spouse w chromosomal abnormality
69
Q
how is fetal lung maturity determined in amniocentisis
A
lecithin/sphingomyelin (L/S) ratio determined after amniotic fluid is aspirated
70
Q
normal L/S ratio
A
2/1
71
Q
high frequency sound waves that resonate between ultrasound wand to fetus is called
A
ultrasonography
72
Q
used to confirm fetal viability, gestational age/growth, fetal anatomy and placental location
A
ultrasonography
73
Q
is being under what age a risk factor for complications
A
17 y/o
74
Q
parity of what is a risk for pregnant complications
A
5 or more (multiparity)
75
Q
risk factors for pregnancy complications
A
under 17 y/o
AIDS
diabetes
drug abuse
nullipara over age 35
parity of 5 or more
T.O.R.C.H. infections
previous hemorrhage
heart disease
history of premature labor
hypertension
malnutrition
rh negative
sickle cell
thyroid disease
massive obesity
76
Q
what are T.O.R.C.H infections
A
Toxoplasmosis
Others (syphilis, hepatitis B)
Rubella
Cytomegalovirus
Herpes simplex
77
Q
risk factors that can be discovered during antepartum
A
abnormal fetoprotein values
anemia
elevated glucose levels
perinatal infection
preeclampsia/eclampsia
premature labor
Rh immunization problems
TORCH infections
78
Q
placenta development within lower uterine segment and covers cervix
A
placenta previa
79
Q
risk factors for placenta previa
A
multiparity
older age
previous uterine surgery
hx of placenta previa
80
Q
signs of placenta previa risk factors
A
painless bright red vagin*l bleeding (gushing or intermittently)
soft non tender uterus
81
Q
should you perform a vagin*l exam on a pt with hx of placenta previa?
A
no
82
Q
how should you measure blood loss in pt with hx of placenta previa
A
through perineal pad counts
83
Q
what type of delivery is indicated for pt at risk for placenta previa
A
cesarean
84
Q
what should be done with pt at risk for placenta previa
A
hospitalize and put on bed rest
85
Q
premature separation of placenta from implantation site
A
abruptio placentae
86
Q
how will hemorrhage from abruptio placentae be
A
external or concealed
87
Q
how is concealed hemorrhage in abruptio placentae is diagnosed
A
sonogram
88
Q
signs of abruptio placentae
A
-dark red blood
-intense, continuous cramping abdominal pain
-uterine tenderness
- absent/slow fetal heart rate
89
Q
how to prevent supine hypotension in abruptio placentae pt
A
bed rest in wedge position
90
Q
termination of pregnancy before viability of fetus is called
A
abortion
91
Q
when is an abortion generally performed
A
before 20 wks gestation
92
Q
involuntary delivery of fetus or miscarriage is called
A
spontaneous abortion
93
Q
voluntary termination of pregnancy is called
A
elective abortion
94
Q
signs of abortion
A
vagin*l bleeding
frequent intense contractions
passage of conception products
95
Q
what to do if abortion is threatened?
A
bed rest
pelvic rest
stress reduction
assist with hemostasis
surgical intervention
provide emotional support
96
Q
what is hemostasis
A
stopping bleeding
97
Q
pathological clotting disorder that is diffuse and causes injury rather than protecting coagulation sites is called
A
disseminated intravascular coagulation
98
Q
consumption of clothing factors (platelets/fibrinogen) resulting in widespread bleeding
A
disseminated intravascular coagulation
99
Q
signs of disseminated intravascular coagulation
A
spontaneous/uncontrolled bleeding
decreased platelets/fibrinogen
increasing prothrombin time
tachycardia
anxiety
restlessness
100
Q
what to do for spontaneous/uncontrolled bleeding in disseminated intravascular coagulation
A
deliver fetus
remove abrupted placenta
treat preeclampsia
101
Q
what to do if platelets/fibrinogen decrease and prothrombin time increases in D.I.C pt
A
replace blood/blood products
give heparin to prevent clots
102
Q
hypertension in normotensive preg pt without proteinuria is called
A
gestational hypertension
103
Q
when does gestational hypertension resolve
A
by day 10 of postpartum
104
Q
signs of gestational hypertension
A
increased bp
no proteinuria
facial/hand edema
105
Q
acute hypertension in pregnancy with proteinuria is called
A
preeclampsia
106
Q
how is preeclampsia graded
A
from mild to severe
107
Q
onset of preeclampsia
A
after week 20
108
Q
signs of preeclampsia
A
increased bp
proteinuria
sudden weight gain
transient headache
109
Q
signs of severe preeclampsia
A
oliguria
visual disturbances
abdominal pain
hyperreflexia
epigastric pain
110
Q
seizures in preeclamptic women is called
A
eclampsia
111
Q
signs of eclampsia
A
increased bp
severe putting edema
oliguria
visual disturbances
severe abdominal pain
hyperreflexia
change in LOC
112
Q
how many of the four symptoms must be present to diagnose preeclampsia
A
2 out of 4
113
Q
what are the 4 sxs of preeclampsia that 2/4 must be present for diagnosis
A
elevated bp
proteinuria
facial/hand edema
weight gain of more than 4.5/week
114
Q
what position should eclampsia pt be maintained in during bed rest to prevent it
A
left lateral position
115
Q
what kind of environment should pt at risk of eclampsia be kept in
A
quiet environment
116
Q
can a pt at risk of eclampsia have a bunch of visitors
A
no
117
Q
what precautions should pt at risk for eclampsia be on
A
seizure precautions
118
Q
when can hcg be detected in urine
A
7-8 days
