OB test 2 set 2

Card Set Information

OB test 2 set 2
2013-11-26 13:16:58

Show Answers:

  1. weight gain 1st, 2nd, and 3rd tri's

    normal weight gain in women w/ normal BMI
    1st= 1kb, approx 5lbs

    2nd and 3rd= 1lb per week

    nl gain= 25-35lbs
  2. IUGR
    • growth restriction
    • not just <10% in weight, but also in length and head circumference
  3. kcal increase
    300 kcal/day in 2nd and 3rd tri's
  4. Folic Acid Defficiency
    • neural tube defects
    • premature placental seperation
    • spontaneous abortions

    recommend 400mcg daily
  5. morning sickness
    Hyperemesis Gravidarum
    ms= crackers

    • hg= unresolved vomiting
    •  = volume and hydration and nutrition deficeits

    give KCl and fluid
  6. S & Sx of Neonatal Abstinence Syndrome
    • irritability
    • incessant crying
    • tremors
    • hyper-reflexia
    • tachypnea / apnea

    this is baby withdrawl
  7. effects of cocaine baby
    • learning and behavior disabilities
    • inability to express feelings
    • strong seperation anxiety
    • poor socilaztion skills
    • easily overstimulated
    • sleep deprived
  8. management of withdrawl baby
    • Tx of S & Sx
    • test for infections
    • check urine and meconium for presence of drug
    • call social services
  9. domestic violence screening
    • screened at first prenatal visit when partner is out of room
    • screened at least once per trimester
  10. what is the goal of antepartum care, screening, and testing?
    to ID high risk pregos
  11. high risk prego
    is one in which the life or health of the mother or fetus is jeopardized by a disorder coincidental with or unique to pregnancy
  12. routine assessment includes:
    • BP and weight check
    • FHR
    • kick count
    • Bld tests
    • Urine screen for protein, glucose, and ketones
  13. kick count
    a least 3 w/n an hour

    if less, NST, CST, or BPP test used
  14. what next if mother's bld type is Rh +?

    Rh+ = no intervention needed

    Rh- = indirect Coombs test used on maternal blood
  15. indirect Coombs test
    maternal blood tested to determine amount of Rh antibodies in mom blood
  16. what next if Indirect Coombs is negative?

    neg= just monitor fetus

    • pos= give Rhogam at 28 weeks gest
    • = after delivery, test baby blood with Direct Coombs test
  17. Direct Coombs test
    fetal blood tested to determine presence of Rh antibodies
  18. what next if Direct Coombs is negative?

    neg= mom does NOT need Rhogam again

    pos= mom gets 2nd dose of Rhogam w/n 72 of delivery
  19. urine analysis for protein and glucose
    +1 glucose is nl

    protein= HTN issues
  20. Group Beta Strep and test
    • commonly found in vaginal floura
    • concern if mom tests + at 35 wks gest
    • -inc risk of PTL and transmission

    Women Tx with 2 doses of antibiotics before delivery
  21. Quadruple screen
    • screen, NOT Dx
    • done at 15-20 wks
    • tests mom's blood for low vs high risk of congenital diseases
  22. what next if Quad screen is low risk?

    low= routine care

    • high= ultrasound to look at baby
    •  = genetic testing for Downs and others
  23. what trimester for transvag vs abd ultrasound
    vag= 1st tri or during any if women is obese

    abd= 2nd and 3rd
  24. fetal nuchal test
    • 11-13 wks
    • screens for trisomies 13, 18, 21
    • look for excess accumulation of fluid on neck

    if abnl= CVS test or Amniocentesis
  25. Eval of placental maturity
    • doen by ultrasound in 2nd or 3rd tri
    • look for changes
    • graded
  26. placenta maturity grade scale:

    I= no indents or califications

    II= subtle indents and small calcifications

    • III= large and calcified
    •  = smoking, PT, pre-eclamp, GD
  27. Chorionic Villus Sampling CVS
    • done at 10-12 wks
    • remove small sample of chorionic villi from developing placenta

    comlications= blding, miscarriage, ROM, limb anomalies possible if done before 10 wks
  28. Percutaneous Umbilical Blood Sampling PUBS
    • done during 2nd and 3rd tri's
    • fetal blood obtained

    can test for many things
  29. Amniocentesis
    amniotic fluid obtained after 14th wk

    used for genetic testing, lung maturity, among others

    ultrasound used first to determine baby's location
  30. 2 tests used for lung maturity
    Lecithin/sphingomyelin ratio (L/S)

    Phosphatidylglycerol )PG)
  31. L/S test
    these are 2 components of surfactant

    Ratio= 2:1 = maturity
  32. PG test
    • appears in amniotic fluid at 25 wks
    • indicated mature lungs
  33. Doppler flow studies
    tell us how perfusion is b/w mother and fetal circulation
  34. what 2 electronic fetal monitors tests are used?
    • NST
    • CST
  35. NST
    • non stress
    • monitor hooked up and mom given button to push when fetal movement felt

    good to see accelerations with movement

    can get false positives
  36. reasons for NST use
    • maternal DM
    • chronic HTN
    • prego HTN
    • IUGR
    • dec. fetal movement
    • etc.
  37. reactive vs non reactive NST
    reactive= at least 2 accels of 15bpm lasting 15 seconds

    non= do a CST or BPP
  38. if the NST fails, then what?
    CST is done
  39. CST
    contraction stress test

    tests for uterosufficiency

    need at least 3 good contractions lasting at least 40 seconds
  40. positive and negative CST results
    pos= there are repeat late decelerations :(

    neg= there are no late decels  :) :)
  41. positive and negative results for the NST and CST

    which is good and bad?
    • NST:
    • postive = GOOD
    • negative = bad

    • CST:
    • positive = bad
    • negative = GOOD