Chorionic Villus Sampling (CVS) - CORRECT ANSWER-done at 10-13 weeks gestation
to look for genetic abnormalities, have pt drink water before procedure
... [Show More] to help visualize
the uterus
informed consent
Advantages:
Advantages of CVS - CORRECT ANSWER-Advantages of CVS
During the first trimester what is ultrasonography used for? - CORRECT ANSWERConfirm pregnancy, verify location of pregnancy, identify multifetal gestation, gestational
age with crown-rump and head measurement, number and fiability of fetuses, identify
markers such as nuchal translucence, which suggests chromosome or other
abnormalities, determine location of uterus, cervix, and placenta for procedures as CVS.
During the second and third trimester what is ultrasonography used for? - CORRECT
ANSWER-Confirm viability, evaluate fetal anatomy, gestational age, serial fetal growth,
compare growth of multiple fetuses, evaulate four of five markers in a biophysical
profile, locate placenta during previa, determine presentation, and guide the needle for
amniocentesis or PUBS.
Disadvantages of CVS - CORRECT ANSWER-Rate of pregnancy loss after CVS, more
than two attempts or bleeding during the week before procedure increases risk for fetal
loss, and reports of limb reduction defects.
After CVS, what are some things you should do as a nurse as far as monitoring and
discharge instructions? - CORRECT ANSWER-FHR activity, maternal VS, and woman
is allowed to void if needed. Woman should rest at home for a couple of hours after
procedure and sexual intercourse should be limited for a few days. Rhogam is given to
women who are Rh-negative.
how is ultrasound usually done in the first trimester? - CORRECT ANSWERTransvaginal
When is gestational diabetes screening done by random 50 gram oral glucose test?
what is considered an abnormal result? - CORRECT ANSWER-24-28 weeks
abnormal is > 140 mg/dL
if it is over 200 mg/dL you treat it as diabetes
What is the gold standard for diagnosis of gestational diabetes - CORRECT ANSWER-3
hour oral glucose
check at 1, 2, and 3 hours- must exceed 2 or more values to be considered postive test
single abnormal result means increased risk for macrosomia and neonatal morbidityshould repeat test in 2-4 weeks and monitor blood glucose in the meantime
Signs and symptoms of gestational diabetes mellitus - CORRECT ANSWERhypoglycemia
hyperglycemia
shaking clammy pale skin
shallow respirations.
rapid pulse
hyperglycemia
vomiting
excess weight gain during pregnancy.
Gestational Age Determination - CORRECT ANSWER-CRL (Crown to Rump Length)
most accurate measurement for determining gestational age; made in the first trimester
Amniocentesis - CORRECT ANSWER-done at 15-20 weeks gestation, performed to
determine genetic disorders, metabolic defects, and look at fetal lung maturity.
informed consent, <20 weeks-pt needs full bladder, >20 weeks-pt needs empty bladder,
ultrasound done before to locate the placenta
Nonstress test - CORRECT ANSWER-looks at placental fx, oxygenation, fetal HR in
response to movement
external transducer is placed on mom, lateral position, client presses button every time
she feels movement.
reactive-normal
nonreactive-abnormal
Purposes for midtrimester amniocentesis - CORRECT ANSWER-examine fetal cells
and present in amiotic fluid to identify chromosome abnormalities, evaluate fetal
condition when the woman id sensitized to Rh- positive blood, diagnose intrauterine
infections, and investigate AFAFP when multiple marker test is done when maternal
serum is not normal
Purpose for third trimester amniocentesis - CORRECT ANSWER-determine fetal lung
maturity, and test for hemolytic disease
Procedure for amniocentesis - CORRECT ANSWER-Woman placed in supine position,
get baseline BP and FHR, ultrasound is used to find largest pocket of fluid, a 3- to 4-
inch, 20- or 21-gauge spinal needle is inserted into the pocket of fluid, discard 1-2 mls
then get 20 mls for sample.
Discharge instructions for woman who had amniocentesis - CORRECT ANSWERResume normal activites after 24 hours, strenuous activities like jogging or cardio
should be resumed after 1 or 2 days, and she should report frequent contractions,
vaginal bleeding, leakage of amniotic fluid and fever.
Three tests done to determine fetal lung maturity - CORRECT ANSWER-L/S ratio (2:1),
PG, and PI
What are 4 ways to do kick counts? - CORRECT ANSWER-1) Count fetal movements
for 30 minutes three times per day. 2) Count fetal movements daily for 1 hour; if fewer
than 10 movements felt, continue for a second hour; fewer than 10 in 2 hours should be
reported. 3) Count the first 10 movements and note the start time and end time. 4)
Count fetal movements for 30 minutes in morning and evening to establish baseline. If
50% decrease or no movement occurs, extend the counting period for 30 minutes.
NST, Providers sometimes suggest that the mother drink ___to increase their blood
glucose and stimulate fetal movement. - CORRECT ANSWER-Orange juice
NST, Test results - CORRECT ANSWER-either reactive or nonreactive.
Non stress test (NST) - CORRECT ANSWER-most widely applied technique for
antepartum evaluation of the fetus. Premise: normal fetus produces characteristic HR
patterns in response to fetal movement, uterine cntrxns, or stimulation. Once initiated it
is usually preformed once or twice weekly until birth.
Contraction Stress Test (CST) - CORRECT ANSWER-aka Oxytocin Challenge Test
(OCT). Applied to fetus to assess: hypoxia, Uterine cntrxns, placental perfusion,
Uteroplacental Insufficiency (UPI) with late decels, Healthy fetoplacental unit without
late decels.
Contraction Stress Test, Interpretation, Positive result may mean: - CORRECT
ANSWER-Intrauterine fetal death . Late FHR decelerations in labor. IUGR. Meconiumstained amniotic fluid.
Contraction Stress Test, Interpretation, Negative - CORRECT ANSWER-3 U/C in 10
min. without late or significant variable decelerations. Resume routine weekly testing.
Contraction Stress Test, Interpretation, Positive - CORRECT ANSWER-Late
decelerations in ≥ 50% U/C regardless frequency. Hospital admit for evaluation/delivery.
BPP, Rubric, 5 categories - CORRECT ANSWER-Fetal Breathing Movements (FBM).
Fetal Movements. Amniotic Fluid Index (AFI). Fetal Tone. NST [Show Less]