Podcast
Questions and Answers
What is a key characteristic of placental abruption?
What is a key characteristic of placental abruption?
Which maneuver is indicated for shoulder dystocia?
Which maneuver is indicated for shoulder dystocia?
During which stage of labor does cervical dilation occur from 0 to 6 cm?
During which stage of labor does cervical dilation occur from 0 to 6 cm?
What is NOT an intervention for a prolapsed cord?
What is NOT an intervention for a prolapsed cord?
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What is indicated by late decelerations during labor?
What is indicated by late decelerations during labor?
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What is a common sign of uterine rupture?
What is a common sign of uterine rupture?
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What stage of lochia is characterized by a yellow/white color?
What stage of lochia is characterized by a yellow/white color?
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Which of the following is a sign of cold stress in newborns?
Which of the following is a sign of cold stress in newborns?
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What maternal change during pregnancy involves an increase in both cardiovascular volume and risk for thromboembolism?
What maternal change during pregnancy involves an increase in both cardiovascular volume and risk for thromboembolism?
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What is a common complication associated with gestational diabetes?
What is a common complication associated with gestational diabetes?
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Which of the following signs is NOT included in the danger signs of pregnancy mnemonic 'BURNT HOT'?
Which of the following signs is NOT included in the danger signs of pregnancy mnemonic 'BURNT HOT'?
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What is the recommended weight gain target for a woman with a normal BMI during pregnancy?
What is the recommended weight gain target for a woman with a normal BMI during pregnancy?
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What dietary recommendation is given regarding calcium intake during pregnancy?
What dietary recommendation is given regarding calcium intake during pregnancy?
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Which approach is used to manage severe preeclampsia?
Which approach is used to manage severe preeclampsia?
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Which of the following nutritional requirements should be increased by 10g/day during pregnancy?
Which of the following nutritional requirements should be increased by 10g/day during pregnancy?
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What action should be taken to prevent supine hypotensive syndrome during pregnancy?
What action should be taken to prevent supine hypotensive syndrome during pregnancy?
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Study Notes
Antepartum Care
- Breast Changes: Size increases; pigmentation changes.
- Cardiac Output: Increases by 50%. Monitor for DVT and PE.
- Hematologic Changes: Hemodilution (increased plasma volume), increased fibrinogen (hypercoagulable state), slight decrease in hemoglobin and hematocrit.
- Supine Hypotensive Syndrome: Avoid lying flat to prevent vena cava compression. Turn to the left side.
- Gastrointestinal (GI) System: Slows down, increased risk of constipation.
- Endocrine System: Increased progesterone and relaxin cause muscle relaxation (watch for UTIs).
- Psychosocial: Normal ambivalence in early pregnancy.
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Danger Signs of Pregnancy ("BURNT HOT"):
- Blurry vision (B)
- Urinary pain or urgency (U)
- Red vaginal bleeding (R)
- Severe nausea/vomiting (N)
- Temperature > 101°F (T)
- Severe headaches (H)
- Low urine output (O)
- Trauma (T)
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Weight Gain Targets:
- Normal BMI: 25-35 lbs
- Overweight BMI: 15-25 lbs
- Underweight BMI: 28-40 lbs
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Nutritional Requirements:
- Increase protein by 10g/day
- Folic acid: 400-800 mcg/day for neural tube development
- Iron: 27 mg/day, best absorbed with Vitamin C
- Calcium: 1000 mg/day for bone and tooth formation
- Hydration: 2-3 L/day; avoid excessive caffeine (limit to 200-300 mg/day).
- Preeclampsia: High blood pressure with proteinuria after 20 weeks.
Intrapartum Care
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VEAL CHOP:
- V: Variable decelerations - Cord compression - Reposition
- E: Early decelerations - Head compression - OK
- A: Accelerations - Oxygenated - OK
- L: Late decelerations - Placental insufficiency - Stop pitocin, reposition, give oxygen
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Stages of Labor:
- 1st Stage: Onset to 10 cm dilation (latent phase 0-6 cm, active phase 6-10 cm)
- 2nd Stage: 10 cm to delivery
- 3rd Stage: Delivery of placenta
- 4th Stage: Recovery and stabilization
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Severe Signs- include vision changes, headaches, epigastric pain, hyperreflexia. Magnesium sulfate for seizure prevention if these are severe.
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HELLP Mnemonic: H: Hemolysis, EL: Elevated Liver Enzymes, LP: Low Platelets
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Gestational Diabetes:
- Diagnosis: 1-hour glucose challenge test (>140 mg/dL); confirm with 3-hour test
- Complications: Macrosomia, shoulder dystocia, neonatal hypoglycemia
- Management: Diet, exercise, insulin if needed.
- Monitoring: Blood glucose target 70-110 mg/dL
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Placenta Previa (P-CLUB) vs. Abruption (P-BAD):
- Placenta Previa (P-CLUB): Painless bright red bleeding, c-section possible, low lying placenta.
- Abruption (P-BAD): Painful dark red bleeding, board-like abdomen, sudden onset, decelerations (fetal distress).
Postpartum Care
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BUBBLEHE Assessment:
- Breasts (engorgement, latch)
- Uterus (firm, midline, fundal height)
- Bladder (voiding issues, distension)
- Bowel (constipation, hemorrhoids)
- Lochia (rubra, serosa, alba)
- Episiotomy (healing)
- Homan's Sign (DVT check)
- Emotions (bonding, baby blues)
- 4 T's of Postpartum Hemorrhage: Tone, Tissue, Trauma, Thrombin
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Lochia Stages:
- Rubra: Days 1-3 (dark red)
- Serosa: Days 4-10 (pink/brown)
- Alba: Days 11-6 weeks (yellow/white)
Newborn Care
- Thermoregulation: Keep baby warm and dry to prevent cold stress.
- Signs of Cold Stress: Hypoglycemia, increased oxygen demand, decreased surfactant production.
- Interventions: Skin-to-skin contact, warm blankets/room.
- Newborn Reflexes: Moro, rooting, Babinski, palmar grasp
Breastfeeding Tips
- Feed often (8-12 times/day).
- Ensure proper latch.
- Relief for engorgement: warm or cold compresses.
- Signs of healthy feeding: 6-8 wet diapers/day, yellow stools.
Key Medications
- Magnesium Sulfate: Preeclampsia seizure prevention. Toxicity signs: blood pressure drop, urine output < 30 mL/hr, respirations < 12/min, absent patellar reflexes.
- Betamethasone: Promotes fetal lung maturity in preterm labor. Dosage: 12mg IM every 24 hrs for 2 doses.
- Oxytocin (Pitocin): Labor induction, postpartum hemorrhage control.
Practice Questions
- Client with painless, bloody discharge (34 weeks): Likely diagnosis is Placenta Previa
- Postpartum boggy, displaced uterus: Encourage the client to urinate
- Prolapsed umbilical cord: Reposition the client to relieve pressure.
- Fetal monitor showing late decelerations: Turn the client to the left side.
- Magnesium sulfate-low respiratory rate: Stop the infusion and administer oxygen.
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Description
This quiz covers key concepts related to antepartum care, including breast and cardiac changes, hematologic alterations, and potential danger signs during pregnancy. It also addresses psychosocial factors and weight gain recommendations for expectant mothers. Test your knowledge on these critical aspects of prenatal health.
