Podcast
Questions and Answers
What is the recommended weight gain target for an individual with a normal BMI during pregnancy?
What is the recommended weight gain target for an individual with a normal BMI during pregnancy?
What is the indicative blood pressure and symptom relationship for diagnosing preeclampsia?
What is the indicative blood pressure and symptom relationship for diagnosing preeclampsia?
Which of the following is NOT a danger sign of pregnancy as indicated by the mnemonic 'BURNT HOT'?
Which of the following is NOT a danger sign of pregnancy as indicated by the mnemonic 'BURNT HOT'?
For optimal calcium intake during pregnancy, what is the daily requirement?
For optimal calcium intake during pregnancy, what is the daily requirement?
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Which nutrient's increase is essential for neural tube development during pregnancy?
Which nutrient's increase is essential for neural tube development during pregnancy?
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What should be the target blood glucose range for monitoring gestational diabetes?
What should be the target blood glucose range for monitoring gestational diabetes?
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Which symptom is commonly a result of increased progesterone during pregnancy?
Which symptom is commonly a result of increased progesterone during pregnancy?
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What is the best management action for a pregnant woman experiencing severe signs of preeclampsia?
What is the best management action for a pregnant woman experiencing severe signs of preeclampsia?
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What is NOT a recommended limit for caffeine consumption during pregnancy?
What is NOT a recommended limit for caffeine consumption during pregnancy?
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What is a significant cardiovascular change that occurs during pregnancy?
What is a significant cardiovascular change that occurs during pregnancy?
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Which of the following best describes the characteristics of abruption?
Which of the following best describes the characteristics of abruption?
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What does the 'V' in VEAL CHOP represent?
What does the 'V' in VEAL CHOP represent?
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Which stage of labor marks the transition from 0-6 cm dilation?
Which stage of labor marks the transition from 0-6 cm dilation?
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What is the primary intervention for a prolapsed cord?
What is the primary intervention for a prolapsed cord?
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Which of the following is NOT one of the 4 T's of postpartum hemorrhage?
Which of the following is NOT one of the 4 T's of postpartum hemorrhage?
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Which lochia stage is characterized by a yellow/white discharge lasting from 11 days to 6 weeks postpartum?
Which lochia stage is characterized by a yellow/white discharge lasting from 11 days to 6 weeks postpartum?
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What is a common sign of cold stress in newborns?
What is a common sign of cold stress in newborns?
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Which newborn reflex is indicated when the baby's toes fan out when the sole is stroked?
Which newborn reflex is indicated when the baby's toes fan out when the sole is stroked?
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What does the 'D' in the P-BAD mnemonic stand for in relation to abruption?
What does the 'D' in the P-BAD mnemonic stand for in relation to abruption?
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In postpartum assessment, what is the expected finding for the 'U' in BUBBLEHE?
In postpartum assessment, what is the expected finding for the 'U' in BUBBLEHE?
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Study Notes
Antepartum Care
- Breast Changes: Size increases, pigmentation changes
- Cardiac Output: Increases by 50%. Watch for DVTs and PEs
- Hematologic Changes: Hemodilution (increased plasma volume relative to RBCs), increased fibrinogen (hypercoagulable state), and slight decrease in hemoglobin and hematocrit.
- Supine Hypotensive Syndrome: Avoid lying flat to prevent vena cava compression. Turn to the left side.
- GI System: Slows, risk for constipation.
- Endocrine: Increased progesterone and relaxin cause muscle relaxation (watch for UTIs).
- Psychosocial: Normal ambivalence in early pregnancy
Key Mnemonics
-
"BURNT HOT": Danger signs of pregnancy
- Blurry vision
- Urinary pain/urgency
- Red vaginal bleeding
- Nausea/severe vomiting
- Temperature > 101°F
- Severe headaches
- Low urine output
- Trauma (falls, accidents)
-
Weight Gain Targets:
- Normal BMI: 25-35 lbs
- Overweight BMI: 15-25 lbs
- Underweight BMI: 28-40 lbs
Nutritional Requirements
- Protein: Increase by 10g/day.
- Folic Acid: Essential for neural tube development (400-800 mcg/day)
- Iron: Increase to 27 mg/day (best absorbed with Vitamin C)
- Calcium: 1,000 mg/day (bone and tooth formation)
- Hydration: 2-3 L/day; avoid excessive caffeine (limit to 200-300 mg/day)
Conditions
- Preeclampsia: High BP with proteinuria after 20 weeks
Intrapartum Care
-
VEAL CHOP
- Variable decelerations: Cord Compression → Reposition
- Early decelerations: Head compression → OK
- Accelerations: Oxygenated → OK
- Late decelerations: Placental insufficiency → Stop Pitocin, reposition, give oxygen
-
Stages of Labor:
- 1st Stage: Onset to 10 cm dilation (latent 0-6 cm, active 6-10 cm)
- 2nd Stage: 10 cm to delivery
- 3rd Stage: Delivery of placenta
- 4th Stage: Recovery and stabilization
Postpartum Care
-
BUBBLEHE Assessment:
- Breasts (engorgement, latch)
- Uterus (firm, midline, fundal height)
- Bladder (voiding issues, distension)
- Bowel (constipation, hemorrhoids)
- Lochia (rubra, serosa, alba)
- Episiotomy (lacerations, healing)
- Homan's Sign (DVT check)
- Emotions (bonding, baby blues)
-
4 T's of Postpartum Hemorrhage:
- Tone: Uterine atony (boggy fundus)
- Tissue: Retained placenta
- Trauma: Lacerations, hematomas
- Thrombin: Coagulopathy
-
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
- Signs of Cold Stress: Hypoglycemia, Increased oxygen demand, decreased surfactant production
- Newborn Reflexes: Moro, Rooting, Babinski, Palmar Grasp
- Breastfeeding Tips: Feed 8-12 times/day, proper latch, engorgement relief (warm/cold compress)
Key Medications
-
Magnesium Sulfate: Preeclampsia seizure prevention
- Toxicity Signs (BURP): Blood pressure drop, Urine output <30 mL/hr, Respirations <12/min, Patellar reflexes absent
- Antidote: Calcium gluconate
- Monitoring: Continuous FHR monitoring, respiratory checks, DTR checks every 1-2 hours
-
Betamethasone: Promotes fetal lung maturity in preterm labor
- Dose: 12 mg IM every 24 hours for 2 doses
- Oxytocin (Pitocin): Labor induction, postpartum hemorrhage control
Emergencies
- Prolapsed cord: Trendelenburg or knee-chest, relieve pressure, prepare for C-section
- Shoulder dystocia: McRoberts maneuver, suprapubic pressure
- Uterine rupture: Sudden, severe abdominal pain, loss of fetal station, no uterine contractions; Emergency C-section, supportive care
Practice Questions (Answers Provided)
- Question 1: Painless, bright red vaginal bleeding at 34 weeks. Likely diagnosis? Answer: Placenta previa
- Question 2: Postpartum client with boggy, displaced uterus. First action? Answer: Encourage the client to void.
- Question 3: Prolapsed umbilical cord. Priority intervention? Answer: Reposition the client to relieve pressure on the cord.
- Question 4: Late decelerations on fetal monitor. Priority action? Answer: Turn the client to the left side.
- Question 5: Client receiving magnesium sulfate has a respiratory rate of 10 bpm. First action? Answer: Stop the infusion.
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Description
This quiz focuses on key aspects of antepartum care, including physiological changes during pregnancy, danger signs, and weight gain targets. It also covers important mnemonics to remember the warning signs and guidelines for managing health during pregnancy. Perfect for nursing students or those preparing for obstetric exams.
