Antepartum Care: Prenatal Visits and Risk Assessment
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What is the primary purpose of the first prenatal visit at 6-8 weeks for low-risk pregnancies?

  • To administer the oral glucose test for diabetes screening
  • To perform an ultrasound to determine fetal age
  • To assess risk, promote health, and address medical and psychosocial issues (correct)
  • To perform a nonstress test to monitor fetal heart rate

    • How often should a pregnant individual walk during travel after 36 weeks?

  • Every 5-6 hours
  • Every 1-2 hours (correct)
  • Every 3-4 hours
  • Every 7-8 hours

    • What is the recommended daily dosage of folic acid to prevent neurotube defects?

  • 2 mg
  • 4 mg (correct)
  • 0.4 mg
  • 1 mg

    • At what week of gestation can the fetal heart rate be heard?

    <p>12 weeks</p> Signup and view all the answers

    What laboratory test is performed at the initial prenatal visit?

    <p>Bloodwork: CBC w/di</p> Signup and view all the answers

    What is the recommended weight gain for pregnant individuals with a prepregnancy BMI >29?

    <p>11-20 lbs</p> Signup and view all the answers

    When is the fetal survey ultrasound typically performed?

    <p>18-24 weeks</p> Signup and view all the answers

    What is the last system to develop in the fetus?

    <p>Respiratory</p> Signup and view all the answers

    What is the purpose of Naegel's rule in pregnancy dating?

    <p>To determine the gestational age from the LMP</p> Signup and view all the answers

    Which of the following is NOT a criterion for diabetes screening?

    <p>Hemoglobin electrophoresis</p> Signup and view all the answers

    What is the purpose of testing for Rubella antibody (IgG) in pregnant women?

    <p>To determine immunity to Rubella</p> Signup and view all the answers

    At what uterine size is the fetus approximately 12 weeks old?

    <p>Grapefruit</p> Signup and view all the answers

    Why is varicella immunity (varicella IgG) tested in pregnant women without documentation of vaccine or known history of disease?

    <p>To determine immunity to varicella</p> Signup and view all the answers

    If a patient's LMP was 5/3/24, what is the estimated EDD using Naegel's rule?

    <p>12/10/24</p> Signup and view all the answers

    A patient presents with a BMI of 27, a history of gestational diabetes, and a first-degree relative with type 2 diabetes. Which of the following tests would be appropriate to order for diabetes screening?

    <p>Both Hemoglobin A1c and fasting blood glucose</p> Signup and view all the answers

    A pregnant patient presents with a uterine size consistent with a large orange. Based on the provided information, what is the estimated gestational age?

    <p>8 weeks</p> Signup and view all the answers

    A pregnant patient's LMP was 10/20/23. Using Naegel's rule, what is the estimated EDD?

    <p>7/13/24</p> Signup and view all the answers

    A pregnant patient presents with a history of a first-degree relative with cystic fibrosis. Which of the following genetic screening tests would be recommended for this patient?

    <p>Cystic fibrosis carrier testing</p> Signup and view all the answers

    A pregnant patient is concerned about the potential for an ectopic pregnancy. Which of the following would prompt the ordering of an ultrasound?

    <p>All of the above</p> Signup and view all the answers

    A pregnant patient presents with a history of varicella without documentation of vaccination or known history of the disease. Which of the following laboratory tests would be recommended?

    <p>Varicella IgG</p> Signup and view all the answers

    What is the recommended frequency for maternal kick counts during pregnancy?

    <p>5 movements in 1 hour or 10 movements in 2 hours</p> Signup and view all the answers

    Which of the following dietary restrictions is advised for pregnant individuals?

    <p>Avoiding cold lunch meats</p> Signup and view all the answers

    During the initial prenatal visit, which aspect is NOT typically included in the history taking?

    <p>History of cosmetic procedures</p> Signup and view all the answers

    Which laboratory test is indicated for pregnant individuals at their initial visit?

    <p>CBC with differential</p> Signup and view all the answers

    When should diabetes screening occur for obese pregnant individuals?

    <p>At the first prenatal visit only</p> Signup and view all the answers

    What is the maximum recommended travel period for pregnant individuals without complications?

    <p>Up to 36 weeks</p> Signup and view all the answers

    Which of the following is a critical factor in fetal heart rate monitoring during a nonstress test?

    <p>Ensuring a minimum of 20 minutes observation</p> Signup and view all the answers

    What should be the focus of shared decision-making with pregnant individuals?

    <p>Personalizing education and care options</p> Signup and view all the answers

    Study Notes

    Antepartum Care Overview

    • Initial prenatal visit recommended at 6-8 weeks for risk assessment and health promotion.
    • Gather comprehensive history, including chronic medical issues, previous pregnancies, genetic screenings, and psychosocial history.

    Estimation of Delivery

    • Estimated date of delivery (EDD) calculated as 40 weeks from the last menstrual period (LMP) for regular 28-day cycles.

    Prenatal Visits

    • Regular visits monitor weight, blood pressure, fetal measurements, and overall health.
    • Diabetes screening involves an oral glucose test at 24-28 weeks; for obese women, testing occurs at the first visit.
    • Fetal heart rate can be detected as early as 12 weeks.
    • Ultrasound for fetal survey performed between 18-24 weeks.

    Fetal Monitoring and Movement

    • Nonstress test assesses fetal heart rate patterns and accelerations over at least 20 minutes.
    • Maternal kick counts recommend observing for 5 movements in 1 hour or 10 movements in 2 hours.

    Maternal Health Considerations

    • Fundal height and amniotic fluid volume are measured during prenatal visits.
    • Respiratory system is the last to develop in the fetus.
    • Folic acid supplementation should be 0.4 mg daily; 4 mg daily for those with neurotube defects.

    Weight Gain Recommendations

    • Pre-pregnancy BMI under 29 allows for a weight gain of 11-20 lbs.

    Dietary Restrictions

    • Avoid consumption of cold lunch meats and unpasteurized dairy products.
    • Moderate exercise and sexual activity are generally permitted; travel up to 36 weeks is acceptable with breaks every 1-2 hours.

    Medication and Health Precautions

    • Avoid certain medications such as ACE inhibitors, Coumadin, and retinoids.
    • Emphasize shared decision-making and patient education during all visits.

    Initial Prenatal Visit Components

    • Initial visit often occurs around 10 weeks, with a thorough history and physical exam similar to preconception visits.
    • Full head-to-toe examination includes vital signs, HEENT, cardiovascular, respiratory, abdomen, musculoskeletal, neurological, gynecological evaluations.

    Laboratory Tests During Initial Visit

    • Blood tests include CBC with differential, blood type and Rh factor, antibody screen, and infectious disease screening (e.g., HIV, Hepatitis B).
    • Urinalysis and cultures for urinary tract infections and sexually transmitted infections.

    Additional Testing Based on History

    • Diabetes screening for individuals with BMI over 25 and risk factors relating to diabetes.
    • TSH levels checked for thyroid disorders; additional genetic and cancer screenings if needed.
    • Varicella immunity confirmed if vaccination history is unclear.

    Dating the Pregnancy

    • Determining EDD based on LMP using Naegel’s rule: add 7 days to LMP, subtract 3 months, adjusting days for different months.
    • Demonstrates uterine size progression from nonpregnant to 12 weeks, described as varying fruit sizes.

    Example Calculation

    • If LMP is May 3, 2024, EDD would be calculated accordingly.

    Antepartum Care Overview

    • Initial prenatal visit recommended at 6-8 weeks for risk assessment and health promotion.
    • Gather comprehensive history, including chronic medical issues, previous pregnancies, genetic screenings, and psychosocial history.

    Estimation of Delivery

    • Estimated date of delivery (EDD) calculated as 40 weeks from the last menstrual period (LMP) for regular 28-day cycles.

    Prenatal Visits

    • Regular visits monitor weight, blood pressure, fetal measurements, and overall health.
    • Diabetes screening involves an oral glucose test at 24-28 weeks; for obese women, testing occurs at the first visit.
    • Fetal heart rate can be detected as early as 12 weeks.
    • Ultrasound for fetal survey performed between 18-24 weeks.

    Fetal Monitoring and Movement

    • Nonstress test assesses fetal heart rate patterns and accelerations over at least 20 minutes.
    • Maternal kick counts recommend observing for 5 movements in 1 hour or 10 movements in 2 hours.

    Maternal Health Considerations

    • Fundal height and amniotic fluid volume are measured during prenatal visits.
    • Respiratory system is the last to develop in the fetus.
    • Folic acid supplementation should be 0.4 mg daily; 4 mg daily for those with neurotube defects.

    Weight Gain Recommendations

    • Pre-pregnancy BMI under 29 allows for a weight gain of 11-20 lbs.

    Dietary Restrictions

    • Avoid consumption of cold lunch meats and unpasteurized dairy products.
    • Moderate exercise and sexual activity are generally permitted; travel up to 36 weeks is acceptable with breaks every 1-2 hours.

    Medication and Health Precautions

    • Avoid certain medications such as ACE inhibitors, Coumadin, and retinoids.
    • Emphasize shared decision-making and patient education during all visits.

    Initial Prenatal Visit Components

    • Initial visit often occurs around 10 weeks, with a thorough history and physical exam similar to preconception visits.
    • Full head-to-toe examination includes vital signs, HEENT, cardiovascular, respiratory, abdomen, musculoskeletal, neurological, gynecological evaluations.

    Laboratory Tests During Initial Visit

    • Blood tests include CBC with differential, blood type and Rh factor, antibody screen, and infectious disease screening (e.g., HIV, Hepatitis B).
    • Urinalysis and cultures for urinary tract infections and sexually transmitted infections.

    Additional Testing Based on History

    • Diabetes screening for individuals with BMI over 25 and risk factors relating to diabetes.
    • TSH levels checked for thyroid disorders; additional genetic and cancer screenings if needed.
    • Varicella immunity confirmed if vaccination history is unclear.

    Dating the Pregnancy

    • Determining EDD based on LMP using Naegel’s rule: add 7 days to LMP, subtract 3 months, adjusting days for different months.
    • Demonstrates uterine size progression from nonpregnant to 12 weeks, described as varying fruit sizes.

    Example Calculation

    • If LMP is May 3, 2024, EDD would be calculated accordingly.

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    Related Documents

    Antepartum care.docx

    Description

    This quiz covers the essential aspects of antepartum care, including the first prenatal visit, risk assessment, and health promotion. It also discusses chronic medical issues, pregnancy history, and genetic screening. Learn about estimating the due date and routine checks during each visit.

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