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Questions and Answers
What method is typically used to detect the presence of hCG for a pregnancy test?
At what gestational age does quickening typically occur for a primigravida?
Which of the following is a probable sign of pregnancy?
Which sign indicates a firm diagnosis of pregnancy?
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What is the primary hormone detected in a pregnancy test?
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Which symptoms are common during the first trimester of pregnancy?
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What indicates non-reassuring fetal status in NST scoring?
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Which of the following is NOT a presumptive sign of pregnancy?
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What physiological change occurs in the uterus during pregnancy?
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Which hormone is primarily responsible for the relaxation of smooth muscle during pregnancy?
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What is a common cause of edema in the lower extremities during pregnancy?
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What is the recommended position to help relieve compression of the inferior vena cava during pregnancy?
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How can pregnant individuals monitor fetal movements after approximately 28 weeks of gestation?
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What lab value changes may occur due to adaptations in the cardiovascular system during pregnancy?
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Which symptom is associated with increased levels of estrogen, progesterone, and prostaglandins during pregnancy?
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What effect does decreased renal flow in the third trimester have on pregnant individuals?
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What is the primary purpose of testing for human chorionic gonadotropin (HCG) in urine during early pregnancy?
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Which of the following is NOT included in the initial prenatal visit assessment?
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What does teratogenesis refer to in the context of fetal development?
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When is the recommended screening for Group B Streptococcus (GBS) during pregnancy?
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Which of the following accurately describes a common sign of pregnancy during the first trimester?
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What does the 'T' in GTPAL stand for?
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Which statement regarding fetal movement is accurate in evaluating pregnancy?
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Which of these factors is NOT assessed during an initial prenatal visit's comprehensive health assessment?
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Study Notes
NST and Scoring System
- Non-stress test (NST) measures fetal heart rate (FHR) and other fetal indicators.
- Key indicators include FHR activity, fetal breathing movements, fetal movements, fetal tone, and amniotic fluid index (AFI).
- Scoring system categorizes results:
- 8/10: Reassuring
- 6/10: Equivocal, repeat testing recommended
- 4/10: Non-reassuring, further evaluation needed
- 2/10: Indication for immediate delivery
Diagnosing Pregnancy
-
Presumptive Signs:
- Amenorrhea: Absence of menstruation.
- Nausea and vomiting: Commonly present from week 2 to 12.
- Breast changes: Enlargement, tenderness, and increased vascularity by 2-3 weeks.
- Fatigue: Frequent in the first trimester.
- Frequent urination: Caused by pressure from the enlarging uterus.
- Quickening: Fetal movement awareness occurring at 18-20 weeks in first-time mothers.
-
Probable Signs:
- Uterine and abdominal growth.
- Skin pigmentation changes: Melasma and linea nigra formation.
- Ballottement: Fetal rebound response detectable at 16-18 weeks.
-
Positive Signs:
- Fetal heart auscultation detectable by 10-12 weeks using Doppler.
- Examiner’s observation of fetal movement after 20 weeks.
- Sonographic visualization of fetal cardiac movement from 4-8 weeks.
Hormonal Detection
- Urine and blood tests detect human chorionic gonadotropin (hCG), confirming pregnancy.
- Blood tests can identify hCG before a missed period, while urine tests are best taken with the first morning specimen.
Physiological Adaptations to Pregnancy
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Uterine Changes:
- Hypertrophy and increased contractility of the uterine wall.
- Softening of the vaginal muscle and connective tissue.
- Mucus plug forms from cervical gland hypertrophy for protection.
- Increased blood volume and vascular congestion.
-
Hormonal Effects:
- Muscle relaxation due to estrogen, progesterone, and prostaglandins.
- Increased risks of dyspnea, nasal congestion, and urinary incontinence.
-
Edema in Lower Extremities:
- Caused by increased venous pressure and compression of veins.
- Relief methods: Side sleeping, elevation, hydration, exercise, and compression socks.
-
Nasal and Sinus Congestion:
- Increased levels of estrogen, progesterone, and prostaglandins contribute.
-
Cardiovascular Changes:
- Increased RBC count and plasma volume; decreased hemoglobin levels.
Fetal Movement Counts (FMC)
- Recommended maternal surveillance after 28 weeks.
- Two methods:
- 10 distinct movements in 2 hours.
- 4 movements in 1 hour.
- Instruct lying on side if no fetal movements are felt after eating/drinking.
Prenatal Care Components
- Initial prenatal visit entails comprehensive health assessment, medical history, physical examination, estimated due date, nutrition, psychosocial assessment, and screening for intimate partner violence.
- Essential lab tests include blood type, CBC, syphilis, HIV, hepatitis B, rubella titer, tuberculosis skin test, urinalysis, and cultures for STIs.
Teratogenesis
- Refers to congenital malformations in a developing fetus due to exposure to teratogens.
Educational Topics for Prenatal Care
- Pain relief and postpartum care (3rd trimester).
- Breastfeeding and signs of labor (2nd and 3rd trimesters).
- Early pregnancy discomforts (1st trimester) and parenting education (3rd trimester).
Obstetric History Documentation (GTPAL)
- G: Number of pregnancies.
- T: Number of term infants (37+ weeks).
- P: Number of preterm infants.
- A: Number of abortions (spontaneous or induced).
- L: Number of living children.
Screening Recommendations
- Gestational diabetes screening at 24-28 weeks.
- Group B Streptococcus (GBS) screening at 35-37 weeks.
Definition of Infertility
- Defined as the inability to conceive and maintain a pregnancy for 6 months in women under 35.
Fertilization Location
- Occurs in the outer third of the fallopian tube, resulting in a zygote and subsequent blastocyst formation.
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Description
This quiz covers the evaluation of Non-Stress Tests (NST) with a 30-minute ultrasound, focusing on fetal heart rate activity, fetal movements, and scoring interpretations. Understand the significance of various indicators such as fetal tone and amniotic fluid index (AFI) and what the scores imply for pregnancy health management.
