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Questions and Answers
What indicates a non-reactive non-stress test?
What action should be taken if a patient voids prior to a pelvic ultrasound?
Why is RhoGam administered to Rh negative women during pregnancy?
After a percutaneous umbilical cord blood sampling (PUBS) procedure, what is critical to monitor?
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What is the main purpose of conducting a Papanicolaou smear during the first prenatal visit?
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What is the primary purpose of conducting a Non Stress Test (NST) during pregnancy?
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In a Non Stress Test, which equipment is primarily used to monitor fetal heart rate?
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During a Non Stress Test, how is fetal activity assessed?
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What is the primary purpose of the fourth maneuver in Leopold's maneuvers?
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What is a common indication for performing a Non Stress Test in pregnant women?
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In a Non Stress Test, what does a non-reactive result indicate?
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In which situation might Leopold's maneuvers be particularly challenging to perform?
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What is the recommended total weight gain for a woman with a normal Body Mass Index during pregnancy?
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What is typically required from a patient prior to conducting a Non Stress Test?
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What is the ideal position for a pregnant woman during a Non Stress Test?
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What weight gain pattern is expected during the first trimester?
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What does an elevated alpha-fetoprotein (AFP) level indicate?
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Which of the following findings in a Non Stress Test is considered reassuring?
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What is the aim of an amniocentesis during pregnancy?
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How long is a typical Non Stress Test performed for optimal assessment?
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What factor is considered more important than the total amount of weight gained during pregnancy?
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During a Non Stress Test, which condition does a positive result indicate?
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What is a potential consequence of failure to gain appropriate weight during pregnancy?
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Study Notes
Nursing Alerts and Procedures
- Chorionic Villus Sampling: Conducted between 14-16 weeks AOG to assess chromosomal abnormalities; after 35 weeks AOG to check fetal lung maturity.
- L/S Ratio: A ratio of 1:2 indicates fetal lung maturity.
- Patient Instructions: Advise to void if gestation exceeds 20 weeks; position in supine; report fetal movement changes and any abnormal symptoms.
Risk Factors and Complications
- Complications of procedures may include placental, cord, and bladder puncture, as well as spontaneous abortion and infection for chorionic villus sampling.
- Coombs Test: Direct Coombs test indicates erythroblastosis fetalis in newborns due to maternal antibodies.
Fetal Monitoring Tests
- Contraction Stress Test (CST): Evaluates uteroplacental insufficiency. A negative test indicates no abnormal decelerations; a positive test indicates abnormal fetal heart rate with decelerations.
- Types of CST: Includes nipple-stimulated CST and intravenous oxytocin methods to measure uterine response.
Fetal Heart Rate Monitoring
- Early Deceleration: Indicates fetal head compression; no treatment required.
- Late Deceleration: Reflects placental insufficiency, requiring oxygen administration.
- Variable Deceleration: Indicates cord compression; change patient position and provide oxygen.
Non-Stress Test
- Procedure: Involves a pregnant woman lying down with belts attached for monitoring fetal heart rate (FHR).
- Reactive Test: FHR accelerates by more than 15 beats for at least 15 seconds, indicating fetal well-being.
- Non-Reactive Test: Less than a 15 beat increase indicates potential fetal jeopardy.
Additional Assessments
- Pelvic Ultrasound: Requires increased fluid intake before the procedure to enhance organ visibility.
- Percutaneous Umbilical Cord Blood Sampling (PUBS): Removes blood from the umbilical vein for assessment; involves monitoring the fetus pre and post-procedure.
Weight Gain Guidelines
- Recommended Gain: Total of 25-35 lbs for women with normal BMI, varying throughout trimesters (1 lb/month in first trimester; 0.9-1 lb/week in second; 0.5-1 lb/week in third).
- Importance of Patterns: Emphasis on normal weight gain patterns for maternal and fetal health; inadequate weight gain signals potential health issues.
Diagnostic Tests
- Alpha-Fetoprotein Levels: Elevated AFP levels indicate neural tube defects; decreased levels suggest Down’s syndrome.
- Amniocentesis: Used to assess fetal growth/maturity, determine genetic disorders, and identify fetal sex.
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Description
This quiz covers critical nursing alerts and procedures related to obstetrics, including chorionic villus sampling and fetal monitoring tests. Understand key risk factors, complications, and patient instructions for safe prenatal care. Test your knowledge on essential practices and assessments for maternal-fetal health.