Pregnancy Management and Group A Beta-Hemolytic Strep
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Questions and Answers

Why is there a shortage of reliable data regarding drug toxicity during pregnancy and breastfeeding?

  • Due to the lack of interest from pharmaceutical companies in studying drug toxicity during pregnancy.
  • Due to the ethical concerns of conducting drug toxicity studies on pregnant or breastfeeding patients.
  • Because third-phase clinical trials are not conducted on pregnant or breastfeeding patients. (correct)
  • Because pregnant patients are not willing to participate in drug toxicity studies.

    • Why do two-thirds of pregnant patients take at least one medication?

  • To improve their mental health and emotional well-being during pregnancy.
  • To increase their appetite and food intake during pregnancy.
  • To enhance their physical strength during pregnancy.
  • To manage pregnancy-related problems like nausea and constipation. (correct)

    • What physiological changes during the third trimester of pregnancy impact drug disposition and dosing?

  • Liver function is significantly reduced.
  • Lung capacity decreases leading to decreased metabolism of drugs.
  • Gastric emptying time is shortened, causing faster drug absorption.
  • Renal flow is doubled and renal excretion is accelerated. (correct)

    • Why do pregnant patients need to understand that all drugs can cross the placenta?

    <p>To be aware that the medications they take can affect the developing fetus.</p> Signup and view all the answers

    What is the term for a female who has not been pregnant?

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

    Which vaccines should not be given during pregnancy?

    <p>MMR, varicella, HPV, meningococcal polysaccharide</p> Signup and view all the answers

    What should be encouraged for women before, during, and after pregnancy?

    <p>Maintaining average body weight</p> Signup and view all the answers

    Which of the following is an increased risk factor for pregnancy?

    <p>Previous preterm labor</p> Signup and view all the answers

    What is the recommended daily dose of folic acid to decrease the risk of neural tube defects?

    <p>0.4 milligrams per day</p> Signup and view all the answers

    What type of patient should have a good obstetric history and thorough gynecologic surgical history obtained?

    <p>Patients needing preconception care</p> Signup and view all the answers

    What vaccine can be given to a pregnant woman traveling to areas with an increased risk of yellow fever?

    <p>$Yellow fever$</p> Signup and view all the answers

    What patient characteristic poses an increased risk factor for pregnancy?

    <p>$Maternal age$</p> Signup and view all the answers

    What should be evaluated by obtaining a pap smear and screening for sexually transmitted diseases?

    <p>$Gynecologic surgical history$</p> Signup and view all the answers

    "In utero exposure to DES" refers to exposure to which substance?

    <p>$Diethylstilbestrol$</p> Signup and view all the answers

    What is often the first sign of pregnancy?

    <p>Breast tenderness</p> Signup and view all the answers

    During which trimester does urinary frequency occur and then go away a little bit before coming back again?

    <p>First trimester</p> Signup and view all the answers

    What can cause abdominal discomfort in the second trimester?

    <p>Round ligament pain</p> Signup and view all the answers

    What causes brown patches on the face during pregnancy?

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

    What should be done when pregnant women experience contractions and suspect they are in early labor?

    <p>Have them drink about 16 ounces of water</p> Signup and view all the answers

    What is Goodell's sign associated with during the first trimester?

    <p>Cervical softening</p> Signup and view all the answers

    At what point in the pregnancy is the fundus palpable at the umbilicus?

    <p>20 weeks gestation</p> Signup and view all the answers

    What grows approximately one centimeter per week after 20 weeks gestation?

    <p>The fundus</p> Signup and view all the answers

    When do Leopold maneuvers become feasible during a pregnancy?

    <p>After 20 weeks gestation</p> Signup and view all the answers

    What causes syncopal episodes during pregnancy?

    <p>Not super common</p> Signup and view all the answers

    At what point do Braxton-Hicks contractions typically start occurring?

    <p>Third trimester</p> Signup and view all the answers

    What is often the cause of difficulty breathing for many women during the third trimester?

    <p>Increased pressure on the pelvis</p> Signup and view all the answers

    During which stage of development does organogenesis take place?

    <p>Week three through eight</p> Signup and view all the answers

    What is the main purpose of the Pregnancy Lactation Labeling Rule (PLLR) initiated by the FDA?

    <p>To provide prescribers with relevant information for treating pregnant and lactating women</p> Signup and view all the answers

    What can cause gross malformations such as cleft palate and clubfoot in the fetus?

    <p>Teratogenic medications</p> Signup and view all the answers

    Why did the FDA initiate the Pregnancy Lactation Labeling Rule (PLLR) in 2015?

    <p>To provide clearer information on medication risks and benefits for pregnant and lactating women</p> Signup and view all the answers

    Which stage of development is the most critical period for the occurrence of gross malformations caused by teratogens?

    <p>Week three through week eight</p> Signup and view all the answers

    What do prostaglandins stimulate during pregnancy?

    <p>Uterine contractions</p> Signup and view all the answers

    Why is it important to minimize the risks for teratogenesis during pregnancy?

    <p>To avoid unnecessary drug use that could harm the fetus</p> Signup and view all the answers

    What action did the FDA take with medication lettering labels in 2020?

    <p>They required all prescriptions to remove the lettering labels.</p> Signup and view all the answers

    What is the significance of the embryonic period in terms of teratogen exposure?

    <p>It is when organogenesis takes place and may lead to gross malformations caused by teratogens.</p> Signup and view all the answers

    What was a drawback of the old lettering categories (A, B, C, D, and X) used for medications during pregnancy?

    <p>They were confusing and did not accurately reflect a medication's risk to the fetus.</p> Signup and view all the answers

    Why is it important for prescribers to have relevant information on medication risks during pregnancy?

    <p>To make informed decisions when treating pregnant patients.</p> Signup and view all the answers

    What type of health information is collected from women who take prescription medications or vaccines when they are pregnant?

    <p>Health information of the mother and the newborn baby</p> Signup and view all the answers

    When is it recommended to administer the influenza vaccine during pregnancy?

    <p>Between October and March</p> Signup and view all the answers

    What is the duration of antibody protection until after birth with the tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis vaccine when administered during pregnancy?

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

    What type of vaccines can be given during pregnancy?

    <p>Viruses that are killed or inactivated</p> Signup and view all the answers

    What should providers do with their pregnant patients in relation to pregnancy exposure registries?

    <p>Providers should enroll pregnant patients in exposure registries if they are taking any medication</p> Signup and view all the answers

    What does lactation information need to contain?

    <p>Risk summary, clinical considerations, and data</p> Signup and view all the answers

    What do providers need to do with medications that are excreted in breast milk?

    <p>Choose drugs that tend to be excluded from milk</p> Signup and view all the answers

    When should immunizations against preventable diseases be administered to women?

    <p>Prior to pregnancy whenever possible</p> Signup and view all the answers

    When can live attenuated vaccines be given during pregnancy?

    <p>They cannot be given during pregnancy</p> Signup and view all the answers

    What is recommended if someone receives a vaccine with a lot of virus in it while attempting to become pregnant?

    <p>They should not attempt pregnancy for at least 28 days</p> Signup and view all the answers

    What is the primary purpose of enrolling pregnant patients in an exposure registry?

    <p>To compare the health information of mothers who have taken medication during pregnancy with those who have not</p> Signup and view all the answers

    What are some occupational issues that pregnant females need to consider?

    <p>Exposure to teratogens such as radiation, chemotherapy, and chemicals</p> Signup and view all the answers

    When should pregnant females avoid sexual intercourse?

    <p>If there is a threatening abortion or preterm labor</p> Signup and view all the answers

    What are some danger signs of pregnancy that require medical attention?

    <p>Swelling of the face or fingers, severe or continuous headache, and marked changes in frequency or intensity of fetal movements</p> Signup and view all the answers

    What should pregnant females do when traveling by car or plane to reduce the risk of blood clots?

    <p>Walk at least every two hours</p> Signup and view all the answers

    What should pregnant females do to ensure proper use of seatbelts in vehicles?

    <p>Ensure the lap belt is under the abdomen and across the upper thighs, and the shoulder belt is placed snugly across the abdomen and between the breasts</p> Signup and view all the answers

    When should high-risk pregnancy patients be referred out from a primary care setting?

    <p>When they have recurrent pregnancy losses or previous fetal death in utero, family history of genetic anomalies, Rh sensitization, or abnormal lab results</p> Signup and view all the answers

    What is the recommended weight gain for normal-weight females during pregnancy?

    <p>25 to 35 pounds</p> Signup and view all the answers

    How is the date of confinement calculated using Naegele's rule?

    <p>Add seven days and subtract three months from the first day of the last menstrual period</p> Signup and view all the answers

    Why is it important to perform Leopold's maneuvers during pregnancy?

    <p>To determine fetal lie positions</p> Signup and view all the answers

    What is the purpose of performing a culture for Group A beta-hemolytic Strep during pregnancy?

    <p>To detect infections that may affect the pregnancy</p> Signup and view all the answers

    What activities are contraindicated during pregnancy?

    <p>Scuba diving, roller coasters, and bungee jumping</p> Signup and view all the answers

    What should be done if the culture for Group A beta-hemolytic Strep is positive during pregnancy?

    <p>Treat with medication and consider repeating the CBC</p> Signup and view all the answers

    How often are prenatal visits recommended after 36 weeks of pregnancy?

    <p>Every week</p> Signup and view all the answers

    What nutritional advice should be given to pregnant women regarding seafood consumption?

    <p>&quot;Consume only fish that is low in mercury, such as salmon, tilapia, and shrimp&quot;</p> Signup and view all the answers

    What is the recommended daily intake of folic acid for pregnant females?

    <p>.4 milligrams per day</p> Signup and view all the answers

    "How often should urine tests for protein, glucose, and ketones be performed during prenatal visits?"

    <p>At each visit</p> Signup and view all the answers

    "What is the recommended daily intake of elemental iron for pregnant females?"

    <p>30 milligrams a day</p> Signup and view all the answers

    "What should be done if spotting occurs after sexual intercourse during pregnancy?"

    <p>Continue sexual activity as long as the spotting is minimal</p> Signup and view all the answers

    At what point in the pregnancy should a repeat CBC (complete blood count) be done?

    <p>Between 28 and 36 weeks</p> Signup and view all the answers

    When should diabetic screening be done during pregnancy?

    <p>Between 24 and 28 weeks</p> Signup and view all the answers

    What diagnostic test is recommended for patients at high risk for Down syndrome?

    <p>Chorionic villus sampling</p> Signup and view all the answers

    During which trimester is an increase in Braxton-Hicks contractions and rupture in the membranes likely to occur?

    <p>Third trimester</p> Signup and view all the answers

    When should RhoGAM be given to un-sensitized Rh-negative mothers?

    <p>Between 28 and 36 weeks</p> Signup and view all the answers

    At what point in the pregnancy are hemoglobin and hematocrit levels recommended to be repeated?

    <p>Between 28 and 36 weeks</p> Signup and view all the answers

    When is chorionic villus sampling typically performed?

    <p>11 to 14 weeks</p> Signup and view all the answers

    When should diagnostic tests for STDs, hepatitis B, sickle cell screen, and others be performed?

    <p>First visit in the first trimester</p> Signup and view all the answers

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