1. What are presumptive signs of pregnancy?
- “She said” … The assumption that she is pregnant.
o Missed period.
o N/V
o Changes in appetite or food cravings
o Mood swings o Spotting o Darkening nipples o Increase sensitivity to odors.
2. What are probable signs of pregnancy?
- Things that could indicate pregnancy but could also me caused by other things not
pregnancy related.
o Pregnancy test- trigger shot for IUI can cause a false positive.
o Chadwick – blush discoloration of cervix d/t increase blood flow to the area. o
Goodell sign – softening of the cervix that can be felt during pelvis examination
caused my increased mucus secretion.
o Haggar sign – softening of the lower part of the uterus Feeling like the tip of
the nose.
o Ballottement – tap back. o Braxton Hicks contractions
3. What are positive signs of pregnancy? Ultrasound, Provider feeling the baby move, Hear
fetal HR.
4. What is Pica?
- Consuming nonfood
substance o Corn starch
o Paper o Laundry detergent o
Caused by low iron or its cultural
5. What is the treatment of PICA? Iron, Vitamin C
6. What do we want to avoid that impact the absorption of iron?
Calcium or other dairy products
7. Dietary sources of iron?
Green leafy veggies, beans legumes, chicken, dried fruits, organ meats
8. What are signs of ectopic pregnancy? Unilateral abdominal pain
9. What are kick count? Fetal movement 10 in 2hrs
10. What makes a reactive NST? Is a reassuring NST. 2 or more fetal HR accelerations of at
least 15 beats in 15minutes in a 20min span over 32weeks. 10 x 10 if less then 32 weeks.
11. What makes a nonreactive NST? Is a concerning NST. Not having 2 in 20 mins.
, 12. What will we do if we get a nonreactive NST? Biophysical profile which is a prenatal test
that uses both FHR and ultrasound examination to measure if fetus is doing well. A
number from 0-2 for each criterion: Amniotic Fluid volume, fetal muscle tone, Fetal
movement, and Fetal Breathing Movements.
13. What is a Gestational Condition? A disorder that didn’t exist before the pregnancy. Eg:
gestational hypertension, pre-eclampsia, hyperemesis, gestational diabetes, UTI
14. What is the difference between chronic hypertension, gestational hypertension, and
preeclampsia? Normal Blood pressure 120/80
- Chronic Hypertension - A patient will be diagnosed with chronic hypertension if they had
it before pregnancy or before 20weeks. Systolic pressure greater than or equal to 140 or
diastolic blood pressure greater than or equal to 90. These measurements must be
confirmed on two separate occasions at least 4hrs apart.
- Gestational Hypertension – After 20 weeks on two different occasions at least 4 hours
apart the patients blood pressure measures equal to or greater than 140/90 and not
showing signs of affecting systems as in preeclampsia (proteinuria).
- Preeclampsia – same as above but starts to affect other system of the body. Cannot be
diagnosed with preeclampsia before 20 weeks. Examples include Right upper quadrant
pain – liver is affected, headaches or vision impairment – brain is affected. Elevated liver
enzymes (AST/ALT) – liver is affected. Proteinuria or less than 30 milliliters per hour –
kidney is affected.
15. High risk factors for Hypertension?
Obesity, smoking, AMA over 40 or 19, African American, gestation with multiples, and
family history of hypertension.
16. What are your pregnancy risks if you have hypertension?
Abruption, intra uterine growth restrictions, preterm birth, fetal mortality, still birth,
edema, HELLP Syndrome – hemolysis of red blood cells resulting in poor perfusion,
elevated liver enzymes which signal liver damage, low platelet count due in part to
vascular damage.
17. What are we looking for when we do a physical assess for preeclampsia?
Deep tendon reflexes, clonus, visual disturbances and edema.
18. What labs do we check for a patient with preeclampsia?
liver enzymes, CBC for (RBC and platelets), and urinalysis for protein in urine.]
19. How do we manage mild preeclampsia? Blood pressure is 140 to 159 systolic or 90 to
110 diastolic. Check blood pressure, ask about right upper quadrant pain, any visual
disturbances, any headaches, checking edema, checking for pulmonary edema whch
may present as SOB and fluid in lungs. Frequent assessment on mom and baby: NST and
ultrasound
20. How do we manage severe preeclampsia? Blood pressure is 160 and above systolic or
110 and above. Call provider and prepare to start Magnesium sulfate. Prepare to deliver
baby, seizure precautions, calcium gluconate.