PCEP Book 1
Unit 1 - answer Unit 1
high risk - answer pregnancy in which risk factors indicate an increased likelihood of
illness or death for the fetus or pregnant woman.
- does not mean a woman or fetus will always develop a problem
- may develop at any time during pregnancy or labor
INCLUDES:
> Maternal Medical Conditions
- HTN, Diabetes, Obesity, thyroid, STI
> Others
- Maternal age, substance use, adverse socioeconomic factors
> Past History
- previous C/S, macrosomia newborn, stillborn, high parity
> Current Pregnancy
- hydramnios, oligohydramnios, growth restriction, preterm rupture or labor, post term,
hemorrhage, previa
> Abnormal labor
- prolonged, vacuum, forceps, mec, rapid, prolapsed cord, shoulder dystocia
every - answerregardless of initial risk status, ________ pregnant woman and fetus
needs a
1) comprehensive examination to identify risk factors
2) review of risk factors and patient status at every prenatal visit
3) determination of pregnancy dates as early as a accurately as possible
at risk - answerMom
- abnormal vital signs
- abnormal weight gain or loss
- abnormal lab findings
- well controlled medical illness
- obstetric complication in previous pregnancy
- stable obstetric complication in current pregnancy
- substance use
- adverse social, economic, work or psychological conditions
- psychiatric illness
- exposure to infectious diseases that may adversely affect the fetus
,sick - answerMom
- BP >160/110
- abnormal labs
- medical illness in poor control
- unstable obstetric complication in current pregnancy
- unstable psychiatric illness
- systemic infectious disease that may adversely affec tthe fetus
at risk - answerBaby
- abnormal fetal growth
- category II FHR tracing
- abnormal fetal activity
- abnormal ultrasound findings: decreased or increased amniotic fluid volume, fetal
malformation, or placenta previa
- a mother with one or more risk factors
sick - answerBaby
- a decrease or unexpected increase in fundal height
- decreased fetal activity
- category III FHR tracing
- fetal growth restriction
- abnormal anatomy
- abnormal ultrasound findings: decreased amniotic fluid, poor muscle tone, no
mmovement etc
- seriously ill mother
management of care - answer1) by the woman's obstetrician with initial or continuing
consultation with a specialist at a regional perinatal center
2) through co-management by the woman's obstetrician and specialist, who examines
the patient periodically during her pregnancy
3) with a transfer of care of the patient to a specialist at a regional perinatal center
well
at risk
B - answerA healthy, 20 year old woman who is pregnant with her second child comes
for a routine prenatal visit at 35 weeks. SHe has normal vitals, weight gain, and
increase in uterine size. You note a baseline fetal heart rate of 174.
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
, C) intervene promptly to investigate or correct the problem
at risk
at risk
B - answera healthy 26 year old woman who is pregnant with her first child has a brief
episode of vaginal bleeding at 35 weeks. A placenta previa is diagnosed by ultrasound.
The fetus has normal activity, growth, and heart rate
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
C) intervene promptly to investigate or correct the problem
at risk
at risk
B - answerA 30 year old woman with compromised but stable kidney function is
pregnant at 26 weeks with first child
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
C) intervene promptly to investigate or correct the problem
Sick
At risk
C - answerAt 32 weeks gestation the womans renal function begins to deteriorate. Fetal
growth has been normal; fetal activity and heart rate are normal
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
C) intervene promptly to investigate or correct the problem
C - answerAll of the following actions are indicated for all women having high risk
deliveries except:
a) start an IV
b) use continuous fetal heart rate and uterine contraction monitoring
c) use only epidural anesthesia
d) notify pediatric personnel of maternal/fetal condition as soon as woman is admitted.
Unit 1 - answer Unit 1
high risk - answer pregnancy in which risk factors indicate an increased likelihood of
illness or death for the fetus or pregnant woman.
- does not mean a woman or fetus will always develop a problem
- may develop at any time during pregnancy or labor
INCLUDES:
> Maternal Medical Conditions
- HTN, Diabetes, Obesity, thyroid, STI
> Others
- Maternal age, substance use, adverse socioeconomic factors
> Past History
- previous C/S, macrosomia newborn, stillborn, high parity
> Current Pregnancy
- hydramnios, oligohydramnios, growth restriction, preterm rupture or labor, post term,
hemorrhage, previa
> Abnormal labor
- prolonged, vacuum, forceps, mec, rapid, prolapsed cord, shoulder dystocia
every - answerregardless of initial risk status, ________ pregnant woman and fetus
needs a
1) comprehensive examination to identify risk factors
2) review of risk factors and patient status at every prenatal visit
3) determination of pregnancy dates as early as a accurately as possible
at risk - answerMom
- abnormal vital signs
- abnormal weight gain or loss
- abnormal lab findings
- well controlled medical illness
- obstetric complication in previous pregnancy
- stable obstetric complication in current pregnancy
- substance use
- adverse social, economic, work or psychological conditions
- psychiatric illness
- exposure to infectious diseases that may adversely affect the fetus
,sick - answerMom
- BP >160/110
- abnormal labs
- medical illness in poor control
- unstable obstetric complication in current pregnancy
- unstable psychiatric illness
- systemic infectious disease that may adversely affec tthe fetus
at risk - answerBaby
- abnormal fetal growth
- category II FHR tracing
- abnormal fetal activity
- abnormal ultrasound findings: decreased or increased amniotic fluid volume, fetal
malformation, or placenta previa
- a mother with one or more risk factors
sick - answerBaby
- a decrease or unexpected increase in fundal height
- decreased fetal activity
- category III FHR tracing
- fetal growth restriction
- abnormal anatomy
- abnormal ultrasound findings: decreased amniotic fluid, poor muscle tone, no
mmovement etc
- seriously ill mother
management of care - answer1) by the woman's obstetrician with initial or continuing
consultation with a specialist at a regional perinatal center
2) through co-management by the woman's obstetrician and specialist, who examines
the patient periodically during her pregnancy
3) with a transfer of care of the patient to a specialist at a regional perinatal center
well
at risk
B - answerA healthy, 20 year old woman who is pregnant with her second child comes
for a routine prenatal visit at 35 weeks. SHe has normal vitals, weight gain, and
increase in uterine size. You note a baseline fetal heart rate of 174.
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
, C) intervene promptly to investigate or correct the problem
at risk
at risk
B - answera healthy 26 year old woman who is pregnant with her first child has a brief
episode of vaginal bleeding at 35 weeks. A placenta previa is diagnosed by ultrasound.
The fetus has normal activity, growth, and heart rate
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
C) intervene promptly to investigate or correct the problem
at risk
at risk
B - answerA 30 year old woman with compromised but stable kidney function is
pregnant at 26 weeks with first child
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
C) intervene promptly to investigate or correct the problem
Sick
At risk
C - answerAt 32 weeks gestation the womans renal function begins to deteriorate. Fetal
growth has been normal; fetal activity and heart rate are normal
The woman is __________
The fetus is ____________
You Should: ________
A) Evaluate the woman and fetus at regular intervals
B) Anticipate problems, investigate suspicious findings, and reevaluate frequently
C) intervene promptly to investigate or correct the problem
C - answerAll of the following actions are indicated for all women having high risk
deliveries except:
a) start an IV
b) use continuous fetal heart rate and uterine contraction monitoring
c) use only epidural anesthesia
d) notify pediatric personnel of maternal/fetal condition as soon as woman is admitted.
