CNM flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Naegele's rule

Estimated due date is calculated as the first day of the last menstrual period plus 7 days, minus 3 months, plus 1 year.

Gravida versus para

Gravida counts every pregnancy including the current one; para counts births occurring at 20 weeks gestation or later, regardless of outcome.

Glucose challenge test timing

Routine 50-g one-hour glucose challenge screening is performed at 24 to 28 weeks gestation; a result of 130 to 140 mg/dL prompts a 3-hour diagnostic test.

Fundal height rule

Between 20 and 36 weeks, fundal height in centimeters approximates gestational age in weeks, within plus or minus 2 to 3 centimeters.

RhoGAM at 28 weeks

Unsensitized Rh-negative women receive anti-D immune globulin at 28 weeks and again within 72 hours after delivery of an Rh-positive infant.

Active phase labor

Active labor begins at 6 cm dilation and continues to full dilation; minimum normal cervical change is roughly 0.5 to 1 cm per hour.

Category I fetal tracing

Baseline 110 to 160 bpm with moderate variability, no late or variable decelerations, and accelerations present or absent; predicts normal acid-base status.

Late decelerations cause

Reflect uteroplacental insufficiency; respond by repositioning to left lateral, giving oxygen, stopping oxytocin, and considering an intravenous fluid bolus.

Variable decelerations cause

Reflect umbilical cord compression; management includes maternal position change, amnioinfusion for recurrent variables, and vaginal examination to rule out cord prolapse.

Shoulder dystocia maneuvers

First-line is McRoberts maneuver with suprapubic pressure; next consider rotational maneuvers such as Rubin II or Woods screw, then delivery of the posterior arm.

Uterine atony treatment

Atony is the most common cause of postpartum hemorrhage; treat with massage, oxytocin, then methylergonovine (avoid in hypertension) or carboprost (avoid in asthma).

Lochia progression

Lochia rubra is red and lasts 1 to 3 days, serosa is pink-brown for 4 to 10 days, and alba is white-yellow beyond 10 days.

Postpartum endometritis

Fever of 38 degrees Celsius or higher on two of the first 10 postpartum days with uterine tenderness; typical treatment is clindamycin plus gentamicin.

Postpartum hemorrhage definition

ACOG defines it as cumulative blood loss of 1000 mL or more, or bleeding with signs of hypovolemia within 24 hours of birth, by any route.

Mastitis organism

Staphylococcus aureus is the most common cause; treatment includes frequent feeding, analgesics, and dicloxacillin or cephalexin when antibiotics are indicated.

Apgar components

Heart rate, respiratory effort, muscle tone, reflex irritability, and color are each scored 0 to 2 at 1 and 5 minutes after birth.

Newborn weight loss

Term infants may lose up to 7 to 10 percent of birth weight in the first week and typically regain birth weight by 10 to 14 days.

Vitamin K at birth

All newborns receive 0.5 to 1 mg of vitamin K1 intramuscularly after birth to prevent vitamin K deficiency bleeding.

Newborn screening timing

Heel-stick newborn screening blood is collected between 24 and 72 hours after birth, after feeding has begun.

Hypertension staging

Normal is below 120/80; elevated is 120 to 129 over below 80; stage 1 is 130 to 139 over 80 to 89; stage 2 is 140/90 or higher.

Cervical cancer screening intervals

USPSTF: cytology every 3 years from ages 21 to 29; for ages 30 to 65, cytology every 3 years, co-testing every 5, or HPV testing every 5.

Diabetes A1c threshold

An A1c of 6.5 percent or higher, fasting glucose of 126 mg/dL or higher, or a 2-hour OGTT of 200 mg/dL or higher supports diabetes diagnosis.

Tdap in pregnancy

One dose of Tdap is recommended during every pregnancy, ideally between 27 and 36 weeks gestation, regardless of the prior vaccination interval.

Copper IUD emergency contraception

Placed within 5 days of unprotected intercourse, the copper IUD is the most effective emergency contraception, with pregnancy rates under 0.1 percent.

Menopause definition

Twelve consecutive months of amenorrhea without another cause; follicle-stimulating hormone is typically elevated above 30 mIU/mL.

PCOS Rotterdam criteria

Diagnosis requires two of three: oligo-ovulation or anovulation, clinical or biochemical hyperandrogenism, and polycystic ovaries on ultrasound.

Bacterial vaginosis diagnosis

Amsel criteria require three of four: homogeneous discharge, pH above 4.5, positive whiff test, and clue cells; first-line treatment is metronidazole.

COC absolute contraindications

Include migraine with aura, smoking at age 35 or older, prior venous thromboembolism, uncontrolled hypertension, and known thrombogenic mutations.

Informed consent elements

Requires patient capacity, adequate disclosure of risks and alternatives, comprehension, and voluntariness, with the process documented in the medical record.

Belmont Report principles

Respect for persons, beneficence, and justice form the ethical framework governing research involving human subjects in the United States.

EMTALA requirement

Medicare-participating hospitals must provide a medical screening examination and stabilizing treatment for emergency conditions regardless of ability to pay.

Mandatory reporting duties

Clinicians must report suspected child or elder abuse and specified communicable diseases to designated authorities as required by state law.