Symptoms and Tests for OB/GYN Conditions

It is important for the obstetric registered nurse to recognize the following danger signs of pregnancy: profuse vaginal bleeding, severe headaches/visual disturbances/abdominal pain, persistent vomiting, fever, chills, or swelling in the face or fingers. These may be signs of placental abnormalities, hypertensive disorders or pregnancy, maternal infection, or hyperemesis. Increased urination may be concerning to some women, but during pregnancy, the increased mass of the uterus induces pressure upon the bladder.

The alpha-fetal protein (AFP) test is the only test that can predict neural tube defects in a fetus during pregnancy. CVS can detect fetal karyotype, sickle-cell anemia, phenylketonuria (PKU), Down syndrome, and Duchenne muscular dystrophy. Amniocentesis can detect genetic disorders and lung maturity. Ultrasounds provide images of the fetal position, measurements of the fetus and placenta, and can confirm pregnancy and gestational age. Non-stress tests (NST) are used to record fetal heart rate to assess fetal well being after 28 weeks gestation.

The nurse must suspect rupture of the membranes (amniotic sac). Assess fetal heart rate if rupture of the membranes may have occurred. With rupture comes the potential for cord prolapse. Assess fetal heart rate for baseline variability. Marked variability may be cause for concern and the nurse should monitor the patient for signs of infection.

In placenta previa, the placenta develops in such a way that all or part of it is positioned in the lower one-third of the uterus, placing it between the fetus and the cervix. This can cause the placenta to tear and bleed. The most common sign is painless vaginal bleeding in the third trimester (generally after week 32).

The basal body temperature is a method many women use to determine when ovulation occurs. To take a basal body temperature, one must use a basal thermometer (which is more sensitive) and take their body temperature before getting out of bed (or even sitting up) each morning. This method is utilized the best if a woman wakes up and takes her temperature at the same time daily.

Increment is the beginning or rise of the contraction. Acme is the peak of the contraction. Decrement is the fall of the contraction. Frequency is measured from the beginning of one contraction to the beginning of another, so it should be measured from the increment of the first contraction to the increment of the second contraction.

In the average normal pregnancy, the GFR increases by upwards of 50%. This correlates with an overall 50% increase in blood plasma volume.

Premature ovarian failure is the loss of ovarian function in an individual under the age of 40. A and would be indicative of this condition.

ASC-US or LSIL in women age 21-24 should be managed by repeat cytology in one year. Neither cervical conization nor LEEP (loop electrosurgical excision procedure) would be appropriate in a patient of this age or presentation.

Hegar's sign is indicated by a softening of the portion of the uterus between the uterus and a portion of the cervix. The remaining choices are all examples of various skin discolorations commonly associated with pregnancy.