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WH717: Module 1 Antepartum Questions with Correct Answers
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WH717: Module 1 Antepartum Questions with Correct Answers
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WH717: Module 1 Antepartum Questions withCorrect Answers
Causes of benign abdominal pain Correct Answer-1. Round ligament
pain
2. Constipation
3. Bloating
4. Braxton-hicks contractions
5. Heartburn
6. Corpus luteum cyst
Round Ligament Pain Correct Answer-• D/t stretching of ligaments
supporting uterus.
• They become thin and stretched like rubber bands
• Brief, sharp, or dull ache, unilateral or bilateral
• Occurs in 2nd trimester most commonly when sudden change of
position, coughing, rolling over In bed
• RX = apply heat to area, bend knees to chest to shorten ligament,
change position slowly, reassurance of normalcy
Constipation Correct Answer-• Caused by progesterone slowing GI
motility
• Occurs in 50% of pregnant women
• Can cause cramping
• RX = high fiber diet, exercise, increase fluids, prunes, eliminate iron
supplements, OTC bulking agent like Metamucil
,• No laxatives
Bloating Correct Answer-• Caused by increased gas formation d/t
decreased GI motility
• Can be sharp, severe, one sided, short-lived, or lasting for awhile
• Check for lactose intolerance in African American Women
• RX = side lying to allow gas to pass, decrease gas forming foods,
exercise to increase GI motility & regularity
Braxton-Hicks Contractions Correct Answer-• Most often 3rd trimester
• Abdomen tight, can be uncomfortable
• Occurs at regular intervals with rest between
• RX = hydration, rest, reassurance of normalcy
Heartburn (pyrosis) Correct Answer-• GERD (gastroesophogeal reflux
disease) or "heartburn" in pregnancy is common
• Due to progesterone relaxation of esophageal sphincter & delayed
gastric emptying (hence, not really a disease)
• Pain after meals, located in the substernum epigastric area
• RX = watch food choices, antacids, reassurance of normalcy (Review
NM617 & Varney for complete picture)
Corpus luteum cyst Correct Answer-• Corpus luteum makes
progesterone to support pregnancy
• Usually resolve early 2nd trimester without problem
,• May see this on early USN, can be 2cm-6cm
• Sometimes cyst will rupture causing several hours of pain
• Usually resolves quickly, no residual problem
Causes of Abnormal Abdominal Pain Correct Answer-• Miscarriage
• Ectopic pregnancy
• Preterm labor
• Placental abruption
• UTI
• Appendicitis
• Intestinal obstruction
• Cholecystitis
• HELLP syndrome
Miscarriage Correct Answer-• Occurs primarily 1st trimester
• Sensation of intermittent uterine cramping, colicky, increasing in
severity over time
• Accompanied by bleeding
Ectopic Pregnancy Correct Answer-• Symptoms present primarily
between 6-9 weeks gestation
• Unilateral sharp pain, can be intermittent or constant (rupture)
• Perceived higher than round ligament pain
• 50% of women with ectopic will also have bleeding
, Preterm Labor Correct Answer-• Most often 3rd trimester
• Pain most often above pubic bone (cervix) occurring at regular
intervals (though can be perceived as back pain)
• Increasing in severity over time
• May see increased vaginal discharge
• Accompanied by cervical change
Placental Abruption Correct Answer-• Occurs in the 3rd trimester
• Pain is constant, increasing over time, or can be sudden if trauma
involved
• Can be perceived in the back at first if placenta posterior
• Accompanied by uterine rigidity
• Bleeding may be a later sign for some women
Urinary Tract Infection Correct Answer-• Occurs anytime in pregnancy•
Perceived as fairly constant suprapubic discomfort• Often accompanied
by other symptoms of UTI like urgency, dysuria
Appendicitis Correct Answer-• Acute appendicitis is the most common
cause of prenatal surgery
• Incidence = about 1/1000 pregnant women
• Rupture is more common in pregnancy d/t delay of diagnosis
• Presents as vague right sided pain
• Muscle guarding and rebound tenderness may or may not be present
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