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OB - Napier > Exam 1 blueprint > Flashcards

Exam 1 blueprint Flashcards

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1
Q

what causes urinary frequency during pregnancy?

A

uterus pressing on the bladder

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2
Q

how is fundal height measured?

A

from symphysis pubis to the top of the fundus (in cm)

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3
Q

where should the fundus measure at 20 weeks?

A

in line with the umbilicus

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4
Q

what should be used to prevent neural tube defects?

A

folic acid supplements
(400 mcg at childbearing age and 600 mcg once pregnant)

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5
Q

what neural tube defect is characterized by incomplete development of the fetal skull and brain?

A

anencephaly

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6
Q

which neural tube defect is characterized by an open spine?

A

spina bifida

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7
Q

which neural tube defect is a defect of the abdominal wall?

A

omphalocele

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8
Q

what surgical intervention is utilized for reduced cervical competence?

A

cerclage

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9
Q

what s/s should a patient report following a cerclage?

A

report pain, increased pressure, ROM and s/s of infection

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10
Q

what is the antidote for magnesium sulfate?

A

calcium gluconate

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11
Q

what complication of magnesium administration would cause absence of DTR or RR < 12/min?

A

toxicity

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12
Q

what does the BURP mnemonic stand for for magnesium sulfate toxicity?

A

B - BP decreased
U - UOP decreased
R - RR < 12
P - patellar reflex absent

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13
Q

what are the indications for magnesium sulfate?

A

eclampsia and severe eclampsia (seizures)

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14
Q

what type of abortion is characterized by no dilation or passage of tissue and slight bleeding, where pregnancy may continue?

A

threatened abortion

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15
Q

what type of abortion is characterized by dilation of the cervix, moderate bleeding w/cramping, and definite loss of pregnancy?

A

inevitable abortion

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16
Q

what type of abortion has retained tissue that causes continued bleeding and possible infection, as well as passage of some tissue, bleeding, cramping and dilation of cervix?

A

incomplete abortion

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17
Q

what is a complete abortion?

A

all pregnancy tissue passes through the dilated cervix

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18
Q

what is a missed abortion?

A

fetus has died (no heart beat), no bleeding or spotting

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19
Q

what is a septic abortion?

A

severe infection following an abortion that causes a malodorous discharge

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20
Q

what causes supine hypotension?

A

weight of the gravid uterus compressing the vena cava, reducing the blood supply

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21
Q

how can supine hypotension be alleviated?

A

lay on side

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22
Q

what type of sign of pregnancy is a positive pregnancy test?

A

probable

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23
Q

what may cause a false positive pregnancy test?

A

a hormone secreting tumor

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24
Q

about what week can quickening be felt?

A

around 20 weeks

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25
what area is most likely to be damaged during childbirth?
perineum (between vaginal opening and anus)
26
what is suspected if a female of childbearing age complains of unilateral stabbing pain, red/brown spotting and referred pain in the shoulder?
ectopic pregnancy
27
what medication may be administered for the treatment of a non-ruptured ectopic pregnancy?
methotrexate
28
what treatment measure is indicated for a ruptured ectopic pregnancy?
laparoscopic salpingectomy (removal of tube)
29
what pregnancy complication is characterized by very painful, dark red vaginal bleeding, contractions and a board-like abdomen?
placental abruption
30
which pregnancy complication is characterized by painless, bright red vaginal bleeding after 20 weeks?
placenta previa
31
how is placenta previa diagnosed?
ultrasound
32
what must be avoided if placenta previa is suspected or diagnosed?
NOTHING in vagina (no vaginal exams or sexual intercourse)
33
what type of birth is indicated for those with placenta previa?
cesarean
34
what is a medication given for mothers with placenta previa if less than 34 weeks? why?
betamethasone promote fetal lung maturity
35
what should be immediately applied to the mother who is having a placental abruption to monitor the status of the fetus?
EFM (electronic fetal monitor)
36
what is the earliest genetic testing available?
CVS (chorionic villus sampling)
37
when can a CVS be performed?
10 - 13 weeks
38
why should the nurse instruct the mother to drink 1 -2 glasses of water prior to the CVS testing?
a full bladder is necessary
39
which genetic testing is performed by a passing a catheter through the cervix and into the uterus or through abdominal wall and obtaining a sample of the finger-like projections of the developing placenta?
CVS (chorionic villus sampling)
40
why may a CVS be performed?
if the mother is at risk for giving birth to a neonate with a genetic chromosomal abnormality
41
when can an amniocentesis be performed?
15 weeks to birth
42
when can the AFP (alpha fetoprotein) test be performed?
15 - 18 weeks
43
what may a high level of AFP indicate?
neural tube defect or open abdominal defect
44
what may a low level of AFP indicate?
down syndrome
45
when may a targeted ultrasound be performed?
after 18 weeks
46
which genetic test is characterized by a complete scan of the fetal anatomy to assess for potential genetic abnormalities?
Level II ultrasound/targeted ultrasound
47
what are the signs of hemorrhage that may be seen as a result of placental abruption?
- tachycardia - hypotension - pallor - tachypnea
48
what is the first line management of placental abruption?
immediate birth
49
what are the nursing interventions for placental abruption?
- palpate uterus for tenderness/tone - serial monitoring of fundal height - assess FHR pattern - emotional support
50
what medication is given to dissolve the pregnancy of a non ruptured ectopic pregnancy?
methotrexate
51
what may indicate that an ectopic pregnancy has ruptured?
red vaginal bleeding and potential signs of hemorrhage
52
Determine whether it is a presumptive, probable or positive sign of pregnancy? - amenorrhea
presumptive
53
Determine whether it is a presumptive, probable or positive sign of pregnancy? - N/V and fatigue
presumptive
54
Determine whether it is a presumptive, probable or positive sign of pregnancy? - urinary frequency or breast changes
presumptive
55
Determine whether it is a presumptive, probable or positive sign of pregnancy? - quickening
presumptive
56
Determine whether it is a presumptive, probable or positive sign of pregnancy? - uterine enlargement
presumptive
57
Determine whether it is a presumptive, probable or positive sign of pregnancy? - positive pregnancy test
probable
58
Determine whether it is a presumptive, probable or positive sign of pregnancy? - abdominal enlargement
probable
59
Determine whether it is a presumptive, probable or positive sign of pregnancy? - Chadwick's sign (bluish color of vulva, vagina, cervix)
probable
60
Determine whether it is a presumptive, probable or positive sign of pregnancy? - auscultation of fetal heart sounds
positive
61
Determine whether it is a presumptive, probable or positive sign of pregnancy? - fetal movement felt by examiner
positive
62
Determine whether it is a presumptive, probable or positive sign of pregnancy? - visualization of fetus by examiner
positive
63
Determine whether it is a presumptive, probable or positive sign of pregnancy? - deliver of the baby
positive
64
Determine whether it is a presumptive, probable or positive sign of pregnancy? - Hegar's sign (softening of cervix)
probable
65
what result is indicative of a reactive non-stress test?
FHR increases at least 15/min for at least 15 seconds and occurs at twice during a 20 min period
66
what do 2 or more accelerations within 20 mins indicate for a non-stress test?
reactive
67
what type of test may be indicated for a nonreactive non-stress test?
BPP (biophysical profile)
68
what indicates that a non-stress test is nonreactive?
there are not 2 accelerations within the 20 minute window
69
is a negative CST normal or abnormal?
normal
70
is a positive CST normal or abnormal?
abnormal
71
what test combines a non-stress test and fetal ultrasound?
BPP (biophysical profile)
72
besides a nonreactive non-stress test, what are 3 indications for a biophysical profile?
- suspected oligohydramnios - suspected polyhydramnios - suspected fetal hypoxia
73
what are the 5 variables of a biophysical profile?
- FHR - fetal breathing movements - gross body movements - fetal tone - qualitative amniotic fluid volume
74
what is a normal score of the BPP?
8-10
75
What is G in GTPAL?
Gravidy (number of pregnancies, regardless of outcome)
76
What is T in GTPAL?
Term (number of pregnancies delivered past 37 weeks)
77
What is P in GTPAL?
Preterm (delivered before 37 weeks)
78
What is A in GTPAL?
Abortion (pregnancy ended before 20 weeks)
79
What is L in GTPAL?
Living (how many are alive now)
80
What is L in GTPAL?
Living (how many are alive now)
81
when may macrosomia occur?
gestational diabetes
82
what complication may occur as a result of uncontrolled diabetes?
fetal demise (vasoconstriction reduces blood flow/oxygen/nutrients to baby)
83
does gestational hypertension have proteinuria?
NO
84
what diagnosis is suspected for a patient who has a BP of 160/90 and 3+ protein in urine?
preeclampsia
85
what diagnosis is suspected for a mother at 25 weeks gestation with BP 144/95 and no protein detected by UA?
gestational hypertension
86
what is indicated by 160/110 and >3+ proteinuria?
severe preeclampsia
87
what is necessary for the treatment of class A2 gestational diabetes?
medications
87
how is class A1 gestational diabetes managed?
diet
88
what BG value for a 1hr GTT indicates the need for a 3hr GTT?
130-140
89
what is indicated if 3 or more of the values collected during a 3 hr glucose tolerance test are elevated?
gestational diabetes diagnosis
90
what is the gold standard intervention for diabetics to reduce perinatal mortality and reduce to the prevalence of congenital anomalies?
preconception counseling

OB - Napier (7 decks)

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