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OB Final Exam > Exam 2 Content > Flashcards

Exam 2 Content Flashcards

(39 cards)

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1
Q

Tachysystole & treatment

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A

5+ contractions in a 10 minute window averaged over a 30 minute period

  • too many contractions

Tx = terbutaline

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2
Q

What is tachysystole?

A

5+ contractions in a 10 minute segment / window averaged over a 30 minute period

  • too many contractions
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3
Q

What is the treatment for tachysystole?

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A

Terbutaline

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4
Q

Chorioamnionitis

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A

Bacterial infection of the amniotic cavity

  • Tx = broad spectrum antibiotics
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5
Q

What is chorioamnionitis?

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A

Bacterial infection of the amniotic cavity / sac

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6
Q

What is the treatment for chorioamnionitis?

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A

Broad spectrum antibiotics

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7
Q

Gestational Hypertension

A

Development of HTN after week 20 of pregnancy in a previously normotensive woman without proteinuria or other findings

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8
Q

Preeclampsia

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A

Development of hypertension AND proteinuria after 20 weeks gestation in a previously normotensive woman

Can also involve HTN with new onset of:

  • thrombocytopenia
  • renal insufficiency
  • impaired liver function
  • pulmonary edema
  • cerebral or visual symptoms
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9
Q

Eclampsia

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A

Development of seizures or coma NOT attributable to other causes in women with preeclampsia

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10
Q

Chronic Hypertension

A

HTN in a pregnant woman present before pregnancy

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11
Q

Superimposed preeclampsia

A

Chronic HTN in association with preeclampsia

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12
Q

What medications is used for preventing & treating seizure activity (eclampsia)?

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A

Magnesium Sulfate via IV

  • initial loading dose of 4-6 g IV over 15-30 minutes
  • maintenance of 2-3 g/hr
  • Therapeutic Magnesium level is 4-7 mEq/L
  • Given for neuroprotection

*

Antidote = calcium gluconate

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13
Q

What is Magnesium Sulfate used to treat in pregnancy and what is the antidote for it?

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A

Preventing & treating seizure activity (eclampsia)

  • antidote = calcium gluconate

S/S of Magnesium Toxicity
* absent DTRs
* decreased RR
* decreased LOC

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14
Q

What medications can be used to control blood pressure in patients with preeclampsia?

A
  • Nifedipine
  • Labetalol
  • Hydralazine
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15
Q

Shoulder Dystocia

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A

Head is born but the anterior shoulder can NOT pass under the pubic arch

  • apply suprapubic pressure above the pubic bone
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16
Q

Prolapsed Cord

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A

Umbilical cord lies below the presenting part of the fetus

  • change position
17
Q

Group Beta Strep (GBS)

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A

Leading cause of perinatal infections including bacteremia, endometritis, chorioamnionitis, & UTIs

Tx: IAP antibiotics (intrapartum antibiotic prophylaxis)

Can cause severe respiratory distress, pneumonia, shock, & in rare cases meningitis in newborns

18
Q

Postpartum Hemorrhage

  • Early PPH
  • Late PPH
  • Medications

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A

Cumulative blood loss ≥ 1000 mL or s/s of hypovolemia with in 24 hours after birth

  • Early (within 24 hr of birth) – atony, bladder distension, trauma
  • Late (> 24 hr to < 6 weeks) – infection, subinvolution, retained placenta, coagulation defects

Medications = Methergine or Hemabate

19
Q

Early Postpartum Hemorrhage

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A

within 24 hours after birth

  • uterine atony
  • bladder distension
  • cervical laceration
20
Q

Late Postpartum Hemorrhage

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A

More than 24 hours but less than 6 weeks after birth

  • infection
  • subinvolution
  • retained placenta
21
Q

What medications can be used to treat Postpartum Hemorrhage?
* indicate any contraindications

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A

Methergine
* contraindicated w/ HTN

Hemabate
contraindicated w/ Asthma

Oxytocin

Cytotec

22
Q

What are the 2 main medications to treat postpartum hemorrhage?

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A

Hemabate & Methergine

23
Q

Contraindications for Hemabate

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A

Asthma patients

24
Q

Contraindications for Methergine

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25
**What is the treatment for preeclampsia / eclampsia (seizures)?** | **KNOW THIS!!!!!**
**Magnesium sulfate**
26
**What is the antidote for magnesium sulfate?** | **KNOW THIS!!!!!**
**Calcium gluconate**
27
**Placenta Previa** | **KNOW THIS!!!!!**
**Placenta is implanted in LOWER uterine segment** *Signs & Symptoms:* * **painless bright red vaginal bleeding** during 2nd or 3rd trimester * soft, relaxed, non-tender uterus w/ normal tone
28
**Placental Abruption** | **KNOW THIS!!!!!**
**Premature separation / detachment of part or all of the placenta from the uterus** *Signs & Symptoms:* * vaginal bleeding * abdominal pain * uterine tenderness * contractions * **board-like abdomen**
29
**What is the difference in placenta previa & placental abruption?** | **KNOW THIS!!!!!**
**Previa = placenta is attached in lower uterine segment** * PP = attachment issue * PA = detachment issue **Placental Abruption = premature separation / detachment of placenta from uterus**
30
**Differentiate the signs & symptoms associated with placental abruption & placenta previa.** | **KNOW THIS!!!!!**
**Placenta Previa** * **painless, bright red vaginal bleeding** * **non-tender** uterus * *Placental Abruption:* * *board-like abdomen* * *uterine tenderness* * *bleeding WITH pain*
31
**Key Symptom associated with Placenta Previa & Placental Abruption!!!!!** | **KNOW THIS!!!!!**
**Placenta Previa = painless, bright red bleeding** * *Placental Abruption = board-like abdomen & painful vaginal bleeding*
32
**Gestational Diabetes**
**Risk Factors** * family hx of DM * previous pregnancy that resulted in unexplained stillbirth or birth of a malformed or macrosomic fetus * obesity, HTN, glycosuria, maternal age > 25 years * more than half of women with GDM have none of these risk facotrs **Diagnosed in 2nd half of pregnancy**
33
**Gestational Hypertension** | **KNOW THIS!!!!!**
* Onset of **HTN without other findings after 20 weeks gestation** * * **BP > 140/90** (resolves after giving birth)
34
**What are Macrosomic Infants at risk for?** | **KNOW THIS!!!!!**
**Hypoglycemia** (after birth) * polycythemia (RBCs) * Birth injuries (shoulder dystocia) * Metabolic issues (obesity, diabetes, cardiovascular disease)
35
**Preconception Guidance for Gestational Diabetes** | **Know the Bold**
* Frequent monitoring in pregnancy * *Primary Goal: achieve & maintain constant euglycemia* * **diet, exercise, insulin therapy, self monitoring blood glucose, urine testing**
36
**How to calculate Newborn Weight Loss Percentage** | **KNOW THIS!!!!!**
**(weight at birth - current weight)** **/** **birth weight x 100** ## Footnote **100 - (**current weight **/** birth weight**)** * 100 - **(**3000/3500**) = 0.857** * 0.857 = 85.7 * 100 - 85.7 **= 14.3**
37
**What are the 3 Tocolytic drugs & what are they used for?** | **KNOW THIS!!!!!**
**Tocolytic = INHIBIT** contractions **N**ot **M**y **T**ime * **N**ifedipine * **M**agnesium sulfate * **T**erbutaline
38
**What medications are used for postpartum hemorrhage?** | **KNOW THIS!!!!!**
* **Cytotec** (misoprostol) * **Hemabate --** do NOT use w/ *asthma* * **Methergine --** do NOT use w/ HTN * **Oxytocin / pitocin**
39
**What is methotrexate used for?** | **KNOW THIS!!!!!**
Used for medical treatment of **ectopic pregnancy**

OB Final Exam (8 decks)

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