Families Exam 1 Flashcards
(168 cards)
1
Q
What are some presumptive signs of pregnancy?
A
- amenorrhea
- fatigue
- N/V
- quickening
- uterine enlargement
2
Q
What is Hegar’s sign?
A
softening/compressibility of the lower uterus
3
Q
What is Chadwick’s sign?
A
blue/purple color of the cervix and vaginal mucosa
4
Q
What is Goodell’s sign?
A
softening of the cervical tip
5
Q
What sign of pregnancy is ballottement?
A
Probable
6
Q
Is a positive pregnancy test a probable or positive sign of pregnancy?
A
Probable
7
Q
What cardiovascular components INCREASE with pregnancy?
A
- CO (30-50%)
- BV (30-45% @ term)
- HR (10-15/min)
8
Q
What is striae gravidarum?
A
stretch marks
9
Q
What is linea nigra?
A
a dark line from the belly to the pubic area
10
Q
What is chloasma?
A
increased pigmentation on face
11
Q
What does Naegle’s rule determine? How?
A
- delivery date
- take the first day of your last period, subtract 3 months and add 7 days
12
Q
What is the G in GTPAL?
A
Gravidity: # of pregnancies, including current pregnancy and abortion/miscarriage
13
Q
What is the T in GTPAL?
A
Term births: 38+ weeks
14
Q
What is the P in GTPAL?
A
Preterm births: up to 38 weeks
15
Q
What is the A in GTPAL?
A
Abortion/miscarriage: lost before 20 weeks
16
Q
What is the L in GTPAL?
A
Living children
17
Q
What are signs of infection during pregnancy?
A
- burning on urination
- diarrhea
- fever/chills
18
Q
What are signs of miscarriage or ectopic pregnancy?
A
- abdominal cramping
- vaginal bleeding
19
Q
How can backache be relieved during pregnancy?
A
- pelvic tilt exercises
- side-lying position
20
Q
What side should you lay on if experiencing supine hypotension?
A
left
21
Q
How can SOB be relieved during pregnancy?
A
extra pillows
22
Q
How can gingivitis be relieved during pregnancy?
A
brushing teeth gently
23
Q
How can nasal stuffiness be relieved during pregnancy?
A
use of a humidifier
24
Q
How can epistaxis be relieved during pregnancy?
A
NS drops/spray
25
How can varicose veins and edema be relived during pregnancy?
- elevate legs
- NO restrictive clothing
- DONT sit/stand too long
- DONT cross knees
26
What could a gush of fluid from the vagina mean?
ROM
27
What could decreased fetal movement mean?
fetal distress
28
When is a GBS done?
35-37 weeks
29
What med do you give if the patient is GBS positive?
Penicillin G
30
What could protein in the urine indicate?
gestational HTN
31
What could glucose/ketones in the urine indicate?
gestational diabetes
32
What could WBC's in the urine indicate?
infection/UTI
33
What does TORCH stand for?
- toxoplasmosis
- other infections
- rubella
- cytomegalovirus
- herpes
34
When is a maternal serum alpha-fetoprotein test done? What does it test for?
- between 15-22 weeks
- down syndrome (low level)
- neural tube defects (high level)
35
What should the patient do before an amniocentesis?
empty their bladder
36
What position should the patient be in for an amniocentesis?
supine with a wedge under the right hip
37
What complications can arise from an amniocentesis?
- AF emboli
- hemorrhage
- infection
- PROM
38
What med promotes fetal lung maturity?
betamethasone
39
When is a glucose tolerance test done?
between 24-28 weeks
40
Why would you do a 3 hour glucose tolerance test?
if the 1 hour result was >140
41
What glucose test do you have to fast for?
3 hour
42
How is gestational diabetes diagnosed?
by 2 elevated blood glucose readings from the 3 hour glucose tolerance test
43
How much weight gain should occur during the first trimester?
up to 4.4 pounds
44
How much weight gain should occur in the second and third trimesters?
1 pound/week
45
How much weight should a normal person gain during pregnancy?
25-35 pounds
46
How much weight should an underweight person gain during pregnancy?
28-40 pounds
47
How much weight should an overweight person gain during pregnancy?
15-25 pounds
48
How much weight should an obese person gain during pregnancy?
11-20 pounds
49
In what trimester should your calories increase by 340?
second
50
In what trimester should your calories increase by 452?
third
51
What should you eat in the morning before getting up if experiencing nausea?
crackers or dry toast
52
How much folic acid should you take a day when pregnant?
600 mcg
53
How much calcium should be taken when pregnant?
1000 mg
54
How should iron supplements be taken?
in between meals with vitamin C
55
What does the BPP assess?
- FHR
- fetal breathing movements
- gross body movements
- fetal tone
- qualitative amniotic fluid volume
56
What is an ideal BPP score?
8-10
57
What does an NST assess?
FHR response to fetal movement
58
What position should the patient be in for an NST?
reclining chair, semi-fowlers, or left lateral
59
What should the patient do during an NST?
press the button when she feels the baby move (FHR should increase)
60
What result do you want from an NST?
- reactive
- moderate variability
- accelerations (15/min for 15 seconds, 2 times in 20 mins)
61
What should you do if you receive a nonreactive NST result?
CST or BPP
62
How can you test how the fetus will tolerate labor?
a contraction stress test
63
What is a negative CST result?
- normal finding
- 3 contractions with NO late decels in a 10 min period
64
Which type of ultrasound requires a full bladder?
transabdominal
65
What is the biggest risk to the fetus with gestational diabetes?
HYPOGLYCEMIA
66
How is gestational diabetes treated?
diet and exercise
67
Is there treatment for cytomegalovirus?
NO
68
What med should be administered to babies born to a mom with Gonorrhea?
erythromycin eye drops
69
What causes the compromise of fetal circulation?
placental abruption
70
What term explains gestational HTN with proteinuria?
preeclampsia
71
What BP and level of proteinuria show MILD preeclampsia?
- BP 140/90
- 1+ proteinuria
72
What BP and level of proteinuria show SEVERE preeclampsia?
- BP 160/110
- 3+ proteinuria
73
What symptom might you see with SEVERE preeclampsia?
RUQ abdominal pain
74
What symptoms might you see with preeclampsia?
- severe HA
- blurry vision
- face/hand edema
- weight gain
75
How can you assess for proteinuria?
clean catch specimen
76
What med should you give if the systolic BP is >160?
labetalol
77
What med can you give for preterm labor?
mag sulfate
78
What should you monitor is preterm labor is suspected?
FHR and contraction pattern
79
How long should you avoid pregnancy after a spontaneous abortion?
2 months
80
Hyperemesis gravidarium can cause metabolic acidosis and metabolic alkalosis. How?
- starvation can cause met. acidosis
- vomiting can cause met. acidosis
81
What happens the electrolytes with hyperemesis gravidarium?
they are low (Na, K, Cl)
82
What happens to HR and BP with hyperemesis gravidarium?
HR increases and BP decreases
83
What does HELLP stand for?
- Hemolysis
- Elevated Liver enzymes
- Low Platelets
84
What can low platelets result in?
- thrombocytopenia
- abnormal bleeding/clotting time
- bleeding gums
- petechiae
- DIC
85
What are the symptoms of HELLP syndrome?
- severe continuous HA
- N/V
- blurred vision, flashes of lights/dots
- periorbital/facial/hand/abdominal edema
- proteinuria
- jaundice
- epigastric/RUQ pain
- seizures
86
What med prevents seizures, suppresses contractions/stops labor, and is used for HTN?
mag sulfate
87
What do decreased DTR's, LOC, UO, and RR show signs of?
mag sulfate toxicity
88
What is the antidote for mag sulfate?
calcium gluconate/chloride
89
What is the therapeutic range for mag sulfate?
5-8
90
When is rhogam given?
- between 24-28 weeks
- 72 hours after birth
- after amniocentesis
91
What is terbutaline's function?
- relaxes smooth muscles
- inhibits uterine activity
92
What is the fetal lie?
- the baby's spine in relation to the mom's spine
93
What are the 3 types of fetal lie?
- longitudinal/parallel: up & down
- oblique: diagonal
- transverse: straight across
94
What is fetal attitude?
The relationship of fetal parts to one another
95
What do you want the fetal attitude to be?
flexed chin
96
What is a negative fetal station?
- above the ischial spine
- no baby yet
97
What is a positive fetal station?
- below the ischial spine
- yes baby
98
What is station 0?
- presenting part: baby's head
- widest part of the head is level with mom's ischial spine
99
What are the most favorable and least favorable passageways?
- most: gynaecoid
- least: platypelloid
100
What causes enlargement/widening of the cervical opening and canal?
dilation
101
What causes the shortening/thinning of the cervix?
effacement
102
How soon after ROM does labor usually occur?
within 24 hours
103
What is the pH of amniotic fluid?
7-7.5
104
What should be assessed immediately after ROM?
FHR
105
What are the cardinal movements?
1. engagement
2. descent
3. flexion
4. internal rotation
5. extension
6. external rotation
7. birth by expulsion
106
What do Leopold's maneuvers determine?
- baby's position
- position, lie, attitude
107
What is the fetal part that is ideal at the fundus?
the butt (should feel soft and squishy)
108
How can you tell if the baby is engaged?
it cannot be pushed back up from the lower part of the uterus
109
What is lightening?
when the fetal head descends onto the pelvis
110
When does lightening happen, and what does it help with?
- about 14 days before labor
- makes it easier to breathe
111
How much weight is lost preceding labor?
1-3.5 pounds
112
What position does the cervix move to in true labor?
anterior
113
How dilated is the patient during the latent phase?
0-3 cm
114
What is the duration and frequency of ctx during the latent phase?
30-45 seconds for 5-30 mins
115
How dilated is the patient during the active phase?
4-7 cm
116
What is the duration and frequency of ctx during the active phase?
40-70 seconds for 3-5 mins
117
How dilated is the patient during the transition phase?
8-10 cm
118
What is the duration and frequency of ctx during the transition phase?
45-90 seconds for 2-3 mins
119
What is the pushing stage of labor?
second
120
How frequent are contractions during the second stage of labor, and how long does the stage last?
every 1-2 minutes for 30 mins-2 hours
121
What part of the placenta should be delivered first?
the surface that was facing the baby and touching amniotic fluid (shiny shultze)
122
How long does the third stage of labor last?
5-30 mins
123
How long does the fourth stage of labor last?
1-4 hours
124
What is considered a prolonged contraction?
>90 seconds
125
What is considered too frequent of contractions?
>5 in 10 mins
126
What can a bad resting tone lead to?
hypoxia and decreased FHR
127
What is effleurage?
light, gentle, circular stroking of the patient's abdomen with the fingertips
128
What is sacral counterpressure?
applying pressure to the patient's sacral area using the heel of the hand or fist to counteract lower back pain
129
When during labor are opioids given?
the early part of active labor (labor must be well established - 4 cm dilated, station 0)
130
What is the antidote for opioid toxicity?
naloxone
131
How long can opioids be given?
NOT after 7 cm dilated
132
When can epidural anesthesia be used during labor?
From at least 4 cm dilated until 9.5 cm dilated
133
What eliminates sensation from the belly button to the thighs?
epidural anesthesia
134
How should the patient be positioned for epidural anesthesia?
with back curved
135
How can you prevent hypotension with an epidural?
- 2 L IV fluid bolus before
- IV vasopressor
136
What is local anesthesia for the perineum, vulva, and rectal areas?
pudendal block
137
When is a pudendal block given?
10-20 mins before delivery
138
What is a normal FHR?
110-160 bpm
139
Do you want variability in the FHR?
yes, moderate (6-25/min)
140
What variability of the FHR is non-reassuring?
none, minimal (<5/min) or too much (>25/min)
141
What decelerations of the FHR are non-reassuring?
late and variable
142
Are FHR accelerations normal?
YES
143
What should you do for a patient having late decels?
- side lying position
- increase IVF
- O2
- prepare for c-section
144
What can cause variable decels?
cord compression
145
What can cause early decels?
head compression
146
What can cause late decels?
placental indufficiency
147
What medication should you give for hypotonic ctx?
oxytocin
148
What medication should you give for hypertonic contractions?
mag sulfate
149
What does the bishop score have to be for induction of labor?
>8 for multiparous, >10 for nulliparous
150
What is rated for the bishop score?
- dilation
- effacement
- consistency
- position
- station
151
What should you watch for with pitocin/oxytocin?
uterine hyperstimulation
152
How is oxytocin given?
on a pump using the most central IV port
153
If the patient reports feeling something coming through her vagina, what could this be?
the umbilical cord
154
How can severe fetal hypoxia possibly be identified?
excessive fetal activity and then no fetal activity
155
What position should the patient be in if prolapsed cord is suspected?
knees to chest
156
How should you keep the visible umbilical cord from drying out?
a warm, sterile, saline-soaked towel
157
What is McRoberts maneuver?
bringing the mom's thighs close to the chest to help with shoulder dystocia
158
Why should panting be encouraged during precipitous labor?
it controls the urge to push
159
What characterizes fetal bradycardia?
FHR <110/min for 10 mins or more
160
What should you do to oxytocin in the event of fetal bradycardia?
DISCONTINUE
161
What characterizes fetal tachycardia?
FHR is >160/min for 10 mins or more
162
Most commonly, what color is meconium-stained amniotic fluid?
green
163
What L/S ratio indicates fetal lung maturity?
2:1
164
What does the absence of PG indicate?
respiratory distress
165
What ctx frequency is associated with uterine hyper stimulation?
> q 2 mins
166
What ctx duration is associated with uterine hyperstimulation?
> 90 seconds
167
What ctx intensity pressure is associated with uterine hyperstimulation?
> 90 mmHg
168
What uterine resting tone is associated with uterine hyperstimulation?
> 20 mmHg between ctx
