Maternity: Exam 2 - Study Guide Flashcards
(29 cards)
How does gestational diabetes affect the fetus and newborn?
Increased risk of macrosomia, hypoglycemia, respiratory distress syndrome, jaundice, and birth trauma.
What preconception guidance is recommended for women with diabetes?
Achieve tight glucose control (A1C <6.5%), start folic acid, screen for complications (retinopathy, nephropathy), and consult with a healthcare provider before conception.
What are common complications of pregnancy that require patient teaching?
Preterm labor, gestational diabetes, preeclampsia, placenta previa, abruptio placentae, fetal growth restrictions, and infections.
What are the signs and symptoms of a ruptured ectopic pregnancy?
Severe abdominal pain, shoulder pain, dizziness, hypotension, tachycardia, signs of shock.
How is an unruptured ectopic pregnancy treated?
Methotrexate (if stable, unruptured, and <3.5 cm in size).
What patient teaching is needed for methotrexate therapy?
Avoid folic acid, NSAIDs, alcohol, and strenuous activity. Monitor for severe pain, dizziness, and signs of rupture.
What is an amniotomy, and what are the risks?
Artificial rupture of membranes (AROM). Risks include cord prolapse, infection, fetal distress.
What is the difference between induction and augmentation of labor?
Induction: Labor started artificially (e.g., Pitocin, cervical ripening). Augmentation: Labor is already started but contractions need enhancement.
What are signs and symptoms of preterm labor?
Regular contractions, pelvic pressure, lower back pain, cervical changes, increased vaginal discharge.
What are the indications for forceps vs. vacuum-assisted delivery?
Forceps: Prolonged second stage, abnormal fetal position, maternal exhaustion. Vacuum: Mild fetal distress, maternal exhaustion, failure of fetal descent.
How is a macrosomic infant cared for after birth?
Monitor for hypoglycemia, birth trauma, respiratory distress, polycythemia, jaundice.
What are important aspects of care after a cesarean section?
Pain management, incision care, early ambulation, DVT prophylaxis, emotional support.
What are the causes of early vs. late postpartum hemorrhage?
Early (<24 hrs): Uterine atony, retained placenta, cervical/vaginal lacerations, coagulation disorders. Late (24 hrs - 6 weeks): Subinvolution, retained placenta, infection.
What are signs of cervical lacerations after delivery?
Bright red bleeding with a firm uterus, minimal/no clots.
What medications are used for PPH management?
Oxytocin, Misoprostol (Cytotec), Methergine (contraindicated in HTN), Hemabate (contraindicated in asthma).
What is included in a Biophysical Profile (BPP)?
Fetal breathing, movement, tone, amniotic fluid volume, non-stress test (NST).
What do different BPP scores indicate?
8-10: Normal; 6: Equivocal; ≤4: Abnormal, consider immediate delivery.
What is intrauterine growth restriction (IUGR), and what causes it?
Fetal growth below the 10th percentile due to placental insufficiency, infections, genetic disorders, maternal health conditions.
What are the hallmark signs of preeclampsia?
Hypertension (≥140/90), proteinuria, headache, visual changes, edema, epigastric pain.
What medications are used to manage hypertension in pregnancy?
Labetalol, Hydralazine, Nifedipine.
What is magnesium sulfate used for in pregnancy?
Preventing seizures in preeclampsia, neuroprotection in preterm labor.
What are signs of magnesium toxicity?
Respiratory depression, absent reflexes, lethargy, oliguria.
What is the antidote for magnesium toxicity?
Calcium gluconate.
What is cervical cerclage, and when is it indicated?
Surgical reinforcement of the cervix to prevent preterm birth in cases of cervical insufficiency.
