OB (5/10)

Question 1

s/e of terbutaline for tocolysis

Answer 1

1. tachycardia
2. increased blood glucose

Question 2

__________________ is a tocolytic that relaxes vascular and bronchial smooth muscles

Answer 2

magnesium

Question 3

use of magnesium in OB

Answer 3

1. pre-eclampsia
2. tocolysis

Question 4

dose of magnesium for tocolysis or pre-eclampsia

Answer 4

4-6 gm IV bolus over 20 minutes

2-4 gm/hr infusion

Question 5

if your pregnant pt is on magnesium, what blood level would be therapeutic

Answer 5

4-8 mg/dL

Question 6

s/e of magnesium for tocolysis/pre-eclampsia

Answer 6

1. hypotension
2. flushing
3. lightheaded

Question 7

_________________ is a opioid receptor agonist/antagonist used in OB. chemically related to naloxone and oxymorphone

Answer 7

nubain (nalbuphine)

Question 8

what drug would you use to reverse the pruritus from epidural opioids but maintain the analgesia in pregnant mom

Answer 8

nubain (nalbuphine)

Question 9

what drugs are opioid agonist/antagonists commonly used in OB

Answer 9

1. nubain (nalbuphine)
2. stadol (butorphanol)

Question 10

dose of stadol (butorphanol)

Answer 10

0.5-2 mg q3-4 hours

Question 11

dose of zofran for N/V in laboring mother

Answer 11

4 mg

Question 12

dose of phenergen in laboring mother for N/V

Answer 12

12.5-25 mg IV q4-6 h

Question 13

use of benadryl in OB

Answer 13

1. pruritus
2. cervical “swelling”

Question 14

dose of benadryl in OB

Answer 14

12.5-50 mg

Question 15

what is zyrtec used for in OB

Answer 15

for itching 2/2 neuraxial opioids

Question 16

dose of zyrtec for itching in OB

Answer 16

10 mg

Question 17

dose of phenylephrine for parturient

Answer 17

10-30 mcg

Question 18

if mom is hypotensive, but has a HR of 60, what pressor would you use

Answer 18

ephedrine

Question 19

if mom is hypotensive and has a HR of 120 what pressor would you use

Answer 19

phenylephrine

Question 20

which pressor used in OB can compromise uterine blood flow

Answer 20

phenylephrine

Question 21

how do you mix phenylephrine in the OB setting

Answer 21

1. 10 mg/mL vial
2. take 10 mL NS and 1 mg (0.1 mL) of drug
3. = 100 mcg/mL

Question 22

infusion dose of phenylephrine in OB

Answer 22

30 mcg/min

Question 23

usual dose of ephedrine in OB

Answer 23

5-10 mg

Question 24

how do you mix ephedrine for OB

Answer 24

1. 50 mg/mL vial
2. take 9 mL add 50 mg
3. = 5 mg/mL

Question 25

_______________ if used for hypotension in the mother will also cause increase in fetal HR

Answer 25

ephedrine

Question 26

_________________ is the process of strong contractions that thin the cervix permitting passage of fetus through the birth canal

Answer 26

parturition

Question 27

full term pregnancy

Answer 27

40 weeks +/- 2 weeks from LMP

Question 28

true labor is defined as?

Answer 28

braxton hicks contractions that increase in strength and frequency into a regular pattern

Question 29

T/F: true labor is always defined as amniotic membranes rupture spontaneous then contractions start to follow

Answer 29

false; while this can happen sometimes contractions begin and first and cause the membranes to rupture

Question 30

gravida

Answer 30

number of pregnancies (delivered or not)

Question 31

para

Answer 31

number of pregnancies delivered past 20 weeks

Question 32

primigravida

Answer 32

a woman who is pregnant for the first time

Question 33

multigravida (multiparous)

Answer 33

2+ pregnancies

Question 34

grand maltip

Answer 34

5+ pregnancies

Question 35

who is at higher risk of hemorrhage the primigravida or the multigravida

Answer 35

multigravida d/t uterus being "old and stretched out" so does not clamp down the way it should

Question 36

what is the first stage of labor

Answer 36

begins with regular painful uterine contractions and ends with complete dilation of cervix

Question 37

what is the pain pathway for the first stage of labor

Answer 37

uterocervical afferents pass through paracervical ganglion, hypogastric nerve, and lumbar sympathetic chain entering spinal cord in the T10 - L1 area

Question 38

during the first stage of labor, you would want to ensure your epidural has coverage over what area

Answer 38

T10-L1

Question 39

which stage of labor is described as "visceral pain"

Answer 39

first stage

Question 40

______________ is described as the final phase of the first stage of labor

Answer 40

transition phase

Question 41

the transition phase of labor is categorized when the cervix is _________ cm dilated

Answer 41

7-10

Question 42

second stage of labor begins with ____________ and ends with ______________

Answer 42

complete dilation of cervix; birth of the baby

Question 43

pain pathway for the second stage of labor

Answer 43

additional afferent innervate the cervix, vagina, perineum and pass througth the pudendal nerve at S2-S4 and are processed in the spinal cord

Question 44

which stage of labor is described as "somatic pain"

Answer 44

second stage

Question 45

third stage of labor begins with ___________ and ends with __________

Answer 45

birth of the baby; delivery of the placenta

Question 46

you have given mom and epidural and it has been has been working wonderfully, suddenly she starts to call out and c/o pain and pressure in her bottom - what do you think is occuring

Answer 46

she has entered transition phase of labor, should ask nurse to check cervix

Question 47

what is normal fetal HR

Answer 47

110-160

Question 48

fetal HR should have variability between __________ bpm

Answer 48

6-25

Question 49

absence of fetal heart rate variability is associated with what?

Answer 49

fetal distress

Question 50

dose of nubain (nalbuphine)

Answer 50

10 mg IV/IM/SQ/PCA