OB exam 1 Flashcards
1
Q
Para
A
Number of pregnancies that reached viability. Dead or alive. Greater than 20 weeks.
2
Q
Gravida
A
Is or has been preg. Includes abortions.
3
Q
Primigravida
A
First pregnancy
4
Q
Primipara
A
Has given birth to one child past age of viability
5
Q
Multi gravity
A
Has been preg previously
6
Q
Multipara
A
Has carried two or more pregnancies to viability.
7
Q
Nulligravida
A
Has never been and is not currently preg
8
Q
Post term
A
Pregnancy that goes beyond 42 weeks plus 6 days
9
Q
Preterm
A
Preg that has gone beyond 20 weeks but has not completed the full 38 weeks plus 6 days
10
Q
Term
A
Beginning of 38 weeks and went to the end of the 42nd week plus 6 days
11
Q
Viability
A
Capable of. Living outside uterus. 22-25 weeks
12
Q
Fertilization
A
Union of ovum and spermatozoon. Occurs in the outer third of Fallopian tube
13
Q
Implantation
A
Contact between growing structure and uterine endometrium. 8-10 days after fertilization
14
Q
Decidua
A
Shedding the lining of the uterus
15
Q
Chorionic villi
A
Join with soft tissue to make placenta
16
Q
Babies body
Placenta is
A
Pumps blood
The reservoir
17
Q
2 arteries 1 vein. In placenta
A
Vein brings oxygenated blood.
18
Q
Ductus arterioles
A
Bypass lung
19
Q
Foramen ovale
A
Bypass right ventricle.
20
Q
NST
A
Want 2 accelerations of 15 bpm, lasting 15 seconds, within 20 minutes.
21
Q
Positive NST/CST
A
BAD! Want it to be negative.
22
Q
Biophysical profile
A
NST, fetal breathing, gross body movement, fetal tone, quantity of fluid, grade placenta.
23
Q
Fetal kick count
A
Over 6 per hour.
24
Q
Fundal height
A
Should be at belly button at 20 weeks.
25
Fungal height
Measure from pubic symphysis to fundus.
26
Maternal serum alpha feto protein. MSAFP
If more than specific amount than suspect neural tube defect. If lower suspect downs.
27
Chorionic villus sampling CVS
Get DNA from placenta .can be done before 12 weeks.
28
Pericutaneous umbilical sampling PUBS
Done under general anesthesia. Take blood from cord. Done late. 36 weeks.
29
Amniocentesis
To get DNA. 1 weeks.
30
Pseudocyesis
False pregnancy.
31
Presumptive signs of preg
```
Amenorrhea
Breast soreness
NV
Frequent urine
Quickening.
Linea negra, melasma, striae gravidarum
```
32
Probable signs of pregnancy
Lab test 95-98% reliable.
Home test, if neg repeat in week.
Hegar-vaginal exam to feel uterus and baby.
Goodell-cervix become soft
Chadwicks-cervix become engorged with blood and become bluish.
Braxton hicks- contraction of uterus to help blood flow and growth.
Fetal outline felt.
33
Accelerations
Increase HR of baby to we know brain is being oxygenated.
| If flat than baby could be asleep or in bad shape.
34
Placental function
```
Lungs- o2 and co2 exchange.
GI-absorbe nutrients
Renal- filter urea and other waste.
Liver-processes moms blood for iron.
Endocrine- maintains pregnancy and prevents another. Prepares breasts for lactation.
Thermal control.
Immune- mostly bacterial stuff.
```
35
Whartens jelly
Cushions cord.
36
HCG hormone produced to...
Continue to manufacture progesterone.
37
Where does contraction start?
Top middle of fundus then goes down and in.
38
During contraction 02 is temporally cut off.
Not completely.
39
Compromise=
Hypoxemia deteriorating to severe hypoxia. Can lead to cerebral palsy.
40
Decrease in oxygen can be from
```
Contractions
HTN
Hypo(supine, hemorrhage, anesthesia)
Hypovolemia
Anemia
Alterations in fetal circ. (Cord compression)
```
41
Use Doppler 1st stage; 2nd stage
Q15-30 min
| Q5-15 min
42
If water breaks, check?
FHT, cord may be compressed.
43
Position changes
Put in knee chest position (on back, hips off bed)
| Never trendelenberg!
44
Internal monitoring
IFM direct
45
External monitoring
EFM, indirect
46
IUPC
Shows intensity of contraction, duration, and resting tone.
| Can pull or push fluids.
47
TOCO
Electrical fetal monitoring, shows contractions. Do not use gel.
48
Fetal ultra sound
Use gel.
Detects movement, not sound.
Apply to babies back.
49
Spiral electrode
Internal monitor.
Shows dysrhythmias with no artifact.
Accurate short term variability STV
Must be 2cm dilated. And head in pelvis.
50
Augmentation
Having contractions but give ptosin to make them stronger.
51
Kangaroo care
Warm baby by putting on moms bare chest
52
How many extremities do we take baby BP
2
53
First VS taken
RR. 30-60 normal.
| Take for 1 full minute!!
54
When taking measurements of baby
Head, chest, belly.
| Head should be the biggest.
55
TOLAC
Attempts to labor by women that has previously had a C-section.
56
VBAC
Successful trail of labor resulting in vaginal birth.
57
Contractions are:
Involuntary, neural, hormonal, and pharm influences.
58
Relaxation period must be how long?
60 seconds to reprofuse blood.
59
3 stages of contraction
Increment, Acme, decrement.
60
Hyper tonus
Resting state.
< 25 mmhg.
Normal resting tone- 5-25.
Average 8-12
61
Monte vedeo units, MVU
Anything between 150-200 is adequate. Shows contractions are strong enough to give birth.
If over 300 stop ptosin. Baby is being stressed.
62
Dystocia
Slow labor; abnormal; cant get contractions started.
63
NADIR
Shows depth of de-accelerations.
64
Duration and intervals are measured in?
Seconds.
65
Coupling
Two contractions at once.
| Depends on position of baby.
66
Hyperstimulation
One contraction after another. No 60 seconds.
| Could be from abruption (uterus shedding placenta)
67
Tetany
Long contraction.
| Shouldn’t last of 90 seconds.
68
Variability contraction
Good variability shows well being.
| Push and pull of nervous system.
69
Marked variability, good or bad?
Bad. Turn mom to left side to improve o2 and circulation to uterus.
70
Periodic changes happen?
With each UC
71
Episodic
Not associated with UC.
72
Early decelarations
Response to fetal head compression.
73
Late decelerations due to?
Uteroplacental insufficiency. Not good, low o2
74
Variable decel due to?
Cord compression.
75
Early decel
Baby could be breached
76
cephalo pelvic disproportion
Pelvis too small
77
As hypoxia continues you will see:
Late decels
> loss of accels
>loss of variability
> rising or lowering baseline.
78
Actions for hypoxia:
```
Get help!
DC oxytocin(ptosin), aminoinfusion.
Put on left side.
Fluid bolus LR or NS to slow contraction
O2 by mask 8-10L
check BP.
```
79
If hypoxia than what meds?
Epinephrine if BP is the problem
Terbutaline if contractions are the problem
Possibly mag sulfate.
80
To assess fetal well being:
Scalp stimulation
Scalp sampling (to do ABG)
Spiral electrode test
81
Recommended auscultation:
Q15 in first stage
Q5 in second stage.
Q10 thereafter. Review tracing that often.
82
What to chart
```
Baseline rate
Variability
FHR, changes with characteristics.
Contraction patterns
Interventions, response, communication
```
83
Goal for hypoxia
Detect early to prevent acidosis, and brain injury.
84
Danger signs 1st trimester
Severe persistant vomiting.
Abd pain and vaginal bleeding
Infection
85
Danger signs 2nd trimester
```
Maternal-
Preeclampsia
Premature rupture of membranes.
Premature labor
Fetal-
Decreased fundal height.
Absence of fetal movement.
```
86
Danger signs 3rd trimester
```
Maternal-
Gestational diabetes
Placenta previa
Abruption
Fetal-
Hypoxia
```
87
Prolactin
Milk manufacture
88
Estrogen
Duct sprouting
89
Progesterone
Lobule formation
90
Oxytosin
Let down.
91
Let down, hypothalamus
Sucking stimulates nerve fibers in the nipple, message goes up spinal column.
92
Let down, pituitary gland
Responds by releasing hormones prolactin and oxytocin.
Pro- stim milk production
Oxy- stimulate muscle contraction of uterus.
93
Breast feeding should be done how long on each side?
10 minutes
94
Should have How many wet diapers per day?
At least 6
