OB intro, prenatal care, L&D (exam1)

Question 1

estimated due date calculation

Answer 1

first day of last menstrual period - 3 months + 7 days

Question 2

Rh sensitization

Answer 2

mom makes Rh antibodies that attack future Rh+ babies in utero

Question 3

management of RH sensitive (Rh incompatibility)

Answer 3

rhogam - prevents rh negative being attacked by rh positive
blood product
deep IM injection

Question 4

when is Rhogam given

Answer 4

mom is Rh negative - prophylactically at 28 weeks
baby is Rh +
indirect coombs is negative

after abdominal trauma
terminated pregnancy before fetal Rh factor
ANY TIME BLOOD CAN MIX

Question 5

indirect coombs

Answer 5

moms blood, detects antibodies for Rh factor

Question 6

direct coombs

Answer 6

babys blood
if positive - cord bili
NEGATIVE IS GOOD

Question 7

what do you do if mom is RH negative and baby is RH positive

Answer 7

give rhogam within 72 hours
give rhogam if indirect coombs is -

Question 8

GTPAL

Answer 8

G pregnancy
T erm births (38-32 wks)
P preterm births (20-37wks)
A bortions (ends prior to 20wks)
L living children

Question 9

leopolds maneuver

Answer 9

4 movements
uterine fundus
sides of uterus
lower abdomen
palpate fetal back to determine flexion of fetal head
feel sides to find fetal back position

Question 10

expected weight gain in pregnancy

Answer 10

3.5- 5 lbs in first trimester (12 weeks)
1lb each week after

Question 11

first prenatal visit

Answer 11

CBC
Rubella
papsmear - HIV, gonorrhea
Hep B
Rh factor
sickle cell

Question 12

recommended weight gain during pregnancy

Answer 12

25-35 lbs

Question 13

danger signs of pregnancy

Answer 13

vaginal bleeding
persistent vomiting
chills/fever
fluid from vagina
chest pain

Question 14

pregnancy changes/ discomforts

Answer 14

dyspnea
backaches
frequent urination
pyrosis
swelling of hands and feet
braxton hicks
increasing weight gain
fatigue

Question 15

true labor characteristics

Answer 15

regular contractions
contractions increase in frequency and intensity
contractions start in back and move to front
walking increases intensity of contractions

Question 16

false labor characteristics

Answer 16

irregular
contractions dont intensify or become more frequent
walking relieves intensity of contraction

Question 17

premonitory signs of labor

Answer 17

7-10 days before labor
lightening ( baby drops)
cervical ripening (mucus plug, bloody show, softening/dilation)
braxton hicks
sudden burst of energy (nesting)
rupture of membranes

Question 18

what does first stage of labor start

Answer 18

when cervix is fully dilated

Question 19

second stage of labor

Answer 19

from time that cervix is completely dilated until delivery of the fetus

Question 20

meconium

Answer 20

baby’s first stool (black tarry)

Question 21

amnion - bag of waters function

Answer 21

allows for bouyancy
protects umbilical cord
sterile
thermoregulation

Question 22

wartons jelly

Answer 22

outside part of umbilical cord - protects blood vessels

Question 23

fern test

Answer 23

amniotic fluid will crystalize

Question 24

if bag of waters breaks

Answer 24

immediately check fetal HR
check for cord prolapse
document amniotic fluid (normal: clear)
date/time of rupture

Question 25

aminisure

Answer 25

looks like pee stick + amniotic fluid - urine

Question 26

rupture of membranes priority

Answer 26

r/f infection (mom) - temp q2hrs till delivery r/f impaired gas exchange (fetus) possible cord compression (fetus)

Question 27

meconium stained amniotic fluid

Answer 27

fetal distress in utero risk for aspiration at birth - suction mouth then nose

Question 28

rupture of membranes interventions r/f infection

Answer 28

limit vaginal exams temp q 2 hrs assess HR monitor fluid

Question 29

rupture of membranes interventions r/f impaired gas exchange

Answer 29

administer oxygen to mom 8-10mL (face mask) reposition hydration (bolus)

Question 30

if BOW ruptures when do you want to deliver by?

Answer 30

within 24 hours

Question 31

prevention of cord prolapse

Answer 31

start pelvic exam and move baby up ongoing assessment of fetal HR bedrest if fetal head is not engaged

Question 32

total dilation

Answer 32

10cm

Question 33

50 % effacement

Answer 33

cervix is half thinned

Question 34

0 station

Answer 34

head is engaged

Question 35

fetal station

Answer 35

- # above belly button 0 - at belly button + # below belly button +4 crowning of fetus

Question 36

abnormal fetal lie

Answer 36

transverse (needs c section)

Question 37

normal fetal lie

Answer 37

longitudinal parallel to maternal axis

Question 38

most common breech

Answer 38

frank breech sacrum presents, hips flexed

Question 39

complete breech

Answer 39

fully flexed

Question 40

fetal occiput posterior position

Answer 40

baby born face up mom has backaches pelvic rock increased pressure on sacral nerves

Question 41

csection birth leads to

Answer 41

future csection births

Question 42

fetal heart auscultation

Answer 42

listen thru back if head is down - doppler below belly button if head is up - doppler above belly button

Question 43

tocodynamometer

Answer 43

pressure sensor placed over fundus: point of max contraction force

Question 44

stage 2 birth canal

Answer 44

fetal head descends

Question 45

ideal time to give pain meds/ epidural in labor

Answer 45

active state of labor 4-7cm

Question 46

cervical softening

Answer 46

prepidil / cervidil gel

Question 47

pitocin

Answer 47

augmentation of labor IV drip

Question 48

induction/ augmentation warning signs

Answer 48

contraction frequency less than 2 mins contraction duration greater than 90 secs contraction strength greater than 90 mmHg fetal rate variations

Question 49

VBAC - vaginal birth after csection

Answer 49

depends on incision - low transverse one previous csection only greater risk for uterine rupture vaginal birth is not guaranteed

Question 50

best position for epidural

Answer 50

side of bed with back arched

Question 51

first stage of labor

Answer 51

laboring patient 1-10cm

Question 52

red rough side of placenta

Answer 52

maternal side

Question 53

endorphins increase _____

Answer 53

pain threshold

Question 54

still born at 16 wks considered

Answer 54

abortion

Question 55

improper latch causes

Answer 55

tenderness

Question 56

massage the fundus when _____

Answer 56

boggy uterus