OB/Peds Exam 2

Question 1

Antepartum

Answer 1

“Prenatal”…before birth

Question 2

Intrapartum

Answer 2

During birth

Question 3

Postpartum

Answer 3

After birth

Question 4

Prenatal Visit Schedule

Answer 4

Conception - 18 wks q 4 wks. 19-36 wks q 2-3 wks. 37 wks - birth q weekly

Question 5

Gravida

Answer 5

Any pregnancy, regardless of duration, including the one in progress

Question 6

Para

Answer 6

A woman who has given birth to one or more children who reached 20 weeks regardless of whether it was alive

Question 7

Folic Acid

Answer 7

Pevents spina bifida or any neural tube defects. If the pt has cx however, it will increase growth cells

Question 8

TPALM

Answer 8

T (# of term infants born after 38 wks) P (# of preterm infants born) A (# of abortions) L (# of living children) M (# number of multiple births)

Question 9

Nagele’s Rule

Answer 9

Identify first day of the LNMP, count backwards 3 months and then add 7 days.

Question 10

Chloasma

Answer 10

Mask of pregnancy

Question 11

Goodell’s Sign

Answer 11

Softening of the cervix and the vagina caused by increased vascular congestion

Question 12

Chadwick’s Sign

Answer 12

Purplish or bluish discoloration of the cervix, vagina, and vulva caused by increased vascular congestion

Question 13

Hegar’s Sign

Answer 13

Softening of the lower uterine segment

Question 14

Ballottement

Answer 14

A maneuver by which the fetal part is displaced by a light tap of the examining finger on the cervix and then rebounds quickly

Question 15

Fetal Heartbeat

Answer 15

detected as early as 10 wks using a Doppler. Ranges between 110-160 bpm.

Question 16

Endocrine Changes

Answer 16

Addition of placenta as a temporary endocrine organ that produces large amts of estrogen and progesterone. hPL increases maternal insulin resistance providing the fetus with glucose for growth.

Question 17

Colostrum

Answer 17

High in protein, fat-soluble vitamins and minerals, low in calories, fat and sugar. Contains the mothers antibodies to diseases and is secreted for the first 2-3 days after birth

Question 18

Hyperemesis Gravidarum

Answer 18

Excessive nausea and vomiting that can significantly interfere with food intake and fluid balance, fetal growth may be restricted. Dehydration impairs perfusion of the placenta, reducing the delivery of blood oxygen and nutrients to the fetus.

Question 19

Manifestations of Hyperemesis Gravidarum

Answer 19

Differs from morning sickness in one of the following ways: persistent n/v, significant weight loss, dehydration, electrolyte and acid-base imbalances

Question 20

Cerclage

Answer 20

Suturing of an incompetent cervix that opens when the growing fetus grows against it, it is successful in most cases. Low hCG or low fetal heart rate by 8 weeks may be an ominous sign

Question 21

Hydatidiform Mole

Answer 21

AKA gestational trophoblastic disease or molar pregnancy…May cause hemorrhage, clotting abnormalities, hypertension, or cx development later. More likely in women at the age of extremes of reproductive life.

Question 22

Placenta Previa

Answer 22

Occurs when the placenta develops in the lower part of the uterus rather than the upper

Question 23

Marginal (Placenta Previa)

Answer 23

Placenta reaches within 2-3 cm of the cervical opening

Question 24

Partial (Placenta Previa)

Answer 24

Placenta partly covers the cervical opening

Question 25

Total (Placenta Previa)

Answer 25

Placenta completely covers the cervical opening

Question 26

Manifestations of Placenta Previa

Answer 26

Painless vaginal bleeding, usually bright red, is the main manifestation.

Question 27

Abruptio Placentae

Answer 27

The premature separation of a placenta that is normally implanted

Question 28

Manifestations of Abruptio Placentae

Answer 28

Bleeding accompanied by abdominal or lower back pain

Question 29

Eclampsia

Answer 29

Progression to eclampsia from preeclampsia occurs when the woman has one or more generalized tonic-clonic seizures (may result in cerebral hemorrhage, abruptio placentae, fetal compromise, or death of the mother or fetus)

Question 30

HELLP Syndrome

Answer 30

A variant of GH that involves hemolysis, elevated liver enzymes, and low platelets.

Question 31

Magnesium Sulfate for Tx of GH

Answer 31

An anticonvulsant given to prevent seizures; given IV for 12-24 hrs, Poor urine output may allow toxic level to be reached. It inhibits uterine contractions so most women receive oxytocin which puts them at an increased rick of hemorrhage. Therapeutic serum level is 4-8 mg/dL.

Question 32

TORCH

Answer 32

Toxoplasmosis, "O"ther, Rubella, Cytomegalovirus, Herpes......Infections that can be devastating for the fetus or newborn.

Question 33

Cytomegalovirus

Answer 33

A widespread infection that commonly occurs during the childbearing years. Often asymptomatic in the mother. Infant may have mental retardation, seizures, blindness, deafness, dental abnormalities, petechiae. There is no effective tx for CMV infection.

Question 34

Rubella

Answer 34

A mild viral disease with a low fever and rash. In very early pregnancy it can disrupt the formation of major body systems, later it is more likely to damage organs that are already formed. Microcephaly, Mental retardation, Congenital Cataracts, Deafness, Intrauterine Growth Restrictions may be present in the embryo/fetus. Immunization is NOT used during pregnancy because it is a live attenuated.

Question 35

Manifestations of IICP

Answer 35

Slowed pulse rate, irregular respirations, increased BP